Lecture 2 Notes: Psychotherapy

Types of Therapy

There are various therapeutic approaches available, and therapists may be trained in one or use techniques from different methods to help a client. The choice of therapy can be limited by access, but private therapists offer more options. The therapist-client relationship is generally more important than the specific approach used.

Adlerian Therapy

Developed by Alfred Adler, also known as individual psychology. It posits that early life experiences, especially within the family, shape our worldview and reactions. Unconscious logic and goals developed in childhood govern adult behavior. Therapists help clients understand their behaviors to find better ways of reacting.

Other Therapies

• Animal-assisted therapy: Uses interaction with animals to explore difficult feelings.

• Creative therapies: Include visual arts, dance movement, drama, music, writing, and sand play to express feelings beyond traditional talking therapies.

• Family therapy: Involves family members expressing and exploring difficult thoughts and emotions.

These therapies assume people repress uncomfortable feelings into their unconscious mind which need a safe setting to be explored.

Freud's Influence

All these therapies are derived from the work of Sigmund Freud.

Clinical Psychology Lecture 2: Psychotherapy

Lecture Sections

1. A Life of Freud

2. Origins of Psychotherapy

3. Defense Mechanisms

4. Psychotherapy: Career Paths

Section 1: A Life of Freud

Freud's Impact

Freud's concepts like unconscious motives, id, ego, superego, Oedipus complex, defense mechanisms, repression, and Freudian slips have become part of popular culture.

Freud's Early Life

• Born on May 6, 1856, in Freiberg, Moravia (now Příbor, Czech Republic).

• Moved to Vienna at age 3.5 due to his father’s bankruptcy.

• Lived at Berggasse 19 in Vienna until 1938.

Freud's Family

• Father: Jacob Freud, described as warm but weak, with an unsuccessful wool business.

• Mother: Amalia Nathansohn, described as vain and demanding.

Freud's Childhood

When his brother Alexander was born, Freud emphasized Alexander the Great's exploits.

Freud rejected his father due to financial failures.

In "The Interpretation of Dreams", Freud tells a story where his father was subjected to antisemitism and complied meekly, causing Freud to admire Hannibal.

Freud's Mother

Referred to Sigmund as "My Golden Sigi" and favored him.

His sister's piano was removed when it disturbed him.

His niece described his mother as shrill, domineering, charming to strangers, but tyrannical to family.

Even when Freud was over seventy, his mother still caused him stomachaches.

Freud's Education

• An outstanding student, first in his class for 6 years.

• Fluent in Greek, Latin, German, and Hebrew; knew French, German, Spanish, and Italian.

• Started reading Shakespeare at age 8.

• Family life revolved around his studies.

• Controlling towards his sisters, stopping them from reading racy novels or expressing emotions openly.

Freud's Marriage

In 1882, met Martha Bernays and married her in 1886 after four years and over 900 letters.

Freud's Children

Favored his youngest daughter, Anna.

Anna Freud

Became a psychoanalyst and remained loyal to Freud’s teachings.

Departure from Vienna

The political climate in Germany changed and in 1933, Freud’s books were burned.

Freud wrote, "What progress we are making. In the Middle Ages they would have burnt me; nowadays they are content with burning my books."

• In 1925, Freud noted the rise of anti-Semitism in Germany and Austria.

• In 1930, received the Goethe Prize for his writings in German.

Escape from Vienna

On March 22, 1938, Anna Freud was arrested by the Gestapo.

Freud spent the day pacing and smoking cigars.

With intervention and funds from Princess Bonaparte, Freud and his family escaped.

Four of his five sisters died in concentration camps.

Final Years in London

The Freuds moved to Maresfield Gardens, London in 1939.

Freud died in his study.

Section 2: Origins of Psychotherapy

Joseph Breuer

• A well-respected physician in Vienna.

• Married to Mathilde Altmann with five children.

• Modest and kind.

• Discovered the role of the vagus nerve in respiration.

• Inventor of Psychoanalysis

Bertha Pappenheim

• Met Breuer in 1880 when she became ill after nursing her dying father.

• Displayed strange behaviors, including partial paralysis.

• Breuer found no physical basis for her symptoms.

• Bertha was intelligent but lived a monotonous life in a puritanical family.

• Denied higher education while her brother pursued a professional career.

Cathartic Method

• Breuer developed the cathartic method, which they called "the talking cure" or "chimney sweeping."

• Recovered unconscious memories and expressed repressed emotions.

• Bertha devoted herself to abolishing trafficking of poor girls from Eastern Europe and became Germany's first social worker.

• She got a stamp in honor in 1945

Studies in Hysteria

Freud and Breuer published "Studies in Hysteria" in 1895, including Bertha’s case as ‘Anna O.’.

Freud increasingly disagreed with Breuer and minimized his role in psychoanalysis.

Freud and Breuer's Relationship

Breuer withdrew from psychology to focus on his medical practice.

Breuer had supported Freud financially and professionally.

Freud cut Breuer out of his life after "Studies" was published.

The Vienna Psychoanalytical Society

Freud built his reputation through the Wednesday Psychoanalytical Society in Vienna.

Attracted devoted followers like Otto Rank, Alfred Adler, and Carl Jung.

Intolerance of Dissent

Freud's insistence on being right led to purges of members who disagreed with him, including: Alfred Adler, Wilhelm Stekel, Otto Rank, Carl Jung, Sandor Ferenczi, and Joseph Breuer. 'The Committee' Earnest Jones was an early member.

British Psychoanalytical Society

Founded in 1919 by Ernest Jones in London.

Strictly Freudian.

Later split into Freudian, Kleinian, and Independent groups due to infighting between Anna Freud and Melanie Klein.

Melanie Klein focussed on children and developed use of dolls and other appropriate aids..

Divided Opinions

Philosophers and psychologists had postulated an unconscious mind before Freud.

Eysenck (1985) stated that Freud’s theories were not new or true.

Gedo (2002) argued that Freud’s discovery was that conscious thinking is the exception rather than the rule.

Unconscious Rationalizations

Wilson & Nisbett (1978) conducted a study on electric shocks. Participants were given intense electric shocks

• Experimental Group reassured beforehand "but of course they won't do any permanent damage”.

• Control Group told later.

The two groups did not differ in the shock level they said they’d endure (Exp: $3.3V$; Con: $3.48V$).

A large proportion of the Experimental Group thought that prior reassurance of a lack of permanent damage had increased their willingness to accept shock!

Halo Effect

Nisbett & Wilson (1977) showed participants videos of a teacher with ‘warm’ or ‘cold’ teaching styles.

Evaluations of the teacher’s mannerisms were influenced by the teaching style.

Participants got matters precisely backwards. Their liking for the teacher was manipulated, and this affected their ratings of particular attributes (e.g. mannerisms).

Section 3: Defense Mechanisms: Repression

Repression

Freud (1896, 1926) focused on defense mechanisms against aversive thoughts and feelings, with emphasis on Repression.

Freud (1915) described repression as turning something away from consciousness.

Freudian Repression of Memories

Anderson & Green (2001) used the think/no-think procedure where participants trained with word pairs and then either said the associated word out loud or suppressed it.

Suppression Hypothesis

The suppression hypothesis states that suppression is not the result of diversionary strategies or weakening associations, but direct inhibition of the target.

Associative Interference

Anderson & Green (2001) found that recall suppression proceeded well even with an independent cue.

Withholding Recalled Response

Anderson & Green (2001) told participants to guess if unsure and gave them money for correct answers; the independent cue result remained intact.

Regulation of Consciousness

Anderson & Green (2001) stated that regulation is achieved by an inhibitory control mechanism that suppresses the unwanted memory itself.

Selective Repression

Lambert et al. (2010) researched if think/no-think suppression and Freudian repression arise from common mechanisms and suppression would be more responsive to emotionally negative material.

Suppression to negative words was seen in both Trained and Independent Cue conditions.

Suppression of Positive Words

Lambert et al. (2010) found that suppression did not occur with positive words in either condition.

Suppression/repression was selective for negative words, as per Freud’s original formulation.

Voluntary Repression

Lambert et al. (2010) suggested that the TNT task represents a laboratory analogue of voluntary repression.

Neurological Basis of Repression

Freud, a “biologist of the mind” (Sulloway 1979), awaited validation through brain scanning techniques (Gedo, 2002).

Anderson et al. (2004) found increased activity in the dorsolateral prefrontal cortex and decreased activity in the hippocampus during suppression trials.

The cortex suppressing hippocampal memory ‘function’.

Inhibitory Control

Apšvalka et al. (2022) proposed that the lateral prefrontal cortex exerted inhibitory control over motor circuity and recall of emotionally aversive memories via the hippocampus.

Stop-Signal Task

Apšvalka et al. (2022) required participants to learn both a stop-signal task and a think/no-think task.

5/30 participants did not reach the 40% learning criterion on the Think/No-Think task and fell asleep during fMRI.

Cross-Task Correlation

Apšvalka et al. (2022) found that participants’ inhibitory performance on the stop-signal motor task correlated with their performance on the think/no-think task, suggesting a common neural mechanism being at work.

Section 4: Psychotherapy: Career Paths

Resources

NHS Inform provides information on counselling and psychotherapy.

BACP (British Association for Counselling and Psychotherapy):

The BACP Provides information about therapy options and a therapist directory for finding therapists.

BACP Training Stages

1. Introduction to counselling: Taster courses at further education colleges (8-12 weeks).

2. Certificate in counselling skills: Understanding theories, ethics, and self-awareness (1 year part-time at local colleges).

3. Core practitioner training: In-depth professional program at higher education colleges/universities (1 year full-time, 2 years part-time).

BACP has an accredited courses directory

UKCP (UK Council for Psychotherapy)

The UKCP provides a register and means for finding accredited psychotherapists.

Has information on training courses.