Psychodynamic Therapy

Question 1

What’s the most basic premise of psychodynamic therapy?

Answer 1

People do things for a reason, though they may not realize exactly what that reason is.

Question 2

Does psychodynamic therapy focus more on the past or the present?

Answer 2

Focuses more on the past.

Question 3

What is the concept of “pattern compulsion”?

Answer 3

The mind replays past scenarios (esp traumatic ones) in order to “master” them and do “better” in the future, and this leads to patterns of behavior.

Question 4

Proximate goal of psychodynamic therapy?

Answer 4

Bring painful emotions to the surface.

Question 5

Ultimate goal of psychodynamic therapy?

Answer 5

Have the patient gain insight into their behaviors and the motivations that underly them, and by being conscious of them, modify them.

Question 6

Broadly speaking, how well does psychotherapy work?

Answer 6

Pretty well. It doesn’t necessarily work any better than CBT… but mayyybe has the potential for longer term impacts.

Question 7

Can you see psychodynamic therapy have effects on people’s brains with imaging studies?

Answer 7

Yep. (In areas such as amygdala, anterior cingulate, hippocampus, medial prefrontal cortex. Amount of change correlated with how better the patient felt.)

Question 8

What are the 3 structures in the classical, Freudian model for psychotherapy?

Answer 8

Id - instinctual drives
Ego - conscious self, perception
Super-ego - morality, values, etc.

Question 9

What are the 3 steps after “impulse” (drive or wish) in the ego psychology conceptual framework?

Answer 9

Prohibition (fear or anxiety of consequences of fulfilling desire).
Defense.
Compromise Formation (behavioral patterns).

Question 10

What’s a simple definition of a defense mechanism?

Answer 10

A way to express unconscious, conflicted thoughts/feelings in a disguised form.

Question 11

4 main categories of defense mechanisms?

Answer 11

Narcissistic
Neurotic
Immature
Mature

Question 12

What are 2 key narcissistic defenses?

Answer 12

Projection

Idealization / Devaluation

Question 13

What are idealization and devaluation?

Answer 13

Idealization: making yourself feel better by saying that you associate with the best.
Devaluation: Making yourself feel better by saying everyone else is bad.

Question 14

What’s projection?

Answer 14

Assigning your own desires to somebody else.

Question 15

What are 3 neurotic defenses?

Answer 15

Intellectualization
Isolation of Affect
Repression

Question 16

What’s intellectualization?

Answer 16

Speaking about a situation in the abstract, 3rd person, without any personal connection to it.
“A soldier has to follow orders.”

Question 17

What’s isolation of affect?

Answer 17

Similar to intellectualization, but more about focusing on the details of a situation without feeling the emotion of the big picture.

Question 18

What’s repression?

Answer 18

Dealing with unwanted instincts, emotions, or ideas by being unable to remember or be conscious of them. They’re “expelled from consciousness.”

Question 19

How does repression contrast from denial and suppression?

Answer 19

Repression: Removing experience from conscious thought.
Denial: Doesn’t believe experience actually happened - detachment from reality.
Suppression: Consciously deciding not to think about it right now, but I’ll address it later.

Question 20

What are 6 core problems often addressed in psychodynamic therapy?

Answer 20

Depression
Low Self-Esteem
Trauma
Fear of Abandonment
Obsessionality
Panic Anxiety

Question 21

What’s does psychodynamic theory say is the etiology of panic anxiety?

Answer 21

Unconscious conflicted feelings that “break through” to the surface.

Question 22

In the case example given, how does the patient being dependent on a loved one lead to conflicted unconscious feelings? How does this manifest as panic?

Answer 22

Dependence on loved one -> fear of loss ->
Great effort to maintain bond ->
resentment of one-sidedness of relationship ->
Repression of anger (due to fear it would drive away the loved one).
Patient associates being assertive with that fear, thus has panic attacks in situations where he must be assertive.

Question 23

What’s transference? What information does it give you?

Answer 23

Patient “replaying” to the therapist feelings that came from other, earlier relationships. Patient paints their past relationships (and how they feel about people in general) on the blank canvas that is the therapist.