Psychodynamic Psychotherapies - Benefits and Shortcomings - Coursework Example

PSYCHODYNAMIC PSYCHOTHERAPIES Psychodynamics, in psychology, is the study of the relationship between the numerous areas of the personality, mind, and psyche as they relate to emotional, mental, or motivational, laying emphasis on the changing nature the unconscious. Its central focus is on the development of psychic energy and its circulation over the human system and growth through the interaction among the mental states – id, ego and superego defined by Freud. The main purpose of psychodynamics consists of the clarification or interpretation of overt behavior or mental state through the unmoving unconscious conflict or processes (Sarason & Sarason, 2005). DEFENSE MECHANISMS The defense mechanisms have been constructed by the Freudian psychoanalytical approach. They were developed to aid in the explanation of person’s responses to anxiety (Myers, 2001). They have been evolved from their original background to help enlighten being’s coping styles. Individuals are not aware of the operations taking in the mind; therefore they are unconscious. Each individual uses a different set of defense mechanism so they are also individualized. Lastly, every individual makes use of them so they are thought to be normal. But if the use of the defense mechanisms becomes exaggerated than clinical interest arises. a) Sublimation The defense mechanism of sublimation is utilized when intentions are either violent or sexual showing the psychoanalytic aspects of thanatos and libido. They are transmitted towards non-instinctual course. For example, aggressive temperament may be transmitted towards a more acceptable structure of games. b) Regression Regression takes place when an earlier developmental stage reappears for the coping behaviors (Sarason & Sarason, 2005). For example, throwing a tantrum or crying may be used to deal with a tense experience. These behaviors are usually unacceptable for adults. c) Repression Repression is focal point psychoanalytical approach. It is used when there is a very high anxiety deep in the unconscious and which does not affect the activities in the conscious. Items which are repressed may however, become apparent themselves in slips of the tongue or dreams. They are mostly not present for recall. Instead, it may appear later, unexpectedly (Barlow & Durand, 2002). For example, there was a time when I tried to recall the Independence days I had ten years ago but failed to do so. But, a few weeks later, they suddenly hit me while taking a shower. The thought had been repressed because I had been into a major family dispute. d) Reaction formation The defense mechanism reaction formation is unconsciously presenting the total opposite of an individual’s true intentions or motivation. Therefore, when saying "I hate you." may in actualities mean love instead. Or for example, an individual believes that he loves teaching after spending years preparing it but in the end he found out the he could find joy only in job violent and horrible school. The alternative is to accept the wasted energy and time getting ready for the job, or to consider that it’s enjoyable. e) Rationalization Rationalization is accepting that an individual’s intentions are not always clean or generally acceptable and substituting suitable intentions (Anonymous, 2009). For example, a student who was unable to study because he was exhausted rather than lazy as being lazy is an unacceptable intention in the society. f) Projection Projection is the mechanism of holding someone else responsible for one’s failures or problems (Morgan, King, Weisz, & Schopler, 1986). For example, an individual might say, "It was the devil that pushed me". g) Intellectualization To treat a high emotion-arising situation in an unemotional or muted manner. For example, when an individual who takes in the news of a death without any emotion. h) Fantasy Making up of an imagined situation in order to substitute an actual one is called fantasy (Anonymous, 2006). A common example is imagining your own sexual partner as being someone else. i) Displacement To redirect the energy from a forbidden entity towards a socially acceptable energy is known as displacement (Wagner, 2009). For example, to play n instrument instead of attraction towards someone who is married. j) Denial Denial is not accepting the actual situation unconsciously. This may result in some king of problematic behavior. For example, a mother may unconsciously refuse to accept that her child is a thief as it is too anxiety-arousing. k) Compensation An unconscious deficiency is compensated by success in another area or skill. For example, an unconscious thought of being short of height is compensated by proficiency in business. TRANSFERENCE Transference occurs when the patient projects unrealistic thoughts onto the therapist. These may compose of attitudes and feelings that were previously experienced from some other individuals in the patient’s life (Sarason & Sarason, 2005). For example, a patient might feel very annoyed towards the therapist because some past feelings are brought back to life. The feelings directed towards the therapist might be the result of some previous anger towards his mother. In psychoanalysis, transference is neither positive nor negative. It is at all times a distortion of the reality by projecting previous emotions to the current events (Conner, 2009). Some issues regarding transference are particularly contradictory. For example, in transference, over-idealization can lead to problems in two areas: (i) As transference is the creation of the patients inner world and no person can actually fill that role, so it brings rage and disappointment (ii) Transference not only occurs with patients in therapy but it is also present in the world around us so the therapists are not able to come up to the actual projected transference by the clients. Transference may also lead to sexual attraction by the patient towards the therapist. Some psychotic transferences are also present in which the patient does no see the therapist as the representation of the object but the object itself. Transference is a critical part of interpersonal relationships and, therefore, of the physician-patient relationship. Transference can be perceived as a rerunning of parental relationships in adulthood. By nature, parental relationships are inconsistent as no parent can always be flawlessly in tune to a childs needs. Conflicts about sexual strivings and separation toward the parent predictably occur, and the child is left with both loving feelings for the parents and hostile feelings. These feelings constitute the unconscious mental information that is transferred onto the therapist (LaCombe, 2006). COUNTERTRANSFERENCE Countertransference is the reaction that is drawn out in the therapist by the patients unconscious transference. Countertransference reaction includes both associated thoughts and feelings. If transference feelings are not vital in the therapeutic relationship, then there is no countertranference (Pitchford & Young, 2005). In countertranference, the doctor might feel very stressful but it may prove a very useful tool in completely understanding the patient as he or she is unconsciously communicating his or her feelings to the therapist rather than an unthinking reaction from the therapist. The feelings elicited should be interpreted to the patient and should be clarified in team discussions. Furthermore, these can also be useful in guiding into the patients expectations of relationships. Also, they are easily identifiable if they are not similar to the therapist’s expectations of his or her role or personality (Elam, 2009). If the therapist’s own conflicts threaten to take over the therapist-patient relationship, then steps should be taken to stay away from them or minimize them. These may include consultation with colleagues, self-observation and analysis, or the last resort may be to transfer the patient to another physician (Anonymous, 2003). BOUNDARY ISSUES Violation of the boundary issues are perhaps the most destructive events to our profession and to our patients. Even though, the phrase is in general used to refer to major sexual violation but there are other lesser misbehaviors which often happen in therapy. Some researchers use the phrase boundary crossings to differentiate these small events. It is suggested that these violations take place because therapists believe that they know what is best for the patient and are acting on this knowledge. Regardless of the approaches employed in therapy, the therapeutic relationship plays a major role in the success of failure of the therapy. If the patient is sexually abused by the therapist, then this therapeutic relationship is contemptuously exploited in a way that does not fulfill the needs and wants of the patient rather it further creates problems for the patient. And when this patient looks for reparative therapy, the other therapist needs to closely concentrate on the issues that were breached by the previous therapist. INTERPRETATIONS In the psychodynamic model, the therapist listens and observes carefully when the patient talks, he looks for clues and draws tentative conclusions (Comer, 2001). When the therapist starts to develop an idea or a tentative statement known as hypotheses about the nature and type of the unconscious conflict, he or she will start to suggest various types of interpretations of the client’s behavior or experiences to the client himself. It is through interpretations that the therapist starts to make the client alert of his or her conflicts and so it is extremely important to time the interpretation exactly (Eysenck, 1998). At times the client may disagree with what the therapist has to offer and this is known as resistance. Furthermore, resistance is the unconscious refusal from the patient’s side to take complete part in the therapeutic session, and when the patient cannot suddenly freely associate or change a subject to avoid some painful aspect of life (Comer, 2001). In psychoanalytic approach, resistance is important because it shows the clients attempt to prevent the looking of his inner or unconscious conflicts. But it also may be possible that the interpretation might be wrong as well. A problem is psychoanalysis is to how to resolve between the cline and the therapist, given that each reaction the client makes is interpreted by the therapist as a show of his or her problem (Sarason & Sarason, 2005). Reference: Anonymous (2009). Defense Mechanisms. Changing Minds.org. Retrieved March 31. 2009, from http://changingminds.org/explanations/behaviors/coping/defense_ mechanisms.htm Anonymous (2006). Defense Mechanisms. PlanetPsych.com: A world of information. Retrieved March 31, 2009, from http://www.planetpsych.com/z Psychology_ 101/defense_mechanisms.htm Anonymous (2003). Countertransference. Psychoanalysis. Retrieved March 31, 2009, from http://www.freudfile.org/psychoanalysis/countertransference.html Barlow, D. H. & Durand, V. M. (2002). Abnormal Psychology: An integrative approach. (3rd Ed.). United States of America: Wadsworth Group, Inc. Comer, R. J. (2001). Abnormal Psychology. (4th Ed.). United States of America: Worth Publishers & W. H. Freeman and Company, Inc. Conner, M. G. (2009). Transference: Are you a biological time machine? Articles. Retrieved March 31, 2009, from http://www.crisiscounseling.com/Articles/ Transference.htm Elam, P. (2009). Therapists Countertransference. Changing Minds. Retrieved March 31, 2009, from http://yourtotalhealth.ivillage.com/therapists-countertransference.html Eysenck, M. (1998). Psychology: An integrated approach. United States of America: Addison Wesley Longman, Inc. LaCombe, S. (2006). Transference. Counseling theory. Retrieved March 31, 2009, from http://www.myshrink.com/counseling-theory.php?t_id=18 Morgan, C. T.; King, R. A.; Weisz, J. R. & Schopler, J. (1986). Introduction to Psychology. Singapore: McGraw-Hill Book, Inc. Myers, D. G. (2001). Psychology. (6th Ed.). United States of America: Worth Publishers, Inc. Pitchford, I. & Young, R. M. (2005). Analytic Space: Countertransference. Mental Space. Retrieved March 31, 2009, from http://www.human-nature.com/mental/chap4.html Sarason, I. G. & Sarason, B. R. (2005). Abnormal Psychology: The problem of maladaptive behavior. (10th Ed.). Singapore: Pearson Education, Inc. Wagner, K. V. (2009). Defense Mechanisms. About.com: Psychology. Retrieved March 31, 2009, from http://psychology.about.com/od/theoriesofpersonality/ss/defensemech.htm Read More