Psychodynamic approch

Psychodynamic approch

1. Freud

   • oral stage
     • - feeling at this stage influence personality - emotions generated depending on if the infant's needs are met
   • anal stage
     • unable to express feelings or emotions
   • phallic stage
     • - longing for opposite sex parent caused sexual feelings to be repressed in fear of punishment from same sex parent - this sexual experience continues to affect relationship style in adult life
   • id 'it'
     • - primitive insticts - irrational - ultimate motives of behaviour
   • ego 'I'
     • rational
   • superego 'above I'
     • - rules and taboos - internalisation of parents' attitudes and belief
   • defence mechanism
     • protect ego from pressure caused by conflict with other regions
     • repression
     • denial
     • projection
       • attributing the feelings to the others rather than themselves
     • Displacement
     • reaction formation
     • sublimation
     • regression

2. Counsellor

   • unravel the motives which are disguised by defence mechanism
   • counter-transference
     • therapist's own personality
     • therapist's response to client's relationship
     • shared interpersonal reality
   • insights to maintain system

3. Features

   • development of personality in childhood influence adult life
   • transference (repeated destructive relationship pattern)
   • defence mechanism - protect inner self
   • counter-transference (helper's own feelings)
   • problems = unresolved developmental tasks
   • secure and consistent emotional attachment - crucial for mental health
   • unconscious
   • subjective

4. Techniques

   • transference
     • counsellor being a blank slate
   • analysis
   • free assocation
   • dreams
   • interpretation
   • arts/toys/tests/diaries
   • time-limited approach
     • assessment
     • alternative referral/treatment
     • IDE formula
       • I-interpersonal (issues from relationship) D-developmental (issues from psycho-social development) E-existential (aloneness, death) 
     • why now
     • identify and interpret transference as soon as it arises

5. Object Relations (Melanie Klein)

   • - quality of relationship with mother sets pattern in future relationship in adult life - splitting occurs to defend the love and hate feelings against the same object

6. attachment theory (Bolwby)

   • - internal working model similar to relations model but - emphasis on biological based mechanism - attachment style caused by significant others
   • Strange Situation (Mary Ainsworth)
     • secure
     • insecure-avoidant
     • insecure-ambivalent
     • insecure-disoriented
   • Adult Attachment Interview (Mary Main)
     • secure/automous
     • dismissing
     • preoccupied
     • unresolved disorganised

7. Conversational Model

   • - clients talking about their feelings is important - embrace traditional psychodynamic concepts (separation/loss), humanistic theory (growth, awareness), existential (aloneness/togetherness)
   • feeling words/metaphors
   • links between feelings and event
   • discovery of true voice