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Introduction to Psychodynamic Therapy

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1 Introduction to Psychodynamic Therapy
Lyn Siegel, MPH, MSW, LCSW 51 Main St. Suite 12 Clinton, NJ 08809 Web:

2 General Approaches of Psychological Theories
Psychodynamic Behavioral Cognitive 3 main approaches of psychology Psychodynamic- basis is Freudian thought. It is based on the view that an individual is propelled by sexual and aggressive drives which conflict with societal norms for behavior. behavioral :” action-oriented methods to help people change what they are doing and thinking” change behavior not necessarily personality cognitive- focus on restructuring dysfunctional belief and thought in order to change dysfunctional behaviors newer behavioral techniques (in the last 30 years) emphasize cognitive process e.g cognitive behavioral approaches are widely used in family therapy to focus on the interactions within the family

3 Psychotherapy psychoanalysis psychodynamic existential cognitive behavioral cognitive/behavioral

4 Sigmund Freud’s Major Contributions to Psychodynamics
Structure of Personality: ID, EGO, super-ego The most comprehensive theory of personality and psychotherapy ever developed Concepts of the conscious, preconscious and the unconscious ID is the instinctual part t o Freud’s structure of personality . At birth we are all ID. The Id is uncomfortable with tension and so it discharges tension immediately in order to return to a steady state. The ID is illogical and immoral ID impulses form our sexual and aggressive drives Ego is the part of the ID which changes due to what goes on in the external world. It is formed by taking psychic energy from the ID The Super Ego is the judicial branch of personality it represents a steady state It is the part of the personality that represents the ideal values of society .(AS HANDED DOWN TO THEM). It inhibits the id impulses, argues with the ego for perfection rather than pleasure which is the ego’s goal

5 Freud’s Structure of Personality
Freud’s greatest contributions were the conscious and unconscious. The unconscious store all our dreams, experiences, and repressed memories--but is outside of our awareness or conscious control. The unconscious not directly accessible, it can’t be studied, only inferred from behavior. Most of our functioning is out of the unconscious so we don’ really understand our unconscious motives at a conscious level the aim of therapy is to make the unconscious motives conscious and to change personality

6 Sigmund Freud’s Major Contributions to Psychodynamics
Clinical Evidence for postulating the unconscious (which can not be studied directly) dreams slips of the tongue forgetting posthypnotic suggestions material from free-association techniques the symbolic content of psychotic symptoms

7 Sigmund Freud’s Major Contributions to Psychodynamic Therapy
Ego-defense mechanisms repression denial reaction formation projection displacement rationalization sublimation regression, introjection identification compensation Ego-defense mechanisms that we use in order not to deal with unconscious drives.

8 Sigmund Freud’s Major Contributions to Psychodynamic Therapy
Psychosexual stages oral anal phallic latency genital

9 Sigmund Freud’s Major Contributions to Psychodynamic Therapy
Important to Psychologists, Psychiatrists, Social Workers: Transference projecting feelings from the past on the therapist as a significant figure of the past Counter-transference seeing yourself in a client meeting your own needs through a client

10 Overview of Psychodynamic Psychotherapy
Other names for Psychodynamic psychotherapy Psychoanalytic psychotherapy Exploratory psychotherapy Insight oriented therapy

11 Overview of Psychodynamic Psychotherapy
General approach historical focus: interpretations or observations are based on the client’s history always based on the transference--patient/therapist relationship It’s assumptions unconscious mind exists holds painful feelings we avoid thru our defenses Needs, drives and feelings motivate behavior

12 Overview of Psychodynamic Psychotherapy
Goals make client’s problem clear (elucidate) understand defense mechanisms and transference responses Techniques used (origins in Freud) therapeutic alliance free association defense and transference interpretation Bring unconscious conflict to awareness = emotional insight

13 Overview of Psychodynamic Psychotherapy
Therapists’ role unconditional acceptance make interpretations

14 Overview of Psychodynamic Psychotherapy
Duration/frequency months to years longer term: open-ended 1-3 x weekly brief therapy techniques growing 1 x week

15 Overview of Psychodynamic Psychotherapy
Psychoanalysis Psychodynamic Repressed childhood conflicts, Id content, ego activity Bringing conflict to conscious awareness overcome neurosis Less emphasis on sexual and aggressive drives Less emphasis on unconscious info More emphasis on past relationships Differences in Assumptions and Focus

16 Overview of Psychodynamic Psychotherapy
Psychoanalysis Psychodynamic Offshoot of the psychoanalytic school Interpretation is main tool Mediator, a conscience, and a devil all adult problems can be traced back to childhood interaction of ego, superego, id Differences in Assumptions and Focus

17 Carl Jung’s Major Contributions to Psychodynamics
Theory of the mind/psyche (psyche = the personality as a whole), ego-the organizer of the conscious mind: Theory of archetypes Theory of dynamics of the psyche: principle of opposites, principle of equivalence, principle of entropy Theory of synchronicity Theory of dynamics---pscyhe is a relatively closed system can receive energy from other source (E.G. THE BODY, the environment but they then are contained in a closed system because of this the psyche is in a continuous state of change and can never reach equilibrium principle of opposites There is no consciousness without discrimination of opposites (I.e between the ego and the unconscious) principle of equivalence states that if the amt of energy consigned to a given psychic element decreases or disappears that amount of energy will appear in another psychic element principle o f entrophy involves the transfer of psychic energy from one psychic structure to another Theory of synchronicity: A phenomenon where an event in the outside world coincides meaningfully with a psychological state of mind.

18 Carl Jung’s Major Contributions to Psychodynamics
Important concepts complexes (a feature of the personal unconscious in which groups of contents clump together) individuation (the process by which the consciousness of a person becomes individualized or differentiated from other people)

19 Carl Jung’s Major Contributions to Psychodynamics
Understanding of the human personality Psychological typology attitudes = introversion/extroversion the functions = thinking, feeling, sensation, and intuition

20 Carl Jung’s Major Contributions to Psychodynamics
Human development, especially in middle age A spiritual approach A spiritual approach that places great emphasis on being impelled to find meaning in life in contrast to being driven by the psychological and biological forces described by Freud this was a major departure from Freud

21 Carl Jung’s Major Contributions to Psychodynamics
That the personality is also based on who we want to become, rather than just the past (movement toward self-actualization) Dreams as an attempt to express rather than repress

22 Carl Jung’s Major Contributions to Psychodynamics
An archetype is the content of the collective unconscious. The persona: our public image, a mask (or public face) that we wear to protect ourselves. Shadow: represents our dark side, the thoughts, feelings, and actions that are socially reprehensible and that we tend to disown by projecting them outward.

23 Carl Jung’s Major Contributions to Psychodynamics
Archetypes (con’t) Anima/ animus Syzygy: divine couple. wholeness and integration. The opposites of the inner and outer life are joined in marriage. Mother: the nurturing one

24 Carl Jung’s Major Contribution to Psychodynamics
Archetypes (con’t) Father: guide or authority figure Child: a pattern related to the hope and promise for new beginnings.

25 Other Disciplines in Psychodynamic Psychotherapy
Adlerian Object relations/ Psychoanalytic self psychology (Kohut) Ego psychology Psychoanalytically-oriented psychotherapy Transactional analysis-Berne

26 Individual (Adlerian) Psychology
Underlying is a theory of personality, psychopathology, and psychotherapy His theory is connected to a humanistic philosophy of living Core premise: the extent of feeling of community (connectedness) is both an index and goal of mental health Holds philosophical ideals as therapeutic goals for individuals and groups

27 Individual (Adlerian) Psychology
Techniques: analysis of birth order, coping patterns, early memory work Systems view Within the systems context: 3 key life tasks-vocation, love, and sex These and our relationships are social challenges First system: family-the origin of our world view and attitude toward life

28 Individual (Adlerian) Psychology
“Fictional finalism”- a central goal guiding a person behaviors “Only when I am perfect can I be secure” “Only when I am important can I be accepted”

29 Individual (Adlerian) Psychology
Treatment Brief, couple, family Goals: Connected-ness, self-development, contribute to others’ welfare Correct mistaken assumptions, attitudes, behaviors and feelings about the world Objective: redirect self-focused behaviors toward social contribution

30 Psychoanalytic Self Psychology (Kohut)
Emphasizes empathy “Empathy is used to describe an intrapsychic process in the therapist by which an understanding of the patient, particularly an emotional understanding, a capacity to feel what the other is feeling is enhanced. Situated somewhere between listening and interpreting, empathy serves as a precondition for both.”-Berger 1987 Empathy: The power of entering into the experience of or understanding objects or emotions outside ourselves

31 Psychoanalytic Self Psychology (Kohut)
Understanding and explanation ( interpretative process) are offered from the client’s perspective Prevailing form of psychoanalysis in Europe

32 Psychoanalytic Self Psychology (Kohut)
Revolutionary departure from the “biological model” Kohut claimed it would form a framework in which Empathetic, subjective methods were overiding Other methods could be used Distinctions between psychiatry and psychology were no longer relevant

33 Ego psychology Groundwork Anna Freud-building blocks of defense theory
Erikson-Psychosocial stages Emphasized ego’s role in development Focuses on social influences throughout the life span Deals with early AND later developmental stages

34 Ego psychology Heinz Hartmann-leader of ego therapy
It’s really structural theory-ego therapist interested in all aspects--incl ID the preservation of Freud’s drive theory emphasizes the centrality of the ego Focuses on the ego’s workings in creating defenses rather than focusing on the underlying id content Engages the patient, less emphasis on uncovering hidden secrets, more on psychic structure-i.e the relationships between the id, the ego, and superego (Mitchell and Black-1995)

35 Ego Psychology Heinz Hartmann: the father of Ego Psychology
Studied”the ways in which the Ego organizes itself, adapts, and deploys ID drives Contributions: neutralization (rather than sublimation)-the ego strips the drives of their sexual and aggressive qualities changing their nature-e.g like a power plant notion of “ a child born with an innate potential that unfolds naturally in a receptive environment” and “average receptive environment”- Mitchell and Black 1995

36 Sources Brown D, Pedder J, Introduction to Psychotherapy, Tavistock/Routledge, 1991 Covey, Gerald. Theory and Practice of Counseling and Psychotherapy: Brook/Cole, 2001 Mitchell SA and Black MJ, Freud and Beyond-A History of Modern Psychoanalytic Thought: The Perseus Books Groups, 1995 Ursano RJ, Sonnenberg SM, Lazar SG, Psychodynamic Psychotherapy: American Psychiatric Press, 1991 Hall CS, Nordby SH, A Primer of Jungian Psychology: Penguin Group, 1973 http//

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