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Introduction to Psychodynamic Therapy Lyn Siegel, MPH, MSW, LCSW 51 Main St. Suite 12 Clinton, NJ 08809 908-586-3254 e-mail [email protected] Web: www.clintontherapist.citymax.com General Approaches of Psychological Theories Psychodynamic Behavioral Cognitive Psychotherapy psychoanalysis psychodynamic existential cognitive behavioral cognitive/behavioral 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 Freud’s Structure of Personality 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 Sigmund Freud’s Major Contributions to Psychodynamic Therapy Ego-defense mechanisms – repression – denial – reaction formation – projection – displacement – rationalization – – – – – sublimation regression, introjection identification compensation Sigmund Freud’s Major Contributions to Psychodynamic Therapy Psychosexual stages – oral – anal – phallic – latency – genital 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 Overview of Psychodynamic Psychotherapy Other names for Psychodynamic psychotherapy – Psychoanalytic psychotherapy – Exploratory psychotherapy – Insight oriented therapy 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 Overview of Psychodynamic Psychotherapy Goals Bring unconscious conflict to awareness = emotional insight 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 Overview of Psychodynamic Psychotherapy Therapists’ role – unconditional acceptance – make interpretations Overview of Psychodynamic Psychotherapy Duration/frequency – months to years longer term: open-ended 1-3 x weekly – brief therapy techniques growing 1 x week Overview of Psychodynamic Psychotherapy Psychoanalysis Psychodynamic Repressed childhood conflicts, Id content, ego activity Less emphasis on sexual and aggressive drives Bringing conflict to conscious awareness overcome neurosis Less emphasis on unconscious info More emphasis on past relationships Differences in Assumptions and Focus Overview of Psychodynamic Psychotherapy Psychoanalysis all adult problems can be traced back to childhood interaction of ego, superego, id Psychodynamic Offshoot of the psychoanalytic school Interpretation is main tool Mediator, a conscience, and a devil Differences in Assumptions and Focus 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 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) Carl Jung’s Major Contributions to Psychodynamics Understanding of the human personality – Psychological typology attitudes = introversion/extroversion the functions = thinking, feeling, sensation, and intuition Carl Jung’s Major Contributions to Psychodynamics Human development, especially in middle age A spiritual approach 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 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. 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 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. Other Disciplines in Psychodynamic Psychotherapy Adlerian Object relations/ Psychoanalytic self psychology (Kohut) Ego psychology Psychoanalytically-oriented psychotherapy Transactional analysis-Berne 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 Individual (Adlerian) Psychology Techniques: analysis of birth order, coping patterns, early memory work Systems view – Within the systems context: 3 key life tasksvocation, love, and sex – These and our relationships are social challenges – First system: family-the origin of our world view and attitude toward life 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” 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 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 Psychoanalytic Self Psychology (Kohut) Understanding and explanation ( interpretative process) are offered from the client’s perspective Prevailing form of psychoanalysis in Europe 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 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 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) 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 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:psychcentral.com/therapy.htm http//easyweb.easynet.co.un/simplepsych/204 http://www.ni.edu/acad/psych/frauenglass/psychodynamic.html http://meagerlab.tamu.esu/M-Meagher/Intro/TREATMENT.html