Introduction to Psychodynamic TherapyIntroduction 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

General Approaches ofGeneral Approaches ofPsychological TheoriesPsychological Theories

CognitiveCognitiveBehavioralBehavioralPsychodynamicPsychodynamic

Psychotherapy

psychoanalysis psychodynamic existentialcognitivebehavioralcognitive/behavioral

Sigmund Freud’s Major Contributions to Sigmund Freud’s Major Contributions to PsychodynamicsPsychodynamics

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 PersonalityFreud’s Structure of Personality

Sigmund Freud’s Major Contributions to Sigmund Freud’s Major Contributions to PsychodynamicsPsychodynamics

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 Sigmund Freud’s Major Contributions to Psychodynamic TherapyPsychodynamic Therapy

Ego-defense mechanisms– repression– denial– reaction formation– projection– displacement– rationalization

– sublimation– regression,– introjection– identification– compensation

Sigmund Freud’s Major Contributions to Sigmund Freud’s Major Contributions to Psychodynamic TherapyPsychodynamic Therapy

Psychosexual stages– oral– anal– phallic– latency– genital

Sigmund Freud’s Major Contributions to Sigmund Freud’s Major Contributions to Psychodynamic TherapyPsychodynamic 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 Overview of Psychodynamic PsychotherapyPsychotherapy

Other names for Psychodynamic psychotherapy– Psychoanalytic psychotherapy– Exploratory psychotherapy– Insight oriented therapy

Overview of Psychodynamic Overview of Psychodynamic PsychotherapyPsychotherapy

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 Overview of Psychodynamic PsychotherapyPsychotherapy

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

Overview of Psychodynamic Overview of Psychodynamic PsychotherapyPsychotherapy

Therapists’ role– unconditional acceptance– make interpretations

Overview of Psychodynamic Overview of Psychodynamic PsychotherapyPsychotherapy

Duration/frequency– months to years

longer term: open-ended 1-3 x weekly

– brief therapy techniques growing 1 x week

Overview of Psychodynamic Overview of Psychodynamic PsychotherapyPsychotherapy

Differences in Assumptions and Focus

Psychoanalysis Psychodynamic

Repressed childhood conflicts, Id content, ego activity

Bringing conflict to consciousawareness overcome neurosis

Less emphasis on sexual and aggressive drives

Less emphasis on unconscious info

More emphasis on past relationships

Overview of Psychodynamic Overview of Psychodynamic PsychotherapyPsychotherapy

Differences in Assumptions and Focus

Psychoanalysis Psychodynamic

Offshoot of thepsychoanalytic school

Interpretation is main tool

Mediator, a conscience,and a devil

all adult problemscan be traced back tochildhood

interaction of ego, superego, id

Carl Jung’s Major Contributions to Carl Jung’s Major Contributions to PsychodynamicsPsychodynamics

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 Carl Jung’s Major Contributions to PsychodynamicsPsychodynamics

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 Carl Jung’s Major Contributions to PsychodynamicsPsychodynamics

Understanding of the human personality– Psychological typology

attitudes = introversion/extroversion the functions = thinking, feeling, sensation, and

intuition

Carl Jung’s Major Contributions to Carl Jung’s Major Contributions to PsychodynamicsPsychodynamics

Human development, especially in middle age A spiritual approach

Carl Jung’s Major Contributions to Carl Jung’s Major Contributions to PsychodynamicsPsychodynamics

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 Carl Jung’s Major Contributions to PsychodynamicsPsychodynamics

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 Carl Jung’s Major Contributions to PsychodynamicsPsychodynamics

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 Carl Jung’s Major Contribution to PsychodynamicsPsychodynamics

Archetypes (con’t)

– Father: guide or authority figure– Child: a pattern related to the hope and

promise for new beginnings.

Other Disciplines in Psychodynamic Other Disciplines in Psychodynamic PsychotherapyPsychotherapy

Adlerian Object relations/ Psychoanalytic self psychology

(Kohut) Ego psychology Psychoanalytically-oriented psychotherapy Transactional analysis-Berne

Individual (Adlerian) PsychologyIndividual (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) PsychologyIndividual (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

Individual (Adlerian) PsychologyIndividual (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) PsychologyIndividual (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)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 theexperience of or understanding objects oremotions outside ourselves

Psychoanalytic Self Psychology (Kohut)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)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 psychologyEgo 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 psychologyEgo 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 PsychologyEgo 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

SourcesSources

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