Psychodynamic psychotherapy Flashcards
Learn the basics of psychotherapy and the subsequent strands of therepy
What is the root / history of psychodynamic therapy?
The principles ofpsychodynamicswere introduced in the 1874 publicationLectures on Physiologyby German scientistErnst Wilhelm von Brücke.
Von Brücke, taking a cue fromthermodynamics, suggested all living organisms are energy systems, governed by the principle ofenergy conservation.
During the same year, von Brücke was supervisor to first-year medical studentSigmund Freudat theUniversity of Vienna. Freud later adopted this new construct of “dynamic” physiology to aid in his own conceptualization of the human psyche.
Later, both the concept and application of psychodynamics were further developed by the likes ofCarl Jung,Alfred Adler,Otto Rank, andMelanie Klein.
Who are the people who developed psychodynamic psychotherapy?
Ernst Wilhelm von Brücke
Sigmund Freud
Carl Jung,
Alfred Adler,
Otto Rank,
Melanie Klein.
What is the key premise of psychodynamic psychotherapy?
Psychodynamic psychotherapyorpsychoanalytic psychotherapy is a form ofdepth psychology, the primary focus of which is to reveal the unconscious content of a client’s psyche in an effort to alleviate psychic tension.
Psychodynamic therapy is similar to psychoanalytic therapy in that it is an in-depth form of talk therapy based on the theories and principles of psychoanalysis. But psychodynamic therapy is less focused on the patient-therapist relationship, because it is equally focused on the patient’s relationship with his or her external world. Often, psychodynamic therapy is shorter than psychoanalytic therapy with respect to the frequency and number of sessions, but this is not always the case.
The theories and techniques that distinguish psychodynamic therapy from other types of therapy include a focus on recognizing, acknowledging,understanding, expressing, and overcoming negative and contradictory feelings and repressed emotions in order to improve the patient’s interpersonal experiences and relationships. This includes helping the patient understand how repressed earlier emotions affect currentdecision-making, behavior, and relationships. Psychodynamic therapy also aims to help those who are aware of and understand the origins of their social difficulties, but are not able to overcome their problems on their own. Patients learn to analyze and resolve their current issues and change their behavior in current relationships through this deep exploration and analysis of earlier experiences and emotions.
Rorschach Inkblots
The original Rorschach inkblots were developed in the early 1900s by psychologist Hermann Rorschach (Framingham, 2016). At the time, a popular game called Blotto involved a set of inkblots that could be organized into a poem or story or used in a round of charades. Rorschach noticed that patients diagnosed with schizophrenia reacted differently to these inkblots, and began studying their use as a tool for diagnosis and discussion of symptoms.
His work resulted in a set of 10 inkblot images that can be presented to a client with the intention of observing and projecting based on their reactions to the images.
To conduct the Rorschach test, the therapist will present each inkblot to the client individually and ask the client to describe what they see. They are free to use the image as a whole, a piece of the image, or even the blank space surrounding the image to form an interpretation.
The therapist will take notes on the client’s descriptions and how they interpret the image. He or she may also ask additional questions to get the client to elaborate on what they see.
While there is controversy over how valid and reliable the results of this test should be considered, many therapists find that they provide valuable qualitative information about how the client is feeling and how they think (Cherry, 2017). It has also been found to be somewhat effective in the diagnosis of thinking disorders (such as schizophrenia and bipolar disorder). Those with these types of disorders tend to see and interpret the images differently than those without such diagnoses.
The important part of this test is the process of interpretation and description undertaken by the client, rather than any specific content seen in the inkblots. As such, the use of this test requires a highly trained professional to conduct, score, and interpret.
To see an online version of this test based on the work of researcher Harrower-Erickson, clickhere…
https://openpsychometrics.org/tests/HEMCR/
The Freudian Slip
The Freudian theory holds that no behavior is accidental or random; rather, every move you make and every word you say are determined by your mind (conscious, subconscious, or unconscious) and your circumstances.
A psychodynamic therapist may pay special attention to any such slips, whether they occur in session or are simply related by the client during a session, and find meaning in the word substitution. They may conclude that a slip is actually a little piece of your unconscious finding its way to the surface, indicating an unmet desire or unknown association between two concepts.
While most modern psychologists agree that Freudian slips are generally just “slips,” it’s hard to argue that occasionally a slip of the tongue can reveal an interesting connection in the speaker’s mind.
Free Association
Free association may be the single most important and most used tool for psychodynamic therapists. This technique is a simple one, but can be extremely effective.
In the context of psychodynamic therapy, there are two meanings attached to “free association”: the more official therapy technique of free association, and the general method of in-session discussion driven by the client’s free association between topics.
The more formal technique involves the therapist reading a list of words and the client responding immediately with the first word that comes to mind. This exercise can shed light on some of the associations and connections the client has hidden deep below the surface.
This technique may not be as useful to a client who is resistant to the exercise or to sharing intimate details with the therapist. However, therapists should not assume that a client who pauses before responding is resistant – it may indicate that the client is getting closer to a repressed or highly significant connection.
Free association may provoke an especially intense or vivid memory of a traumatic event, called an abreaction. This can be extremely distressing for the client, but it can also lead to a healing experience of catharsis if the client feels like it helped them work through a significant problem (McLeod, 2014).
The less formal concept of free association is simply the tendency to allow the client to lead the discussion in psychodynamic therapy sessions. This kind of relaxed, non-structured approach to dialogue in therapy is a hallmark of psychodynamics.
Practicing this type of informal free association ensures that the therapist is not leading the client anywhere in particular and that the client is moving authentically from one subject to the next. This is critical in psychodynamic therapy, as it is unlikely to reach the unconscious sources of psychological distress without following the client’s lead.
Dream Analysis
Dream Analysis
Another vestige of Freudian therapy, this highly subjective technique can prove useful for some, although its efficacy as a treatment technique is not proven via the scientific method.
However, the effectiveness of therapy cannot always be measured and codified by double-blind random control trials (RCTs), the gold standard of research. Sometimes it is nearly impossible to determine which components or modes of treatment brought about success in therapy.
It is in this ambiguous environment that some of those not-quite-established techniques can contribute to real progress for the client. While dream analysis cannot be formally recommended as a reliable and effective tool, it is unlikely to cause any harm and should, therefore, be left up to the client and therapist whether to include it in the treatment regimen.
Dream analysis is undertaken by discussing the client’s dreams in detail. The therapist will guide the client through this discussion, asking questions and prodding the client to remember and describe the dream in as much detail as possible.
While the client talks about their dream, the therapist will attempt to aid the client is sorting the “manifest” content from “latent” content. The manifest content is what the client remembers about their dream – what happened, who was there, how it felt, the physical and temporal environment of the dream, etc. The latent content is what is beneath the surface of the dream, and this is where the meaning of the dream lies (McLeod, 2014).
While Freud would nearly always find a repressed sexual urge or sex-related significance in the latent content, today’s dream interpreters have broadened their scope of meaning.
There are nearly countless ways that therapists, coaches, counselors, and practitioners of the more mystical arts engage in dream analysis, none of which have been identified as more effective or useful than the others.
However, one popular method of analyzing dream comes from psychologist and author Dr. Patrick McNamara. His theory of the dreaming process can be explored on an individual level, allowing the client to attempt to sort through their own dreams to find meaning.
McNamara’s proposed process of dreaming is as follows:
Step One: The dreamer disentangles their consciousness from executive control/personal agency. In other words, the dreamer de-identifies with their usual self and sets up a “liminal state” – a state in which the dreamer is prepared to explore a new identity.Step Two: The dreamer moves into this liminal space, opening him- or herself up to a world of possibilities in regards to their identity. This step is like taking off your usual “mask” and set it aside in anticipation of finding a new mask.Step Three: This step typically occupies the most time and material of the dream, in which the dreamer “tries on” a new identity. The dreamer may be experiencing fear or anxiety associated with shedding their identity, and he or she may seek to reestablish a sense of control by searching for another identity or alternate sense of self.Step Four: The dreamer finds a new, altered identity or resumes their old identity. McNamara believes we are searching for a more unified sense of self, but that we often find an identity that includes aspects of our darker side (McNamara, 2017).
These steps are tied into four literary tropes that some believe we use to make sense of thenarrativeswe encounter and experience: metonymy (breaking up the pieces of a narrative), synecdoche (reorganizing those pieces into a new whole), metaphor (comparison of the pieces or the whole with something familiar), and irony (reflection of the new whole).
Using these tools for understanding narrative, McNamara suggests we can apply this process and the literary tropes to parse the meaning of any dream or dream sequence (2017). Of course, this technique has not been proven through scientific research, but you may find it helpful nonetheless.
For more information on McNamara’s system for dream interpretation, clickhere…
https://www.psychologytoday.com/intl/blog/dream-catcher/201703/dream-interpretation
