Psychodynamic Approach to Therapy
In this article we will be taking a closer look at the psychotherapeutic model known as psychodynamic therapy. While these two are often used interchangeably in popular media, it is important to state upfront the differences between psychodynamic therapy and psychoanalytical therapy.
The relationship between these two approaches can be described as their being like “two peas in a pod.” While psychodynamic therapy is targeting patient’s unconscious and is based on psychoanalytical theory it is still a completely independent approach to treatment.
Why is this important? There is an interdependence between the dynamics of psychodynamic and psychoanalysis therapy that can be confusing. In order to better understand the psychodynamic approach lets start with some basic facts.
Psychoanalysis: Rooted in the early works of Sigmund Freud and his research in the area of the human mind, psychoanalytic theory caused revolution in early-20th century psychology. In his theory, Freud postulated that the human mind has three areas in which it functions; the superego (the conscious), the ego (the unconscious), and the id (the sub-conscious).
In order to become a healthy adult person must move through a series of developmental stages. The tasks and the person’s ability to meet those tasks is stored in the id. When an adult is troubled by unexplained thought and behaviors, it is through the application of psychoanalytical therapy that the cause can be identified.
Here are some of the important aspects of psychoanalytical therapy:
Understanding Schizophrenia: Creativity, Divergent Thinking, and the Frontal Lobe
Schizophrenics exhibit brain abnormalities that go beyond emotional disturbances and delusions, including diminished frontal lobe activity, which results in a range of cognitive deficits. The brain’s ability to process information in a cognitively organized way, for example, is disrupted, and the filters that allow neurotypical people to screen out irrelevant stimuli are often absent. As a result, the schizophrenic’s mental functioning is frequently impaired. Whether this impairment is part of the cause of schizophrenic symptoms or arises as a result of them is, as yet, not known.
Despite their cognitive impairments, the IQ scores of schizophrenics are similar in range to those of the rest of the population. While movies like “A Beautiful Mind” have given rise to the idea that mental illness often goes hand in hand with genius, this is simply not the case; indeed, schizophrenics actually perform better, cognitively, once they are medicated and the mental illness is under control.
There is one aptitude, however, which may indeed be found in greater measure in the minds of schizophrenics: Creativity. Functional schizophrenics are often able to organize myriad pieces of information (ones that are both cognitive and sensory in nature) to yield unique and often highly insightful solutions to problems. This heightened creativity may account for the mistaken belief that mentally ill people are more intelligent than average.
Transference in Psychotherapy
Here is another psychological “inside” term or jargon, transference. This is a very common occurrence among therapists and their clients. Generally speaking, when recognized transference is quickly and easily dealt with. In this article we will take an in-depth look at transference, what does it mean, is it important, and how is it dealt with.
We all experience transference in some form or other. For most of us it is nothing more than our use of our imagination to enjoy an experience that we may not otherwise ever have. For many adolescent girls this occurs when they become infatuated with the latest teen heart throb. Their imagination takes over and they spend time daydreaming about their relationship. Not to be outdone the male of the species encounters the same experience. The focus of their attention usually is different, but the results are the same.
Although not fully understood transference is often the result intense and prolonged exposure to something or someone that make an indelible mark on the mind of the client. One example might be having someone who listens, really listens to you without making any judgments. The more you encounter this attention the easier it is to develop special feelings toward the listener
Understanding Play Therapy: Solving Problems Through Play
Children are often poor at verbalizing what is bothering them; parents and guardians are left to understand their children by observing them and waiting for issues to become evident in their behavior. Often, when children are having problems, they “act out”, rebel, or become anxious and unusually withdrawn. While these actions may be frustrating, it’s important to remember that they are often cries for help.
Parents often become reactive, however, as they worry that their child’s behavior will grow worse over time, and result in more serious problems during adolescence and into adulthood. Parents may also be judged negatively and face criticism and complaints from teachers, daycare workers, coaches, or other parents, which leads to parents wishing to shut down the negative behaviors as quickly as possible. This, however, is seldom effective; instead, parents and guardians should seek help for the troubled child in the form of therapy —Notably, through the child-centric approach known as play therapy.
What is Play Therapy?
Play therapy is a method of psychotherapeutic treatment which was specifically created to help children between the ages of three to 12 years old. While its title may sound causal, play therapy is administered by a trained mental health professional, called a play therapist.
Children habitually use play to understand the world around them; a play therapist exploits this natural ability to work with a child in exploring and resolving problems through play, by making the play itself therapeutic in nature. This is performed in a counselling space known as a playroom, which is designed to look and feel like a standard playroom, while including toys that have actually been specially chosen to encourage the safe expression of feelings and streamline the learning of healthier behaviors.
Psychological Assessments – from Confucius to Modern Times
If you are one of the many thousands of people who suffer from test anxiety here’s some good news. Psychological tests are not the kind of tests you can fail. They are simply assessment tools used by psychologists to gain additional insight into who you are and how you function.
Assessments like these have been in use for decades. In early China, at the time of Confucius (551–479 BC), testing was done to gauge the proficiency and knowledge of those applying for advanced studies or official positions. This type of testing was called Imperial examination. It was in Europe during the 18th and 19th century that rather unscientific and unorthodox methods of personality specific assessments came into popularity. These were soon replaced, expanded upon, and standardized.
Why psychological assessments?
Most of us are familiar with an IQ test or a personality test, but there are many more psychological testing tools. Depending on the type of data collected from a test one of the primary reasons for obtaining the results is to establish a baseline for normalcy. As used here, normalcy is nothing more than a generalized comparison of the shared traits and behaviors we all have. When someone is tested and found to be outside the range of these normalcies there usually are problems that exist.
There are several other valid reasons for the use of psychological assessments, including the identification of both strengths and limitations that a client may face. There are tests used to measure for almost any form of issue, functioning, or mental health diagnosis. These can range from depression scales, bipolar scales, level of functioning, geriatric, children and many more scales. If a psychologist has a question about someone’s ability to function, he or she can usually find a test instrument to learn more.
Depression – Challenging the Status Quo
By now, the belief that depression is a biological disease that arises from an imbalance of serotonin and the improper function of neurotransmitters is widespread, with the typical course of treatment involving the long-term medication of these imbalances — a very lucrative prospect for Big Pharma.
Perhaps it is sadly unsurprising, then, that this belief about depression may be incorrect, and the adoption of it so widespread owing to the influence of the pharmaceutical industry. It is coming to light that this industry has been engaged in study suppression, falsification, strategic marketing, and the use of “financial incentives” to woo the field of academic psychiatry into agreeing with its favored approach, leading to a staggering 11 billion dollars’ worth of antidepressant sales in 2011 alone.
According to Dr. Ben Goldacre, the member of the Royal College of Psychiatrists and research fellow at the London Institute of Psychiatry, the issue of study suppression has a long and sordid history. Over the last 15 years, it was found that 50% of the 76 studies analyzed by Dr. Goldacre were positive and 50% were negative—and yet, only a few of the negative studies ever saw the light of day, with almost all of them remaining unpublished. In 2004 alone, approximately 50% of those studies that weren’t already suppressed by the pharmaceutical industry found that antidepressants have little more effect than a placebo on many of those with depression—and in children, they are even less effective. Even in the “positive” studies, when one reads the “fine print”, one discovers that an antidepressant only has to be 10% more effective than a placebo to be deemed a useful drug. Ergo, every day, thousands of people are being prescribed drugs that only need to work about 10% of the time, and which often come with a significant list of harmful side effects.
Obviously, this kind of logic simply doesn’t mesh with real science, where theories must be correct 100% of the time to be considered truly valid.
On Acceptance and Commitment Therapy (ACT)
Let’s begin with a comparison of three mainstream psychological treatments or psychotherapies. They significantly differ from each other, yet each has specific advantages and intended use modality. These are:
Psychoanalysis: Built on the work of Sigmund Freud, psychoanalysis is still based on how many contemporary psychologists understand the human mind. As a treatment it includes the identification and resolution of deeply rooted sub and unconscious thoughts.
Cognitive Behavioral Therapy (CBT): This remains among the most popular of therapies used by clinicians today. Based on the union of behavioral therapy and cognitive psychology the goal of CBT is to change maladaptive behavior that could be altered using rational thought. Here, the clinical focus is on changing behavior by linking cognitive activity to behavior.
Acceptance and Commitment Therapy (ACT): First introduced in the late 1980’s by Steven C. Hayes, PhD of the University of Nevada, ACT is now an accepted treatment worldwide. Upon first look ACT and CBT may seem similar, but there are several significant distinctions.
| Psychoanalysis – WHAT are the problems/issues? | CBT – Where are these issues? (mind/body/spirit?) | ACT- WHY is there a problem? |
| From infancy forward the human must meet certain stage related criteria. A malfunction occurs when self-analysis cannot change the mind. Yet, a problem cannot be altered or changed until it is identified. It is in the identification of a problem that change can begin. | In order for a client to change, the cognitive therapist focuses on problems the therapist believes are caused by irrational thinking or faulty perceptions. A cognitive/behaviorist therapist works with a client to change thought patterns and behaviors. | The goal of the ACT therapist is to assist the client in understanding why there is a problem. That WHY relates to the inflexibility and definitions given to certain situations by the client. By understanding the roots of the problem, the client is empowered to change his behavior. |
| Approach to Treatment | ||
| Usually involves a long term exploration of client’s personal history directed toward getting the client fully involved in the psychoanalytical treatment. | CBT is often called “brief psychotherapy”, it mainly focuses on present and the goal of CBT is helping the client cognitively understand their behaviors. | The core of ACT treatment is to accept what is in your life, being attentive of the valued choices you have available, and then committing yourself to do what is right or valued. |
Psychoanalytic Therapy: Unconscious vs. Subconscious Mind
Within the world of psychoanalytic theory resides what has become the accepted classical view of the human mind; a three tier system where human experience is processed. It consists of the conscious, the unconscious and subconscious areas of the human mind. Each area are part of a three layer system that make up the mind. The psychoanalytic therapy deals with unconscious mind and its influences on our behaviors and thoughts, by detecting and resolving conflicts buried deep inside patient’s unconscious mind the therapy process helps alter problematic behavior and though patterns. To understand how therapy works we need to first explore Freud’s 3-tier model of human mind.
Conceptually, this can easily become confusing for many. We can dispense of the conscious mind quite easily. It is an area where there is an awareness of thought and behavior. Nothing too mystical going on here. This leaves us with the subconscious and the unconscious elements of the mind.
Which area serves what function and in what ways are they dependent and independent of each other? In this article we will clarify the functions of the unconscious and subconscious mind. Based on the hypothetical assignment of roles in the system of the human mind it is constructed in the following manner:
An overview of Dialectical Behavioral Therapy (DBT)
I am a strong believer in DBT and use this therapeutic modality quite often. It is certainly less known than Cognitive or Cognitive Behavioral Therapies, so in this article I will take you on the grand tour of DBT. It is quite unusual how DBT came about. Let’s begin there.
Marsha M. Linehan and DBT
Born in Oklahoma than 70 years ago, Marsha lived what must have been a confusing and maybe even a terrifying childhood. Early on she began displaying significant behavioral abnormalities. So much so that eventually her parents hospitalized her in Connecticut for evaluation and treatment.
Indications at the hospital pointed toward her having schizophrenia. While an inpatient Marsha underwent treatments that included ECT, Librium, Thorazine, seclusion, along with other treatments. This was her youth until her discharge at 18.
After discharge Marsha pursued advanced education at Loyola University, earning a Master’s degree in psychology and graduating cum laude. Moving on, she then earned a PhD is psychology. This led to her ongoing work in the area of suicide and related destructive behaviors. As her interest and knowledge grew, she became a researcher and professor of psychology. In later years she reminisced about her diagnosis and feels that she had a Borderline Personality Disorder.
Today, she is an internationally known author, teacher and researcher in the field of psychology. Masha M. Linehan, PhD plays a key leadership role in the psychology and psychiatry departments of the University of Washington. She is best known for her clinical and theoretical development of DBT.
Cognitive and Cognitive Behavioral Therapies
According to the Merriam-Webster dictionary when used in the more general everyday language, cognitive means, “relating to, being, or involving conscious intellectual activity (as thinking, reasoning, or remembering)”. To simplify this, let’s consider this as having to do with how we think.
How we think is a very basic rudimentary process. When we are sitting around with a group of friends and somebody asks, “Do you remember…” and others nod in the affirmative they are using their cognitive resources in their most basic form. This type of cognitive use is often informal.
In the contemporary scientific world of psychology add the word behavioral to cognitive and you change the whole meaning of the word from a description of how we think to why we think in certain ways.
All of us carry within us a given set of reactions or responses to our thoughts. For most those responses pose no significant problem. We have become accustomed to behaving in certain ways when faced with different events. The exception are those who temporarily or chronically experience their thoughts as out of the range of normal, a condition sometimes referred to as distorted thinking.
It is in the why of cognition that additional ideas can cause maladaptive behaviors to occur. Think about it this way, if you are presented with solving a simple math equation such as 2 + 2 =?, little effort is needed to come up with the answer. Add into that mix the numeric values of 3.97, 52, and -12.5 and decisions become more challenging. Yet, in both cases you use your well learned HOW cognitive processes. As the problem or mental association become more complex there is no simple and learned HOW cognitive process to point out. Cognitive behavioral therapy focuses on WHY you thought the way you did and selected this particular HOW process. In other words, in the psycho-therapeutic world of behavioral cognition the therapist focuses not so much on how you came to behave in certain way, but rather why are you behaving this way?
Was it a part of the normal pattern of thinking that pushed you into anxiety and depression, or are there unique circumstances that caused you to step outside the lines of how you think? There are reams of paper dedicated to telling us how we think. Most sit in the archives of world-wide scientific research. Early in the practice of how we think was and remains an act of making choices between this or that. It’s really fairly black and white. We face decisions, we react automatically to those decisions, and then go on our merry way. This is how we think.
