Psychotherapy Flashcards
What is interpretation in psychodynamic therapy?
Refers to the expression of therapist’s understanding of the meaning of feelings,
attitudes, defense mechanisms and behaviours currently exhibited during therapy. Interpretation
is usually based on psychoanalytical theory practiced by the therapist. Interpretation made by a
therapist sheds light on an unconscious process in the patient, therefore making it accessible to
the conscious mind.
What is transference?
The feelings, thoughts and attitudes given to a person in the present (such as the
therapist), that do not befit that person but actually originate from a person or figure in the
patient’s past (such as a parent).
What is countertransference?
The therapist’s spontaneous feelings and emotions that are evoked when
s/he ‘tunes in’ to the patient’s unconscious communication, including the patient’s transference.
Analysing counter-transference can provide insight into a patient’s psychic state in the same
sense as analysing transference.
What is acting out?
Performing an action to express unconscious emotional conflicts.
While
acting out, the unconscious impulse is discharged by means of an action instead of verbalization.
What is working through in psychodynamic therapy?
A process of unlearning prior misconceptions and
learning new constructions.
Immature defence mechanisms
Acting out
Regression
Denial
Psychotic defence mechanisms
Splitting
Idealisation/denigration
Projection
Projective identification
Neurotic defence mechanism
Repression Intellectualisation Rationalisation Reaction formation Displacement Magical thinking
Mature defence mechanisms
Humour
Altruism
Sublimation
CI to psychodynamic therapy
Poor impulse control
Poor frustration tolerance
Low motivation.
Antisocial personality disorder
Absence of psychological mindedness (ability to scrutinize and verbalize one’s own cognitive
processes)
Being in the midst of a major life crisis.
Poor ego strength (capacity to shuffle oneself appropriately between two different ego states e.g.,
being a passive and dependent patient vs. being autonomous and plan one’s routine life outside
the therapy)
Severe active psychosis
Poor ability to form and sustain relationships
Indications for supportive psychotherapy
Helpful for periods of transition and adaptation, when a
deeper working through particular problems is not required
Methods in brief psychodynamic therapy
Goal setting and explicit identification of the anxiety and defenses to be tackled.
Focus choosing: Identification of currently active problem (here and now – core conflictual
relationship themes that represent cyclical maladaptive patterns are focused). Explore
symptom precipitants and associated early trauma and avoidance.
Active interpretation: Therapist may guide therapy by use of interpretation at an earlier point
than in more prolonged methods.
Creating heightened emotional contexts conducive to change
Predictors of good outcomes in brief, psychodynamic therapy
Circumscribed problem Strong motivation Able to express feeling at assessment Psychological-mindedness At least one good relationship Evidence of achievement Not actively suicidal, chronically obsessional or phobic Not grossly destructive or self-destructive; not actively abusing illicit drugs
Primary aim of supportive psychotherapy
To support reality testing
Provide ego support
Reestablish usual level of functioning
When to use supportive psychotherapy
in otherwise healthy patients with overwhelming ongoing crises and those
with ego deficits. Also useful in those who are not psychologically motivated to ‘explore’
themselves. This is not time limited and the therapist must be predictable available in times of
need. Problem solving, advice, reinforcement and reassurance are the main tools.
Key idea of general systems theory in family therapy
A system is a set of interconnected components that form a whole; The components
show properties of the whole, rather than of individual components; Cycles of feedback between
different components within the system continuously create and re-create a basis for interaction.
Types of family therapy
Behavioural Psychoeducational Strategic Family systems approach Structural Dynamic
What is aim and theory of dynamic family therapy
•Theme: To bring to light forces at play that influence the way a family functions. Emphasizes
individual maturation in the context of the family system.
•Theory: There are unconscious processes which, when noticed and worked through, can bring
relief to the family’s conflictual experiences
Methods of dynamic family therapy
Makes interpretations, noticing the formation of alliances, dyads and triads between
members. Therapists seek to establish an intimate bond with each family member. Family
sculpting refers to family members physically arranging themselves in a scene depicting
individual view of relationships.
What is aim and theory of structural family therapy
•Theme: Challenges the patterns of behaviours or interactions that disrupt a family structure.
•Theory: A well-functioning family has a structure: clear hierarchies, boundaries between
generations, and well-defined rules. When these are disrupted, problems occur.
Methods of structural family therapy
The therapist challenges the interactions between the generations. Both individual
and family sessions used.
What is aim and theory of family systems approach to family therapy
•Theme: Emphasizes one’s ability to retain individual self in the face of familial tension.
•Theory: An emotional triangle is a three-party system where closeness of two members (in
either positive or negative sense) tends to exclude a third. This hot triangle leads to symptom
formation
Methods of family systems approach of family therapy
The degree of enmeshment is analysed. The therapist maintains minimal emotional
contact with family members. Bowen also found a tool to analyse history of families across
generations – called the genogram.
What is the aim and theory of strategic approach of family therapy
•Theme: Aims to find the positives in a system and builds on them
•Theory:Problems within families can be maintained by over-emphasising them, so that they end up being
maintained rather than resolved