Psychoanalytic Approach
Welcome to this video about the psychoanalytic approach, which is a therapeutic model based on the classic psychoanalysis theory developed by Sigmund Freud, an Austrian neurologist, around the beginning of the 1900s. The psychoanalytic approach acted as a foundation to today’s psychodynamic therapy, though psychodynamic therapy also incorporates some of the ideas of those who followed Freud, such as Carl Jung, Alfred Adler, Melanie Klein, and Erik Erikson. Psychodynamic therapy is used primarily to treat depression and anxiety.
Sigmund Freud’s psychoanalysis theorized that the unconscious mind shaped a person’s feelings, ideas, and behavior, and this remains central to psychodynamic therapy. His psychoanalytic theory included the following concepts:
Freud believed that the personality was divided into 3 components: the id, ego, and superego:
- First, the id is present at birth and represents the pleasure principles. The id is the basis of the instinctual drive for pleasure and gratification.
- Second, the ego develops from the id during an infant’s first 3 years of life. The ego represents the reality principle as it strives to modify the responses of the id, such as through delayed gratification, so that they are socially acceptable.
- And third, the superego develops between ages 3 and 6 and represents unconscious, internalized ideals and morality derived from interactions with parents and other authority figures. According to Freud, the superego is composed of the ego-ideal (internalized values) and the conscience (which experiences guilt).
Freud also described the mind as composed of three categories:
- The conscious, which includes memories of which the person is aware, comprising about 10% of total memories
- The preconscious, which includes memories that may be forgotten but can be retrieved, comprising about 10% to 15% of total memories
- And the unconscious, which includes all memories that cannot be easily retrieved because they are not important, are unpleasant, or are repressed, comprising 75% to 80% of total memories
Another Freudian concept is that of defense mechanisms. Sigmund Freud believed that defense mechanisms helped people to unconsciously protect themselves from anxiety. Common defense mechanisms include repression, regression, sublimation, and displacement.
Freud also believed that mental functioning required psychic energy in order to fulfill basic needs and to divert energy from the id to the ego and then to the superego. Freud labeled this psychic energy the libido, believing that it was always seeking pleasure and gratification and was the driving force behind all types of behavior, not just sexual behavior.
Freud also developed the concept of transference and countertransference. Transference occurs when the client experiences thoughts about or feelings toward the therapist that were originally directed at another person in the client’s life. Countertransference is when the therapist responds to a client based on something in their own life, not the client’s. Both types of reactions may be positive or negative.
Now, let’s consider how Freud’s psychoanalytic theory is incorporated into psychodynamic therapy today.
While many approaches to psychological therapy, such as cognitive behavioral therapy, focus on the present, psychodynamic therapy focuses instead on how the past, such as early childhood experiences, has influenced the present so that this understanding of the past can lead to changes in the present.
Central to psychodynamic therapy is the understanding of the role of the unconscious and the belief that repressed memories in the unconscious mind, especially of traumatic events, lead to depression, anxiety, or other disorders.
Psychodynamic therapy supports the idea that unconscious factors over which the individual has no control are the basis of behavior rather than free will, although it recognizes the effects of social factors as well as instincts, which are represented by the id. It focuses on the relationship of the therapist and client as well as the client’s relationship to others and the world in general.
Psychodynamic therapy usually dispenses with the couch and has the client sit face-to-face with the therapist. It lasts longer than many other types of therapy, often occurring one or two times weekly for months or years. Sessions are typically lightly structured; the therapist may ask some guiding questions but avoids giving their own opinions.
Brief psychodynamic therapy is another approach that usually limits visits to 25 to 40 sessions, still long in comparison to many other types of therapy, and tends to focus on specific problems and goals rather than the free association usually encouraged in the more common approaches. In brief psychodynamic therapy sessions, the therapist takes a more active role in keeping the client focused.
One form of brief psychodynamic therapy, for example, is called supportive-expressive psychotherapy and focuses on addressing substance abuse disorders.
Basic assumptions of psychodynamic therapy include:
- The idea that there is an underlying cause to all behavior and that behavior originates in the unconscious
- Different components of the unconscious are in conflict with each other
- Adult emotions and behavior are products of experiences that occurred during childhood AND
- Both internal and external processes are contributors to the adult’s personality
Techniques and concepts from psychoanalysis that are also often used in psychodynamic therapy include:
- Free association: The client is free to guide the conversation in any direction. Another type of free association occurs when the therapist uses a more formal approach and provides a word, such as mother, and asks the client to respond with whatever words or thoughts come to mind without censoring them.
- Dream analysis: Psychodynamic therapy recognizes dreams as representing the unconscious mind and utilizes dream analysis to access the unconscious urges of the client. The dreams are believed to represent the conflicts within the client that produce symptoms, such as anxiety.
- Memory retrieval: The therapist helps the client to explore and learn from emerging memories.
- Transference and countertransference: Psychodynamic therapy integrates this into the therapeutic relationship, exploring the transference of feelings from an earlier relationship toward the therapist in order to help the client understand the unconscious basis of the feelings. The therapist also recognizes his or her own negative or positive countertransference in order to maintain appropriate boundaries.
- Defense mechanisms: Psychodynamic therapy helps clients recognize their defense mechanisms, such as avoidance, and the effects on their behavior in order to explore ways to develop more effective defense mechanisms.
- Pattern recognition: Psychodynamic therapy helps clients to recognize negative patterns, such as recurring thoughts, emotions, behaviors, or relationships, in order to develop more positive patterns.
- Rorschach inkblots: The psychodynamic therapist may show a Rorschach inkblot to a client and ask the client to describe the image because this can provide information about the client’s thoughts and feelings.
- Freudian slips: Psychodynamic therapists help clients to explore Freudian slips, believing they are meaningful rather than accidental misstatements.
The primary goals of psychodynamic therapy are to help the client to gain self-awareness and to understand how the past has influenced the present. Through this process, the client can begin to recognize patterns of thought and behavior and to develop strategies to modify them.
That’s all for this review. Thanks for watching, and happy studying!