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1. The aim of psychodynamic therapy is not to ‘cure’ the patient’s psychological problems, in the way that the medical profession might hope to find a cure for…
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  • 1. The aim of psychodynamic therapy is not to ‘cure’ the patient’s psychological problems, in the way that the medical profession might hope to find a cure for cancer. Rather, the aim is to enable the person to cope better with inner emotional conflicts that are causing disturbance. The problem is to be found in the unconscious. The aim of therapy is to make the unconscious conscious and then deal with it in the safety of the consulting room. Freud believed that disorders come from ego defence mechanisms, e.g. a phobia involves repression. An important part of this is that confusing or traumatic childhood experiences can be better understood when looked at as an adult. Psychoanalysis is literally, analysing the mind. In psychodynamic therapy, a variety of techniques are used which include the following: Treatment Use of treatment Mode of action Appropriateness Effectiveness Ethics Psychanalysis: This is based on the assumption that individuals are often unaware of the influence of unconscious conflicts on their current psychological state. Psychoanalysis helps to bring these conflicts into the conscious mind, where they can be dealt with. Conditions such as phobias, sexual problems, etc. This is also useful in cases of neuroses. However, patients with schizophrenia cannot use psychoanalysis. - Free association: The client is asked to recline on a chair with the therapist out of sight] and allow the free flow of feelings, thoughts or images. As these come to mind, clients express them in words, without criticism or censorship from either the ego or the analyst. The analyst must not use their own values and judgements. The idea is that associations should arise from the problems in the unconscious. There may also be resistance from the unconscious and this may appear in various forms, e.g. when the person is close to the problem, they may unconsciously change their train of thought, Freud saw resistance as natural because it is preventing the painful conflicts being brought into their conscious awareness. - Dream analysis: Freud believed that our unconscious drives and wishes can be seen uncensored in dreams, although they are disguised in symbols in - Psychoanalysis is based on Freud’s theory of personality; if that is flawed, then so are the therapies. Also, the theory cannot be falsified, and the theory is based on a set of non- representative sample (middle- class neurotic women) - Eysenck (1966) therapy delays recovery. It is appropriate only for certain mental illnesses (in which patients have insight into their condition) and certain groups of people (those who are articulate and have the time and money for treatments). - False memories- memories recovered from repression. Many critics argue that many therapists are not helping patients recover repressed memories, but are implanting false memories of sexual abuse, alien abduction. Probably the most quoted criticism against psychodynamic therapy came from Eysenck (1952) who claimed that it simply does not work. He reviewed two outcome studies, incorporating waiting list controls, which showed that 66% of the control group improved spontaneously, whereas only 44% of psychoanalysis patients improved. Eysenck’s papers were subsequently reviewed by Bergin (1971) who found that patients in one of the control groups were in fact hospitalised and those in the other group were being treated by their GP, creating very different groups, a fact that Eysenck had ignored. - Corsini and Wedding (1995) also explain that there are too many variables involved to enable a controlled and statistically valid outcome study. Comparisons may be made between symptoms at the
  • 2. order to protect the conscious mind. The role of the analyst is to help the client interpret their dreams significance. In Freudian psychoanalysis, dreams are interpreted as wish-fulfilment, usually of a sexual or aggressive nature. Things that happened during the day made the person think about repressed childhood memories and desires. However, because some desires are too disturbing for an individual to face, even when asleep, they are expressed in symbolic form. Freud used the term manifest content to describe the content of the dream as reported by the dreamer and latent content to refer to the dream’s presumed hidden or symbolic content. - Hypnosis: This is the method that Freud originally used to gain access to the unconscious. However, Freud abandoned it because the client might deny the accuracy of what had been revealed when they were hypnotised. Others found the revelations to be too premature and painful. - Transference: This occurs when the client redirects feelings [e.g. of hostility] towards the therapist, which are beginning and end of treatment, but during the course of therapy other complications may arise as a direct result of what happens during therapy. Because treatment is over such a long period, there may also be other factors occurring in the client’s life during the course of therapy which have an effect on the person’s life. Life may have been favourable for some clients and unfavourable for others. Effectiveness is a subjective concept, measurable only by the extent to which clients themselves feel that their condition has improved. Despite difficulties in evaluation, psychodynamic therapies continue to thrive and newer versions are more accessible and affordable.
  • 3. unconsciously directed towards a significant person in their life [usually a parent]. The person has feelings which the conscious mind does not allow to be expressed, so they are transferred onto the therapist. Transference is important because it indicates that repressed conflict is getting very close to conscious awareness. Transference must occur naturally, however, and the therapist must neither encourage nor prevent it. The aim is to identify who the person is really thinking of and the circumstances surrounding the repression. Psychodrama - Psychodrama is an active method of group psychotherapy in which past and present experiences are explored, - Moreno developed psychodrama, and claimed that psychodrama is an extension of children’s natural play. The tools are psychoanalysis are:- - Director (leads the session, who provides direction to the other group members (auxilaries), also enables pps to explore their feelings and release their emotions (Catharsis), also allows pps to observe links between present problems and past difficulties. - Protagonist – this is the person who is the focus of the session, whose experiences will be analysed - Auxiliaries – other group members who play a part in the enactments. They may act out roles of mother, father, brother, etc. There are three stages to Psychodrama: - Warm-up: Cognitive, sensory, verbal, behavioural, and physical activities. E.g., the ‘Empty Chair’ Task’, they ask the protagonist to think of a person in the chair who they would like to talk to. - Action phase: A theme is chosen, e.g., poor relationships with their children). Simple props are used to make the situation more real. - Sharing: This involves group members sharing what they experienced in the It’s suitable for people with unresolved issues in their lives, including family and relationship difficulties, for those suffering from anxiety, loss or depression and those who want to realise their potential. Psychodrama for people with mental retardation has been most effective when a directive style with structured session is used. - There are very few carefully controlled trials using randomly assigned conditions to assess the effectiveness of psychodrama. - Psychodrama is a flexible approach. Pps can try out new responses to old situations. This is suitable for people who have difficulty verbalising their emotions. It’s a doing and showing rather than a telling therapy. - There’s no agreed code of ethics in psychodrama therapy. - Lazarus (1994) claims that such ethical guidelines would affect the creativity and spontaneity.
  • 4. drama. This helps to release one’s emotions. Judgements of the protagonist should not be made.
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