Psychodynamic- Mechanisms Of Change

Question 1

Insight

Answer 1

With the help of the therapist’s careful listening and interpreting, the patient may develop greater understanding of their intrapsychic and interpersonal dynamics and their origins. Such understanding may allow for greater flexibility in responding to internal and external stimuli.

Question 2

Relationship

Answer 2

Insight – or changes in feeling, thinking, or behaving – depend for their effectiveness on the positive, relational context in which they occur. That is not to say that the relational context will be free from strife.

Question 3

Mutual recognition

Answer 3

Developed through rupture and repair— “a relation in which each person experiences the other as a ‘like subject,’ another mind who can be ‘felt with,’ yet has a distinct, separate center of feeling and perception”

Question 4

Doer/done-to

Answer 4

one in which the subjectivity of only one member of a dyad is recognized and given voice, leading to the objectification and subjugation of the other member.

Question 5

“Analytic third”

Answer 5

a means by which such doer, done-to impasses can be broken. It can be said to involve both members of an analytic or therapeutic dyad surrendering or giving themselves over to the mutual, intersubjective, co-created process that is inevitable and yet so rarely acknowledged.

Question 6

A supportive treatment

Answer 6

A supportive treatment can be said to artificially co-create the illusion that the patient’s subjectivity is all that exists.
▪ This illusion, and the therapist’s consistent, benevolent regard, often leads to a positive transference (which may be idealizing, mirroring, or twinning).
▪ This positive transference is stabilizing, organizing, and leads to symptom-relief.

Question 7

Uncovering treatment

Answer 7

Uncovering work is more appropriate when the patient has such stability. In uncovering work, ruptures and negative transference need not be as quickly pacified – they can be explored for what they may reveal about the patient’s internal and interpersonal dynamics, and these can be modified and worked through.

Question 8

Robert Gordon’s Operationalized PDM and Nancy McWilliams’ Psychoanalytic Diagnosis

Answer 8

can help indicate whether a supportive or uncovering therapy might be more appropriate. They can also help a clinician determine someone’s level of functioning, personality style, and cognitive and affective styles. Treatment can then be adapted to provide what would be most helpful. As such, using these diagnostic aids can serve as mechanisms of change in their own right.