Is Freud Still Dead? November 12, 2010

Magazine covers of Freud

1981 Magazine covers of Freud (2)

Freudian vocabulary EgoEgo IdIdSuperegoSuperego Oedipus complex Oral personality Anal personality Defense Mechanisms DenialDenial RepressionRepression RationalizationRationalization ProjectionProjection Reaction formation Penis Envy Castration Anxiety

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Behaviorism 1 Watson (1913) “Psychology as a Behaviorist Views It” Psychological data = behavior Psychological data = behavior No inferences about mental states No inferences about mental states BehaviorismBehaviorism Psychopathology = maladaptive behavior

Cognitivism Methodological behaviorism + cognitive inferences Psychopathology = disordered thinking and reasoning CognitivismCognitivism Cognitive-Behavioral Therapy (CBT)

Evolutionary Psych Looks to adaptive functions of mind, behavior Focus on human commonalities, not individual differences Evolutionary Psychology Little impact on clinical, applied psychology

Recasting Freud Psychoanalysis as a behavioral learning theory (Dollard & Miller, 1950) Psychoanalysis as a cognitive theory (Erdelyi et al) Recasting Freud Psychoanalysis = psychodynamic?

Freud’s ideas (1) HedonismHedonism Impact of childhood experiences on development Freud’s Ideas Freud’s ideas not Freud’s ideas Sexuality and aggression

Freud’s ideas (1) Freud’s Ideas Psychosexual stages – childhood sexuality Primacy of unconscious processes

Fate of Freud’s ideas: Hedonism, sexuality, childhood Hedonism?Hedonism? Impact of childhood experiences Fate of Freud’s Ideas Sexuality and aggression? VERY old idea, still viable Focus of evolutionary psychology Aggression activates same dopamine circuits as other rewards (Couppis & Kennedy, 2008) Generally accepted Attachment theory Anecdotal evidence

Fate of Freud’s ideas: Childhood sexuality Childhood sexuality? Fate of Freud’s Ideas Knoth et al (1988): 40% of males report first sexual arousal before 8 years. Okami et al (1997): 50% of young adults report ‘interactive sexual activities’ before age 6. 75% of mothers report sex play before age 6. Friedrich et al (1991): Parent-reported sexual behavior between 2 and 6 years. Masturbation: 23% M; 16% F Touching genitals: 64% M; 54% F

Fate of Freud’s ideas: Oedipus complex? Oedipus complex? Fate of Freud’s Ideas Boy wants to have sex with mother. Boy wants to kill father. Boy fears castration at hands of father. Boy identifies with Dad, Mom to resolve complex, forms superego and moral sense. Boy continues to seek mom-replacement as mate.

Fate of Freud’s ideas: Oedipus! Oedipus complex! Fate of Freud’s Ideas Boy wants exclusive access to caretaker’s time and attention. Boy wants to eliminate rival for that attention. Boy fears castration at hands of father. Boy identifies with Dad, Mom to resolve complex, forms superego and moral sense. Boy continues to seek mom-replacement as mate. (sexual imprinting?)

Fate of Freud’s ideas: Unconscious processes Unconscious processes? Fate of Freud’s Ideas Hypnotic phenomena Split-brain patients BlindsightBlindsight Subliminal priming Implicit attitudes

Psychodynamic therapy (Shedler, Ablon & Jones) Shedler (2010): Meta-analyses of therapeutic effectiveness. (American Psychologist, 2010: Scientific American Mind, 2010) Psychodynamic Therapy Experts in cognitive-behavioral therapy and psychodynamic therapy construct prototype of each therapy using Psychotherapy Process Q- Set Ablon & Jones (1998):

Psychodynamic therapy (Ablon & Jones) Ablon & Jones (1998): Psychodynamic Therapy “Panels of experts developed prototypes of psychodynamic and cognitive-behavioral therapy using the Psychotherapy Process Q- set. The prototypes were used to assess the extent to which treatments conformed to the prototypes in 3 archived treatment samples. The degree to which the treatments adhered to the prototypes was measured quantitatively and correlated with outcome.”

Psychodynamic therapy prototype Psychodynamic Therapy P’s dreams of fantasies are discussed. T is neutral. T points out P’s use of defenses, e.g. undoing, denial. T draws connections between therapeutic relationship and other relationships. T is sensitive to P’s feelings, empathic. T interprets warded-off or unconscious wishes, feelings, ideas. P achieves new understanding or insight. Therapy relationship is focus of discussion. T conveys sense of nonjudgmental acceptance.

Cognitive-behavioral therapy prototype Cognitive-Behavioral Therapy Discussion of tasks, activities for P to perform outside session. Discussion centers on cognitive themes, i.e., ideas or belief systems. P’s treatment goals are discussed. T actively exerts control over interaction; structuring, introducing new topics). T adopts supportive stance. T asks for more information or elaboration. P’s current or recent life situation is emphasized in discussion. T gives explicit advice and guidance. T presents experiences or events in a different perspective.

Relationship between therapy and prototypes Relationship Between Therapy and Prototypes Correlation with Prototype Psychodynamic Therapy Psychodynamic Therapy for PTSD Cognitive- Behavioral Therapy Psychodynamic Therapy Cognitive-Behavioral Therapy

TCS = Target Complaint Scale BPRS = Brief Psychiatric Rating Scale Relationship between prototype and outcome – psychodynamic sample Correlation Between Prototype and Outcome Correlation with Prototype Psychodynamic Therapy Sample Psychodynamic Therapy Cognitive-Behavioral Therapy TCS (P) TCS (T) TCS (E) BPRS (T) BPRS (E) TCS (P) TCS (T) TCS (E) BPRS (T) BPRS (E).10.10

ATQ = Automatic Thoughts Questionnaire HRSD = Hamilton Rating Scale, Depression MMPI-D = MMPI Depression score Relationship between prototype and outcome – CBT sample Correlation Between Prototype and Outcome Correlation with Prototype CBT Therapy Sample Psychodynamic Therapy Cognitive-Behavioral Therapy BDIBDI ATQFATQF ATQBATQBHRSDHRSDMMPI-DMMPI-D BDI = Deck Depression Inventory BDIBDI ATQFATQF ATQBATQBHRSDHRSDMMPI-DMMPI-D

Psychodynamic therapy – summary of Ablon & Jones Ablon & Jones (1998): Psychodynamic Therapy “The psychodynamic prototype constructed by experts was consistently significantly correlated with positive outcome in both psychodynamic and cognitive-behavioral therapy. The cognitive-behavioral prototype was not consistently significantly correlated with positive outcome in either type of therapy.”

The End (for now)

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