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Psychotherapy

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Psychodynamic Approaches

All of the many psychodynamic therapies derive from the treatment called psychoanalysis, which Sigmund Freud developed and used in the late 1800s and early 1900s. (See Chapter 13 for more information on Freud and his theory of psychoanalysis.)

Psychoanalytic treatment focuses on uncovering unconscious motives, conflicts, and defenses that relate to childhood experiences. Freud believed that people experience anxiety because of conflicts among the id, ego, and superego. To manage these conflicts, people use defense mechanisms, which can often be self-defeating and unsuccessful at fully controlling anxiety.

Psychoanalytic Techniques

In the traditional form of psychoanalysis, clients meet with a psychoanalyst several times a week for many years. The psychoanalyst sits out of view of the client, who sometimes lies on a couch.

Some techniques commonly used in psychoanalysis include free association, dream analysis, and interpretation:

  • Free association: Psychoanalysts encourage clients to say anything that comes to mind. Clients are expected to put all thoughts into words, even if those thoughts are incoherent, inappropriate, rude, or seemingly irrelevant. Free associations reveal the client’s unconscious to the psychoanalyst.
  • Dream analysis: Dreams also reveal the subconscious. Clients describe their dreams in detail, and the psychoanalyst interprets the latent content, or the hidden meaning, of these dreams.
  • Interpretation: A key technique in psychoanalysis, interpretation refers to the psychoanalyst’s efforts to uncover the hidden meanings in the client’s free associations, dreams, feelings, memories, and behavior. Psychoanalysts are trained to make interpretations carefully and only when a client is ready to accept them. Ideally, such interpretations increase the client’s insight .
Psychoanalytic Concepts

Three important concepts involved in psychoanalysis are transference, resistance, and catharsis:

  • Transference refers to the process by which clients relate to their psychoanalysts as they would to important figures in their past. Psychoanalysts usually encourage transference because it helps them to uncover the client’s hidden conflicts and helps the client to work through such conflicts.

Example: A client who is resentful about her mother’s authority over her might show angry, rebellious behavior toward the psychoanalyst.

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