Psychodynamic Therapies
Diane R. Gehart, Ph.D.
California State University,
Northridge
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Psychoanalytic and Psychodynamic
Theories
• First form of “talk therapy”; late 1800’s with
Sigmund Freud in Vienna
• Common threads
• Focus on analyzing inner life
• Focus on unconscious mental processes
• Life stage models; problems emerge when person
does not accomplish stage tasks
• Mental structures: ego, id, superego, collective
unconscious, etc.
• Transference and Counter-transference
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Major Schools of Psychodynamic
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Psychoanalysis (Freud)
Ego Psychology
Object Relations
Self Psychology
Jungian Psychology
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Freudian Analysis
• Deterministic: Personality and behavior fixed by 6
years old.
• Oedipal and Electra complexes.
• Drives
• Inability to manage sexual and aggressive drives creates
need for defense mechanism.
• Personality Structures
• Ego mediates between desires of Id and prohibitions of
Superego.
• Therapeutic Relationship
• Neutral “blank slate”
• Anonymity
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The Structure of Personality
• THE ID — The Demanding Child
• Ruled by the pleasure principle
• THE EGO — The Traffic Cop
• Ruled by the reality principle
• THE SUPEREGO — The Judge
• Ruled by the moral principle
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The Unconscious
• Unconscious revealed through:
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Dreams
Slips of the tongue
Posthypnotic suggestions
Material derived from free-association
Material derived from projective techniques
Symbolic content of psychotic symptoms
• NOTE: consciousness is only a thin slice of the total
mind
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Ego Psychology:
Anna Freud and Erik Erikson
• Ego Psychology
• Focus on defense mechanisms, considering
adaptive and maladaptive functions.
• Goals
• See the world as it is
• Build ego strength, the capacity of the go to
pursue its healthy goals in spite of threat and
stress
• Therapeutic Relationship
• Used to loosen rigid defense patterns
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Ego-Defense Mechanisms
• Ego-defense mechanisms:
• Are normal behaviors which operate on an
unconscious level and tend to deny or
distort reality
• Help the individual cope with anxiety and
prevent the ego from being overwhelmed
• Have adaptive value if they do not become
a style of life to avoid facing reality
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Defense Mechanisms
• Rationalization: Logical
defense to ward off feelings
• Reaction Formation: Act in
opposition to impulses
• Projection: Attribute to others
your way of being.
• Repression: Forget pain
• Suppression: Conscious
effort to push pain out of
consciousness
• Displacement: Take out
hostility on safer target.
• Denial: Refuse to “see”
problem.
• Sublimation: Transform sex
and aggressive drives to
acceptable behavior.
• Regression: Behave in less
mature way.
• Identification: Overcome
inferiority by allying with
more successful
person/group.
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Object Relations:
Fairbairn, Winnicott, Kernberg, Mahler
• Object: Mental representations of others, especially
early caregivers.
• Basic premise: Early patterns tend to be repeated, causing
problems in adult life.
• “Good Enough Mother”
• Responsiveness of mother key to emotional functioning of
child.
• If mother unable to balance care for physical needs with
child’s need for independence (support individuation), child
likely to develop pathology.
• Object Constancy and Splitting
• The inability to synthesize good and bad (to know that a
person who loves us may be mad at us, not give us what we
want, etc.) creates particularly destructive pattern of splitting.
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Self Psychology: Kohut
• Grew out of object relations, but focus is on “self” that
relates to the object.
• Like object relations, early relationships with caregivers is
believed to determine level of mental health.
• Sense of Self developed in first 3 years
• Infant needs “mirroring”
• Parents are “idealized” and later incorporated into the “ego
ideal”
• Chronic failure of parents to mirror child’s emotions creates
pathology.
• Therapeutic Relationship
• Empathetic immersion in client’s inner life, radically different
from other psychodynamic approaches
• Foster client introspection
• Uses self to encourage corrective emotional experiences 11
Jungian Psychology
• Added concept of “collective unconscious”
• Archetypes: persona, shadow, anima, animus, etc.
• Self actualization
• Living up to potential
• Stages of therapy
• Confession: share story
• Elucidation of transference and countertransference
• Education: new action in everyday life
• Transformation: self actualization
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Therapeutic Process
• Initial Stage
• Interpretation
• Confrontation
• Resistance
• Middles State: Working Through
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Client insight
Experiment with new ways of interacting
Gains in one area expanded to others
This phase can last for years
• Final State: Termination
• Loss
• Therapist seen less idealistically
• Past issues revisited in therapeutic relationship
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Areas for Potential Assessment
• Analysis of Ego Structure functions (analysis)
• Analysis of unconscious material to identify relational
patterns (analysis)
• Analysis of relationship with parents (analysis; ego;
obj)
• Defense mechanisms (ego)
• Level/functioning of ego strength (ego)
• Analysis of object-relations patterns (obj rel; self)
• Pattern of splitting (obj rel)
• Authentic Self (self)
• Level of self actualization (Jung)
• Influence of collective unconscious (Jung)
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Technique: Analysis of Transference
and Countertransference
• Transference
• The client reacts to the therapist as he did to an earlier
significant other
• This allows the client to experience feelings that would
otherwise be inaccessible
• ANALYSIS OF TRANSFERENCE — allows the client to
achieve insight into the influence of the past
• Countertransference
• The reaction of the therapist toward the client that may
interfere with objectivity
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Technique: Analysis of
Resistance
• Resistance
• Anything that works against the progress of therapy and
prevents the production of unconscious material
• Analysis of Resistance
• Helps the client to see that canceling appointments, fleeing
from therapy prematurely, etc., are ways of defending
against anxiety
• These acts interfere with the ability to accept changes which
could lead to a more satisfying life
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Other Psychoanalytic Techniques
• Free Association
• Client reports immediately without censoring any feelings or
thoughts
• Interpretation
• Therapist points out, explains, and teaches the meanings of
whatever is revealed
• Dream Analysis
• Therapist uses the “royal road to the unconscious” to bring
unconscious material to light
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Critique
• Feminist
• Oedipus and Electra Complexes
• Penis envy
• Good enough mother and mother blaming
• Heterosexual ennoblement
• Theory based on attraction to opposite sex
• Cultural limitations
• Emotional expression
• Unconscious and stereotypes
• Social class
• Cost
• Psychologically minded
• Lack of research
• Negativity
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