Understanding Psychodynamic Psychotherapy: Unconscious Exploration
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.
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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
