Cortina, M. (2010). The future of psychodynamic psychotherapy. Psychiatry, 73(1), 43-56.
Long, C. (2002). Psychoanalytic community psychology: Crossing worlds or worlds apart? In L.Swartz,
K.Gibson, & T.Gelman (Eds.), Reflective Practice: Psychodynamic ideas in the community (pp. 113-124). Cape
Town, South Africa: HSRC Publishers.
PSYCHODYNAMIC PSYCHOTHERAPY
•
The Psychoanalytic Perspective
•
Pioneered by Sigmund Freud and Josef Breuer
•
Hysteria used to explain medically unexplained symptoms
•
Manifested by paralysis in a limb, loss of feeling, blindness, inability to speak etc.
•
Emphasized role of early childhood experiences
•
Emphasis on unconscious conflicts
•
The Structure of Personality (Sigmund Freud)
•
Three forces shape personality and may lead to symptoms of psychopathology
•
Id – instinctual needs, pleasure principle
•
Ego – attempts to control the impulses of the id, reality principle
•
Superego – develops out of the id and ego, societal values
•
Defense mechanisms allow us to avoid confronting these conflicts (e.g. repression,
projection)
•
•
Psychoanalytic Approach to Treatment
•
Long-term
•
Two or three sessions per week
•
Therapist as blank slate (‘one-person’ psychology)
•
Talking cure through catharsis
•
Catharsis - memories need to be unearthed and associated affect needs to be
abreacted
•
Free association, dream analysis, hypnosis
•
Anonymity of the analyst facilitates patient’s transference neurosis and uncovering
of and resolution of unconscious conflicts
•
Interpretation used to resolve neurosis
•
Psychodynamic Psychotherapy
•
Psychoanalytic theories were expanded upon and adapted
•
Insight-oriented therapy
•
Forms of treatment for emotional and psychiatric disorders that rely on talking and
the relationship with the therapist
•
Approaching the patient empathically from the inside in order to help them identify
and understand what is happening in their inner world, in relation to background,
upbringing and development
•
Relationship in which client can share and explore the underlying nature of their
troubles, and change some of the determinants of these through experiencing
unrecognized forces in themselves
•
Psychodynamic Psychotherapy – Basic Concepts
•
Conflict
•
Aspects of ourselves which conflict with consciously held ideals may be
denied, suppressed or disowned i.e. become unconscious
•
Disagreeable feelings
•
Painful memories
•
Thoughts or feelings that conflict with our view of ourselves and of what is
acceptable
•
Conflicts can lead to anxiety, guilt and psychic pain if acknowledged
•
Defense Mechanisms
•
Defense mechanisms allow us to avoid confronting these conflicts
•
Repression
•
Denial
•
Projection
•
Displacement
•
Splitting
•
Dissociation
•
Intersubjective abilities and communication
•
How we learn how to communicate and know how to be with others is not
conscious
•
Gestures, taking turns, recognizing emotions and the intention of others are
intersubjective abilities that are gradually acquired before language develops
by end of second year of life
•
World of “implicit relational knowing” provides the background to verbal
communication
•
Unconscious forms of communication e.g. transference and projective
identification
•
Attachment
•
People have a natural instinct to attach themselves to a loved one
•
This innate behaviour ensures survival
•
Reactions to separation: protest, despair, dissociation
•
Attachment patterns in infancy predict adult attachment patterns
•
Attachment Styles
•
Secure
•
Insecure-ambivalent
•
Insecure-fearful/avoidant
•
Insecure-disorganized
•
Models of the mind
•
Wide range of theories – move away from Freud’s theories towards more
interpersonal models of the mind
•
Models emphasize the importance of:
•
Internal representations and working models of early relationships
•
The development of the self
•
The Therapeutic Relationship
•
The therapeutic relationship is the vehicle for growth and change
•
‘two-person’ relationship – shared space where client and therapist engage in
exploring and resolving conflict
•
Creating a safe space where the client can feel secure enough to be themselves, to