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Chapter 12

Clinical Psychology Chapter 12.docx

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John Stephens

Chapter 12- Psychotherapy: The Psychodynamic Perspective Psychoanalysis: The Beginnings • Freud & Charcot • Talking cure: techniques that encourage patient talking as a way of addressing and alleviating neurotic symptoms • Hysteria was viewed as a female disorder most often marked by paralysis, blindness, and deafness • Anna O presented many classical hysteria symptoms and Breuer treated her using hypnosis • Freud found that placing his hands on patients foreheads and asking them to remember events surrounding the origin of the symptom was just as effective as hypnosis • This was the beginning of what came to be known as the method of free association • Freudian Views • Psychic determinism: A major assumption of Freudian theory that holds that everything one does has meaning and is goal directed • There are no accidents • If you say something “by accident” there is a reason behind it • Unconscious motivations • Healthy behavior is behavior for which the person understands the motivation • Instincts • The energy that makes the human machine function is provided by two sets of instincts: • Life (Eros) • Basis for all positive and constructive aspects of behavior which includes bodily urges such as sex, hunger, and thirst as well as the creative components of culture such as art, music, and literature • Death (Thanatos) • When these activities serve as destructive ends, death instincts are responsible • Personality structures • Id • Deep inaccessible portion of the personality • Pleasure Principle • Uses a primary process kind of thinking, expanding energy immediately in motor activity • Manufactures a mental image of whatever will reduce the tension • Expressiveness of instincts • Without values, ethics, or logic • Guiding Principle: • Pleasure • Tasks: • Attain gratification of wants, needs, and impulses • Ego • Executive of the personality • Organized, rational system that uses perception, learning, memory and so on in the service of need satisfaction • Operates according to the reality principle, deferring the gratification of instinctual urges until a suitable object and mode are discovered • The secondary process is used- a process that involves learning, memory, planning, judgment, and so on • Current cognitive and emotional state • You make choices based on logic • Learning has an impact on you, this keeps you balanced • Guiding Principle: • Reality • Tasks: • Mediate demands of id and superego; cope with the real world • Superego • Oedipal complex is the child’s sexual attraction to the parent of the opposite sex and it represents the ideals and values of society as they are conveyed to the child through the words and deeds of the parents • Punished behavior typically becomes incorporated into the individual’s conscience • Rewarded behavior generally becomes part of the ego ideal • All about judgment • Aspects of what is expected of us; our morals • Your ideal; the perfect you which is never really attainable • Guiding Principle: • Morality • Tasks: • Develop conscience, block id impulses • Psychosexual stages: children go through stages marked by the involvement of a particular erogenous zone of the body – Oral: mouth most important for satisfaction – Anal: attention on urination and defecation (6 months to 3 years) – Phallic: sexual organs become source of gratification (ages 3-7) – Latency: lack of overt sexual activity (ages 5-12) – Genital: mature expression of sexuality (from adolescence into adulthood) • Anxiety – Reality: anxiety springs from real danger in the outside world (ego anxiety) – Neurotic: fear that id’s impulses will be expressed unchecked and lead to trouble from environment (id anxiety) – Moral: fear that one will not conform to the standards of the conscience (superego anxiety) • Ego defenses (defense mechanisms) – Repression: banishment of highly threatening material from consciousness – Fixation: anxiety about next psychosexual stage leads to stagnation at current stage – Regression: return to a stage that previously offered gratification – Reaction formation: unconscious impulse consciously represented by its behavioural opposite – Projection: unconscious feelings attributed to another person Techniques of Psychotherapy Seven Key Features of Psychodynamic Psychotherapy - Encourages patients to focus on affect and the expression of emotion - Helps people explore their attempts to avoid distressing thoughts and feelings - Identifies and focuses on recurring themes and patterns in patients’ thoughts, feelings, and behaviors - Helps patient discuss how past experiences affect their current relationships, feelings, and behavior - Focuses on interpersonal relationships and interpersonal experience - Focuses on the current therapy relationship - Encourages patients to explore fantasy life (e.g., uncensored thoughts, feelings, dreams) • Free Association – Patient must say everything that comes to mind without censoring – Believed to shed light on unconscious thoughts and urges • Dream analysis – Reveal nature of the unconscious
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