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Psychodynamic Family Psychodynamic Family TherapyTherapy

EPSY 6393 -- Dr. SparrowEPSY 6393 -- Dr. Sparrow

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Original ConceptsOriginal Concepts

Basis of unconscious drives were sexual and Basis of unconscious drives were sexual and aggressive; therapy was reductionisticaggressive; therapy was reductionistic

Clients labored under intrapsychic conflicts Clients labored under intrapsychic conflicts stemming from childhood, having to do with stemming from childhood, having to do with whether they could express their impulses.whether they could express their impulses. Anxiety, expectation of punishmentAnxiety, expectation of punishment Depression, calamity has already happenedDepression, calamity has already happened

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Original ConceptsOriginal Concepts

Family was the source of the problem, but did Family was the source of the problem, but did not sustain it in the present. Relationship with not sustain it in the present. Relationship with analyst was sufficient to reawaken all of the analyst was sufficient to reawaken all of the conflict associated with the original parents. conflict associated with the original parents. The focus was the resolution of transference.The focus was the resolution of transference.

Therapy was retrospectiveTherapy was retrospective Therapy was individual, and not interpersonal Therapy was individual, and not interpersonal

beyond the analyst-patient relationshipsbeyond the analyst-patient relationships

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TreatmentTreatment

Uncovering and interpreting unconscious Uncovering and interpreting unconscious impulses and defenses against them.impulses and defenses against them.

Either finding a way to relax defenses Either finding a way to relax defenses against the expression of healthy against the expression of healthy impulses, orimpulses, or

Strengthening defenses against excessive Strengthening defenses against excessive gratificationgratification

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Modern DevelopmentsModern Developments

Self Psychology -- KohutSelf Psychology -- Kohut Every human being longs to be appreciatedEvery human being longs to be appreciated If our desire is frustrated at an early age, the If our desire is frustrated at an early age, the

way we go about gaining appreciation is tied to way we go about gaining appreciation is tied to that period of our lives.that period of our lives.

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Modern DevelopmentsModern Developments

Object Relations -- KleinObject Relations -- Klein Bridge between individual theory and family Bridge between individual theory and family

theorytheory Internal “objects,” that is, images of self and Internal “objects,” that is, images of self and

others forged in early fantasy and experiences, others forged in early fantasy and experiences, and internalized.and internalized.

The ego was not so much driven by impulses The ego was not so much driven by impulses as motivated to find an outside match for the as motivated to find an outside match for the internal objectinternal object

Love, and the desire to connect, was more Love, and the desire to connect, was more important than instinctsimportant than instincts

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Attachment theory Attachment theory -- Spitz and Bowlby-- Spitz and Bowlby

A child has a profound need for a stable A child has a profound need for a stable and constant objectand constant object

If frustrated in their search, then children If frustrated in their search, then children will later suffer will later suffer anacliticanaclitic depressiondepression, and , and an extreme sensitivity to a lack of supportan extreme sensitivity to a lack of support

This sensitivity gives rise to enmeshed This sensitivity gives rise to enmeshed and disengaged relationships (Bowen)and disengaged relationships (Bowen)

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Separation-IndividuationSeparation-IndividuationMahler, WinnicottMahler, Winnicott

After the child experiences a period of total After the child experiences a period of total unconscious immersion in, and identification with the unconscious immersion in, and identification with the mother, she begins a process of separation mother, she begins a process of separation (differentiation) at about 6 mos.(differentiation) at about 6 mos.

Average expectable environment facilitates Average expectable environment facilitates individuationindividuation

““Good enough” motherGood enough” mother Devotes herself to child sufficiently to establish Devotes herself to child sufficiently to establish

securitysecurity Shifts to self interest as child needs her lessShifts to self interest as child needs her less Transitional object as a symbol of the motherTransitional object as a symbol of the mother

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Separation-IndividuationSeparation-Individuationcontinuedcontinued

Self-objects are not quite separate in the child’s Self-objects are not quite separate in the child’s experience, so nurturance is taken into the self more experience, so nurturance is taken into the self more easily. Whatever a mother does or says translates into easily. Whatever a mother does or says translates into an experience of self love.an experience of self love.

Two qualities of parenting are thought to be essential Two qualities of parenting are thought to be essential to a secure self:to a secure self: Mirroring = Understanding + AcceptanceMirroring = Understanding + Acceptance IdealizationIdealization

Kohut’s primary narcissism and formation of the Kohut’s primary narcissism and formation of the Narcissistic Personality DisorderNarcissistic Personality Disorder Grandiosity normally gives way to self esteem and Grandiosity normally gives way to self esteem and

idealization forms the basis for personal valuesidealization forms the basis for personal values Rage when frustratedRage when frustrated

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Interpersonal Psychiatry Interpersonal Psychiatry --Sullivan--Sullivan

warm nurturing mother creates good warm nurturing mother creates good feelingsfeelings

frustrating mother leads to child disociating frustrating mother leads to child disociating in order to avoid anxietyin order to avoid anxiety good megood me bad mebad me not menot me

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Interpersonal Psychiatry Interpersonal Psychiatry --Sullivan--Sullivan

Parataxic distortionsParataxic distortions the perception of others, based not on actual

experience with the individual but from a projected fantasy personality

“Falling in love” can create the atmosphere where parataxic distortion is primarily involved in the perception of the object of affection.

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MarriageMarriage A blur of reality and fantasyA blur of reality and fantasy

We fall for someone who is a substitute for We fall for someone who is a substitute for our unattained ideals.our unattained ideals.

We want out mates to conform to an We want out mates to conform to an internalized unrealistic model of fulfillment.internalized unrealistic model of fulfillment.

Conscious and unconscious contractsConscious and unconscious contracts Projective identificationProjective identification -- an interactional -- an interactional

process in which a person behaves according to process in which a person behaves according to our projections of anxiety-arousing aspects of our projections of anxiety-arousing aspects of ourselves.ourselves.

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MarriageMarriage The individual and marital “shadow”The individual and marital “shadow” -- the -- the

repressed aspects of each person which are kept repressed aspects of each person which are kept repressed by tacit understandings (Jung, Sparrow)repressed by tacit understandings (Jung, Sparrow) Original attraction may be to someone who will permit Original attraction may be to someone who will permit

the repression of the individual shadow.the repression of the individual shadow. Example: A woman represses her urge to express Example: A woman represses her urge to express

herself openly for fear of being unlovable, so she herself openly for fear of being unlovable, so she become attracted to a man who is willing to “wear the become attracted to a man who is willing to “wear the pants” in the family, who is repressing his own pants” in the family, who is repressing his own shadow of tenderness and vulnerability.shadow of tenderness and vulnerability.

Problems emerge in midlife when repressed issues Problems emerge in midlife when repressed issues surface. I want to “find my own voice,” so I am no surface. I want to “find my own voice,” so I am no longer attracted to my husband’s assertiveness.longer attracted to my husband’s assertiveness.

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More conceptsMore concepts

Delineations -- when parents project their Delineations -- when parents project their fantasies upon their children, rather than fantasies upon their children, rather than letting them be themselves.letting them be themselves.

The presenting problem (symptom bearer) The presenting problem (symptom bearer) is often symbolic of the parent’s own is often symbolic of the parent’s own denied emotion or wish.denied emotion or wish.

Invisible loyalties -- when a child take on a Invisible loyalties -- when a child take on a symptom to unite their parents in concern.symptom to unite their parents in concern.

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Goals of Psychoanalytic Goals of Psychoanalytic Family TherapyFamily Therapy

To free family members from the power of To free family members from the power of unconscious constraints so they can relate unconscious constraints so they can relate in a healthy way.in a healthy way.

Separation-individuation or differentiation Separation-individuation or differentiation (similar to Bowen’s concept)(similar to Bowen’s concept)

To let go of one another in a way that To let go of one another in a way that frees the other to become more frees the other to become more independentindependent

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Conditions for ChangeConditions for Change

Insight is necessary but not sufficientInsight is necessary but not sufficient Insights have to be “worked through” to Insights have to be “worked through” to

the point where new ways of interacting the point where new ways of interacting emerge.emerge.

The therapist has to interrupt to get The therapist has to interrupt to get couples to get in touch with what they are couples to get in touch with what they are feeling and avoiding (similar to Bowen’s feeling and avoiding (similar to Bowen’s process questions).process questions).

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Therapeutic InterventionsTherapeutic Interventions

ListeningListening EmpathyEmpathy InterpretationsInterpretations Analytic NeutralityAnalytic Neutrality

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What the Therapist What the Therapist is Looking Foris Looking For

Emotion to signal the presence of Emotion to signal the presence of unconscious conflictunconscious conflict

Internal experience and its historyInternal experience and its history How partner triggers the experienceHow partner triggers the experience How therapist plays into the interaction How therapist plays into the interaction

(transference)(transference)

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Scenario OneScenario One Couple comes for counseling. Presenting problem Couple comes for counseling. Presenting problem

is that husband was caught text messaging an old is that husband was caught text messaging an old girlfriend “Happy Birthday-Juan.” Wife has been girlfriend “Happy Birthday-Juan.” Wife has been jealous and insecure, and now she knows without jealous and insecure, and now she knows without a doubt that he is, or will soon, cheat on her. He a doubt that he is, or will soon, cheat on her. He angrily claims that he has been loyal, but that she angrily claims that he has been loyal, but that she is always controlling him, and he’s not free to is always controlling him, and he’s not free to show respect and friendship toward men or show respect and friendship toward men or women he has known. He insists on having more women he has known. He insists on having more freedom, while she insists that he cut off his freedom, while she insists that he cut off his relationships with old girlfriends and men who are relationships with old girlfriends and men who are “bad influences.” “bad influences.”

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Scenario TwoScenario Two Couple comes for counseling. They have been Couple comes for counseling. They have been

married for six years, and have three young married for six years, and have three young children. Mom works and juggles parenting duties children. Mom works and juggles parenting duties with a bank job. Dad is a coach, and is away at with a bank job. Dad is a coach, and is away at night a lot during football and basketball season. night a lot during football and basketball season. Kids are doing well at school, but parents have Kids are doing well at school, but parents have begun arguing over little things. Every time they begun arguing over little things. Every time they talk, they get into an argument, and lately have talk, they get into an argument, and lately have been using a lot of foul language. He thinks she been using a lot of foul language. He thinks she needs to quit work because she doesn’t have any needs to quit work because she doesn’t have any time for him, and she thinks he needs to spend time for him, and she thinks he needs to spend more time at home with the kids.more time at home with the kids. 22

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