Psychodynamic Therapy

Considering the nature of defense mechanisms and the lack of access of the predetermined forces acting in the unconscious, psychoanalytic therapy in its traditional form is a long process that frequently requires between two and five meetings a week over a few years. This method presupposes that symptom decrease alone is insignificant, as if the foundational conflict remains unresolved, additional psychotic symptoms will merely be swapped.

The assessor is typically a ‘blank page,’ revealing very little about themself in order to enable the patient to operate on their unconscious without external influence. The psychoanalyst encourages the patient to acquire insights into their behavior and the significance of their complaints through a variety of interventions, such as inkblots, free association, parapraxes, transference analysis, resistance analysis, and interpretation (including dream analysis).

Inkblots Rorschach inkblots. Due to the lack of accessibility of predetermined forces operating in the unconscious and the nature of defense mechanisms. The Rorschach inkblot is meaningless in and of itself; it is ambiguous (i.e., unclear). What matters is what you make of it. Individuals will perceive things differently depending on the unconscious connections they make. The inkblot is referred to as a measurement tool because the patient interprets the inkblot by ‘projecting’ data from their unconscious mind. Behavioral psychologists including B.F. Skinner, on the other hand, has condemned this strategy as unscientific and subjective.

Freudian Slip. Unconscious feelings and thoughts can transmit to the conscious mind via parapraxes, commonly referred to as Freudian slips or tongue slips. We expose what is truly on our minds when we say something we did not intend to say. For instance, during a speech, a dietitian meant to remark that we should always seek the finest bread but mistakenly said bed. Another instance is when a coworker’s new partner is addressed by the surname of a prior one whom he preferred. Freud felt that tongue slips revealed unconscious thoughts and that there were no coincidences; all conduct (even tongue slips) was meaningful (i.e., all behavior is determined).

Free Association. In psychodynamic psychotherapy, free association is a technique in which a patient expresses whatsoever thoughts come to mind. This technique entails the therapist presenting a word or concept, and the patient responding instantly with the first thing that occurs to them. It is expected that during free association, pieces of repressed memories may resurface, providing a glimpse into the unconscious mind. Free association may be ineffective if the patient exhibits resistance and is unwilling to express his or her thoughts. On the contrary, the appearance of resistance (e.g., an abnormally extended pause) is generally a strong indicator that the client is approaching a significant suppressed thought in his or her mind and that additional exploration by the therapist is necessary.

Freud said that sometimes, his free-associating patients received an emotionally intense and clear recollection to the point of reliving it. This is similar to a “flashback” from a battle or a sexual assault. A distressing memory that is so real that it feels as though it is occurring again is referred to as abreaction. If such an upsetting memory occurs in psychotherapy or with a caring friend and the individual afterward feels better—relieved or cleansed—this is referred to as catharsis. Freud often gained vital understanding into the patient’s difficulties as a result of these extremely emotional experiences.

Dream Analysis. Freud described dream analysis as “the royal road to the unconscious.” He contended that the conscious mind functions similarly to a filter, but is less watchful while we sleep. As a consequence, suppressed ideas are brought to the surface – even if what we remember was changed during the dreaming process. As a result, we must differentiate between a dream’s apparent and hidden content. The former is what we recall. That is, in fact, what it implies. Freud thought that the actual meaning of dreams generally had a sexual connotation, and in his theories of sexual metaphor, he opines the deeper meanings of commonly occurring dream patterns.

Transference. Along with observing communication nuances, psychodynamic therapists are aware that patients commonly unintentionally project their sentiments, aspirations, anxieties, and grudges toward real persons in their life and these might be passed onto the therapist. Transference is a term that refers to the process by which individuals transmit their emotions from the original person to the therapist as a target of those sentiments. Although patients do not always identify transference when it happens, the psychodynamic therapist can understand the correlation, guiding the patient in locating the real origin of those emotions. They frequently involve individuals who represent unsolved problems in the individual’s life and may even indicate misdirected shame or guilt that the individual felt in these interactions.

On the other hand, therapists may have unconscious sentiments toward their patients at any point during therapy, as they, too, are human. Countertransference is a significant feature in psychodynamic treatment. Therapists are educated to identify their own issues in order to minimize their undue effect in therapy. As a result, countertransference can be employed by the therapist to obtain a greater understanding of the patient’s perspective and to approach those challenges appropriately.