The Psychodynamic Approach

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Nicole Stanley
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The Psychodynamic Approach
  1. The assumptions
    1. Influence of childhood
      1. the adult personality is developed in stages known as psychosexual stages, each stage represents the libido fixating on a certain part of the body
        1. it can end up with the person being fixated too much on one stage. leading to long term effects on the personality and it can occur in two ways:
          1. frustration: the childs needs were not met at a stage
            1. over-indulgence: the child is over satisfied so it is reluctant to move through the stages
              1. the stages: oral 0-18m; anal 18m-3y; phallic 3-5y; latency 5y- puberty; genital puberty - onwards
                1. oral
                  1. mouth: sucking, chewing, swallowing and biting
                    1. anal
                      1. phallic
                        1. latency
                          1. genital puberty
                            1. genitals: homosexual intercourse
                              1. well developed adult personalities
                            2. little/ no sexual motivation
                              1. aquiring knowlegde and understanding of the world
                                1. no fixations as no pleasure focus
                              2. genitals: masturbation
                                1. the odeipus complex leads to superego and gender identity
                                  1. self assured, vain, sexuality issues, relationship struggles
                                2. anus: withholding, expelling, playing with faeces
                                  1. potty training
                                    1. fr: stubborn, possessive, overly tidy
                                      1. ov: messy, disorganised, reckless
                                    2. breast feeding. weaning onto solid food sources
                                      1. fr: pessimism, envy, sarcasm
                                        1. ov: optimism, gullibility, neediness
                              3. the unconscious mind
                                1. 3 levels of the mind
                                  1. conscious: a logical part of the mind, and what we are aware of at the time. the smallest of the 3 levels
                                    1. preconscious: just under the surface, can be accessed with prodding, not as large as the unconscious but not as repressed
                                      1. unconscious: cannot be directly accessed and only expresses indirectly e.g. dreams. governed by pleasure seeking and emotion. home of the id, ego and superego and all their conflict. to protect from the conflict the ego uses defence mechanisms
                                  2. each level becomes larger and larger and even harder to access. the deeper levels can only be accessed through dreams and long-term therapy
                                    1. defense mechanisms: there are three which when are overused can be the cause of disturbed behavior
                                      1. displacement: transfer of impulses from one person or object to another
                                        1. projection: undesirable thoughts are attributed to someone else
                                          1. repression: pushing painful memories deep down into out unconscious mind so they are entirely forgotten
                                  3. the tripartite personality
                                    1. the id: the impulsive, unconscious, part of our personality that is present at birth. it demands satisfaction, also refered to as the pleasure principle. the main aim of the id is to gain pleasure and gratification at any cost. driven by the eros - the life drive and the thanatos- the death drive
                                      1. the ego: this is the conscious, rational part of the mind that develops around the age of 2. it exists to work out realistic ways of balancing the demands of id and cosial acceptance. it is governed by the reality principle
                                        1. the superego: this is the last part of our personality to develop, forming around the age of 4. it embodies the child's sense of right and wrong as well as his or her ideal self. the supergeo seeks to perfect and civilise our behaviour. learnerd through identification with one's parents and others.
                                    2. Relationship Formation
                                      1. childhood experiences
                                        1. Childhood experiences, psychodynamic development, influence future relationships.
                                          1. Each stage and fixations involved will affect a person’s adult relationships in different ways:
                                            1. Overindulgence in the oral stage may lead to clingy/ needy partners
                                              1. If the phallic stage is not passed it may lead to not being able to love
                                                1. If the Oedipus complex is not resolved it will lead to homosexuality.
                                              2. defence mechanisms
                                                1. Forming relationships in adulthood can bring up unpleasant emotions from the past. May use ego defences to help them avoid anxiety.
                                                  1. Freud spoke about the mechanisms and how they affect a person’s behaviour including in relationships.
                                                    1. For example, a person in denial about their sexuality might try to form relationships with those not in line with their true feelings, resulting in dysfunctional relationships which break down.
                                                      1. Those who are dishonest in a relationship (i.e. having an affair) may deal with their guilt through rationalisation such as ‘they deserve it as they don’t pay me attention’.
                                                      2. defence mechanisms affect our overall personality and inevitably the relationships formed
                                                      3. Bowlby formed the view that early unhealthy experiences shaped the behaviour of some children
                                                        1. some of the theives he studied had formed an affectionless character and that most of these children had experienced prolonged separation from their mothers at a young age
                                                          1. developed the maternal deprivation hypothesis, the view that the ability to form meaningful social relationships in adulthood was dependant on a close and continiour relationship with the mother or the mother-figure.
                                                            1. first 2 and 1/2 years are most important but up to the age of 5 there is a continuing sensitivity and need for the relationship
                                                              1. acts as a prototype for all future relationships and its disruption would impair the person's ability to relate to others
                                                        2. The Contemporary Debate
                                                          1. Mother should be the primary care giver
                                                            1. feeding
                                                              1. nhs recommends that infants should be breatsfed for the first 6 months at least if possible.
                                                                1. protects child from numerous infections and diseases
                                                                  1. allows a physical and emotional bond to form; important for emotional development
                                                                  2. mother is only person who can feed child; limits other caregivers abilitities maiing the mother the primary
                                                                    1. recommended feed is every 2 hours - hard for woman to work due to this
                                                                  3. Freud's view
                                                                    1. mother-infant relationahip is most improtant
                                                                      1. help to satisfy the initial oral stage of psychosexual development
                                                                        1. satisfy libido
                                                                        2. separation anxiety
                                                                          1. mother's love acts as a prototype for every relationship the infant will form
                                                                        3. deprivation damage
                                                                          1. Bowlby demonstrated that early and prolonged seperation between a child and its mother can have lasting emotional effects
                                                                            1. most likely to lead to affectionless chilldren who lack a sense of shame or responsibility
                                                                              1. called it a maternal deprivation hypothesis
                                                                                1. attchment to caregivers has a special importance for survival; called monotropy
                                                                                2. bowlby identified a central role for the mother in the emotional development
                                                                                  1. based on training as a Freudian psychiatrist
                                                                                3. mothers not fathers
                                                                                  1. biological factors
                                                                                    1. oestrogen underlies caring behaviour meaning women are more orientated to emotion than men
                                                                                    2. social factors
                                                                                      1. sex-stereotypes allow women to be more sensitive then men
                                                                                      2. infant cues
                                                                                        1. evidence that men are less sensitive to infant cues
                                                                                          1. Heermann et al 1994
                                                                                          2. frodi et al 1978 found there was no difference in biological responses between male and female when a infant cried - was on video, could be a flaw
                                                                                      3. Mother does not need to be the primary care giver
                                                                                        1. feeding
                                                                                          1. food does not equal love like it was presented in the 50s
                                                                                            1. Harry Harlow 1959 placed infant monkeys in with 2 wire 'mothers'
                                                                                              1. one only fed - had a feeding bottle attached
                                                                                                1. on provided comfort - covered in soft cloth
                                                                                                  1. spent most time on cloth covered mother - especially when frightened
                                                                                                  2. Schaffer and Emerson 1964 studied human behaviour
                                                                                                    1. primary attachments were not formed by feeding or spending time with the infant
                                                                                                      1. formed by carers who responded quickly ans sensitively to their 'signals' and offered the most interaction
                                                                                                2. Freud's views
                                                                                                  1. consider context - when Freud was writing women didn't even have the right to vote
                                                                                                    1. views could just reflect on the norms and values held by society
                                                                                                    2. did recognise the importance of the father
                                                                                                      1. Oedipus complex - fancy dad (F) / envy dad (M)
                                                                                                        1. father's protection
                                                                                                      2. deprivation damage
                                                                                                        1. bowlby did not exclusivley mean the child's mother in his maternal deprivation hypothesis
                                                                                                          1. he uses the word mothering - allowing for substitutions
                                                                                                          2. Bowlby et al 1956 presented research that some children show no ill effects from early seperation
                                                                                                            1. the children in the study were ill with TB and spent years in hospitals with little family contact
                                                                                                              1. showed few problems in later life
                                                                                                                1. suggests that they coped better due to better attachments to their mothers/substitutes in the first place = resilient
                                                                                                            2. mothers not fathers
                                                                                                              1. men are capable of forming close attachments, as is the case with single parent famillies
                                                                                                                1. view that men are not emotional is outdated
                                                                                                                  1. men become hormonally adapted to parenthood
                                                                                                                    1. gettler et al 2011 suggests that a father's testosterone levels drop in order to help with reponses
                                                                                                            3. Dream Analysis
                                                                                                              1. link to the assumptions
                                                                                                                1. childhood experiences: the therapy will link current issues to the childhood experiences causing the issues
                                                                                                                  1. unconscious mind: the therapy aims to make the unconscious, conscious
                                                                                                                    1. tripartite personality: the desire of the id, which are unacceptable in society, are released to prevent insanity
                                                                                                                      1. dreams act as wish fulfillment; the id's desires and wishes
                                                                                                                        1. the unconscious must do this in order to prevent insanity by letting the id rule when it matters least
                                                                                                                2. our dreams are not blatantly obvious in what wishes they want filled and use symbolism to show dreams indirectly.
                                                                                                                  1. freud considered the context of people's lives when analysisng dremas
                                                                                                                    1. dreams are put into two types of content
                                                                                                                      1. the manifest content: what you actually dream about
                                                                                                                        1. latent content: the real meaning of the dream
                                                                                                                      2. dreamwork is where the latent content of a dream is transformed into manifest content
                                                                                                                        1. it is the therapists role to reverse the dreamwork and provide interpretations that fits the client
                                                                                                                        2. methods:
                                                                                                                          1. - Condensation: dream thoughts are rich in detail and content, but these are condensed to brief images in a dream where one dream image stands out for several associations and ideas
                                                                                                                            1. - Displacement: the emotional significance of a dream object is separated from its real object or content and attached to an entirely different one, so the dream content is not censored – allows disturbing thoughts (e.g. angry at someone – dream that you like them)
                                                                                                                              1. - Representation: a thought is translated into a visual image (e.g. turn desire into images)
                                                                                                                                1. - Symbolism: a symbol replaces an action, person or idea (e.g. directly symbolises desire)
                                                                                                                                  1. - Secondary elaboration: the unconscious mind collects all the different images and ties them together to form a logical story, further disguising the latent content. The actual dream material may be supplied from recent events in a person’s waking life. (e.g. use a story to represent a desire)
                                                                                                                                  2. research evidence
                                                                                                                                    1. Hopfield et al 1983, found that computer simulations trying to mimic the mind had to condense information when it was overloaded, this is similar to Freuds idea of condensation. (not as good as technology was weak)
                                                                                                                                      1. Solms 2000 used PET scans and found that when in the REM stage of sleep the rational part of the brain (ego) is inactive where the memory and motivation parts (id) is active. (tripartite support and unconscious mind is supported as memory section is awake)
                                                                                                                                    2. methodological issues
                                                                                                                                      1. Many studies conducted have been done on humans and animals that are sleep deprived significantly including REM. This disruption will impair biological functions and the secretion of hormones and neurotransmitter. These can act as confounding variables which need to be interpreted with caution
                                                                                                                                        1. When research about dreams are conducted they are done in laboratories, it can be questioned whether the dream state is authentic as not done under normal conditions due to environment and wired that measure electrodes. Compromises the ecological validity.
                                                                                                                                        2. subjective interpretations
                                                                                                                                          1. Finding the meaning of the latent content relies on the subjective interpretation of the therapist. Further the dream being interpreted is a subjective report of the dreamer and may not be reliable. Dream analysis is a highly subjective process going against scientific aims of psychology.
                                                                                                                                          2. therapist client relationship
                                                                                                                                            1. an imbalance between patient and client. Generally, the therapy takes the expert role, offering the patient insight into their unconscious making them reliant on the therapist to make progress
                                                                                                                                              1. is typical of people suffering from depression and other mental illnesses where they rely on others in their life.
                                                                                                                                              2. There can also be a power imbalance in other therapies, such as systematic desensitisation, with the therapist being the authority figure it cancels out the consented hierachy
                                                                                                                                              3. false memory tests
                                                                                                                                                1. These false memories can come to light during psychoanalysis when the therapist claims to have uncovered past traumatic experiences
                                                                                                                                                  1. it is likely to succumb to the belief of the therapist as they act as the authority figure and inks to power imbalance as what the therapist believes about the past the client does too.
                                                                                                                                                    1. Toon et al 1996 suggested that therapists may even induce false memories to extend the length of the therapy and gain more financial
                                                                                                                                                      1. patients may experience much anxiety because of the ‘memories’ of events that didn’t happen
                                                                                                                                                    2. emotional harm
                                                                                                                                                      1. therapist may guide a client towards an insight or interpretation that proves to be emotionally distressing during their session
                                                                                                                                                        1. it is important that psychotherapists warn their clients of this danger before they engage in the therapy.
                                                                                                                                                          1. People with mental health disorders are more vulnrable, people with things such as schizophrenia and psychosis are more likely to have false memories due to voices and hallucinations.
                                                                                                                                                          2. Bowlby 1944
                                                                                                                                                            1. background:During the 1930s/40s, many children had been left orphaned or separated from parents for a long period of time. Childhood depression rose dramatically as did infant mortality
                                                                                                                                                              1. The study was a series of case studies. There was a control group despite it not being an experiment. The final analysis looked at association and experiences in separation. he used oppotuniyt sampling, saved on time and money
                                                                                                                                                              2. The focus was on the ‘thieves’ group, 44 children who attended a child guidance clinic (for emotionally challenge pupils) in London. They were described as thieves because stealing was one of their ‘symptoms’ but only a few children had been charged in court however this is mainly because the others were too young to charge.
                                                                                                                                                                1. 33 buys and 13 girls between the age of 5 and 17 and graded in terms of the seriousness of their stealing. Grade IV thieves (22) had been stealing for a long time, some > 3years. Grade 1 thieves had only one theft (4); The thieves were mainly of average intelligence
                                                                                                                                                                  1. The control group was used, made of 44 children who also attended the clinic. They were of a similar age, sex and IQ to the thieves. Like the thieves they were emotionally disturbed but did not steal.
                                                                                                                                                                2. The mothers of the participants were involved, they were interviewed to assess the participant’s histories.
                                                                                                                                                                  1. Procedures: The initial examination: the sample was obtained through opportunity sampling.
                                                                                                                                                                    1. 1. On arrival at the clinic each child was given mental tests by a psychologist to assess their intelligence (Binet Scale was used) and then the psychologist also noted the emotional attitude of the children.
                                                                                                                                                                      1. 2. Whilst this was happening a social worker would interview the child’s mother and record the preliminary details of the child’s early psychiatric history.
                                                                                                                                                                        1. 3. The psychologist and social worker would then report to the psychiatrist, Bowlby, who would interview both child and mother.
                                                                                                                                                                          1. 4. After the 2-hour examination the team considered school and other reports, discussing the conclusion.
                                                                                                                                                                            1. 5. Therapy: many of the children continued to meet the psychiatrist once a week over a 6 month+ period and the mothers would talk over their problems with the social worker. This enabled a detailed case history to be built and enabled a diagnosis to be made.
                                                                                                                                                                    2. Diagnosis: he wanted to distinguish between the thieves; difficult in children who had not yet formed their whole personality.
                                                                                                                                                                      1. 6 main personality types:
                                                                                                                                                                        1. - Normal (seemed stable);
                                                                                                                                                                          1. - Circular (unstable children who show alternating depression and hyperactivity);
                                                                                                                                                                            1. - Hyperthymic (constantly over-active);
                                                                                                                                                                              1. - Affectionless (lack of normal affection, shame or sense of responsibility);
                                                                                                                                                                                1. - Depressed (children who have been unstable and now they are in a more or less depressed state of mind);
                                                                                                                                                                                  1. - Schizoid (chow schizoid or schizophrenic symptoms)
                                                                                                                                                                                2. the affectionless character
                                                                                                                                                                                  1. Having identified the affectionless group of children a clear pattern of delinquency emerged. Bowlby found that 14/44 thieves were classed as affectionless, 12/14 affectionless had experienced frequent separations from their mothers.
                                                                                                                                                                                    1. Betty.I= placed in a foster home at 7m/o when her parents spilt up, moved from foster home to foster home and spent a year in a convent school before she went home age 5.
                                                                                                                                                                                      1. Derek.B= hospitalised at 18m/o as he developed diphtheria. Stayed there for 9 months and was not visited by parents
                                                                                                                                                                                        1. Kenneth.W= between age 3 and 9 he was primarily cared for by his grandfather who had no control over him.
                                                                                                                                                                                          1. Such separations were very rare amongst other types of thieves. There were 30 non-affectionless thieves and only 3 had experienced separations. In the control group, only 2 experienced prolonged separations.
                                                                                                                                                                                          2. other factors
                                                                                                                                                                                            1. 17 of the thieves experienced early separation. When considering the remaining 27 thieves, Bowlby reported that 17 had mothers who were extremely anxious, irritable/fussy or else were rigid, domineering and oppressive; traits that marks unconscious hostility.
                                                                                                                                                                                              1. 5 of the 27 thieves had fathers who hated them openly. These experiences were also reported by the non-delinquent group. Therefore, such early experiences might explain emotional problems not delinquency.
                                                                                                                                                                                              2. conclusion
                                                                                                                                                                                                1. Children would not have become offenders if they had not experienced things that were harmful to healthy development
                                                                                                                                                                                                  1. proposed that the damage to the relationship between mother and child would affect the development of the superego, leading to a reduced sense in right or wrong
                                                                                                                                                                                                    1. Juvenile delinquency is undoubtably the consequence of many and complex factors, such as poverty, bad housing and lack of recreational facilities. However, this classic study has placed an emphasis on psychoanalytic factors.
                                                                                                                                                                                                      1. If the finding were correct the implication is that treatment should be offered to delinquents, through this process is extremely slow and difficult
                                                                                                                                                                                                        1. preferable approach is prevention rather than treatment however, prolonged separation of a mother and child may on occasion be unavoidable
                                                                                                                                                                                                      2. evaluation: methodology
                                                                                                                                                                                                        1. The study is not fully scientific due to it being based from case studies
                                                                                                                                                                                                          1. The study did not give clear results due to anomalies and other factors not explored properly.
                                                                                                                                                                                                            1. correlation not causation
                                                                                                                                                                                                              1. The study could be replicate again due to the lack of strict criteria there would be a large enough sample to repeat. However, wouldn’t be the same participants.
                                                                                                                                                                                                                1. The study produced qualitative data, data could be useful but not accurate/ true for all people, consequently, it Is not representative. due to all children used in the experiment being emotionally disturbed it cannot be generalised to all children
                                                                                                                                                                                                                  1. The findings could have been manipulated by Bowlby as he conducted the test himself and he may have (un)consciously influenced the results to support his hypothesis
                                                                                                                                                                                                                  2. evaluation: ethics
                                                                                                                                                                                                                    1. The study did it protect the participants confidentiality, proving first name and last initial along with in depth reports on their life making them identifiable.
                                                                                                                                                                                                                      1. It is unclear if the families were told how much information would be shared which if they were not told properly would mean they did not give full consent; . Children could not consent, parents had to do it on behalf if given.
                                                                                                                                                                                                                        1. . Children could not consent, parents had to do it on behalf if given.
                                                                                                                                                                                                                        2. evaluation: alternative evidence
                                                                                                                                                                                                                          1. Separation alone may not cause long-lasting damage especially if the child has a good substitute for emotional care
                                                                                                                                                                                                                            1. a lack of emotional care before the age of 6 months appears to be something appears to be something children can recover from. (Rutter and Sonuga-Barke 2010, romanian orphans)
                                                                                                                                                                                                                              1. Bowlby’s basic conclusion has been supported in subsequent research. Micheal Rutter et al 2010, using romanian orphans The lack of emotional care during key periods of development appears to have lasting and serious consequences
                                                                                                                                                                                                                                1. consequences include physical underdevelopment, intellectual retardation, and difficulty in later relationships: friends, partners and children.
                                                                                                                                                                                                                          2. Evaluation
                                                                                                                                                                                                                            1. strengths
                                                                                                                                                                                                                              1. nature and nurture
                                                                                                                                                                                                                                1. takes both sides into account
                                                                                                                                                                                                                                  1. Freud claimed that the adult personality is the product of innate drives - nature- and childhood experiences - nurture-
                                                                                                                                                                                                                                    1. for freud the id is instinctual and is the biological aspect of our personaility
                                                                                                                                                                                                                                      1. driven by the eros - life drive - and the thanatos - the death drive-
                                                                                                                                                                                                                                      2. influence of nuture comes in the form of psychosexual stages, frustration and overindulgence may lead to frustration
                                                                                                                                                                                                                                        1. predict the adult personality
                                                                                                                                                                                                                                        2. usefulness
                                                                                                                                                                                                                                          1. highlights the fact that the childhood is a critical development point that affects the whole life.
                                                                                                                                                                                                                                            1. ideas put forward by Freud have influenced therapies to treat mental disorders
                                                                                                                                                                                                                                              1. first person to explain psychological factors could be used to explain psychical symptoms - paralysis
                                                                                                                                                                                                                                                1. psychoanalysis widely used to overcome problems
                                                                                                                                                                                                                                              2. useful approach for understanding mental health problems - ie childhood trauma or unconscious conflicts
                                                                                                                                                                                                                                                1. complexity of human behaviour
                                                                                                                                                                                                                                                  1. approach can be seen as HOListic - includes wHOLe of the complexitiies
                                                                                                                                                                                                                                                    1. recognises that human behaviour is influenced by multiple, inseperable factors
                                                                                                                                                                                                                                                    2. improves on other approaches that reduce the complexities to one factor
                                                                                                                                                                                                                                                      1. behvaiourist approach proposes that recovery from mental disorder can be achieved through re-learning and does not look at the cause and it can reappear - symptom substitution
                                                                                                                                                                                                                                                        1. psychoanalysis seeks to undercover deep meanings and acknowledges that understanding behaviour is a lengthy process
                                                                                                                                                                                                                                                  2. weaknesses
                                                                                                                                                                                                                                                    1. reductionist
                                                                                                                                                                                                                                                      1. can be accused of 'mechanistic reductionism' because it oversimplifies complex human behaviourto the mechanics of the mind
                                                                                                                                                                                                                                                        1. ie childhood experiences = psychosexual stages
                                                                                                                                                                                                                                                        2. ignores other influences on behavior such as genetics and biochemistry
                                                                                                                                                                                                                                                          1. during the 50s and 60s, one of the main explainations for autism was that some mothers were very distant from their children and autism was a withdrawal from the lack of involvement
                                                                                                                                                                                                                                                            1. oversimplifies the process of autism. shows the approach can ignore important factors
                                                                                                                                                                                                                                                          2. determinist approach
                                                                                                                                                                                                                                                            1. saw infant behaviour as determined by the libido and adult behaviour determined by childhood experiences
                                                                                                                                                                                                                                                              1. therefore follows that we have no free will in who we become of behave
                                                                                                                                                                                                                                                                1. personality is predetermined and we cannot change them
                                                                                                                                                                                                                                                                2. flaw as we can change our behavior if we want to
                                                                                                                                                                                                                                                                  1. may give some people a plausible excuse for behaving unreasonably or an excuse for criminal behaviour
                                                                                                                                                                                                                                                                    1. implies that people cannot be held responsible for their behaviour
                                                                                                                                                                                                                                                                  2. cannot be prove wrong
                                                                                                                                                                                                                                                                    1. difficult to falsify, a good theory can be tested to see if it is wrong
                                                                                                                                                                                                                                                                      1. karl popper 1934 argued that falsification is the only way to be certain. you cannot prove that a theory is right you can only falsify the theory
                                                                                                                                                                                                                                                                      2. falsify: prove (a statement or theory) to be false
                                                                                                                                                                                                                                                                        1. many of freuds theories are 'slippery' eg - all men have repressed homosexual tendencies cannot be proven as it can be argued that they have them they are just so repressed they are not apparent
                                                                                                                                                                                                                                                                          1. whilst difficult to generate testable hypotheses from freuds theory of personality it is not impossible
                                                                                                                                                                                                                                                                            1. research has looked at relationships between guilt and wrongdoing
                                                                                                                                                                                                                                                                              1. MacKinnon 1938 found that individuals who cheated at a task tended to express less guilt when questioned than those who did not
                                                                                                                                                                                                                                                                                1. supported freud who predicted an inverse relationship
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