EPPP - Clinical Psych - Psychodynamic

structural (drive) theory and developmental theory

id, ego, and superego

present at birth and consists of the person's life and death instincts

serves as the source of all psychic energy

operates on the basis of the pleasure principle and seeks immediate gratification of its instinctual drives and needs in order to avoid tension

develops about six months of age in response to the id's inability to gratify all of its needs

operates on the basis of the reality principle 

defers gratification of the id's instincts until an appropriate object is available in reality and employs secondary process thinking (realistic, rational thinking, and planning)

primary task is to mediate the often conflicting demands of the id and reality and, once it has developed, the superego

emerges between 4 and 5 years old

represents an internalization of society's values and standards, as convey by parents through rewards and punishments

in contrast to the ego, which postpones gratification of the id's instincts, the superego attempts to permanently block the id's socially unacceptable impulses

emphasizes the sexual drives of the id and proposes that an individual's personality is formed during childhood as the result of certain experiences that occur during five predetermined psychosexual stages

During each stage, the id's libido (sexual energy) is centered on a different part of the body, and, as a result, over or under gratification during each stage is associated with different personality outcomes

• oral
• anal
• phallic
• latency
• genital

anxiety is an essential component of this theory

described as an unpleasant feeling linked with excitement of the autonomic nervous system and its function is to alert the ego to an impending internal or external threat (danger arising from a conflict between the id and superego or a real threat in the external environment) 

when the ego is unable to word off danger through rational, realistic means, it may resort to one of its defense mechanisms.

they operate on an unconscious level

serve to deny or distort reality

repression 

underlies all other defense mechanisms 

occurs when the id's drives and needs are excluded from conscious awareness by maintaining them in the unconscious

involves avoiding an anxiety-evoking impulse by expressing its opposite

occurs when a threatening impulse is attributed to another person or other external source

psychopathology stems from an unconscious, unresolved conflict that occurred during childhood

the result of displacement of anxiety onto on object or event that is symbolic of the object or event involved in an unresolved conflict

due to object loss coupled with anger toward the object turned inward

represents a defense against libidinal or aggressive urges that threaten to overwhelm the ego

reduce or eliminate pathological symptoms by bringing the unconscious into conscious awareness and integrating previously repressed material into the personality

primary technique is analysis, and the main targets of analysis are free associations, dreams, resistance, and transferences

underlying the analysis of these events is the assumption of psychic determinism, or the belief that all behaviors are meaningful and serve some psychological function (i.e., slips if the tongue are expressions of unconscious motives)

confrontation 

clarification

interpretation

working through

entails making statements that help the client see his or her behavior  in a new way

involves clarifying the client's feelings and restating their remarks in clearer terms

explicitly connecting current behavior to unconscious processes. Interpretations are less likely to elicit anxiety and resistance and, therefore, are more effective when they address motives and conflicts close to a client's consciousness than when they relate to material buried deep in the unconscious

the emotional release resulting from the recall of unconscious material, and it paves the way for insight into the relationship between unconscious processes and current behaviors

the final and longest stage in psychoanalysis

allows the client to gradually assimilate new insights into their personality

regards behavior as being largely motivated by a person's future goals, rather than determined by past events

• inferiority feelings
• striving for superiority
• style of life
• social interests

develop during childhood as the result of real or perceived biological, psychological, or social weakness, while striving for superiority is an inherent tendency toward perfect completion

the ways a person chooses to compensate for inferiority and achieve superiority determine the style of life, which unifies the various aspects of the personality

healthy

unhealthy/mistaken 

social interest

optimism 

confidence

concern about the welfare of others

self-centeredness

competitiveness

striving for personal power

early experiences, especially those occurring within the context of the family

well-established by four or five years old

• of particular importance is whether a child is pampered or neglected.
• pampered = not developing social feelings. 
• neglected = dominated by a need for revenge

mental disorders represent an unhealthy/mistaken style of life

characterized by maladaptive attempts to compensate for feelings of inferiority, a preoccupation with achieving personal power, and a lack of social interest.

entails establishing a collaborative relationship with the client, helping them identify and understand their style of life and its consequences, and reorienting their beliefs and goals so that they support a more adaptive lifestyle

Through the use of "lifestyle investigation" which yields information about the client's family constellation, fictional (hidden) goals, and "basic mistakes" (distorted beliefs and attitudes

the consequences of both conscious and unconscious factors 

the conscious is oriented towards the external world, is governed by the ego, and represents the individual's thoughts, ideas, feelings, sensory perceptions, and memories 

The unconscious is made up of the personal unconscious and the collective unconscious.

The personal unconscious contains experiences that were unconsciously perceived or were once conscious but now repressed or forgotten 

The collective unconscious is the repository of latent memory traces that have been passed down from one generation to the next. This includes archetypes

primordial images that cause people to experience and understand certain phenomena in a universal way.

the self - represents a striving for a unity of the different parts of the personality 

the persona/public mask - the outward face we present the world and conceals our real self

the shadow - represents the dark side of personality and is composed of repressed ideas, weakness, desires, instinct, and shortcomings 

the animus - the unconscious masculine side of a woman

the anima - the unconscious feminine side of a man

In contrast to Freud who emphasized the impact of the first six years of life, Jung viewed development as continuing throughout the lifespan and was most interested in growth after the mid-30's

extraversion 

introversion

thinking

feeling

sensing

intuiting

Although all four functions operate in the unconscious of all people, one function ordinarily predominates in the consciousness

refers to an integration of the conscious and unconscious aspects of the psyche that leads to the development of a unique identity

An important outcome of individuation is the development of wisdom, which occurs in the later years when a person's interests turn toward spiritual and philosophical issues

symptoms are unconscious messages to the individual that something is awry with him and present him with a task that demands to be fulfilled

the primary goal is to rebridge the gap between the conscious and the personal and collective unconscious

rely primarily on interpretations that are designed to help the client become aware of their inner world.

Dreamwork - Because material in the collective unconscious is often expressed symbolically, dreams are of particular interest and the interpretation of dreams is a key component to therapy. Dreams represent an unconscious message to the person that is revealed in a symbolic form 

Transference - considered to be a projection of the personal and collective unconscious and the analysis of transference is a crucial part of therapy 

countertransference - regarded as useful to provide the therapist with information about what is occurring during the course of therapy 

reflects an optimistic view of human nature  and focuses primarily on the here-and-now with information from the past only being used if it will help to understand the present

consider object-seeking (relationships with others) to be a basic inborn drive, and emphasize a child's early relationships with objects, especially the child's internalize representations (introjects) of objects and object relations that become part of the self and influence interactions with other people in the future

Melanie Klein

Ronald Fairbairn

Margaret Mahler

Otto Kernberg

the process by which an infant assumes their own physical and psychological identity 

her model of early development involves several phases and sub phases

normal infantile autism - occurs during the fist month. The infant is self-absorbed and essentially oblivious to the external environment

normal symbiotic phase - the child becomes aware of the mother but is unable to differentiate between "me" and "not-me" and occurs during the first six months of life 

separation-individuation - the actually development of object relations which begins at four to five months and is composed of four overlapping subphases

differentiation

practicing

reapproachement 

object constancy

the result of abnormalities in early object relations

Mahler traces psychopathology to problems that occurred during the separation-individuation phase

Many believe there is a natural tendency to split mental representations of the self and others into "good" and "bad" and that inadequate resolutions of this splitting is a cause of maladaptive behavior i.e., BPD never integrated the positive and negative aspects of experiences with others and continues to shift back and forth between contradictory images (overidealizing other to devaluating)

therapy is an opportunity to provide support, acceptance, and other conditions that restore the ability to relate to others in meaningful, realistic ways 

A primary goal is to bring maladaptive unconscious relationship dynamics into consciousness so that dysfunctional internalized object representations can be replaced with more appropriate ones

A primary focus is on splitting, projective identification, and other defense mechanisms that serve to maintain pathological object relations

id

ego

id

4-5 

society's standards and values

psychosexual 

libido (sexual energy)

ego

reaction formation

interpretation

countertransference

social 

teleological

style of life

personal 

collective

archetypes

object seeking (relationships with others)

separation-individuation

splitting

interpretation

confidence, optimism, and concern about the welfare of others.

reaction formation.

projection of the personal and collective unconscious.

A

archetypes