L5 - Psychodynamic therapy Flashcards
(31 cards)
analysis
an attempt to create a sphere where the unconscious can be brought to speak and be listened to
what are basic principles commonly accepted across all psychoanalytic disciplines (7)
- humans partly motivated by unconscious wishes, fantasies, knowledge
- increasing awareness of unconscious motivations can enhance personal choice
- crucial to explore how ppl avoid painful or threatening feelings + thoughts
- theres ambivalence about change that needs to be examined
- tr is essential for exploring self-defeating psych processes
- tr also a vital vehicle for change
- helping clients get how they construct past and present aids them in overcoming self-defeating patterns
what is needed for an analysis (4)
A) assumption
- something disturbs our ‘normal’ speaking and self construction -> this is the unconscious that we (client & clinician) strive to discover
B) analysand
- responsible for showing up and saying things that come to mind
C) analyst
- attempts to create a sphere where the unconscious can be brought ito speak and be listened to
D) setting
- analytic process reqiures a space and time where everything CAN be said and listened to
what is the analytic unconscious NOT
- everything that is NOT conscious
- localized in the brain or in the psyche or anywhere else
- the really deep true self
why do we engage in analysis? (3)
- provides a place for desire - free to have any fantasies and drems without censoring anything
- speaks from points where other theories stop
- asks important questions and expands range of possible answers
how to listen with a psychoanalytic ear (6)
- listen for anxiety, resistance and defense
- identification
- transference / countertransference
- how do associationsdevelop
- desire
- repetition
therapy vs analysis
therapy: attempts to attain therapeutic goals by speaking: fucnction better, feel better, have less symptoms etc.
analysis: The analyst aims to create a sphere where the unconscious can speak and be listened to. He or she does not have other aims than that and does not know what is good and bad for the analysand
basic themes (6)
- the unconscious
- fantasy
- primary and secondary processes
- defense
- transference
- one vs two person psychologies
models of unconscious
conflict theory
Intrapsychic conflict: different personality or chatacteristic styles result from compromise between underlying core wishes and characteristic styles of defense that are used to manage these views
models of unconscious
object relations theory
People develop internal representations of others based on early relationships, particularly with caregivers
Affects how people perceive, form and respond to relationships
models of unconscious
John Bowlby: attachment theory
within object relations theories
humans have an instinctual need to maintain proximity to primary caregivers for survival
- infants develop internal working models based on interactions with caregivers to predict behav. that maintain proximity vs threaten relationship
- these models influence how ppl dissociate experiences and feelings that could jeopardize these relationships
attachment theory vs object relations
AT: internal working models are based on actual interactions with caregivers
ORT: internal models are shaped by real experiences AND unconcsious fantasies
models of unconscious
Melanie Klein
within object relatios theories
infants born with instinctual fantasies of love and aggression. They split internal objects into “bad” and “good” to manage conflicting feelings - integration occurs over time
- Clinically rich but conceptually complex and abstract
models of unconscious
Ronald Fairbarn
internal objects form when children retreat from a painful reality and create internal fantasy relationships as substitutes
- adults may seek destructive and familiar relationships that feel “safe” –> addiction to internalized pattern
Klein vs Fairbarn
Klein: insight into severe psych disturbances and human destructiveness
Fairbarn: insight into clients to are addicted to self destructive romantic relationships
–> both emphasize impact of early relationships on later personality and relational patterns
models of unconscious
Winnicott’s theory
within developmental arrest model
developmental arrest:
subjective omnipotence: feeling of subjective omnipotence that mother will satisfy all needs
gradual disillusionment: but this eventually fails –> distinction between reality & fantasies
if failing is gradual enough: optimal disillusionment -> important for development of sense of self
if failing is too quick or intense: false self overcatering to others needs
models of unconscious
Kohut’s self psychology
cohesive sense of self: children need caregivers who provide adequate mirroring or attunement to their needs
empathic failures: inevitably caregivers fail in attunement or empathy but working through these failures is critical for a cohesive sense of self
therapeutic relationship: Both Winnicott and Kohut emphasize -> therapy involves forming a new kind of relationship w/ therapist which helps resume natural developmental process that was arrested
concepts concerning therapeutic interactions (5)
- transference
- countertransference
- resistance
- intersubjectivity
- enactment
therapeutic alliance
collaborative, good relationship is fundamental –> based on clients rational perspective which is DIFFERENT from transference
strength depends on bond & agreement on goals
mechanisms of therapy
making the unconscious conscious
Change involves making the unconscious conscious in a rational or reflective way
Awareness of unconscious wishes and defenses against them -> increase amount of choice available to us and assume a greater degree of agency
mechanisms of therapy
emotional insight
Combining the conceptual with the affective
-> client’s new understanding has an emotionally immediate quality to it
Done through the use of transference interpretations
-> client reflects on their immediate exprience of the therapeutic relationship by observing how they are interpreting things and how they’re acting in the here and now
mechanisms of therapy
creating meaning and historical reconstruction
Providing culturally normative psychological or psychoanalytic explanation for symptoms and emotional pain
- Tailored to client’s unique history and psychology -> becomes a meaningful and refined narrative
Understanding one’s own emotional problems as once adaptive responses in childhood, but now maladaptive can help client become more tolerant -> less self-blame
mechanisms of therapy
increasing and appreciating limits of agency
As clients gain appreciatioz of connections between symptoms, ways of being and own contributions to conflictual patterns it leads to
A growing awareness of one’s personal agency - experientially based
–> this helps them experience a greater degree of choice and experience themselves as agents rather than as victims
The other half is coming to terms with limits of own agency: Can’t have it all & that’s okay
mechanisms of therapy
containment
Because clients tend to project their negative threatening feelings onto the therapist (much like children to parents)
- E.g., the client who experiences nameless feelings of dread and terror dissociates these feelings and in subtle ways evokes these feelings in the therapist.
Therefore, attending to our own emotions as clinicians & the ability to tolerate and process painful or disturbing feelings in a nondefensive way is important
- We help the client to regulate their own emotios by responding this way and not deregulate them
