Introduction to Psychodynamic Therapy

1. Introduction to Psychodynamic Therapy Lyn Siegel, MPH, MSW, LCSW 51 Main St. Suite 12 Clinton, NJ 08809 908-586-3254 e-mail lynsiegel@patmedia.net Web: www.clintontherapist.citymax.com

2. General Approaches ofPsychological Theories Psychodynamic Behavioral Cognitive

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

5. Freud’s Structure of 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. Ego-defense mechanisms repression denial reaction formation projection displacement rationalization sublimation regression, introjection identification compensation Sigmund Freud’s Major Contributions to Psychodynamic Therapy

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 observationsare 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

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

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: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