PSYCH310: Psychodynamic Therapy

Week 2

Topographical model of the conscious

1. Conscious

2. Preconscious

3. Unconscious

Conscious

That which we know

• forefront of mind

• tip of the iceberg

Preconscious

That which we can bring to the mind

• just out of consciousness

• what you did yesterday

• Ego and Superego

Unconscious

That which we do not know

• Experiences, thoughts, feelings we are unaware of

• Actively repressed

• Influence us without our awareness

• Id

How can the unconscious be known?

Through:

• Dreams

• Parapraxes (slips of tongue)

• Mental health symptoms

• Art and play

• Phantasy (patterns of behaviour, emotion, and interaction)

Id

Primitive drives (sexual/aggressive)

• Operates according to the ‘Pleasure principle’

• Values comfort and satisfaction

Ego

Mediates between other parts of mind and external world.

• Operates according to the ‘Reality principle’

• Stop seeking distractions so you pay attention

• Stop worrying so you can enjoy yourself

Superego

Develops last and helps us negotiate the moral demands of society

• Operates according to the ‘Morality principle’

• internalises the requirements of being civilised

• rules upheld internally (source of guilt)

Psychoanalytic defenses

From the ego to fight against unconscious material emerging into consciousness (not always unacceptable material)

• Denial

• Projection

• Displacement

• Isolation

• Reaction formation

• Intellectualisation

• Sublimation

Denial

Avoids anxiety by refusing to acknowledge an aspect of external reality

• when something is to overwhelming and is blocked out

• Usually immediately after a traumatic event

Projection

Attributes unacceptable feelings onto others

• accusing a partner of cheating when being unfaithful

• making it look like it comes from the other person to feel better

Displacement

Directs impulses toward a more appropriate target

• frustrated by boss, takes it out on partner

• less socially acceptable to argue with boss vs. partner

Isolation

Disconnects the idea from feelings associated with it

Reaction formation

Acts in opposite way of impulse he/she is afraid to acknowledge

• Religious leader experiencing sexual desire behaves the opposite way

Intellectualisation

Overly rational response aimed at distancing

• understanding psychological dynamics

• making sense of the situation

• but feels inauthentic

• therefore no change

Sublimation

Expresses unacceptable wishes in socially acceptable ways (art, etc.)

Resistance to therapy

• People spend a lifetime defending against their issues

• even when willing, it can be hard to bring unconscious feelings to the surface

Working alliance with client

Work with the conscious parts that want to make a change to expose hidden unconscious

Toleration

Only go as far as the client can tolerate

• what would they allow themself to know?

Recognising defenses

Point out defenses in therapy

• humor: masks truth in jokes

• Intellectualising: masks through indifference

Allow time

Long time to put away these thoughts and feelings means a long time to bring them forth and accept them

How does development play a role?

• The past creates unconscious associations (phantasy)

• Painful experiences

• Events are seen in the eyes of a child (more extreme emotional experiences)

Children’s phantasies

• My parents are the world

• If my parents left me I would die

• Everything that happens is my fault

• I can kill people with my angry thoughts

• egocentric view

Patterns of relationships

• Relationship experiences throughout development make blueprints

• How we learn to love and expect to be loved

• Can be functional and dysfunctional

Transference

The transfer and repetition of early relationships in the therapy relationship

• therapy becomes a laboratory

• Judgemental father = expects judgement from therapist

counter-transference

Therapists’ own early relationships also influence the way they relate to a client

• need to separate own issues from client

Development of psychological problems

• Conflicts shaped by childhood experience

• Defence mechanisms try to push away conflicts, which creates further problems

• End up with unconsciously motivated patterns of behaviour

Strategies of psychodynamic therapy

• Free association to access unconscious material

• Transference to understand relationship patterns

• Interpretation and questioning to generate insight

• Create freedom and choice

Critique of psychoanalysis

• Early reliance on case study as primary method

• Untestable (too abstract)

• Unfalsifiable (“you just don’t remember because it’s unconscious”)

• Limited evidence

• lengthy and therefore inaccessible

• Hard to standardise