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
"Chapter 12 Psychodynamic Psychotherapy" is the property of its rightful owner. Permission is granted to
download and print the materials on this website for personal, non-commercial use only, and to display it
on your personal computer provided you do not modify the materials and that you retain all copyright
notices contained in the materials. By downloading content from our website, you accept the terms of this
agreement.
Presentation Transcript
01
Chapter 12 Psychodynamic Psychotherapy<br>
02
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<br>
03
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<br>
04
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<br>
05
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<br>
06
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<br>
07
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<br>
08
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<br>
09
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<br>
10
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)<br>
11
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<br>
12
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<br>
13
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<br>
14
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<br>
15
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<br>
16
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<br>
17
Outcome Issues (cont.) Empirical support for components of psychodynamic therapy
Interpretation of transference reactions
Interpretation of countertransference reactions<br>
