Psychotherapy Lecture Flashcards
1
Q
What is free association?
A
- Where the person speaks freely, can talk about whatever they want
- Is therapeutic
- Discovered via hypnosis being beneficial for patients - trance like state allows them to explore
2
Q
Freud theory of hysteria
A
- Like psychic abscess
- Need to go deep into memory and talk about it to allow it to be drained
3
Q
Topographical model of mind
A
- Conscious - active thoughts, what we are aware of thinking
- Pre-conscious - holds information, memory that we have access to
- Unconscious is major part of mind - memories that we don’t have access to, can’t bring to conscious mind
4
Q
Why do we worry about unconscious mind? - Fundamental hypothesis
A
- Conscious mind is driven by unconscious
- Inc sleep - unconscious mind comes out in dreams
5
Q
Structural model of mind
A
- Id - primitive impulses, not often welcomed in society, raw, need immediate gratification as no concept of time or negotiation or the other (eg new born baby eg hunger, aggression)
- Ego - slightly mature aspect of mind, has concept of other, time and is negotiable, reality principle. Logical reasoning. eg toddler
- Super-ego - older child, learning about morals (good and bad), how you treat others, how behave in society. Works on moral principle to make rules. If don’t follow, will punish with guilt. If follow, praised. No concept of time, other or negotiation - rule based.
6
Q
What is projection?
A
- Putting conflict into someone else
- eg you want to each chocolate but you say to a friend, I know you want chocolate
7
Q
What is splitting?
A
- Something bad is inside of someone else - my friend wants me to eat the chocolate
- But I am strong and won’t have any - something good inside me
- Seperate conflict as all good and all bad
8
Q
What is suppression?
A
- Find alternative eg if want chocolate have hot chocolate instead - sugar free or something
- Please Id, super-ego
- Postpone conflict for later
9
Q
What is reaction formation?
A
- Do opposite of impulse eg I am hungry so I will have appetite suppressing tea
10
Q
What is acting out?
A
- Emotions are acted out
- eg if angry, slam door, drive fast etc
11
Q
What part of mind comes up with defence mechanisms?
A
- Ego
- Find coping mechanism for conflict between Id and super ego
- Sometimes the defence mechanisms are worse than the original impulse
12
Q
Types of defence mechanisms
A
- Projection
- Splitting
- Suppression
- Sublimation
- Reaction formation
- Acting out
13
Q
Freuds theory Oedipus
A
- Boy desires mother - aged 3-6
- Son-father competition
- Oedipus complex
- Anxious about castration - dad will not be pleased if finds out attracted to mum
- Defence mechanism - repression and identification (grows up to become like father)
- Lets go of mother
14
Q
What is castration anxiety?
A
- Fear of powerful people
- fear of being dominated
- Fear of being insignificant
15
Q
What is Oedipal resolution?
A
- Change from omnipotent baby
- As child grows up, starts saying no
- Father is authority
- Let’s go of ‘his majesty the baby’ position –> not omnipotent
16
Q
What is sublimation?
A
- Attain gratification in acceptable way
17
Q
What is introjection?
A
- Acquiring qualities of others as part of self
18
Q
Kleinian concepts
A
- Babys born with Id, ego and super-ego from moment of birth
- Oedipus not sexual aspect - wants to possess mother, fused in mind sometimes
- Every mother puts child down at some point, mother has other needs and sets rules - envy (becomes angry)
- Greed - wanting mother more and more, to themselves
- Guilt
- This is all managed by splitting - focuses on positive relationship aspect of mother (the one that doesn’t put them down)
- Also projective identification - identifies with what you have projected
19
Q
How is projective identification used?
A
- Identifies projective coping mechanism
- In therapy can feel the emotions of those talking to - internalise the feelings
20
Q
Winnicott theory
A
- Baby does not know it’s a baby
- Does not have sense of self until mother present
21
Q
Winicott concepts - good enough mother
A
- Mother provides physical sensations like holding baby, washing
- Then finds out what is me and not me
- Initially were fused, then mother helps - mother slowly disengages and baby realises what is me and not me
- Transitional object - children carry objects everywhere, bridge between me and not me, take into real world, teddy represents mother allows transition
22
Q
Clinical psychoanalytic concepts
A
- Internal objects
- Unconscious fantasy
- Transference
- Countretransference
- Doctor-patient relationship
23
Q
What are internal onjects?
A
- Example is:
- There is a mother
- Baby draws picture of mother and is in mind
- Can be similar to mother but not exactly the same
- Baby keeps changing internal version of mother in mind, external behaviour of mother influences internal mother
24
Q
What is unconscious fantasy?
A
- Fantasy for everything - always an explanation for events
- Eg if plan to go to cinema with 3 friends but only 2 show up - are they late? are they dead? do they hate me?
- How single event is perceived different by all of us - gives insight into internal mind and internal objects
25
Q
What is transference?
A
- Early life relationships that child have gets transferred to you as Dr
- If uncaring mother experience, see you has uncaring
26
Q
What is countertransference?
A
- Eg if patient has negative transference (like you don’t care about me because you aren’t giving me what you want)
- Get emotional response eg sad, angry to their behaviour
- And our own early life experiences and internal objects influences how we behave with patients - can trigger thoughts
27
Q
What is attachment theory John Bowlby?
A
- Early attachment with parents are internalised
- Becomes part of personality
- Have internal working model of relationships - relate future relationships to this
28
Q
Risk of psychodynamic therapy
A
- Release some painful emotions and remind of past experiences
- Can push into risky behaviour eg self harm/suicide
- If already risky behaviour –> more careful
29
Q
What hinders formation of transference?
A
- Alcohol
- Drugs
- Psychosis
Do not take contact of patients re this
30
Q
Psychodynamic therapy structure
A
- 50 minute sessions weekly
- Maintain frame - same time, same day weekly
- Allows intensifying of transference
- Do not see inbetween sessions
31
Q
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