Psychodynamic Psychotherapy

Question 1

Describe Psychoanalytic approach to treatment

Answer 1

• Long-term
• 2 or 3 sessions a week
• The therapists is a blank slate, this is a one person psychology
• Free association, dream analysis, hypnosis
• Anonymity of the analyst facilitates the patient’s transference, neurosis and uncovering of and resolution of unconscious conflicts
• Catharsis allows for repressed emotions to be released and gives relief
• Interpretation used for resolving neurosis

Question 2

Describe Psychodynamic Psychotherapy

Answer 2

• it is an insight-oriented therapy
• It is an expansion and an adaptation of psychoanalytic theories
• Treatments for emotional and psychiatric disorders rely on talking and the relationship with the therapist
• Uses an emphatic approach to the client for the inside in order to help them identify and understand what is happening in their inner world, in relation to background, upbringing and development
• Relationship in which the client can share and explore underlying nature of their troubles, and change some of the determinants of these through experiencing unresolved forces in themselves.

Question 3

According to psychodynamic psychotherapy, what are conflicts?

Answer 3

• Aspects of ourselves which conflict with consciously held ideals may be denied, repressed or disowned
• Disagreeable feelings
• painful memories
• Thoughts and feelings that conflict with our view of ourselves and of what is acceptable
• Conflicts can lead to anxiety, guilt and psychic pain if acknowledged

Question 4

What defence mechanisms allow us to avoid confronting conflicts?

Answer 4

Repression; denial; projection; displacement; splitting; dissociation

Question 5

Describe the therapeutic relationship

Answer 5

• it is the vehicle for growth and change
• ‘Two-person’ relationship- shared space where client and therapist engage in exploring and resolving conflict
• Creating a space where the client can feel secure enough to be themselves, to explore their feelings and conflicts
• Listening attentively
• Empathy, respecting the client and being non-judgemental
• Containment

Question 6

What are Randomized controlled trials (RCTs)?

Answer 6

They are used to determine the effectiveness of different types of treatment and/or treatment in comparison to no treatment

Question 7

What is Meta-analysis?

Answer 7

Statistical method used to analyse large data sets from research studies to determine differences between groups

Question 8

Limitations of RCTs and Meta-analysis

Answer 8

• Psychological distress is not easy to quantify
• Mechanisms of change are difficult to quantify
• Process of therapy is different to administering medication
• Every client doesn’t always receive the same treatment
• Process of therapy is complex and variable

Question 9

Critique for Psychodynamic Psychotherapy;

Answer 9

• Theory and practice are based on a Western, Eurocentric world view
• Assumes that theories and concepts are UNIVERSAL
• Views the self same as stable and fixed rather than socially constructed
• Locates Pathology within the individual
• Innaccessible to many South Africans
• Fails to acknowledge the role of economic and socio-political factors in the development of psychological distress

Question 10

Psychodynamic Psychotherapy in South Africa

Answer 10

• In the SA context psychology needs to emancipate itself from its own complicity with oppressive establishments
• Needs to explicitly recognize socio-political influences, the interplay of power and issues of difference
• Needs to adapt to Psychodynamic ideas, concepts, and principles
• Needs transformation of knowledge production and training of therapists
• Services need to be community-based and community involvement is central to service delivery