Psychological therapies

1. Psychological therapies Psychoanalysis

2. Lesson objectives To revise the psychodynamic approach To be able to describe three different psychological therapies for psychoanalysis. To critically evaluate these therapies in terms of their strengths and weaknesses

3. Starter activity In pairs: Go through your notes from the psychodynamic approach. Write down the basic principles of the psychodynamic approach and what each of them says about explaining abnormal behaviour. You have 10 minutes to do this. When you have finished: write down any mental disorders you think this approach can explain. You need to justify how the approach would explain them.

4. Basic principles of the Psychodynamic approach • Mental disorders result from psychological rather than physical causes. • Freud believed that the origins of mental disorder lie in the unresolved conflicts of childhood which are unconscious. • Therefore: Medical illnesses are not the outcome of physical disorders but of psychological conflicts.

5. Basic principles of the Psychodynamic approach • Unresolved conflicts cause mental disorder (Id, ego and superego) • Conflicts between the id, ego and superego create anxiety. The ego protects itself with various defence mechanism (ego defences). • These defences can be the cause of disturbed behaviour if they are overused.

6. Basic principles of the Psychodynamic approach • Early experiences cause mental disorders. • In childhood the ego isn’t developed enough to deal with traumas and therefore they are repressed. E.g a death in the family may result in repressed feelings. • Later in life other losses may cause the individual to re-experience the earlier loss and may lead to depression. Previous unexpressed anger about the loss is the directed inwards towards the self leading to depression.

7. Basic principles of the Psychodynamic approach • Unconscious motivations cause mental disorders. - Ego defences such as repression and regression apply pressure through unconsciously motivated behaviour. • Freud claimed that the unconscious consists of memories that are hard or impossible to bring into conscious awareness. • This often leads to someone feeling distressed because they cannot understand why they are behaving in this way.

8. Psychological therapies Treating abnormal behaviour through psychoanalysis

9. Psychoanalysis • Many mental disorders are caused by unconscious factors and repressed material. • So main aim of therapies is to uncover this repressed material. • Once uncovered, they are able to release the power it has over their behaviour (e.g. causing their mental illness). This is called catharsis. • Free association, dream analysis, projective tests can be used. Not just one technique- a body of techniques.

10. Key terms Free association: technique used in Freudian psychoanalysis. The client is encouraged to express anything that comes into their mind and follow any associations that occur to them. The free association technique is also referred to as the talking cure. Dream analysis: Technique used in Freudian psychoanalysis. The therapist uses the dream work to interpret the manifest content of the dream and to uncover the latent content. Uses processes such as displacement and symbolisation

12. Free association • Patient is encouraged to express their thoughts exactly as they come into their mind, even though they may seem irrelevant or inappropriate. • The ego will attempt the censor what is said, but the free thinking allows previously unconscious thoughts to slip through. • Bring into consciousness memories that have been repressed. • This releases the power it had over their behaviour – hence a ‘talking cure’. • Therapist then interprets this content and feeds back to patient so they might begin to understand problem.

13. Key terms Manifest content: Dream imagery as reported by the dreamer. To uncover the meaningful content the therapist uses the dream work. Dream work: the processes that distort the underlying meaning of the dream (latent) into the manifest content reported by the dreamer. Uses processes such as displacement and symbolisation.

14. Dream analysis Dreams are related by their patients during therapy and they are interpreted by therapist. Freud believed dream content had meaning as it is through dreams that unconscious thoughts are expressed more freely. He suggested the manifest content (the actual literal dream) often conceals a latent content (which is a form of wish fufilment in symbolic form)

15. Think about the last dream you can remember having Try to think of any specific objects, people or activities that occurred in your dream WARNING: Some people may find the following interpretations embarrassing, so you don’t have to share your dream with anyone if you don’t want to!

16. Freudian symbolism • Long things that ‘jut out’: Penis • Mountains, sticks, umbrellas, poles, trees, baguettes, snakes • Objects which can be lengthened: Penis • Aeriels, extendable pens, • Things which go ‘up’: Erection • Helicopters, aeroplanes, rockets • Penetration • Knives, weapons, swords, guns, rifles, cannons • Rhythmical activities: Sexual intercourse • Dancing, climbing, riding. • Authority figures: Father + the oedipus/electra complex • Police, teachers, doctors…

17. Example A patient might report a dream where kings and queens appear. Freud believed kings and queens are not to be taken literally but are parents in symbolic form- this would be the latent content of the dream. It is the latent content of a dream which is interpreted and discussed with the patient.

18. Transference occurs when the client redirects feelings [e.g. of hostility] towards the therapist, which are 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.

19. Ink blots • What do you see….? • Use your imagination, what can you see in your ink blot? • Write you thoughts on your ink blot.

21. Projective tests • Patient required to project or impose their own thoughts and associations on stimulus material. • For example, Rorschach ink blot test. • These ink blots are deliberately ambiguous. People are asked to describe what they see in the ink blot. • Principle underlying this therapy is that people will project their own unconscious concerns, fears and wishes onto the material.

22. Strengths + Effectiveness: Bergin (1971) analysed data from 10,000 patient histories and estimated 80% benefited from psychoanalysis VS 65% from therapies based on a number of different approaches. + Length of treatment: Tschuschke et al (2007) carried out a large study (more than 450 patients) investigating long term psychodynamic treatment. Found:

23. Weaknesses - False memories: Critics have said that some therapists are not helping patients recover repressed memories but are planting false memories of sexual abuse or alien abduction. Loftus claims that All psychoanalysis assumes that a patient can reliably recall early memories that have been repressed yet there is little evidence to support this.

24. Weaknesses • Theoretical weaknesses: Psychoanalysis is based on Freud’s theory of personality: if that is flawed then the explanation of mental illness arising from this theory must be flawed and the therapy therefore is flawed. Eysenck (1986) argued that “... The obvious failure of Freudian therapy to significantly improve on spontaneous remission or placebo treatment is the clearest proof we have of the inadequacy of Freudian theory”.

25. Ethical issues Psychoanalysis has ethical problems: Stress of insight: painful memories are brought into the conscious and there is a controversy over false memories. The issue of “forced termination” where the therapist must break off from a therapeutic relationship before client is ready. This can leave patients feeling distressed.