PSYCHODYNAMIC THERAPY

•Method of treatment
•Modality of treatment
•Duration of treatment
 I N TR O D U C T I O N

• Oldest form of psychotherapy given by sigmund freud

• Carl Jung modified as analytical psychotherapy
• Subsequently Freud’s successors- Neo freudian
establish their own versions….
• Conceptualized the structure of psyche
• Dynamic between the different components of psychic
and the source of psychological distress.
• Conscious, pre conscious and unconscious..
• Id, Ego and superego..
 M E T H O D S O F E L IC I T IN G - I N T R A P S Y C H I C C O N F L I C T

• Main cause is intrapsychic conflicts

• Elicit by free association and dream interpretation
• FREE ASSOCIATION
• Main method of eliciting the client’s problem
• Therapeutic relationship established between T-C
• Base is trust and confidence;
C feels comfortable
C was asked to lie on the couch; Close the eyes
Relaxed and trusting…
Speak out whatever comes to the mind.
 M E T H O D S O F E L I C I T IN G - I N T R A P S Y C H I C C O N F L I C T

• No Censoring superego and No watchful ego, while C- speaks

• Free flow of ideas/ feelings/desires and conflicts of unconscious, which was suppressed by ego,
emerge into conscious state;
• The free uncensored narration of C- helps the T gain access and note down the valid points of
information;
• C- was asked to write/ about his/her dream upon waking
• images and symbols of dreams represent unfulfilled desires and
signify intrapsychic forces
• unfulfilled desires are not expressed directly due to ego, if it is
sos, leads to anxiety
• Hence through symbols it expressed , and we convert the symbols
as translation
• Meaningful sentence
• Indicators of unfulfilled desires is of conflicts
 M O D A LI T Y O F T RE AT M E NT

• Transference and interpretation

• TRANSFERENCE:
• Unconscious desire brought into conscious through free association and dream interpretation.
• C view the T as authority of figure of past (childhood)
• (punitive father of negligent mother)
• T maintain non-judgmental yet permissive attitude
• Allow the C with emotional identification
• T encourage this process to understand unconscious conflict of C
 MODALITY

• TRANSFERENCE NEUROSIS stage:

• C give out his/her frustration, anger, fear and depression towards the person at past, but could not
express at that time.
• C consider T as substitute for “father or Mother”
• Full blown neurosis helps the T to study/ understand the intrapsychic conflict of the client
completely.
• POSITIVE TRANSFERENCE NEUROSIS:
• C treat/ consider the T as God, falls love with T / seek T approval
• NEGATIVE TRANSFERENCE NEUROSIS : Villian, enemy, express anger, fear towards T
 MODALITY

• RESISTANCE:
• During transference the C gives out/expose his/her feelings, desires, wishes and conflicts from
unconscious level
• Which leads to great distress /worry/ painful
• Hence C is unable to bear the great distress /worry/ painful,
• So the C tend to stop/ oppose the transference process in order to protect him/her – RESISTANCE
• R- blocks the progress of Transference process
• R- may be conscious or unconscious
• Conscious R:
• C willingly wants to hides information
• unconscious R:
• silent, skip the appointment, late attendance, not recall the
emotional side of the information..
 MODALITY

• T- overcome the resistance by repeated confront the C, and uncover the fear, anxiety or shame..
• INTERPRETATION
• Fundamental mechanism for effective change
• Confrontation and clarification is the techniques under interpretation
• CONFORNTATION
• T point out the psychic conflict (nature, reason, and its consequence) to C, that he/she was facing..
 MODALITY

• CLARIFICATION
• T collect all aspects/information revealed by C,
• segregated the unimportant and important points related to intrapsychic conflict.
• Thereby the vague or confusing is sharpen to get conclude/ decided
• Interpretation is pinnacle of psychoanalysis,
• T use unconscious materials that was uncovered in the process of
free association, dream interpretation, transference and
resistance
• to make the C aware of conflict
 MODALITY

• WORKING THROUGH
• T repeat the process of using confrontation, clarification and interpretation.
• WT- helps C in understanding him/her; source of problem; integrate uncovered materials in ego
• INSIGHT
• Outcome of working through. Gradual process
• Unconscious memories (events, feelings, desire, conflict) repeatedly integrate/ re-experienced into
conscious
• C- gain insight about the conflict and problem
• Intellectual insight occurs
 MODALITY

• Emotional understanding; accept the unpleasant past

• Willingness to change emotionally and make the change
• INSIGHT is the end point of therapy
• Insight instill clear understanding in C,
• Past conflict, defence mechanism, physical symptoms got decreased or no longer present
• hence he/she become psychologically healthy person
• Psychoanalysis is terminated
 D U R AT I O N O F T R E AT M E N T

• Last for Several years; 1 Hr for 4-5 days/week

• 3- stages
• INITIAL PHASE: C familiar with routine, establish relationship; have some relief with process of
recollect the superficial materials from the consciousness of past and present troublesome event
• MIDDLE PHASE: long process; lead to insight
• C- transference and resistance
• T- confrontation and clarification, working through
• TERMINATION PHASE :relationship dissolve and prepare to leave the therapy
 ETHICS IN PSYCHOTHERAPY

• Informed consent needs to be undertaken

• Confidentiality is maintained
• Alleviating personal distress and suffering should be the goal of all attempts of the therapist
• Integrity of T-C relationship is important
• Respect Human rights and dignity
• Professional competency and skills are essential.