Psychodynamic Therapy for Substance Abuse

Flashcards reviewing key concepts and terms related to psychodynamic therapy for substance abuse.

Psychodynamic Therapy

Focuses on unconscious processes as they manifest in present behavior. Goals include self-awareness and understanding the past's influence on present behavior.

Self-Psychology

Developed in Chicago, this psychology posits that individuals with substance abuse disorders suffer from a weakness in their sense of self.

Kohut's Postulation

States that persons suffering from substance abuse disorders also suffer from a weakness in the core of their personalities--a defect in the formation of the "self."

Drug Ingestion (Self-Psychology)

Substances provide the user with self-esteem and feelings of acceptance and strength, which they lack.

Long-term Psychodynamic Therapy

Requires at least 2 years of sessions to change identity or integrate missed key developmental learning.

Brief Psychodynamic Therapy

Believes changes can happen more rapidly, or a short intervention can start an ongoing process without constant therapist involvement. Focuses on one major issue.

Typical Length of Brief Psychodynamic Therapy

No more than 25 sessions, focusing on substance abuse in association with a core conflict within an interpersonal framework.

Supportive-Expressive (SE) Psychotherapy

Brief psychodynamic approach adapted for substance abuse disorders, modified for opiate and cocaine use disorders.

Core Conflictual Relationship Theme (CCRT)

At the center of a person's problems, developing from early childhood experiences. Awareness can improve behavior control.

Core Response from Others (RO)

A person's predominant expectations or experiences of others' reactions to them.

Core Response of the Self (RS)

A combination of somatic experiences, affects, actions, cognitive style, self-esteem, and self-representations.

Wish (in CCRT)

Reflects what the client yearns for, largely based on individual personality style.

Psychodynamic Theories

Provides coherent explanations for intrapsychic and interpersonal workings.

Therapeutic Alliance

The alliance between therapist and client, a very important factor in successful therapeutic outcomes.

Transference

The process of transferring characteristics of unresolved conflicted relationships onto the therapist.

Wurmser's theory

Suggests substance abusers have overly harsh superegos, and substance abuse is an attempt to flee from dangerous affects.

Goals of Modified Dynamic Group Therapy (MDGT)

The development of affect tolerance, the building of self-esteem, the discussion and improvement of interpersonal relationships and the development of appropriate self-care strategies.

Khantzian's theory

Suggests deficits, rather than conflicts, underlie substance abuse disorders such as weakness or inadequacies in the ego or self.

Self-Medication Hypothesis

States that substance abusers will use substances to medicate specific distressing psychiatric symptoms.

Krystal's Object-Relations Theory

Explains the substance abuser experiences the substance as the primary maternal object and relates to the substance in maladaptive relationship patterns experienced developmentally with the mother.

McDougall's View of Substance Abuse

Views problems as a psychosomatic disorder. Deals with distress that involves externalizing and making physical what is essentially a psychological disturbance

Developmental Level

The client's level of functioning should determine the nature of any intervention

Insight (Psychodynamic Theory)

Regarded as a particular kind of self-realization or self-knowledge, especially regarding the connections of experiences and conflicts in the past with present perceptions and behavior and the recognition of feelings or motivations that have been repressed.

Defence Mechanisms

Bolster the individual's ego or self when under pressure from anxiety. The measures taken to do this are referred to as defence mechanisms.