Psychodynamic Psychotherapy: Unconscious Exploration
Chapter 12
Psychodynamic Psychotherapy
Psychodynamic
Psychotherapy
This is the first of a series of chapters on specific
approaches to psychotherapy
We begin with psychodynamic for numerous reasons
It came first historically
Many other therapies were reactions against it
Despite a recent decline, it still influences many clinical
psychologists
Defining Psychodynamic
Psychotherapy
This textbook uses the term “psychodynamic
psychotherapy” to refer broadly to Sigmund
Freud’s approach to therapy and all
subsequent efforts to revise and expand upon
it
Similar or overlapping terms include
“psychoanalytic therapy” and “neo-Freudian
therapy,” among others
Goal of Psychodynamic
Psychotherapy
The primary goal of psychodynamic
psychotherapy is to make the unconscious
conscious
“Insight” into thoughts, feelings, and other mental
activity previously outside of awareness
The very presence of the unconscious was a
fundamental idea of Sigmund Freud
Accessing the Unconscious
Free Association
Clients simply say whatever comes into
mind without any self-censorship or self-
editing
Not easy to allow self to be absolutely
spontaneous
Allows the unconscious to be expressed
Accessing the Unconscious
(cont.)
Freudian “slips”
Verbal or behavioral “mistakes” reveal unconscious wishes
Dreams
Manifest content represents latent content, which
contains unconscious wishes
Resistance
Clients “resist” certain topics in therapy because they
touch on certain unconscious feelings or thoughts
Missed appointments, tardiness, change subject
Accessing the Unconscious
(cont.)
Defense Mechanisms
Unconscious techniques created by ego, as an
attempt to handle conflict between id and
superego
Repression—keep impulse in unconscious
Projection—attribute impulse to others
Reaction formation—do opposite of impulse
Displacement—redirect impulse
Sublimation—redirect impulse in a way that benefits
others
Accessing the Unconscious
(cont.)
Transference
Client forms a relationship with therapist in which client
unconsciously and unrealistically expects therapist to
behave like important people from the client’s past
Accessing the Unconscious
(cont.)
Transference (cont.)
Clients bring similar transference issues to the
client-therapist relationship, just as they do to
many of the other relationships in their lives
Help clients become aware of their own
transference tendencies and the ways in which
these unrealistic perceptions of others affect their
relationships and their lives
Interpretation, followed by working through phase
“Blank screen” role of therapist facilitates
transference
Psychosexual Stages: Clinical
Implications
Oral stage—birth to 1.5 years old
Key issue is dependency/trust
“Can I trust others to take care of me?”
Underindulgence
distrustful and pessimistic of
others
Overindulgence
naive and overly trusting
Of course, blatantly oral behaviors can occur as
well (e.g., smoking, overeating)
Psychosexual Stages: Clinical
Implications (cont.)
Anal stage—1.5 to 3 years old
Key issue is control
Parents impose control on child (toilet training, and
other forms of self-control)
Overly-demanding parents
“
control freaks,”
obsessiveness
Overly-lenient parents
lax about organization,
”slobs,” disorganization
Psychosexual Stages: Clinical
Implications (cont.)
Phallic stage—3 to 6 years old
Key issue is self-worth/view of self
Children seek to have special, close relationship
with parents
If parents respond too positively, child’s sense
of self becomes overinflated
arrogant,
egotistical
If parents respond too negatively, child’s sense
of self is damaged
insecure, self-doubting
More Contemporary Forms of
Psychodynamic Psychotherapy
Ego psychology
Emphasizes social relationships over psychosexual
stages
Object relations
Emphasizes relationships between internalized
“objects”
Self-psychology
Emphasizes parental roles in the development of
the self, with special attention to narcissism
More Contemporary Forms of
Psychodynamic Psychotherapy
(cont.)
Most recent forms emphasize efficiency or
brevity
Brief Psychodynamic Psychotherapies
Narrow problems, quick alliance, focus on present
as well as past, therapists are more active,
pathology is less severe
More Contemporary Forms of
Psychodynamic Psychotherapy
(cont.)
Interpersonal Therapy (IPT)
Designed to treat depression in 14-18 sessions
Improving interpersonal relationships will alleviate
depression
Emphasis on role expectations
Time-Limited Dynamic Psychotherapy (TDLP)
Focus on transference and a therapy relationship that
doesn’t follow the same unhealthy, unconscious “script” as
previous relationships
Make client aware of script to enable a corrective
emotional experience
Outcome Issues
Very difficult to empirically measure the outcome of
psychodynamic psychotherapy
Improvement can’t be objectively measured
Also difficult to manualize, which inhibits empirical study
Regardless, large-scale reviews support its benefits with
some disorders, but remains unproven with others
Allegiance effects may influence outcome studies,
particularly for psychodynamic therapy
Few empirical outcome researchers are psychodynamic
Researchers’ own orientations may bias the results of their
studies
Outcome Issues (cont.)
Empirical support for components of
psychodynamic therapy
Interpretation of transference reactions
Interpretation of countertransference reactions
Psychodynamic psychotherapy focuses on making the unconscious conscious through techniques like free association, dream analysis, and defense mechanisms. Clients gain insight into hidden thoughts and emotions, uncovering unconscious wishes and addressing resistance in therapy sessions.
Download Presentation
Please find below an Image/Link to download the presentation.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author. Download presentation by click this link. If you encounter any issues during the download, it is possible that the publisher has removed the file from their server.
E N D
Presentation Transcript
Chapter 12 Psychodynamic Psychotherapy
Psychodynamic Psychotherapy This is the first of a series of chapters on specific approaches to psychotherapy We begin with psychodynamic for numerous reasons It came first historically Many other therapies were reactions against it Despite a recent decline, it still influences many clinical psychologists
Defining Psychodynamic Psychotherapy This textbook uses the term psychodynamic psychotherapy to refer broadly to Sigmund Freud s approach to therapy and all subsequent efforts to revise and expand upon it Similar or overlapping terms include psychoanalytic therapy and neo-Freudian therapy, among others
Goal of Psychodynamic Psychotherapy The primary goal of psychodynamic psychotherapy is to make the unconscious conscious Insight into thoughts, feelings, and other mental activity previously outside of awareness The very presence of the unconscious was a fundamental idea of Sigmund Freud
Accessing the Unconscious Free Association Clients simply say whatever comes into mind without any self-censorship or self- editing Not easy to allow self to be absolutely spontaneous Allows the unconscious to be expressed
Accessing the Unconscious (cont.) Freudian slips Verbal or behavioral mistakes reveal unconscious wishes Dreams Manifest content represents latent content, which contains unconscious wishes Resistance Clients resist certain topics in therapy because they touch on certain unconscious feelings or thoughts Missed appointments, tardiness, change subject
Accessing the Unconscious (cont.) Defense Mechanisms Unconscious techniques created by ego, as an attempt to handle conflict between id and superego Repression keep impulse in unconscious Projection attribute impulse to others Reaction formation do opposite of impulse Displacement redirect impulse Sublimation redirect impulse in a way that benefits others
Accessing the Unconscious (cont.) Transference Client forms a relationship with therapist in which client unconsciously and unrealistically expects therapist to behave like important people from the client s past
Accessing the Unconscious (cont.) Transference (cont.) Clients bring similar transference issues to the client-therapist relationship, just as they do to many of the other relationships in their lives Help clients become aware of their own transference tendencies and the ways in which these unrealistic perceptions of others affect their relationships and their lives Interpretation, followed by working through phase Blank screen role of therapist facilitates transference
Psychosexual Stages: Clinical Implications Oral stage birth to 1.5 years old Key issue is dependency/trust Can I trust others to take care of me? Underindulgence distrustful and pessimistic of others Overindulgence naive and overly trusting Of course, blatantly oral behaviors can occur as well (e.g., smoking, overeating)
Psychosexual Stages: Clinical Implications (cont.) Anal stage 1.5 to 3 years old Key issue is control Parents impose control on child (toilet training, and other forms of self-control) Overly-demanding parents control freaks, obsessiveness Overly-lenient parents lax about organization, slobs, disorganization
Psychosexual Stages: Clinical Implications (cont.) Phallic stage 3 to 6 years old Key issue is self-worth/view of self Children seek to have special, close relationship with parents If parents respond too positively, child s sense of self becomes overinflated arrogant, egotistical If parents respond too negatively, child s sense of self is damaged insecure, self-doubting
More Contemporary Forms of Psychodynamic Psychotherapy Ego psychology Emphasizes social relationships over psychosexual stages Object relations Emphasizes relationships between internalized objects Self-psychology Emphasizes parental roles in the development of the self, with special attention to narcissism
More Contemporary Forms of Psychodynamic Psychotherapy (cont.) Most recent forms emphasize efficiency or brevity Brief Psychodynamic Psychotherapies Narrow problems, quick alliance, focus on present as well as past, therapists are more active, pathology is less severe
More Contemporary Forms of Psychodynamic Psychotherapy (cont.) Interpersonal Therapy (IPT) Designed to treat depression in 14-18 sessions Improving interpersonal relationships will alleviate depression Emphasis on role expectations Time-Limited Dynamic Psychotherapy (TDLP) Focus on transference and a therapy relationship that doesn t follow the same unhealthy, unconscious script as previous relationships Make client aware of script to enable a corrective emotional experience
Outcome Issues Very difficult to empirically measure the outcome of psychodynamic psychotherapy Improvement can t be objectively measured Also difficult to manualize, which inhibits empirical study Regardless, large-scale reviews support its benefits with some disorders, but remains unproven with others Allegiance effects may influence outcome studies, particularly for psychodynamic therapy Few empirical outcome researchers are psychodynamic Researchers own orientations may bias the results of their studies
Outcome Issues (cont.) Empirical support for components of psychodynamic therapy Interpretation of transference reactions Interpretation of countertransference reactions
