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B&B Week 8 Flashcards > Lecture 47: Psychodynamic Therapy > Flashcards

Lecture 47: Psychodynamic Therapy Flashcards

1
Q

What are the similarities between cognitive behavioral therapy and psychodynamic therapy (psychotherapy in general)?

A

Goals are:

  1. Stress reduction
  2. Support
  3. Education
  4. Non-judgmental, empathic stance
  5. Therapeutic alliance/safe environment
    • key in leading to good outcomes
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2
Q

Where is Psychodynamic therapy derived from?

A

Inspired by classical Freudian psychoanalysis, though applied with a broadened scope

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3
Q

What is the basic premise of psychodynamic therapy?

A

People act they do for a reason but they are NOT fully AWARE of these motivations

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4
Q

What is the theory of psychodynamic therapy?

A

PAST EXPERIENCES determine how people perceive themselves and their world in the present

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5
Q

What is the assumption of psychotherapy?

A

PATTERNS DEVELOP because of the mind’s desire to “replay” old psychological pain in an attempt to master it
-this is known as REPITITION COMPULSION

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6
Q

What is repetition compulsion?

A

The idea that the mind desires to replay old psychological pain in an attempt to master it
-this is how patterns develop in the mind

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7
Q

What is the technique of psychodynamic therapy?

A

Use of exploratory, open-ended questioning to uncover painful emotions and bring them to the surface

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8
Q

What is the anticipated outcome of psychodynamic therapy?

A
  1. Guide patient to gain insight into their patterns, which often manifest across multiple domains of life
  2. Goal is to help them TOLERATE painful emotions (instead of avoiding them) and increase self awareness, forming new perceptions and behaviors
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9
Q

What does literature show about psychodynamic therapy?

A

Short term psycho dynamic psychotherapies (STPP) appear effective for a broad range of common mental disorders
-evidence of modest to moderate bneefits which generally persist for the long term (Cochrane review)
-helps with panic disorder (statistically)
So this shit works, according to Carlino
-also found that psycho dynamic therapy vs. CBT are EQUALLY effective lmaooo wow so politically correct

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10
Q

What is the MOA of long term psychodynamic psychotherapy?

A

Shows that there were changes in the prefrontal-limbic function in major depression after 15 months of therapy
-neurobiological changes in emotion circuits were found
-decrease left anterior hippocampus/amygdala activity
-decreased subgenual cingulate
-decreased medial prefrontal cortex
Amount of functional brain change ~ amount of symptom improvement!!
Source: Buchheim et al. PLoS One

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11
Q

What is the unconscious mind?

A

The material that is NOT accessible by your conscious

-can only be revealed by dreams and Freudian slips lollll

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12
Q

What is the pre-conscious?

A

The shit that you are not thinking about now, but you can bring up (e.g. your 1st grade teacher)

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13
Q

What is Classical Freudian theory?

A

The structural model that consists of

i. The Id
ii. The Ego
iii. The Super-Ego
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14
Q

What is the Id?

A

The part of your unconscious that controls your Unorganized Instinctual Drives
-most basic mammalian drive

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15
Q

What is the Ego?

A

Devil on your shoulder

  • Maintains contact with reality
  • Controls motility, perception
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16
Q

What is the Super-Ego?

A

The Angel on your shoulder…Kaskade lmaoo

  • Our moral compass
  • compares one’s thoughts & feelings to an internal system of values/ideals
17
Q

What type of shit does the ego psychology grapple with?

A

Drives and impulses
-sexual, aggressive, attachment, mastery
Enters conscious mind as fantasies or ideas
Conflict arises between
-competing drives
-drives/societal/personal values
-drives vs. reality

18
Q

What is an example of pathology of ego psychology?

A

Man is unhappy with work
Gets impulse to tell boss to suck it
But super ego tells him to chill because he needs the money
Well, that leads to a defensive coping mechanism (lashing out at wife/kids)
Compromise Formation that leads to behavioral patterns (Mike lmaooo)

19
Q

What are the four main categories of ego defenses?

A
  1. Narcissistic Defenses
  2. Immature Defenses
    -Tammy lol (acting out, passive aggressive, regression, somatization)
  3. Neurotic Defenses
  4. Mature Defenses
    We all want to strive towards mature defenses (altruism, humor, sublimation, suppression)
20
Q

What are important types of Narcissistic defenses?

A
  1. Projection

2. Idealization/Devaluation

21
Q

What is projection?

A

A type of narcissistic defense
Deals with internal conflicts by FALSELY ATTRIBUTING his/her own unacknowledged feelings/impulses or thoughts onto another person
allows person to talk about feeling but not own the feeling..attributing to someone else

22
Q

What is idealization?

A

A type of narcissistic defense
The individual has intolerable feelings of powerlessness and weakness but compensates by:
-attributing exaggerated POSITIVE qualities to others (people, institutions, etc) that they associate with (being with the best makes you also the best loll)
Tammy lol

23
Q

What is devaluation?

A

A type of narcissistic defense
The individual has intolerable feelings of powerlessness/weakness but compensates by:
-attributing exaggerated NEGATIVE qualities to others to allow them to feel less vulnerable…is often derogatory/sarcastic
-Also Tammy lmaooo

24
Q

What are the important types of neurotic defenses

A
  1. Intellectualization
  2. Isolation of Affect
  3. Repression
25
Q

What is Intellectualization?

A

A type of neurotic defense
The individual deals with disturbing feelings by describing a situation with EXCESSIVE USE of abstract generalizations or 3rd person perspective
-thereby indirectly avoids direct experience of feelings

26
Q

What is repression?

A

A type of neurotic defense
DISTINCT from Denial and Supression
The individuals with unwanted instincts, emotions or ideas by being unable to remember or cognitively aware of their presence
-emotions are withheld or expelled from consciousness and relegated to the unconscious mind…you don’t deny that something happened but you don’t have the emotions associated with it and they can often break through in the form of involuntary behaviors (panic attacks)

27
Q

What is denial?

A

Completely disavowing reality; delusional

28
Q

What is suppression?

A

Consciously repressing an emotion so you can bring it up voluntarily later

29
Q

How do denial, repression and suppression compare among each other?

A

Denial is most primitive
Repression is second most primitive
Suppression is most mature
Repression = I don’t feel guilty about those children dying
Denial = I don’t think that those children actually died…

30
Q

What are the two techniques in psychodynamic therapy?

A
  1. identifying core problem and using that as focus

2. Transferance

31
Q

How does a psychodynamic therapist identify a core problem?

A

-therapist must construct a formulation of patient
-formulation distills the historical data about patients inner/external life in a single theme or pattern
-draws from understanding of the critical conflicts that a patient is experiencing and the defenses employed to resolve them
Pattern recognition is key
Common underlying patterns

32
Q

What are the 6 most common core problems?

A
  1. Depression
    • patterns of loss/rejection
  2. Low self-esteem
    • patterns of self-doubt
  3. Trauma
    • patterns of trust/safety
  4. Fear of abandonment
    • patterns of attachment/independence
  5. Obsessionality
    • patterns of control/resentment
  6. Panic Anxiety
    • patterns of fear of separation, anger
33
Q

What are the key characteristics of panic anxiety as a core problem?

A 
Symptoms: acute paroxysms of anxiety
Panic attacks are the unconscious conflicted feelings that BREAK THROUGH to the surface (according to psychodynamic theory)
	-patient feels dependent on loved one
	-fears potential loss
	-feels resentment/anger about this
	-represses this anger
34
Q

What are the goals of treatment for patients with panic anxiety?

A

Increased independence and ability to be ASSERTIVE without being overwhelmed by anxiety and angers

35
Q

What are the key characteristics of transference?

A

The replay of feelings, thoughts and perceptions about early relationships WITH THERAPIST

- people often will repeat patterns from old relationships in their current relationships (including therapist)
- therapist is a blank screen 
- patient may associate ideas/feelings with therapist nevertheless
- becomes a tool for helping the patient understand self

B&B Week 8 Flashcards (12 decks)

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