Week 2: psychodynamic approach

School of thought (Theories)

  • How therapists understand and support clients

  • each approach has specific ideas about human behaviour, emotions and change

Psychodynamic (unconscious):

  • lay the groundwork for understanding the unconscious mind, early childhood experiences, and personality development

  • key techniques:

    • encourages clients to speak freely without censorship

      • sharing thoughts, memories and feelings

    • openly expressing emotions, reduced anxiety and provided relief

  • Alistair Ross Chapter 3, Psychodynamic practice in Reeve’s (2022)

Humanistic (Growth):

  • represent a significant shift towards understanding an individual’s subjective experience and the importance of self-actualisation

psychoanalytic therapy

  • The foundational therapy of the psychodynamic approach

  • emphasises the role of the unconscious mind

    • unconscious desires, early childhood experiences, and the interactions between the id, ego and superego

  • Freud believed that unresolved conflicts from early childhood could cause adult psychological problems

  • psychological distress is the result of unresolved conflicts

    • unprocessed early experiences

    • unbalanced id, ego, superego

Psychodynamic approach: assumptions

  • id: what we’re aware of (immediate gratification)

    • basic desires (hunger)

    • primal, impulsive and unconscious from birth

    • no consequences

    • no morals

  • ego: what we can recall (rational mind)

    • ‘reality principle’

    • mediates id & superego

    • balances impulses

    • societal expectations

  • Superego: hidden; influence behaviour (moral conscious)

    • internalised societal norms

    • operates across all levels

    • strives for perfection

    • moralistic

    • guilt/shame

Ego

  • the ego mist resolve these conflicts to balance external reality

  • Excessive pressure from the id and superego can overwhelm the ego, leading to anxiety and defence mechanisms

Ego defence mechanisms

  • to manage internal conflict, the ego employs unconscious defence mechanisms

    • repression: pushing distressing memories into the unconscious

    • denial: refusing to acknowledge reality

    • projection: attributing one’s unacceptable thoughts to others

Therapeutic applications

  • understand internal conflicts

    • distress stems from conflicts between the id, ego, superego

    • conflicts are explored and processed in therapy

  • access unconscious

    • the unconscious can explain conflicts

    • Use Free association & dream analysis to access & understand the unconscious

  • Develop healthier coping strategies

    • therapy identifies defence mechanisms that protect internal conflicts (like projection)

    • alternative, healthier strategies are developed

  • strengthen ego

    • therapy aims to strengthen the ego to better mediate the id and superego

    • build self-awareness, tolerate distress, & respond to difficulties

Psychodynamic model in action: key components

Therapy relies on a “therapeutic frame” (rules) to create safety:

  • consistency = same room, same time, every week

  • Boundaries = transparent fees, endings, contract, confidentiality

suspended attention (therapist tool)

  • actively listening for insights into the unconscious

    • verbal language, body language, content of language or dreams