Psychoanalysis & Psychodynamic Psychology
ii. Psychodynamic approach to treatment
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| ii. Psychodynamic approach to treatment Psychoanalysts create conditions for treatment based on their understanding of how the mind works and how psychological difficulties evolve. Major features of psychoanalytic treatment—e.g., frequent sessions patients lying on a couch, rather than sitting face to face empathic listening to the patient’s life story free associations attention to the unconscious—are carefully designed to facilitate insight into the deeper roots of the patient’s psychological difficulties and to encourage emotional growth. Psychodynamic psychotherapy shares these aims, but is a less-intensive process, usually of shorter duration, and generally conducted face to face. A. The treatment frame. Frequency and duration—Psychoanalysts tend to see patients frequently multiple sessions per week) and overextended periods of time to develop a deep and trusting therapeutic relationship and facilitate the gradual emergence and improvement of the patient’s central emotional conflicts, childhood fixations, and compromise formations. The couch—Many patients in psychoanalysis lie on a couch, which can facilitate focusing on the patient’s fantasies, thoughts, feelings, and the emergence of unconscious material. The analyst sits out of the line of vision of the patient in order to help the patient focus attention on their internal experience. In psychodynamic face-to-face therapy, the therapist will also try to encourage the patient to reflect on inner experience. When working with children, psychoanalysts use play instead of free association as the medium of communication. Children will be provided with toys and art materials with which they can express their feelings and concerns. 3. The analyst’s quietness—Analysts are not silent, but they tend to be quiet much of the time, listening carefully to the patients associations and working with the patients to better understand the patients thoughts and feelings. The analyst’s interpretations of underlying feelings, conflicts, and wishes help to provide the patient with insight. Some psychoanalysts have a more active style than others, and all psychoanalysts are more verbal and interactive with certain patients, including child patients. 17 B. Resistance. Definition—While patients come to psychoanalysis seeking help, they also can fear engagement in therapy and at certain points most patients exhibit some resistance to getting better for various reasons. Resistances usually reflect central anxieties with which the patient is struggling in life, and the resistances actually help the analyst identify these anxieties. Example of resistance—As an example, consider a patient who came for help with his detachment from feelings and his inability to trust people. In early sessions, his intellectualization and mistrust of the analyst reflected a resistance that the analyst noted and interpreted to the patient, helping the patient understand his general problems in trusting others. C. Transference. Definition—Patients experience with their psychoanalyst (and with other people in their lives) wishes, memories, fantasies, problems, and characteristic modes of interacting that are rooted in and repeat early childhood relationships. Examples of transference—Transferences affect all of an individual’s relationships but emerge with particular clarity in analysis overtime. As one example, a patient who had an overbearing, critical parent might fear that the analyst will be critical and harsh. Another patient who had a depressed unaffectionate parent might experience the analyst’s quietness as alack of interest and caring. D. Countertransference 1. Definition—Countertransference refers to the thoughts and feelings of the analyst toward the patient. The analyst must carefully monitor the countertransference so that it does not interfere with the treatment. Using the countertransference clinically—The analyst’s countertransference reactions can be extremely helpful in understanding the patient’s personality and emotional conflicts. For example, the patient may generate certain feelings in the analyst that help the analyst understand how the patient generally affects people. The analyst’s analysis—Psychoanalysts go through their own psychoanalyses, in part to understand their own transferences so that they can deal as thoughtfully and effectively as possible with their patients. Download 283.67 Kb. Share with your friends:
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