Psychoanalysis/Psychodynamic Therapy

Psychoanalysis

created by Sigmund Freud, this type of psychotherapy focuses on the unconscious conflicts, within an individual, parental upbringing and unresolved childhood conflicts. Freud believed that it was due to unresolved conflicts within an individual’s early stage of life, these conflicts are maintained within one’s unconscious and subconscious. This causes an individual to act out in maladaptive (Freud used the term ‘neurotic’) ways.

The unconscious conflict would exist between one’s ego, super ego and ID.

ID

is the first mental aspect of an individual’s “brain” (more metaphorically than literally) to form. The ID is focused on the ‘pleasure principle’ which essentially means that is it focused on obtaining pleasure at all costs. It is geared toward survival instincts such as food, sex and connection with others. It is not aware of reality, and therefore does not concern itself with the consequences/future of the outside world. It is the strongest influence within everyone. It remains fully unconscious however, which is why many people according to Freud did not realize when they had ID conflicts.

Ego

this is the next mental  formation to form (metaphorically rather than literally) within an individual. It is subconscious which means that it is located within an individual’s unconscious and conscious parts of themselves. It acts as a mediator between the ID and the Superego (more on that below). It is concerned with consequences, the outside world and how to make the demands of the ID realistic in a practical/real-world context.

Superego

this is the last mental formation to develop within someone (metaphorically rather than literally). The Superego is subconscious as well, so therefore it is concerned with the outside world but also is within ones unconscious realm. The Superego is primarily concerned with perfection. It rejects the demands of the ID and strives for an individual to be perfect. It wants order, security and consistency. It prides itself of individual achievement and is the driving force, according to Freud as to motivation within an individual. It strives for the individual to be productive and efficient This is in direct conflict of the ID since its primary concern is with pleasure.

There are many different ways unconscious conflicts can emulate themselves within somebody. There are more examples than the ones listed here but a general example would be, if someone has a tendency to strive for perfection at all costs, ignore their own personal needs for fun and connection with others, seems emotionally distant – Freud would coin them as having an overly dominant Superego and a weak ID. This also means the Ego is not properly doing its job to remedy the demands of both the Superego and the ID.  However, this is an extremely simplified example, for more in depth information about Freud’s theories, this be found online or at the York University Library.

Methods used in Psychoanalysis 

The method Freud primarily used was ‘free association’ this allows an individual to speak without having any direct rules or questions asked of them.

The Rorschach test is commonly which is various inkblots on a card. The individual is asked to describe what is on the inkblot, in their opinion. Scoring is more subjective than objective to psychologists. There is a scoring method in place – the more common associations that people find vs. uncommon associations people find, however psychologists prefer to use their own intuition in regards to scoring the Rorschach test.  For example, if a client constantly associates every inkblot card with death – the psychologist would try to understand this association in terms of their diagnosis/treatment.

Another test used is the TAT which is called the Thematic Attitude Test. This test has cards with various every day scenarios on it. No words, no story. The client is shown these cards and is asked what do they see within the scenarios presented? The scenarios are purposefully vague/ambiguous in order to get a sense of a clients perception on situations.

Freud also believed that dreams are a direct entry to ones unconscious wishes, desires and conflicts. He did develop his own dream dictionary and he believed that ones answer to many unconscious conflicts could be resolved if one understood the latent or symbolic/undertone messages of their dreams.

In Freud ideally hoped that one would recognize their unconscious conflicts. Once it is brought to a patient’s attention, then they could work on that conflict and essentially break free from their maladaptive attitudes and/or behavioral patterns by knowing the reasoning behind why they developed those.

Psychodynamic

This theory was influenced by Freud and is more modern in terms of psychology. Psychologists who practice the psychodymanic approach believe that some of his theories about the unconscious, parental care and childhood upbringing do impact an individual’s functioning later. However, they do deviate from Freud’s methods and may not use ‘free association’ the TAT test etc. They also do not believe in Freud’s psychosexual stages of development. This is why they are termed, ‘psychodynamic’ for being influenced by Freud and recognizing that. But they are also more modern in their approaches with their clients.

Methods use in Psychodynamic 

they interact with their patients in a face-to-face setting (rather than facing away and letting the client talk freely as in psychoanaylsis). They try to understand the client in viewing their childhood upbringing, their relationships with their parents and others and their genetic factors. They tend to focus on interpersonal relationships and how the quality or dynamic of ones interpersonal relationships with their parents affects their attitudes and behavior. They also examine how one’s childhood could be stored within one’s unconscious and how that manifests within them as they grew older.

They seek to help the patient understand their unconscious drives and meaning behind the reasons they behave and think. Through dissecting an individual’s life, they can help to understand their unconscious motives and drives. Once that is understood by the individual they can now work towards resolving these unconscious conflicts and coming to terms with them.

 

 

Humanistic Therapy

First developed by Carl Rogers, he disliked (in his opinion) how a lot of psychotherapy is about diagnosing therefore, making the patient feel inferior, helpless or “wrong”. He believed that the power struggle observed with a psychologist and patient (one being knowledgable and “powerful” and the other being the one looking for help) this could actually be damaging to the patent’s mental health. This power struggle (according to Carl Rogers) could impact a patient’s growth.

Therefore, he created his own method of therapy termed as, ‘client-centered therapy” which aims at not only udnerstanding, but listening and supporting the client unconditionally.

He believed that if an individual did not receive ‘unconditional positive regard’ (which means essentially loving someone no matter what, feeling supported and heard no matter the circumstances, time etc) from anyone in their life especially from their primary caregivers, this causes an individual to develop ‘conditions of worth’.

Conditions of worth means that an individual learned how to behave in order to receive love, admiration and support from others. They learned a system (this is unique to the individual) in order to be liked. However, this causes the individual distress because they feel that no one truly loves them for who they are, but for who the portray to be.

Therefore, Carl Rogers believed that those struggling, if given unconditional positive regard – would boost their self-esteem, ease their emotions and make them feel more understood. By feeling understood for who they really are, not for who they pretend to be, they will be able to recover and become better.

It also focuses on people’s present self and their daily lives, rather than early childhood. It is also aimed at listening, not giving advice. It is concerned with whatever the client is concerned with. To elaborate, there isn’t a set list of criteria (unlike many other psychotherapies) the psychologist should follow, it is aimed at listening and supporting whatever the client talks about. If the client wants to talk about the unconscious biases they feel they may have, then it is focused on that, but if the client does not talk about it, the psychologist would not not bring it to attention.

This si why this psychotherapy is termed, client-centered because the client has full power and control in the direction of the conversation. The psychologist is meant to listen, validate feelings and support. It is believed that through this safe and inclusive talk, the client will come to its own understanding of why.

 

 

ii. Gestalt

Developed by Max Wetheimer he believed “The whole is greater than the sum of its parts.” Which essentially means that Gestalt tries to understand an individual collectively, rather than isolating aspects to focus on. By collectively understanding a person – family ties, culturally, age, psychologically, emotionally, environment, etc then you can really understand why and provide support.

Gestalt believes in the Law of Pragnanz – this means that people seek out patterns (‘wholes’) in available sensory info. Try to perceive their world in wholes. By seeing the world in thier subjective pattern you can better understand why a person operates and behaves. You must understand their perceptual patterns in which they see the world in, in order to support and help them.

The 5 Laws of Gestalt are :

  • Symmetry – tendency to look for patterns (patterns or shapes rather than separate elements)
  •  Proximity – Objects close together belong together
  • Closure – An object partially defined will be seen as a whole
  • Continuity – Preference for uninterrupted figures
  • Similarity – Objects that are alike will be viewed as a group

 

Behavioral  Therapies

Developed by B.F Skinner and Pavlov this theory focuses on practical reality – ie what you can see and observe. B.F Skinner was unhappy with how psychology was not being regarded as a science or being treated as a science (in his opinion). He wanted to develop a theory that was quantifiable and could be proven systematically, like hard sciences are such as chemistry. Therefore, by doing experiments on cats and rats he developed Operant Conditioning. This theory states that people behave systematically, people go towards/seek out rewards and they fear/avoid punishment.  To extrapolate, this means that people behave in ways which are rewarded and avoid behaving in ways which are punished. In order promote a certain criteria of behaviors, reward what you like and punish what you dislike.

*(It has been interestingly noted that extroverts are more adept in going towards rewards than avoiding punishment, while introverts are more adept in avoiding punishment than going towards rewards – this could have an interesting application when trying to apply this method within an educational institute, family, personally etc)

Pavolv developed another common behavioral theory called, classical conditioning. When Pavolv would ring a bell, the dog would do nothing. However, he decided to ring a bell, and then present the dog with food. The dog would salivate at the food, but not at the bell.

However, after numerous times of ringing the bell and then providing the dog food, the dog started to salivate when the bell rung. In the dog’s mind- he associated the bell with the food, causing the physiological reaction.

Elaborating on this theory, in Pavolv’s opinion he believed that certain actions/behaviors/attitudes arrived due to their association with each other. And that a previously neutral stimuli- one that did not elicit a response can be paired with a stimuli that does elect a response (conditioned stimuli), due to this paring, one will now react to the neutral stimuli as it would to the conditioned stimuli.  To be more specific- an experiment with a boy named Albert was conducted in psychology.

Albert, a baby was in a play pen with a white rat, however any time he attempted to touch / play with the rat a very loud bell would go off which would scare the boy.

Unconditioned Stimuli: white rat

Conditioned Stimuli: Bell

Conditioned Stimuli: fear

After several attempts of trying to touch the rat, Albert eventually became scared of the rat and refused to go near it. Due to his association of the rat and fear.

Conditioned Stimuli: white rat

Conditioned Response: fear

Therefore by taking a previously unconditioned stimuli (rat) and pairing it with a conditioned stimuli (bell) to bring about a conditioned response (fear) the person will begin to associate the unconditional stimuli to the conditioned response.

The main assumptions in behavioral therapy is that behavior is learned and can be unlearned. Malapative behavior is not a symptom of an underlying problem, but the problem itself (according to this theory) by changing ones behavior you will change the person due to positive behavior bringing about more positive rewards in a person’s life. Therefore, due to the (hoped) positive results of a person’s changed behavior they will unlearn their malapadtive behaviors,.

 

 

Methods Used in Behavioral Psychotherapy 

Systematic desensitization

This form of therapy is commonly used to treat phobias, OCD and PTSD. It involves firstly, making the patient relax completely. This can be used by deep breathing, clearing ones mind or thinking pleasant thoughts. This relaxation training helps the patients responses.

Then the patient is told to make a list of fears from least feared to most feared in order for the psychologist to get a sense of what to focus on.

Then, the psychologist exposes them to the said things on the hierarchical fear list. Ranging from least feared to most feared. The hope of this technique is that the patient associates their relaxed state with the feared stimuli, therefore becoming less afraid of said stimuli.

Exposure

This is also commonly used to treat phobias, social anxiety, OCD and PTSD. It consists of a patient being confronted with situations that they fear so the person becomes more habituated to the said situation/stimuli. By becoming more comfortable with the situation and stimuli the person learns to not react emotionally to said situation/stimuli.

It begins with the patient just imagining the stimuli/event first and then relaxing, or trying to feel relaxed even when imagining.

When the person is successful with being relaxed by imagining the situation/stimuli, the person may be placed into a VR world or be shown images of the situation/stimuli, again they are asked to try to remain calm.

Examples of this are, soldiers who suffer from PTSD, they are placed within a virtual reality game such as being back in war, by facing this situation they learn to overcome their intense fear. Or people who have fear of social anxiety, they are placed in groups with other people who also experience social anxiety and are asked to public speak/do team building activities etc by exposing them to more social situations they begin to feel more confident and comfortable within these situations which helps deteriorate their fear.

Cognitive/Cognitive-Behavioral Therapies

One of the leading psychologists to pioneer Cognitive-Behavioral Therapy (CBT)is Aaron Beck. He is also famous for creating the Beck Inventory which is a widely used assessment in order to assess depression within individuals.

CBT is the leading therapy for those suffering from depression and anxiety.

Cognitive psychology is primarily concerned with the mind and how the mind (our thoughts) control our actions.

Our cognition (the way we think) determines our attitudes, beliefs, behaviors etc (according to this theory). Therefore, if you want to change how someone acts/behaves you must focus on how someone thinks.

Methods Used in Cognitive/ CBT Therapy 

Cognitive Therapy and CBT focus on automatic thoughts which means the thoughts that an individual automatically has. These are thoughts that do not come from introspection or contemplating but are automatic thoughts which are triggered by events.

It is believed that those suffering with depression have negative/more negative automatic thoughts, however it is not the thoughts themselves that Cognitive/CBT focuses on. It is how one reacts to these automatic thoughts. Everyone has thoughts they cannot control ie snap judgement, automatic thoughts however, cognitive therapy/CBT tries to help the patient understand that by rationalizing and challenging their automatic thoughts they will come to a better understanding.

An example of this,

An individual gets a lower mark on a test than expected-

the automatic thought is, I am a failure, I am a disappointment.

However, by challenging this thought by thinking also, well I do have 3 A’s in my other classes, maybe I should study harder on this course, it is more challenging than I first assumed, but I know I have the ability to do well in school.

By challenging these automatic thoughts, it will help an individual to not sad/guilty/ashamed/unhappy by how they are feeling, and combat their automatic thoughts with time spent rationalizing and dissecting why it is they think/feel that way.

Another aspect that this theory focuses on is distorted thinking patterns.

A certain way someone thinks is subjective and unique to them, however sometimes people get into a pattern of thinking that is distorted. Active Minds is not a licensed social worker/psychologist and therefore more information regarding distorted thinking patterns can be found at the York Library or Online.

 

Cognitive therapy identifies distorted thinking and ones automatic thought processes and goes towards understanding why one has a distorted thinking pattern, why an individual has a certain automatic thought process and then challenges an individuals distorted thinking and automatic thought process.

It is believed by this theory that cognitive distortions (cognitive therapy) then lead to maladpative behavior (behavior therapy). This therapy differs from behavioral therapy because it focuses on the cognition of an individual, they believe it is not solely the environment that determines ones behavior, they put more focus on the mind of an individual in determining the determinants of behavior.

Some examples of cognitive distortions are:

  • Arbitrary interference – jumping to conclusions without any evidence
  • Selective thinking – focus selectively on one aspect of a situation, leaving out other relevant facts
  • Overgeneralization – making a board rule based on a few limited occurrences.
    Magnification and minimization – person blow bad things out of proportion while minimizing good things (ex: believing that if you fail a quiz then the teacher will completely lose respect for you, that you will not graduate from college, that you will therefore never get a well-paying job, and will ultimately end up unhappy and dissatisfied with life)
  • Personalization – individual takes responsibility or blame for events unnecessarily (If a checkout clerk is rude to you and you automatically believe that you must have done something to cause it)