Relationship between life story and psychotherapy
We can understand much of what goes on in psychotherapy from three frameworks,
Psychodynamic; talk about conflicts inherent in their patients, conflicts between id and
ego, ego and superego. Unconscious conflicts produce anxieties; defence mechanisms are
used to overcome these anxieties. When defence mechanisms fail we can develop
symptoms – symptom represents expression of underlying conflict. Therapist provides
interpretation of patient’s projection. This produces some insight into conflict they have.
Process of producing insight leads to resistance. Cyclical process is expected to occur –
transference material onto therapist, interpretation of transference, patient’s insight, and
then reaction to resistance, which leads to further transference.
Cognitive behavioural therapy – grows out of modern learning traditions. Notion that
antecedent events illicit behaviours, behaviours can be overt or covert. Behaviours have
consequences and whether they are rewarding or punitive you will be more or less likely
to engage in behaviour in future. Cognitive restructuring techniques and behavioural
experiments. CBT therapists may engage in a number of behavioural experiments with a
socially anxious patient for example.
Humanistic/existential therapies – rogerian – conditions of worth that we all learn. One
goal of this therapy, through process of reflection communicate to patient that his or her
thoughts and feelings can be revealed to the world, they don’t have to be suppressed or
All these therapies claim to produce change through different processes and mechanisms.
One major question to haunt psychotherapy research is which one is better? Over four –
five decades, large body of research has emerged testing therapies against each other. Not
one psychotherapy can be said to be superior to the others – no differential efficacy
despite technical diversity.
Three suggestions made to explain why this is the case
Literature is wrong, differences do exist but we have yet to detect them. Symptom
measures have demonstrated reliability and validity so to call into question is to call into
question all research that has been done so this seems like unlikely case
There are different ways of arriving at the same conclusion. Therapies are different but
equally effective routes. This is highly implausible situation
Idea that in spite of technical differences there are common factors to all psychotherapies,
even though they claim to do different things, they are not doing things that are so
different than what other therapists are doing. There are underlying procedures and