2.Psychodynamic Approach

Psychodynamic Theories of Behavior

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Freud’s Theories: Freud was originally trained as a Neurologist- biological approach to illness Treated mostly Hysteria (conversion disorders) Applied findings from abnormal patients to “normal” development Father of psychoanalysis: powerful mentam processes ‘hidden’ from consciousness( the unconscious, preconscious, conscious) Oedipus complex Key Contributions of Freud Psychic Determinism/ Dynamic Model Topographical Model of the Mind Unconscious, Preconscious, Conscious Structural Model of the Mind Stages of Psychosexual Development Defense Mechanisms Transference and Countertransference Basic Principles of Psychodynamics Freud sees people as passive; behaviors determined by interaction of external reality and internal drives Psychic Determinism: all behaviors driven by antecedent events, experiences. There are no accidents; nothing happens by chance Pleasure Principle: constant drive to reduce tension thru expression of instinctual urges Mind is a dynamic (changing/active) process based on the Pleasure Principle Libidinal (sexual, aggressive) instincts drive people In children “libido” isn’t purely sexual, it’s pleasure thru sensations (oral, anal gratification, etc.) Behaviors result from conflicts: Between instinctual libidinal drives (aggression, sex) and efforts to repress them from consciousness) Cathartic Method Therapy benefits thru release of pent-up tensions, “catharsis” Some inherent value in the “talking cure”- being able to “unload”, or “get stuff off your mind” Transference Displacement (false attribution) of feelings, attitudes, behavioral expectations and attributes from important childhood relationships to current ones Traditionally refers to what the patient projects onto the therapist, but applies to other situations as well- ex. relationships in general Aka “emotional baggage” Occurs unconsciously (person’s unaware they’re doing it) Countertransference Feelings toward another are based on your own past relationships/ experiences. Traditionally refers to the therapist projecting their own feelings (“issues”, “emotional baggage”) onto their patient Topographical Model Freud’s first model of psychopathology Division of the mind into three different layers of consciousness: Unconscious Contains repressed thoughts and feelings Unconscious shows itself in: Dreams Hypnosis Parapraxes (Freudian slips) A “slip of the tongue” Errors of speech or hearing that reveal one’s true but unconscious feelings Driven by Primary Process Thinking Not cause-effect; illogical; fantasy Only concern is immediate gratification (drive satisfaction) Does not take reality into account

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Seen in dreams, during hypnosis, some forms of psychosis, young children, psychoanalytic psychotherapy Preconscious Accessible, but not immediately available Always running in the background/ behind the scenes Conscious Fully and readily accessible Conscious mind does not have access to the unconscious Utilizes Secondary Process Thinking: Reality-based (takes external reality into consideration), logical, mature, time-oriented Psychosexual Development Children pass thru a series of age-dependent stages during development Each stage has a designated “pleasure zone” and “primary activity” Each stage requires resolution of a particular conflict/task Psychosexual Stages Failure to successfully navigate a stage’s particular conflict/ task is known as Fixation  Leaving some energy in a stage Specific problems result from Fixation, depending on which stage is involved  Fixation may result from environmental disruption Freud's stages are based on clinical observations of his patients The Stages are: Oral Birth to 18 months Pleasure Zone: Mouth Primary Activity: Nursing Fixation results in difficulties with trust, attachment, commitment Fixation may also manifest as eating disorders, smoking, drinking problems Anal 18months- 2yrs Pleasure Zone: Anus Primary Activity: Toilet training Failure to produce on schedule arouses parental disappointment Parental disappointment, in turn, arouses feelings in child of anger and aggression towards caregivers, which are defended against Fixation may result in either: Anal retentiveness: perfectionism, obsessive-compulsive tendencies Anal expulsive: sloppy, messy, disorganized Phallic Ages 3-6 Pleasure Zone: Genitals Primary Activity: Genital fondling Must successfully navigate the Oedipal Conflict Oedipal Conflict – Boys want to marry mom and kill father, aka Oedipal Complex, but fear retaliation from father (castration anxiety); ultimately resolved thru identification with father Electra Complex – Girls have penis envy, want to marry dad, identify with mom to try to win dad’s love Resolution of the Oedipal Conflict results in formation of the Superego Fixation results in attraction to unattainable partner Latency Ages 6-11 Pleasure Zone: Sex drive is rerouted into socialization and skills development Primary Activity: Same sex play; identification of sex role Don’t like opposite sex Fixation results in lack of initiative, low self esteem; environmental incompetence

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Genital Ages 13- young adulthood Pleasure Zone: Genitals Primary Activity: Adult sexual relationships Fixation results in regression to an earlier stage, lack of sense of self

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Structural (Tripartite) Theory Freud’s second model of the mind to explain psychopathology Developed in the early 1900’s The ID Home of instinctual Drives “I want it and I want it NOW” Completely unconscious Present at birth Operates on the Pleasure Principle and employs Primary Process Thinking Pleasure Principle: constant drive to reduce tension thru expression of instinctual urges Primary Process Thinking: Not cause-effect; illogical; fantasy; only concern is immediate gratification (drive satisfaction) The Superego Internalized morals/values- sense of right and wrong Suppresses instinctual drives of ID (thru guilt and shame) and serves as the moral conscience Largely unconscious, but has conscious component Develops with socialization, and thru identification with same-sex parent (via introjection) at the resolution of the Oedipal Conflict Introjection: absorbing rules for behavior from role models Conscience: Dictates what is proscribed (should not be done); results in guilt Ego-Ideal: Dictates what is prescribed (should be done); results in shame The Ego Created by the ID to help it interface with external reality Mediates between the ID, Superego, and reality Partly conscious Uses Secondary Process Thinking: Logical, rational “Ego” Defense Mechanisms The Ego employs “ego defense mechanisms” They serve to protect an individual from unpleasant thoughts or emotions Keep unconscious conflicts unconscious Defense Mechanisms are primarily unconscious Result from interactions between the ID, Ego, and Superego Thus, they’re compromises: Attempts to express an impulse (to satisfy the ID) in a socially acceptable or disguised way (so that the Superego can deal with it) ess mature defenses protect the person from anxiety and negative feelings, but a at price Some defense mechanisms explain aspects of psychopathology: Ex. Identification with aggressor: can explain tendency of some abused kids to grow into abusers

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Primary Repression Conflict arises when the ID’s drives threaten to overwhelm the controls of the Ego and Superego Ego pushes ID impulses deeper into the unconscious via repression Material pushed into unconscious does not sit quietly- causes symptoms

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Classification of Defenses a. Mature Altruism - Unselfishly assisting others to avoid negative personal feelings Anticipation - Thinking ahead and planning appropriately Humor Sublimation - Rerouting an unacceptable drive in a socially acceptable way, redirecting the energy from a forbidden drive into a constructive act. A healthy conscious defense, for e.g. Martial arts Suppression - Deliberately (consciously) pushing anxiety-provoking or personally unacceptable material out of conscious awareness b. Immature Acting Out - Behaving in an attention-getting, often socially inappropriate manner to avoid dealing with unacceptable emotions or material Somatization - Unconscious transformation of unacceptable impulses or feelings into physical symptoms Regression- Return to earlier level of functioning (childlike behaviors) during stressful situations Denial - Unconsciously discounting external reality Projection- Falsely attributing one’s own unacceptable impulses or feelings onto others. Can manifest as paranoia Splitting- Selectively focusing on only part of a person to meet a current need state; seeing people as either all-good or all-bad. It Serves to relieve the uncertainty engendered by the fact that people have both bad and good qualities and considered normal in childhood Dissociation -Mentally separating part of consciousness from reality; can result in forgetting certain events Reaction Formation - Transforming an unacceptable impulse into a diametrically opposed thought, feeling, attitude, or behavior; denying unacceptable feelings and adopting opposite attitudes Repression - Keeping an idea or feeling out of conscious awareness. Its the primary ego defense to which Freud postulated that other defenses are employed only when repression fails. Magical Thinking - A thought is given great power, deemed to have more of a connection to events than is realistic Isolation of Affect - Stripping an idea from its accompanying feeling or affect and idea is made conscious but the feelings are kept unconscious Intellectualization - Using higher cortical functions to avoid experiencing uncomfortable emotions; thinking without accompanying emotion Rationalization -Unconscious distortion of reality so that it’s negative outcome seems reasonable or “not so bad, after all” (making lemonade out of lemons) and giving seemingly reasonable explanations for unacceptable or irrational feelings Displacement- Redirection of unacceptable feelings, impulses from their source onto a less threatening person or object Narcissistic Neurotic (incapable of enjoyment and efficiency)

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The process of psychoanalysis Stimulate ‘ego’ to fight ‘id’s demands To restore order to the ‘ego’ by detecting materials from the uncosncious 5 key elements: stability, anonimity, passivity, free-floating attention, neutrality

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Carl JUNG "Everything that irritates us about others can lead us to an understanding of ourselves."  Wholly unprepared, we embark upon the second half of life . . . we take the step into the afternoon of life . . . with the false assumption that our truths and ideals will serve as before. But we cannot live the afternoon of life according to the program of life’s morning—for what was great in the morning will be little at evening, and what in the morning was true will at the evening have become a lie. For a young person it is almost a sin, or at least a danger to be too preoccupied with [the] self; but for the aging person it is a duty and a necessity to devote serious attention to [the] self.  Carl Jung (1933) History of Analytical Psychotherapy  Carl Jung : 1902-1909 worked in a psychiatric hospital where he developed his Word Association Test  Jung appointed as president of the International Psychoanalytic Association  Jung and Freud part because of creative and personality differences  The break was solidified after Jung published The Psychology of the Unconscious in 1911 – Revised in 1956 as Symbols of Transformation.  Over the next decade Jung had a period of extreme introversion.  1921 Jung published Psychological Types Current Status of Analytical Therapy  In 2003, International Association for Analytical Psychology had 2,500 certified members in 28 countries and 48 professional societies.  Jungian analysis remains a prerequisite for providing analysis  How to deal with multiculturalism created rifts  One group sought ways to address multicultural, gender, and aging issues  More traditional group rejected the idea of reinterpreting i.e., “watering down” Jung’s words Basic Concepts PSYCHE  Jung defined psyche as the inner realm of personality that balanced the outer reality  The psyche consist of spirit, soul, and idea  Jung’s view of the mind was similar to Freud’s except he believed the unconscious also included undeveloped parts , elements from the collective unconscious , and material unimportant to the psyche. Two Aspects to the Psyche  Conscious /Unconscious 1. Accessible /Not accessible 2. Comprised of one’s senses, intellect/ Comprised of personal experience, 3. Emotions and desires forgotten or denied or collective /unconscious  Vast, hidden psychic resource shared by humans  Jung found a basic motif across individuals in their dreams, fantasies, etc.  Jung defined the collective unconscious as the portion of the unconscious universal to all humans  Images from the collective unconscious are shared by all but modified by our own personal experiences Archetype Organizing principle Universal Symbols: IMAGERY  System of readiness  Dynamic nucleus of energy  An archetype can be viewed as the pathway for communication between collective unconscious and conscious

Mandala  Jung became intrigued with Mandala as a symbol of an archetype of wholeness and of the center of personality  A geometric figure in which a circle and square lie within each other, and each is further subdivided.  Various ritualistic geometric designs symbolic of the universe, used in Hinduism and Buddhism as an aid to meditation  Jung viewed the mandala as an artistic expression of the self Types of Archetypes 1. The Great Mother Goddess 2. The Night Sea Journey 3. The Inner child 4. The Maiden 5. The Heroic Quest 6. The Wise Old Man 7. The Wise Old Woman Comparing Jung and Other Theories  While Freud believed that dreams represented the royal road to the unconscious, Jung believed it was complexes( emotionally charged association of ideas and feelings that draws images, memories and ideas into its orbit )  Jung's emphasis on early recollections , future goals and societal interest paralleled Adler  Similar theory of dreams  Jung also believed that dreams revealed what an individual didn’t want to see about themselves (i.e., shadows) & showed our underlying ways of interacting with the world  Past memories;  Social Interest Future orientation (as well as review of the past) Personality  According to Jung our understanding of ourselves comes from encounters with social reality and what we deduce from our own observations .  Collective unconscious refers to a shared inherited human factor of psychic functioning  In Analytical psychology aspects of the ego denied development, are labeled the shadow  The public image an individual maintains is known as his/her persona  The ego is the most important fragment of self  The personal shadow balances the ego in the unconscious  The persona is the public face we show to others  Task of early life strengthens the ego  Task of later life is individuation, i.e., completeness  Requires assimilation of personal shadow material.  Contrasexual element in the psyche ( Anima – Archetypal image of feminine and Animus – Archetypal image of masculine)  Introduced the concept of Typology in 1921 in Psychological Types to describe individuals and groups of individuals (e.g., countries)  Introversion  Natural, basic, energy flows inward  Adapts outer reality to inner psychology  Needs solitude; few but deep relationships  e.g., Switzerland  Extroversion  Connects with reality through external objects  Adapts self to external environment and others  Communicates well; a people person  e.g., United States  Jung defined the primary task of the first part of life as strengthening the ego  Most people are born with four functional types – Thinking, Feeling, Sensation and Intuition

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The most dominant function is used most and developed more fully Jung stressed the importance of the least developed function This underdeveloped function can bring distress , but also creativity when it comes into consciousness Compensation Everything in the personality balances itself Similar to the homeostatic balance achieved by the physical body Form bridges between opposites allowing a new attitude to develop For Jung the most decisive stage of personality development was preoedipal Psychopathology develops from conflicts in mother-child relationships Made worse by stressors Analytical therapists believe recurrent dreams are often linked with repressed traumas Pathological symptoms occur because of frustrated urges toward wholeness Defense mechanisms are the psyche’s attempts to survive complexes (e.g., group members often project unaccepted parts of their personality onto the group. The group member is projecting his/her shadow) Defense mechanisms can represent normal as well as destructive modes Becomes pathological only if an individual becomes stuck in the defense

Analytical Psychotherapy  In analytical psychotherapy the ultimate goal is self actualization  Personality can heal itself and enlarge ; Psyche is a self regulating system  Unconscious has a creative and compensatory component  Doctor-patient relationship facilitates self-awareness and healing  Personality growth takes place throughout life span  Neurosis occurs when an individual avoids important life task  Four Stages of Psychotherapy 1. Confession – cathartic recounting of one’s history e.g., secrets 2. Elucidation - the therapist attempts to connect the patient's transference to its origins in childhood 3. Education – concerned with persona and ego tasks. The therapist encourages patient to develop an active and health-promoting role in everyday life (many patients stop after the first three stages but some seemed impelled to go further, especially people in the second half of life) 4. Transformation – period of self-actualization Applications  Personality Disorders  Inpatient and follow up care of psychotics  PTSD  Disturbed children  The aging  Dying  Jung described individuals as possessing habitual ways of responding to the world in his theory of typology  Myers-Briggs Type Indicator  A personality measure based on Jung's theory of typology  One of the most popular personality tests available  Developed by Katharine Briggs and her daughter Isabel Briggs Myer  Used Jung’s concepts about type and function.  Typology  e.g., For an individual whose behavior is primarily dictated by hunches the dominant mental function would likely be intuition

Four Scales on Myers-Briggs Type Indicator 1. Extroversion – Introversion (E-I) 1. The most important; 75% of the population is extroverted. 2. Sensing – Intuitive (S-N) 1. 75% of the population is sensing 3. Thinking – Feeling (T-F) 1. Distributed evenly through the population 2. But 2/3s of men are thinkers, while 2/3s of women are feelers 4. Judging – Perceiving (J-P)

Alfred Alder      

B.1870 Vienna Father a successful merchant 2nd of 7 children He was dethroned by younger brother thus had feelings of inferiority and fear of death In 1902 became first associate with Freud and 1st presentation in Vienna Psychoanalytic Association Always disagree with Freud and in 1911 they officially split

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Basic Concepts of Adlerian Theory Inferiority vs. superior ity. Humans are constantly becoming. It is holistic and phenomenological . Society is viewed as teleological.

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Holistic, Socioteleological approach to Psychotherapy People are unaware of their goals and the logic that powers their progress Holistic :cannot be divided into independent mental parts Socio: socially embedded, comprehensible only in groups – relation to others Teleological: goal driven- purpose beihind every behaviour Fictional Goals: The outcome of unconscious notions that have no counterpart in reality. The are concerned with the future. They start early in life--as young as infancy. Fictional conceptualizations become the first goals of what will become lifestyle. Fictional goals are our attempt to belong and be significant in the eyes of others.

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Individual Psychology Style of life Work Friendship Love Striving for perfection Inferiority Complex Organ Inferiority Originates in Infancy Inferior organs Overindulgence Neglect Striving for superiority Aggression Will to power Masculine protest Innate Compensation System in balance Inferior organ compensates Become superior Overcompensate Subjectivity of Perception Social Interest Fictional Final goal

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The Counseling Process The Client-Counseling Relationship: Collaborative, egalitarian, respectful and cooperative. Understanding the Client: How is the client behaving? What does the client gain from this behavior? Why does the client do this in this manner? Assessment and Analysis: Family Atmosphere and Constellation, Birth Order, Early Recollections, Dreams, and Priorities. Strategies for Helping Clients Restatement: Restating the client’s words to form clarity and convey understanding. Reflection: Restating the client’s words to give deeper meaning regarding the underlying feeling. Guesses, Hunches, Hypotheses: Making statements to explain what is happening. Questioning: To get a better understanding but also reframe the symptoms for the client Confrontation: Pointing out discrepancies between what the client says and what the client does. Paradoxical Intention: Asking the client to amplify target behavior to show the client how ridiculous it is. Creating Images: Asks the client to imagine a ridiculous scene as he or she enters into a threatening situation. Asking “The Question”: “If your problem were to disappear overnight, how would things be different?” Midas Technique: Exaggerating the client’s neurotic demands. Pleasing Someone: Helps put the client back into society. The client is instructed to go out and do something nice for someone else. Avoiding the Tar Baby: Acting contrary to what the client expects. Disadvantages of Adlerian Theory The amount of family and lifestyle information that is collected. Sometimes difficult to do the interpretations, especially the dreams. Adlerian therapy works best with highly verbal and intelligent clients. This might leave out many people who do not fit that category. Might be too lengthy for managed care. Adlerians do not like to make diagnoses as it labels people.