Chapter 12 - Psychodynamic Psychotherapy

psychodynamic psychotherapy

approach to psychotherapy deriving from the theories of Sigmund 

Freud, the primary goal of which is to be unconscious conscious

Sigmund Freud

pioneer of the psychodynamic approach to psychotherapy, known as psychoanalysis

psychodynamic therapists

help their clients become aware of thoughts, feelings, and other mental 

activities of which the clients are unaware of at the start of therapy

insight

primary goal of psychodynamic therapy; making the unconscious conscious

unconscious

mental activity occurring outside our awareness, cornerstone of the psychodynamic 

approach, exerts powerful sway over our lives, argue that unconscious processes underlie all forms of psychopathology

inferential

referring to the clinicians reliance on deduction or conjecture rather than empirical or 

directly observable information

free association

therapy technique in which psychodynamic therapists simply ask clients to say 

whatever comes to mind without censoring themselves at all, can be revealing of their innermost thoughts and feelings, involves no stimulus from therapist

word association

technique associated with Carl Jung, client responds with first word that 

comes to mind after hearing a word

Freudian slips

verbal or behavioral mistakes determined, according to psychodynamic therapists, by 

unconscious motivations, no such thing as a random mistake or slip of the tongue 

dreams

in psychodynamic therapy, an important means by which the client’s unconscious material is communicated, and a common focus of interpretation, Freud theorized that when we sleep, our minds convert latent content to manifest content

latent content

raw, unconscious thoughts and feelings represented by a dream

manifest content

the actual plot of the dream as remembered by the dreamer, which 

represents the latent content

dream work

process of converting the latent content of a dream to manifest content, uses symbols to express wishes, can result in unconscious wishes appearing in a very distorted form, therapist attempts to uncover the unconscious meaning behind the dreams

resistance

client behavior that impedes discussion or conscious awareness of selected topics or 

emotions, clients make it clear that they “don’t want to go there”, anxiety motivates them to create distractions or obstacles that impede the exploration of 

uncomfortable thoughts and feelings

defense mechanisms

techniques used by the ego to manage conflict between the id and superego

id

the part of the mind that generates and seeks immediate satisfaction for all the 

pleasure-seeking, selfish, indulgent, animalistic impulses, most biological and oblivious to consequences

superego

the part of the mind that establishes rules, restrictions, and prohibitions, what we “should” do, uses guilt to discourage overindulging 

ego

the part of the mind that manages conflict between the id and the superego and also meets 

the demands of reality; the part of the mind that generates defense mechanisms, faces challenge of partially satisfying both id and superego while also meeting the 

demands of reality

repression

defense mechanism in which the ego represses conscious awareness of conflict 

between id and superego, denial is similar, but refers to events that happen to us 

projection

defense mechanism in which the ego projects an id impulse onto other people, try to convince ourselves that the unacceptable impulse belongs to someone else, we attribute our objectionable qualities to others, and might be possible recipients of 

others unacceptable behaviors

reaction formation

defense mechanism in which the ego forms a reaction against the id impulse, 

resulting in a behavior opposite of the original id impulse, when id urges us to do something selfish, we do something selfless

displacement

defense mechanism in which the ego displaces an id impulse toward a safer target, we redirect the impulse toward another person or object to minimize repercussions, superego somewhat satisfied as well

sublimination

defense mechanism in which the ego redirects the id impulse in such a way that 

the resulting behavior actually benefits others, allows the id to do what it wants while helping others

transference

the tendency of clients to form relationships with therapists in which they unconsciously 

and unrealistically expect the therapist to behave like important people from the clients past, clients prejudge the therapist

interpretation

therapists attempt to formulate and discuss with the client a hypothesized connection 

between unconscious material and client behavior

working through process

often lengthy component of psychodynamic therapy in which the 

interpretations are reconsidered and reevaluated again and again, takes time to “sink in”

blank screen role

the therapist role in which little personal information is revealed to facilitate 

transference

countertransference

transference by the therapist toward the client, reaction to the client that is unconsciously distorted by the therapist's own personal experiences

fixation

unsuccessful resolution of the psychological tasks of a particular developmental stage, as children move through the developmental stages, they may become psychologically “stuck” at any one of them to some extent and may continue to struggle with issues related to that stage for many years

oral stage

the first of the psychosexual developmental stages, and the stage from which issues of 

dependency may emerge

underindulge in oral stage

children may learn that depending on others never works out, and that others 

have no interest in helping them at all, may develop overly mistrusting, suspicious, and pessimistic personalities

overindulge in oral stage

children may learn that depending on others always works out and that other 

people exist to meet their needs, may develop overly trusting, naive, unrealistically optimistic personalities and will form relationships accordingly

anal stage

second of the psychosexual developmental stages, the stage from which issues of control 

may emerge

too demanding during anal stage

children can become overly concerned about getting everything just right, children often grow to become adults who think obsessively and act compulsively in order to stay in control

too lenient during anal stage

children may become lax about organization, children often grow to become adults who are messy, unorganized, and sloppy

phallic stage

the third of the psychosexual developmental stages, and the stage from which issues of 

self-worth may emerge

too positive during phallic stage

children may grow into adults whose opinions of themselves are

unrealistically high and may be seen as egotistical

too negative during phallic stage

children may grow into adults who devalue themselves and 

are insecure and self-doubting

ego psychology

variation of psychodynamic therapy emphasizing the adaptive tendencies of the ego 

over the pleasure based drive of the id, exemplified by Erik Erikson and his eight-stage theory of development, revised Freud’s psychosexual stages to highlight social relationships

object relations school

variation of psychodynamic therapy deemphasizing internal conflict (id vs. 

superego) and instead emphasizing relationships between internalized objects (ex. important people from the clients life), led by Melanie Klein and colleagues

self psychology school

variation of psychodynamic therapy emphasizing parental roles in the child’s 

development of self, with special attention paid to the meaning of narcissism in various points, 

including in therapy, Hans Kohut

Karen Horney

critic of Freud, opposed many ideas that Freud had about girls and women feeling 

inferior to boys and men, influenced feminist theorists

brief psychodynamic psychotherapy

more efficient and increasingly common version of psychodynamic 

therapy, typically lasting about 6 months or less, more successful with mild and narrow problems, focus includes the present rather than the past

interpersonal therapy

specific, manualized, contemporary form of psychodynamic therapy that 

emphasizes interpersonal relationships and has received empirical support for the treatment of 

depression, derived from interpersonal school of psychodynamic thought, Harry Sullivan was the leader, developed in the 1980s

transference-focused therapy

manualized therapy that places strong emphasis on the unconscious 

transference of feelings and expectations by the client to the therapist, helps client understand transference towards other individuals in their daily lives, often used with clients with BPD

mentalization

ability to correctly identify your own feelings and the feelings of other people and 

how they connect or are separate from each other

allegiance effects

in psychotherapy outcome research, the influence of researcher’s own biases and 

preferences on the outcome of their empirical studies