PSYCHODYNAMIC APPROACH TO THERAPY

Psychodynamic Approach focused on unconscious thought processes,

which manifest  themselves in an individual's behavior

patient explores unresolved issues and conflicts from the past that are  believed  to affect them in the present

centered around the concept that some maladaptive functioning is in  play, and that this maladaption is, at least in part, unconscious.

Psychodynamic therapies focus on revealing and resolving these unconscious conflicts that are driving their symptoms

Psychodynamic therapy vs. Psychoanalysis

Freud’s theories were psychoanalytic, whereas the term ‘psychodynamic’ refers to both his theories and those of his followers. Freud’s psychoanalysis is both a theory and a therapy.

Psychodynamic therapy does not include all of  the different analytical techniques and is not conducted by  psychoanalytically trained analysts. 

HistorySigmund Freud

• sexual desires and impulses• emotional problems originate in childhood• unconscious thoughts emerge during therapy• Psychoanalysis

Carl Jung• de-emphasis of the importance of sexuality

and aggression as motives• obstacles to prospective striving to be as

important as childhood conflicts• division of the unconscious into the personal

and the collective (the archetypes)

Alfred Adler

• also disagreed with the emphasis Freud put on sexuality as a motive

• the most important motive is the feeling of inferiority, originating in the sense of dependence and helplessness which infants experience

• focus on striving for superiority seems less abstract than Jung's concept of individuation as the goal of growth

Other schools of thought shaping Psychodynamic Therapy:

Ego Psychology (Anna Freud) - enhancing and maintaining ego function according to the demands of reality.

Object Relations Psychology (John Bowlby) - human beings are always shaped in relation to significant others

 Self Psychology (Heinz Kohut) – the self as perceived in relation to the establishment of boundaries and the differentiations of self from others.

Criticism

The greatest criticism of the psychodynamic approach is that it is unscientific in its analysis of human behaviour. Psychodynamic perspective is unfalsifiable as the theories cannot be empirically investigated. Freud's theories are subjective and as much impossible to scientifically test. Case studies are based on studying only one person in detail.

major techniques used

free association recognizing resistance and transference working through painful memories and

difficult issues building a strong therapeutic alliance catharsis

features that distinguish Psychodynamic therapy:

Focus on affect and expression of emotion• encourages exploration and discussion of

the full range of a patient’s  emotions• recognition that  intellectual insight is not

the same as emotional insight

Exploration of attempts to avoid distressing thoughts and feelings

deals with avoidance (defense and resistance)

may take subtle forms that are difficult to recognize, such as: subtle shifts of topic when certain ideas arise focusing on incidental aspects of an experience

rather than on what is psychologically meaningful

attending to facts and events to the exclusion of affect

focusing on external circumstances rather than one’s own role in shaping events

Identification of recurring themes and patterns

recurring themes and patterns in patients’ thoughts, feelings, self-concept, relationships, and life experiences. 

 a patient may be acutely aware of recurring patterns that are painful or self-defeating but feel unable to escape them

OR the patient may be unaware of the

patterns until the therapist helps him or her recognize and understand them

Discussion of past experience (developmental)

psychodynamic therapists explore early experiences

past and present, and the ways in which the past tends to “live on” in  the present. 

how the past sheds light on current psychological difficulties. 

free patients from the bonds of past experience

Focus on external relations

object relations and attachment aspects of personality and self-concept in

the context of attachment relationships psychological difficulties arise when

problematic interpersonal patterns interfere with a person's emotional needs

Focus on the therapy relationship.                   greater flexibility in interpersonal

relationships and an enhanced capacity to meet interpersonal needs.

Exploration of fantasy life.                   encourages patients to speak freely

about whatever is on their  minds rich source of information how the person views self and others interprets and makes sense of

experience avoids aspects of experience interferes with a potential capacity to

find meaning in life.

CASE STUDY

D's Personal Background member of Breslow Orthodox Sect (Judaism) grew up in American suburb father is an academic, mother is an artist, has 3

siblings family life is important-go to camping trips

every summer immigrated to Israel and settled in Breslow set up high-level computer companies and

gave jobs to religious colleagues due to his parents’ dismay about what he did,

his mother carried out a mock funeral ceremony for him

D's Traumatic Experiences

a man threw a brick at D's car he was driving home with his children

when two men raised pistols at him and narrowly missed

he was on his way home when there was gunfire. He dove to the floor and saw blood covered bodies around him

Palestinians attacked his car with stones

Effects of Traumatic Experiences

had many nightmares would wake up exhausted did everything to avoid crowds checked and rechecked windows and doors

when in the office, synagogue or friend's house can no longer focus on the most basic computer

activity felt his livelihood was in danger suffering from posttraumatic stress disorder

(PTSD)- sleep difficulties, irritability, reduced physical mobility, phobias, concentration difficulties, hypervigilance

D's Treatment

Series of Psychodynamic sessions Dream Analysis Transference/Countertransference Action and Body oriented interventions Sensory Experiencing Desensitization Creative Self-Soothing activities

Sources:

http://nvpp.nl/JonathanShedlerStudy20100202.pdf http://psychcentral.com/lib/2006/psychodynamic-

therapy/ http://www.helptoheal.co.uk/psychodynamic-

therapy.html http://www.articlesbase.com/mental-health-articles/

the-history-of-psychodynamic-therapy-1382532.html http://www.simplypsychology.org/

psychodynamic.html http://www.jungny.com/carl.jung.13.html http://www.ryerson.ca/~glassman/psychdyn.html