Psychodynamic Therapy-

  • The Psychodynamic therapy was introduced by Sigmund Freud. This is the oldest form of psychotherapy. 
  • One of his close collaborators, Carl Jung, modified the Psychodynamic therapy and it came to be known as Analytical Psychotherapy. 
  • Freud’s successor psychologists, better known as Neo-Freudians, also introduced their own versions of the classical psychodynamic therapy. 
  • The Psychodynamic Therapy has conceptualized the structure of the psyche, dynamics between different components of the psyche and the source of psychological distress.

Methods of eliciting the nature of Intra-psychic Conflict-

The Psychoanalytic Approach considers intra-psychic conflicts to be the major cause of psychological disorders. There are two methods for understanding this intra-psychic conflict.

Free Association:

  • It is the main method of understanding the problems of the client. The first step is to form the therapeutic relationship and make the client feel comfortable.
  •  After that, the therapist makes him/her lie down on a couch and asks him/her to speak out anything and everything that comes to his/her mind without witholding anything.  
  • The client is encouraged to freely associate one thought with another and hence the name of this method is free association.
  • The censoring superego and the ever-watchful ego are kept in dormancy as the client speaks out everything that comes to his/her mind without witholding anything, in an environment which is relaxing and comfortable and trustworthy.
  • The therapist does not make any interruptions. There is a free flow of thoughts, ideas, desires and conflicts of the unconscious which had been concealed for a long time by the ego. All these thoughts, ideas, desires and conflicts, emerge into the client’s consciousness.
  • This free and complete narrative of the client is a window into the unconscious realm of the client and the therapist gains access to it.

Dream Interpretation:

  • In this method, the client is asked to write down all of his/her dreams after waking up. The client is instructed to highlight each and every detail in whichever manner the client remembers.
  • According to the Psychoanalytic Therapy, dreams are signs of unfulfilled desires which are present in the unconscious realm of the client. The images or the words in the dreams are symbols which reflect the intra-psychic forces.
  • Dreams use signs and symbols as because they are indirect or abstract expressions. They cannot be too direct because they might alert the ego and the ever-vigilant ego will repress it and hence it would lead to anxiety. 
  • The dream interpretation is done according to an accepted convention of translation as the indicators of unfulfilled desires and conflicts.

Modality of treatment-

The intra-psychic conflicts and unconscious desires, thoughts and ideas are brought into the conscious realm by the means of free association and dream interpretation. 

The two main means of treating the patient are as follows. 

Transference-

  • Once, the unconscious materials are brought in to the conscious realm of the client, the client begins to identify the therapist with the authority figures or other significant people of the past, usually childhood.
  • The therapist may be viewed as the father or the mother or any other significant person of the client’s past. The therapist maintains a non-judgemental but permissive attitude. The therapist allows the client to continue this procedure of emotional identification. Hence, this process is known as Transference.
  • The therapist keeps on encouraging this process because it helps the therapist in understanding the conflicts and the problems of the client. As the client identifies the therapist with an authority figure of his/her childhood, he/she acts out all of his/her frustrations, anger, fear, and depressions that he/she harbored against the person in the past but could not express at that time.
  • Transference Neurosis refers to the stage wherein the therapist becomes a substitute in the present for the person against which the client had harbored frustration in the past. Transference Neurosis is beneficial for the therapist as it helps him/her in understanding the types of the intra-psychic conflicts which are being faced by the client.
  • Positive Neurosis occurs when the client, idolizes or falls in love with the therapist and wants his/her approval. However, Negative Neurosis occurs when the expresses feelings of frustration, aggression, resentment and hostility towards the therapist.

Resistance-

Transference unravels the unconscious wishes and conflicts of the client. As a result, the distress levels of the client increases and the client starts resisting the procedure of transference. Due to resistance, the client prevents the progress of the therapy in order to protect him/her self from recalling the agonizing unconscious memories.

Resistance is of mainly two types:

  • Conscious resistance occurs when the client intentionally hides information during the therapy session.
  • Unconscious resistance occurs when the client becomes silent during the session and recalls other details without recalling the emotional details, comes late for the appointments and tries to miss the sessions. 
  • The therapist overcomes the resistance by frequently confronting the client about the emotional details and unravelling emotions like anxiety, fear, shame which are known to cause the resistance.

Interpretation-

  • Interpretation is the most crucial mechanism by which the change is affected. Interpretation includes 2 scientific methods. One is Confrontation and the other one is Clarification.
  • Confrontation- The therapist brings out an aspect of the client’s psyche that must be confronted by him/her. 
  • Clarification- The therapist brings out a confusing and imprecise event into sharp focus of the client’s consciousness. This is done by separating and highlighting significant details about the event from insignificant ones.
  • Interpretation is a sophisticated process. It is considered as the apex of psychoanalysis. The therapist uses the unconscious material that has been unravelled in the processes of dream interpretation, free association, transference and resistance in order to make client aware of the contents and conflicts in his/her psyche.
  • The 2 main things that interpretation focuses on mainly are intra-psychic conflicts or deprivations experienced in childhood. Working Through is referred to the process of repeatedly using confrontation, clarification and interpretation.
  • Working Through assists the client in understanding him/her self, the cause of the problems faced by him/her and it also integrates the unravelled material into his/her ego.
  • The result of Working Through is known as Insight. Insight is not a sudden process but it occurs gradually. In Insight the unconscious memories are frequently brought into the conscious awareness of the client; these materials are re-experienced in transference and are worked-through. As the procedure advances, the client begins to understand him/her self at an intellectual and emotional level. He/she gains insight about his/her conflicts and issues that trouble him/her. This intellectual understanding is better known as intellectual insight. 
  • Emotional insight refers to the emotional recognition and acceptance of an individual’s unreasonable and incoherent reactions to the past events which are unpleasant, the readiness for emotional adjustment as well as making the change.
  • Insight is considered as the end of therapy as because the client has acquired a completely new understanding of his/her self. Hence, the past conflicts, defence mechanisms and physical symptoms are no longer present. The client is now a healthy person in terms of psychological and emotional health. Psychoanalysis is then dismissed at this stage. 

The duration of the Therapy-

The duration of Psychoanalytic Therapy may extend to several years wherein there are one hour sessions for 4-5 days every week. Psychoanalysis is a very intense therapy and it is divided into 3 stages.

  • Stage 1- It is the first phase where the client becomes acquainted with the therapy routine, establishes a therapeutic relationship with the therapist and gets relieved by recalling the trivial details from the conscious realm about the past and present events which may be unpleasant to the client.
  • Stage 2- It is the middle phase and it is quite a long and time-consuming process. It includes transference, resistance on the client’s part and confrontation, clarification (working-through) on the therapist’s part. All these processes ultimately lead to insight and the client gains a complete new understanding of his/her self.
  • Stage 3- This is the final phase and it is also known the termination phase of the therapy. The therapeutic relationship between the client and therapist is dismissed and the client prepares to leave the therapy.

Psychodynamic Therapy is the oldest and the most complex form of treatment. The duration of the treatment is quite long but it also helps the client is gaining access to a complete new understanding of him/her self after he/she gains insight. Hence, Psychoanalysis is one of the most trusted methods for curing people with psychological disorders.