Theoretical Models of Counseling and Psychotherapy, - PowerPoint Presentation

Slide1

Theoretical Models of Counseling and Psychotherapy, 3rd Edition Chapter 3: Self Psychology

Mario De La Garza, M.Ed.

University of North TexasSlide2

Psychodynamic TheoriesRetain significant similarities to psychoanalysis - Emotions, cognitions, and behaviors are influenced by psychological processes that are, to some degree, unconscious.

- Early caretakers and one’s interactions with them influence the psyche.

- Personality develops through invariant stages.

- Important concepts include defenses and transference.

- A client’s psychic material must be “interpreted.”Slide3

Drive TheoryNearly indistinguishable from Freud’s psychoanalysisEmphasis is on libidinal and aggressive drives that energize psychological processes.Libidinal drives are impulses toward bodily pleasure, excitement, anticipation, love, or happiness; more than just sexual impulses.Slide4

Ego PsychologyEmphasis is on the ego’s role in regulating, controlling, and channeling drives.Anna Freud elaborated on the ego’s defense mechanisms.Heinz Hartmann expanded upon the idea that the ego could actually alter drives or what one experiences as pleasurable; he also expanded upon the separation of the self from the ego.Slide5

Object RelationsObject – object of desire; what satisfies a drive; usually refers to a person’s caregiver or significant others in one’s life.Focus is upon objects in a person’s infancy and early childhood and how a person experienced and internalized those objects.

These internal representations of significant objects are believed to persist in a person’s unconscious mind throughout life greatly influencing one’s experience.Slide6

Object RelationsThese dynamics have great influence on the development of one’s sense of self (ego).A person’s perception of the object is more important than the actual object.A client’s pre-egoic, prerational perception is likely to contain misinterpretations.Slide7

Heinz Kohut & Self psychologyKohut viewed classical psychoanalysis and other psychodynamic theories as limited, especially in understanding and treating more severe psychological disturbances.He expanded on what he termed disorders of the self which included narcissistic, borderline, and psychotic conditions.

In particular, he greatly expanded upon narcissism.Slide8

Heinz KohutBorn in Vienna; the only child of Felix and Else KohutFather was both physically and emotionally distant; mother fluctuated between being oppressively close and distant

Highly educated and graduated from the University of Vienna with a degree in medicine in 1938

Moved to Chicago in 1938 and spent the majority of his life training analysts and practicing psychiatrySlide9

Heinz KohutWas honored and revered by some and shunned by others when he published The Analysis of the Self in 1971Formulated new ideas about how the self develops, how this development can go awry, and how one treats the resulting disturbances of the self

Theory was a humanistic theorySlide10

Philosophical UnderpinningsSlide11

Philosophical UnderpinningsClassical Psychoanalysisbiological urgespathology

irrational drives

distant objectivity

insight as curative

Self Psychology

social urges

developmental potentials

legitimate psychological needs

experience-near subjectivity

empathy as curativeSlide12

Function of the PsychePrimary function of humans: to relate with other human beingsHumans have drives to ensure relationship with others.Sole lifelong human need: to develop and maintain a selfSlide13

Function of the Psyche: What is “Self”?Self – several interrelated functions including: organizing experience restoring cohesion that has been jeopardized

maintaining

homeostasis through tension

regulation

validating

subjective

experience

soothing distress

valuing

one’s abilities and oneselfSlide14

Function of the PsycheInfants are born with the ability to form bonds with self-objects and the potential to develop structural/functional capacities.Self-objects – external objects (usually people) subjectively experienced as providing intrapsychic functionsTransmuting internalization – the functions of the external self-object are slowly, gradually, bit-by-bit transformed into internal capacities.Slide15

Function of the Psyche(innate human self-object needs)Empathic attunement and mirroring – the self-object accurately perceives the infant’s emotional states and emerging abilities and responds with acceptance, validation, admiration, and caring action.Idealization – the infant perceives at least one self-object as great, all-powerful, and all-knowing and connects and merges with that self-object (also known as the idealized parental imago).Slide16

Function of the Psyche(innate human self-object needs)Twinship experience (alter ego needs) – the individual’s need to experience an alikeness to a self-objectOptimal empathic failures – when a self-object fails to empathize in some mild, nontraumatic way with an individualSlide17

Structure of the PsycheSelf – a recipient of impressions and a center of initiative that provides a person cohesion, organization, and continuity in space and timeIncludes three poles: nuclear ambition, talents and skills, and guiding idealsA proactive and creative structure/function

Personality – relatively persistent feelings and actionsSlide18

Role of the EnvironmentA child’s family usually plays the most central role in the development of the child’s self.Any aspect of a thing or person that/who fulfills one or more of a child’s self functions, whether within or outside of the family, is a self-object.Information, fictional characters, celebrities can serve as self-objects.Slide19

Personality DevelopmentDevelopment of a healthy selfEstablishment of self-object bondOptimal empathic failures

Transmuting internalization

Formation of self structure/function

Mirrored grandiosity → plausible ambitions

Idealized parental imago → values and ideals

Experience of twinship → talents and skillsSlide20

Personality DevelopmentDevelopment of unhealthy selfPotential self-objects are neglectful and/or abusive exhibiting physical and/or emotional indifference and/or hostility.

Traumatic empathic failures occur.

Individual perceives little or no empathy, nothing/no one to idealize, and little or no opportunity for

twinship

.

Self-object relationships do not form or are tenuous.

Self remains undeveloped or is arrested or reversed in development.Slide21

Psychopathology earliest and most extensive empathic failures

later and less extensive empathic failures

psychosis

borderline conditions

narcissism

neurosesSlide22

Personality Change ProcessCounseling involves reparenting – the therapist provides self-object functions for the client that the client’s primary caretakers did not provide, transmuting internalization occurs, and the client’s self develops more fully.

Basic therapeutic process:

Reactivation of the client’s needs (self-object transference)

Nonfulfillment

of some of the client’s needs by the counselor (optimal empathic failures); a counselor’s misinterpretations

Reestablishment of the empathic bond between client (self) and counselor (self-object)Slide23

Client’s RoleKohut said the client’s primary responsibility in therapy was to establish self-object transferences; in other words, reactivate those needs that were not met by the client’s self-objects in early life.Clients must be willing to allow counselors to become psychologically important to them (to become self-objects).

Clients must be willing to persevere through the process of empathic failure and repair in order to allow the self to continue to develop.Slide24

Counselor’s RoleThe counselor’s primary responsibility is sustained empathic inquiry into the meaning of the client’s experience of the therapeutic (self-self-object) relationship.To reparent the client; to permit the client to dwell in and consolidate the

transferential

relationship

At times, the counselor must offer misinterpretations (these will inevitably occur).

To detect when empathic failures have occurred,

nondefensively

acknowledge them, and interpret them for the client

To have a strong sense of selfSlide25

Stages and TechniquesThe self/self-object relationship formed through empathic attunement by the counselor is the medium through which the client’s self emerges.Topics in self psychotherapy follow a general sequence:

1) Immediate symptoms and related concerns

2) Client’s history with emphasis upon self-object relationships

3) Nature of immediate relationship between client and counselor

4) Manifestations and resolutions of the client’s self-object transference

Two phases of analysis: understanding phase and explanatory phaseSlide26

Interface with Recent Developments in Mental HealthNature/NurtureKohut emphasized the familial environment’s influence on the self.Kohut

also acknowledged that genetic predisposition does affect an infant’s potential to develop self-object relationships, and thus a healthy self.

DSM 5 Diagnosis

Kohut

did not favor diagnostic labels, but he did refer to diagnostic levels of structural development.

Therapists must be willing to sustain empathy for clients rather than label them as unable to be understood.Slide27

Interface with Recent Developments in Mental HealthPharmacotherapyThere does not seem to be an aversion to using medication alongside psychotherapy.Managed Care/Brief Therapy

Some newer forms are brief in length addressing specific client concerns as well as self/self-object interactions.

Technical Eclecticism

Interfaces well with other theories including cognitive, client-centered, transpersonal, and

integral

Diversity Issues

Honors each client’s unique experience

The “experience-near” approach frees the counselor from cultural preconceptions.

Emphasis on relationshipSlide28

Interface with Recent Developments in Mental HealthSpiritualityHigher power = idealized parental imagoMany transpersonal and integral theorists draw heavily from psychodynamic theories.

Emphasis on relationship

Effectiveness of Psychotherapy

Psychodynamic research has focused more on development than psychotherapy.

Studies have revealed the importance of the therapeutic relationship, perceived similarities between client and counselor, and idealization.Slide29

WeaknessesFailure to acknowledge and integrate ideas of predecessorsUse of the term and concept of restorationNarrow focus on narcissistic issuesConfusion regarding the concept of self as both a person and a psychic structureSlide30

Distinguishing AdditionsReformulations of narcissismDescription of the formation of psychic structure via transmuting internalizationConcepts of self-objects and three self-object transferencesRecognition of the profound importance of empathy and the centrality of the client’s self-experienceSlide31

ReferencesFall, K. A., Holden, J. M., & Marquis, A. (2016). Theoretical models of counseling and psychotherapy (3rd ed.)

. New York: Routledge.