Lecture Notes on Psychodynamic and Psychoanalytic Counseling and Psychotherapy

Lecturer: Dr. Diane Gayheart

Overview:

• Psychoanalysis and psychodynamic theories originated from Freud, marking the first forms of psychotherapy in the Western world.
• These theories have evolved over a century, resulting in several schools under the psychodynamic umbrella.
• The lecture provides a broad overview of psychodynamic theories and practices.

Key Schools in Psychodynamic Theory

1. Psychoanalysis

   • Originated by Freud.
   • Focuses on drive theory, instincts, and conflicts within self.

2. Ego Psychology

   • Emphasizes the ego and defense mechanisms.
   • Notable figures: Anna Freud, Erikson, Horney.

3. Object Relations

   • Focuses on the relationship between self and others (objects).
   • Prominent in current psychodynamic practices.
   • Key figures: Klein, Mahler, Winnicott.

4. Self Psychology

   • Developed by Kohut.
   • Focus on relationships with the self and self-objects.

5. Interpersonal Theory

   • Developed by Harry Stack Sullivan.
   • Focuses on observable interactions and self systems.
   • Basis for contemporary family therapy approaches.

6. Relational/Intersubjectivity Theories

   • Include modern influences from Mitchell, Greenberg, and Stoller.
   • Focus on interpersonal world and relational matrix.

7. Brief Psychodynamic Theories

   • Target specific symptoms like depression or anxiety.

Core Concepts

• Transference and Countertransference

  • Transference: Client projects unresolved issues onto therapist.
  • Countertransference: Therapist projects onto clients.

• Corrective Emotional Experience

  • Therapist helps clients resolve their inner conflicts by responding differently than past caregivers.

Therapeutic Process

• Listening, Interpreting, Working Through

  • Listening involves empathy and unbiased observation.
  • Interpretation promotes insight into personality dynamics.
  • Working through enables clients to address unconscious struggles.

• Therapeutic Relationship

  • Varies across different psychodynamic schools.
  • One-person vs. two-person relationships.
  • Holding Environment and Empathy.

• Case Conceptualization

  • In-depth and unique to psychodynamic therapy.
  • Requires understanding levels of consciousness, structures of the self, and other dynamic elements.

Key Theoretical Concepts

• Structures of the Self

  • Id, Ego, Superego.

• Drive Theory

  • Instinctual drives like libido and aggression.

• Defense Mechanisms

  • Denial, Projection, Interjection, Splitting, Repression, Suppression.

• Stages of Development

  • Freud's Psychosexual and Erikson’s Psychosocial stages.

Contemporary Approaches

• Object Relations

  • Focus on good enough mothering and internal objects.

• Self Objects

  • Objects that define self-identity, influenced by Kohut’s work.

• Relational Matrix

  • Contextual understanding of self and objects within relationships.

• Unconscious Organizing Principles

  • Cultural and relational influences that shape perception and behavior.

Goals and Interventions

• Long-term goals focusing on overall personality restructuring.
• Techniques include interpretation, empathy, free association, and dream interpretation.

Research and Application

• Most research supports brief psychodynamic approaches for specific disorders.

• Challenges in working with diverse populations due to cultural variations.

• Working with Diverse Populations

  • Needs careful adaptation especially regarding race, ethnicity, and socioeconomic diversity.
  • Special considerations for LGBTQ+ clients to avoid pathologizing non-heterosexual orientations.

Conclusion

• Psychodynamic theories provide a comprehensive framework for understanding human behavior and therapy.
• The approach requires extensive training and personal analysis of the therapist.