The psychoanalytic theory

INTRODUCTION

The Psychodynamic theory is a modern version of the psychoanalytic theory, developed by Freud in the early 1900’s, and adapted by the psychoanalytic theorists that followed him. Just like Freud’s Theories this approach believes that our behaviour is shaped to a large extent by our unconscious mind, by the interaction of three mental processes; The Id, Ego and the Superego (O’ Farrell, 2001).

The Psychodynamic Theory focus’s on conscious influences just as much as the unconscious.

The term psychodynamic refers to a wide group of theories, rooted in psychoanalytical psychology, such as drive psychology, ego psychology, object relations psychology, attachment theory and self psychology. These approaches consider the underlying personality structure to play an important role in the human growth and development of individuals.

the psychoanalytic model defines the psychosexual and psychosocial stages of development from birth through to adulthood. Many theorists followed Freud and developed more modern theories such as, Erik Erikson who expanded on Freud’s theory of the psychosexual stages in childhood. His theory of development was that psychosexual growth and psychosocial growth take place together. He describes development in terms of the entire life span, not focusing solely on childhood (Corey, 2009).

Theorists and Theories

Sigmund Freud 1856-1939 is considered the leader of psychoanalysis.

Many well known theorists that followed Freud questioned some of his theories and developed new ideas and perspectives.

These new theories, however, maintain many of the same core beliefs of psychoanalysis, most importantly the view of the unconscious as an important drive in human emotions, cognitions, and behaviours. These include Freud’s ideas about psychosexual development, defence mechanisms, free association and interpretation, including that of transference, defences and dreams, which helps in understanding forgotten experiences that still affect our present behaviour (Feltham and Horton, 2009).

Depth Psychology

Psychodynamic psychotherapy is a form of depth psychology, the main focus is to

explore underlying motives as an approach to understanding personality, behaviours and anxieties.

In this way, it is similar to psychoanalysis but psychodynamic therapy tends to be briefer and less intensive than psychoanalysis. It relies more

on the interpersonal relationship between the client and therapist compared to other forms of depth psychology. This approach, may sometimes

adapt the the different types of techniques used in order to fit the different requirements of the particular settings, rather than relying on a single type of intervention. Freuds theories of psychoanalysis have been further developed by many theorists to become known as depth psychology or psychodynamic psychotherapy. Such as;

Sigmund Freud , born Sigismund Schlomo Freud , was an Austrian psychiatrist who founded the psychoanalysis of psychology. Freud is best known for his theories of the unconscious mind and the defense mechanism of Psychological repression and for creating the clinical practice of psychoanalysis for curing psychopathology through dialogue…

The term Neo-Freudian or Psychodynamic have both been used to describe those who left the psychoanalytic society and formed their own schools of thought.

Most recent psychodynamic theory emphasises conscious experience and its interaction with the unconscious, in addition to the role that social factors play in development. Classic theories about the role of the unconscious sexual and aggressive drives have been re-evaluated to focus on conscious experience, resulting in, for example, the birth of ego psychology. REF

Ego psychology, focus’s on psycho-social development, in both the early and later stages of life, not just childhood. This was developed largely by Erikson, with a view that current behaviours are not entirely linked to unconscious conflicts from early childhood. He considered that, the choices we make, throughout the different stages, has a great impact on our lives.

And the need to deal with the different stages of growth during the continuous development from adolescence to later adult life,

Anna Freud, a central figure in ego psychology, focused on the strategies to protect the ego, especially defense mechanisms; constructions of the ego that work to minimize pain and to maintain a balance between id ego super ego.

She spent most of her professional life adapting psychoanalysis to children and adolescents. (Corey, 2009)

Object Relations psychology was first introduced by several British analysts, among them Melanie Klein, Donald Winnicott,. REF

Klein wanted to explore the interpersonal relationships between our self, as internal process and how we see others, as external objects. As infants we don’t see people as being individual with separate identities but as objects for satisfying our needs

According to this theory, human beings struggle to maintain relationships with others while at the same time distinguish ourselves from others (Corey, 2009).

The psychodynamic approach considers the unconscious influence that other people have on the self.

Self Psychology was founded by Heinz Kohut, in Chicago during the 1950s.

This theory emphasises how we use our relationships with others to develop our own sense of self. (Corey, 2009)

The Core Principles of Freuds Psychodynamic Theory

The importance of both the conscious and unconscious psychological processes and their relation to development

Importance of experiences in early childhood, adolescents and adult life, with

increased attention given to disturbances during childhood and adolescence.

How these earlier experiences have an effect on present relationships

Existence of ego (rationality) & superego (morality)

How repressed emotions often return later in life in the form of symptoms

Existence of defense mechanisms created in order to avoid unpleasant

consequences of conflict

A good therapeutic alliance early in therapy can be viewed as a key factor in a positive therapeutic outcome.

The therapist is less likely to use the couch, as Freud used to in psychoanalysis.

Aims of increasing awareness into the clients behaviour and understanding the meanings of symptoms

Issues may re-emerge and be projected onto the therapist as transference

Interpretations of transferece, defense mechanisms and current symptoms by the

therapist

Long term benefits to help people to maintain long term symptom reduction, rather than to change one’s personality

Use of techniques, such as, symbols and free association as a method for

exploration repressed feelings

Psychoanalysis, this type of therapy is known for long term treatment, typically several times per week, where the unresolved issues from the individual’s childhood are analyzed and resolved. These issues are considered to be primarily unconscious in nature and are kept from consciousness through a complex defense system. Such therapy usually involves once-weekly 50-minute sessions, the length of treatment varying between 3 months and 2 years. The long-term aim of such therapy is twofold: symptom relief and personality change.

In psychodynamic therapy, the patient (as opposed to the client in other types of therapy) talks, and the therapist makes interpretations about the patient’s words and behaviors. Dream interpretation may be a part of psychodynamic therapy.

Psychodynamic psychotherapy is classically indicated in the treatment of unresolved conflicts in early life, as might be found in non-psychotic and personality disorders, but to date there is a lack of convincing evidence concerning its superiority over other forms of treatment. Reference…………

The Basis for Projective Techniques

Psychodynamics emphasizes the importance of understanding unconscious information and to go beyond the surface of defence mechanisms in order to help a person figure out our problems. To find a deeper understanding of motives, beliefs, and drive.

Drives are often buried deep in the unconscious, they control many our behaviours.In order to change these behaviours, we must understand, what they are and where they come from. This information is hidden, we need to try and access it. This will hopefully lead to personality change.

Certain techniques were developed to gain insight into the unconscious material; maintaining the analytic framework, free association, interpretation, dream analysis, analysis of resistance and analysis of transference. (Corey, 2009)

One of Freud’s main techniques is called projection: the projecting of one’s own unconscious onto a less threatening person or objectas a way of accessing the hidden information. However, Heffner (2002) considers that many projective techniques are controversial and open to interpretation. The aim of psychodynamic assessment is to find out what even the client themselves don’t know.

This technique requires the client to interpret vague pictures, fill in the blanks, make associations, or tell stories. The clients will project their own unconscious desires onto the non-threatening objects, allowing the therapist to interpret and help the patient to gain insight and further explanation into their behaviours.The objective is to weaken defence mechanisms and get to the unconscious before these defences have a chance to work(Heffner, 2002).

Examples of projective techniques;

• Rorschach Inkblot Test, developed by Rorscharch, consists of ten white cards with blots of ink on them in either black, black and red, or multi colored. The shapes seen are projections from the unconscious.
• The Thematic Apperception Test (TAT) was developed by Henry Murray. The TAT consists of numerous cards with black and white and grayscale pictures. Individuals are asked to tell a story about each card.
• Dream Analysis, to find themes and hidden meaning in the patients dreams, pieces of the unconscious that seep out while we are asleep e.g. flying may represent freedom.

Others techniques include; House tree person, Free Association, Word Association, Incomplete Sentences and Hypnosis (Heffner, 2002).

Psychodynamic therapists do not use all the techniques associated with Freud’s psychoanalysis. However, they do remain aware of transference, explore dreams, look at issues past and the present, and are concerned with unconscious material. (Corey, 2009)

Psychodynamic therapy aims to assist the client gain access to their repressed memories, bringing them to their attention, make sense of their feelings and begin to heal. Various methods are used, as described earlier, the analysing of symbols, the meaning of dream content and free association.

The therapist takes an attitude of unconditional acceptance and non judgement towards the client. According to Corey (2009), a good therapeutic alliance that is established early in therapy, is now viewed a key factor for a positive therapeutic result. During sessions, the therapist will engage with the client but sometimes may say little. Silence is valued and therapists never talk about themselves.Treatment can be long term and expensive

The nature-nurture question

Are our behaviours as a result of being born wit them or as a result of social influences and experiences we have as we grow, it seem that it is not a question of either/or but that they both play a role in our way of thinking and acting.

People no longer question if genetic and environmental factors influence human

behaviours but how they influence the behaviours. (Hayiou-Thomas, 2006)

From researching the psychodynamic theory, it appears that nurture is an imposrtant aspect of shaping a person through the experiences one has throughout the various developmental stages of life.

Pharmacotherapy

DEF

medication is an important part of any treatment for people with a psychological illnesses, for most effective treatment it should be used in conjunction with

psychotherapy.Find reference

Many patients in psychodynamic therapy may be treated with a combination of medication and psychodynamic therapy find reference

Combined treatment for depression may have beneficial effects when applied to patients with chronic depression and in cases to prevent relapse. but combined treatment may limit the treatment gains offered by CBT alone.

Brief therapy

Also known as Short Term Psychodynamic Psychotherapy (STPP). Created to meet the demands of modern life, such as client’s needs, busy work and family life and expenses.

It is short in duration and usually focus’s on a specific problem, raising awareness of the unconscious material and behaviours that cause symptoms and relationship problems. A time frame is usually established between client and therapist

The main goal is symptom reduction, while the secondary goal involves personality change. These goals can be limited due to the short time period.

In brief therapy, a strong alliance, an active and directive therapist, and early interpretation are important in the therapeutic relationship. (Driessen, Cuijpers, de Maat, Abbass, de Jonghe, Dekker, 2009)

Applicability to diverse populations

It is important, not only in psychodynamic therapy, that the therapist is aware of the differences in counselling people of different age, gender, religion, sexual orientation, physical and mental ability, social and economic factors.

Different cultures must be taken into account for the therapist to form an understanding and sensitivity towards client’s morals, beliefs and values

(Corey, 2009)

Adherence to ‘the common factors’.

The Common Factors in psychotherapy that are present in most, approaches to therapy.

Ethics, confidentiality,

a therapeutic alliance between the client and the therapist

make the client aware of their underlying problems

how to manage them in the present

setting goals

allows the patient to experience past problems in a new more productive way

an agreement/ hope expect that positive change will result from the treatment

therapist qualities, non judgemental, empathy, and positive regard, duty of care, respect, are important for change in treatment

an explanation by the therapist, a reason for the problems that are being experienced

Conclusion

Does it work?Sometimes, but not always.

Psychodynamic therapy has got a scientific record of its effectiveness for certain conditions (e.g. depression). However, because of the way it is carried out it is really hard to judge just how well it does work. The experts tend to argue amongst themselves whether it works, but we think the best judge of the issue are the patients themselves. A lot of patients have reported that it has helped them enormously, and indeed some go on to full psychoanalysis. However, equally a lot of patients, really disliked it. These people tended to drop out of therapy quite quickly.

Psychodynamic therapy is one of the few mainstream therapies that focusses on aspects of your personality, and although it is used to treat a wide variety of conditions, it seems to us particularly suited for problems to do with personalities, and past and present relationships.

Depth psychotherapy is a group of approaches which values self-awareness, life-long growth.

Depth psychotherapy concerned with the quality of change which occurs. improving the overall quality of life of the client.

References

• The American Heritage® Dictionary of the English Language, Fourth Edition copyright ©2000 by Houghton Mifflin Company. Updated in 2009. Published by Houghton Mifflin Company.
• Collins English Dictionary – Complete and Unabridged 6th Edition 2003. © William Collins Sons & Co. Ltd 1979, 1986 © HarperCollins Publishers 1991, 1994, 1998, 2000, 2003
• Ologies & -Isms. Copyright 2008 The Gale Group, Inc. All rights reserved.
• http://www.age-of-the-sage.org/psychology/nature_nurture.html#nature_versus_nurture
• http://en.wikipedia.org/wiki/Nature_versus_nurture
• http://en.wikipedia.org/wiki/Pharmacotherapy
• http://focus.psychiatryonline.org/cgi/content/full/4/2/204
• http://en.wikipedia.org/wiki/Brief_therapy
• http://www.minddisorders.com/Ob-Ps/Psychotherapy-integration.html
• http://allpsych.com/dictionary/p.html
• http://allpsych.com/personalitysynopsis/psychodynamic.html
• http://en.wikipedia.org/wiki/Psychodynamic_psychotherapy
• http://www.absoluteastronomy.com/topics/Psychodynamic_psychotherapy
• http://en.wikipedia.org/wiki/Depth_psychology
• http://www.depth-psychotherapy-network.com/Front_Pages/About_DNP.htm
• http://www.absoluteastronomy.com/topics/Psychodynamic_psychotherapy
• http://allpsych.com/personalitysynopsis

The American Heritage® Dictionary of the English Language, Fourth Edition copyright ©2000 by Houghton Mifflin Company. Updated in 2009. Published by Houghton Mifflin Company.

Collins English Dictionary – Complete and Unabridged 6th Edition 2003. © William Collins Sons & Co. Ltd 1979, 1986 © HarperCollins Publishers 1991, 1994, 1998, 2000, 2003