Session 6a - Psychodynamic Psychotherapy Flashcards
Sigmund Freud is deemed the ‘Father of psychodynamic therapy’. Although a neuroscience by trade, he liked to treat people with hysteria using hypnosis. What part of the treatment did he relate to helping his patients?
The ‘Free association’ part. The part where he would allow his patients to talk without interruption, about whatever came to mind.
What does it mean to refer to a buried memory as an abscess?
Like any physical disease, a memory hidden under our consciousness acts like an abscess, in that it is impacting on us, and needs to be liberated to be treated.
The Topographical model of the mind considers the mind in three parts. What are these, and what does each mean?
Iceberg like model:
Tip of the iceberg - conscious: what is happening right now and we can appreciate
Just under the water - preconscious: what we could recall if given time and a stimulus.
Deep under the water - unconscious: memories that cannot be accessed anymore.
What is the fundamental hypothesis of psychodynamic psychotherapy?
The conscious mind is driven by the unconscious.
The Structural model of the mind, is used by psychologists, to split the mind into three parts as well. What are these parts, and what does each mean?
ID: (like a newborn) primitive, instinctive. No reasoning. Part of the mind required for urges and desires.
Ego (like a 5yr old). Reasoning. Only part to be able to negotiate.
Superego (like a 10yr old). Knows about principles, follows rules. Will reward if rules are followed, but will feel guilt if not not followed. No negotiation.
All three of these will be working at the same time.
Which models of the mind can be combined when looking at psychodynamic psychotherapy?
Structural (ID, Ego, Superego) and Topographical (Iceberg - conscious, preconscious and unconscious)
In terms of the structural model of the mind. What are defence mechanisms?
These are ways in which the Ego can use to negotiate between the ID and the superego. May not always be beneficial to host.
Name 3 defence mechanisms and what they mean.
Maybe use the idea that someone is on a diet, and there is a bar of chocolate in their bag, which is tempting
- Projection- ‘projecting the conflict outside the self’
- Splitting - ‘Separating the conflict as ‘all good’ or ‘all bad’
- Suppression - ‘Consciously postponing the conflict for later’
- Sublimation - ‘Attaining the gratification in an acceptable way’
- Reaction Formation - ‘Doing the opposite of the initial desire’
- Acting out - ‘Discharging the anxiety as an outburst’
- Introjection - ‘Acquiring qualities of others as part of our self’
Explain the three corners of Malan’s Triangle of Conflict:
D.A.F.
Defence (Top left): this relates to the Ego’s defensive mechanisms used by the individual
Anxiety (Top right): is the patient anxious at all, if so, why?
(Conscious - above)
(Unconscious - below)
Hidden Feeling/Impulse (Bottom): what feelings is the patient trying to hide from us - underlying problem.
This triangle links the idea that defence and anxiety are things we can observe, but are a result of an underlying psychological pathology.
Explain what is meant by ‘Attachment Theory’.
The first years of a child’s life is critical for future emotional development. A baby with a strong connection to a primary care giver will be able to love more easily in the future, than a baby who hasn’t formed these early attachments.
During psychodynamic psychotherapy, the clinician acts to build a therapeutic relationship with the patient. What three processes can be used to help achieve this?
Therapeutic alliance - an idea that the patient and clinician work together in achieving a common goal.
Transference - when the patient ‘transfers’ an idea/thought onto the clinical.
Countertransference - either when the clinician transfers an idea onto the patient, or, when the clinician responds to what has been transferred onto them.
Transference works closely with countertransference to achieve therapeutic alliance.
Explain the three corners of Malan’s Triangle of Persons:
O.T.P.
Others (top left): how the patient presents to others
Therapist (top right): how the patient presents to a therapist.
Conscious (above)
Unconscious (below)
Parent/carer (bottom): how the patient presents to his primary care giver(s).
What are the two Malan’s triangles used in psychodynamic therapy to help describe and understand how a patient with a mood disorder presents.
Triangle of Conflict (Defence, Anxiety, Hidden Feeling/Impulse)
Triangle of Persons (Others, Therapist, Parent)
