In this lesson, we'll discuss two more approaches to psychotherapy that we touched on in an earlier lesson on psychological theories. We'll also discuss the theories and rationales behind these approaches, as well as the different practices that each might employ.
The particular areas of focus include:
Psychodynamic theory, as we discussed previously, places the importance on the role of the unconscious, as well as the internal forces and conflicts on our mental states and behaviors.
This is the approach that Freud took. If you recall his analogy, the human mind is a bit like an iceberg. The part that's sticking out of the water, or the conscious mind, is actually only a very small part of the entire thing.
What's under the water, or what he referred to as the unconscious mind, is just as important. In fact, the unconscious mind is much bigger and broader.
Freud's original theories were referred to as psychoanalysis. Freud was himself a therapist to begin with, so a lot of his theories were developed as a result of the treatment of his different patients, and their different neuroses and hysteria, as those issues were called at the time.
According to Freud, these psychological problems are caused by different repressed memories from the past— different unconscious memories and conflicts that the patients might have.
One instance would be different sexual or aggressive feelings that patients might be repressing in their own consciences. These feelings cause various self-defenses or self-defeating behaviors to build up, which can then cause those patients psychological harm in their conscious minds.
The goal of psychoanalysis is to reduce internal conflicts. Since these conflicts are unconscious, Freud used a series of tools to bring them to the conscious mind.
a. Psychoanalytic Tools
The most important of Freud's tools is free association. Free association essentially involves having a person say whatever comes to mind, regardless of how embarrassing or unimportant the person might consider those thoughts.
Freud employed a series of methods to help people do this. There were word association tests, in which the therapist says one word, and the client immediately says whatever word comes to mind.
The Rorschach inkblot tests were also a free association tool, as was the thematic aptitude test, in which the patient is shown a neutral picture and then asked to create a story, impressing his or her own feelings and ideas onto it.
Freud also used dream analysis. He said that dreams were the royal road to the unconscious, and his analysis of those dreams helped him understand what sorts of things were underlying people's conscious behavior.
He categorized the different content he saw in those dreams as well. Manifest content comprised things in the dreams that were directly connected to the problems that the people were having.
Latent content comprised symbols that might provide clues to help Freud understand what was happening.
b. Role of the Therapist
At times, the therapist would note that a patient exhibited resistance. This is when a person refuses to talk or think about a subject that is especially sensitive or problematic.
When the patient was not able to freely associate anymore because of this resistance, the therapist's job was to bring these issues to the patient's attention, so that he or she could deal with them.
This was important because these were issues considered to be at the heart of the patient's psychological problems.
Freud also noted an occurrence of transference, meaning that clients would transfer onto the therapist their feelings about important figures in their different pasts.
These were generally negative feelings, such as anger, rejection, or criticism of the therapist himself, when the patient wasn't actually having those emotions directly toward him.
c. Brief Psychodynamic Theory
One of the big criticisms of psychoanalysis was the amount of time that it took. Generally, it took a patient years and years of therapy before he or she would come to some kind of resolution.
A lot of current psychodynamic theorists employ what's called brief psychodynamic therapy. This involves a smaller amount of time because the techniques that are used bring about quicker insights into the unconscious.
One instance of this is a treatment called interpersonal psychotherapy, or IPT, which is designed to help people improve their relationships with others.
These therapies are generally about 12 to 16 weeks long, and they help people to understand the emotions that they're having towards various figures in their lives, and to develop empathy towards those people.
Oftentimes, this type of therapy uses role playing.
The therapist might play the role of the father or the mother in a person's life, and have the patient express his or her feelings about that person in order to understand what unconscious feelings are underlying the patient's current psychological problems.
The second theory we'll discuss, Gestalt theory, comes from a word that means the whole shape or form of something. This refers to the psychology of understanding the entirety of an experience, rather than reducing the experience down to its component parts.
The therapy is likewise oriented. The idea is to help rebuild people's thinking, feeling, and acting in a connected, or a whole, kind of way.
In other words, Gestalt therapy is about filling in the gaps; it's supposed to integrate different kinds of fragmented experiences in people's lives.
Generally, a lot of these fragmented experiences are negative, and the emotions that they carry for different people are ones that people typically try to avoid.
People who are experiencing grief or other painful emotions due to the death of a loved one might try to distance themselves from or forget about those feelings.
The goal of Gestalt psychotherapy is to bring people back to those feelings in order to experience them as a form of healing. This is different from some of the other therapies, in that the idea is not to rationalize or intellectualize these kinds of experiences, but rather to help clients actually feel or experience the emotions that they are missing in their lives.
With Gestalt psychology, the idea is to be in the present instead of trying to understand and cognitively rationalize those experiences.
In this way, both Gestalt therapy and psychodynamic therapy try to help people deal with psychological issues that are more difficult to address.
In this lesson, you learned about two more approaches to psychotherapy:psychodynamic therapy and Gestalt therapy. Psychodynamic therapy, originally popularized through Freud's psychoanalytic approach, focuses on the unconscious mind and its role in the psychological issues of patients. In order to bring unconscious thoughts and feelings into the conscious mind, Freud used several psychoanalytic tools, such as free association and dream analysis. He also determined that when faced with resistance, it's the role of the therapist to encourage the patient to face the emotions and thoughts that are at the heart of his or her psychological issues. Because a large criticism of psychoanalysis is that it takes too long, some forms of brief psychodynamic therapy have been developed as an alternative.
While different from psychodynamic therapy in that its approach focuses on the psychology of understanding the entirety of an experience, Gestalt therapy -- by encouraging patients to feel difficult emotions instead of avoiding them -- shares the aim of helping people confront psychological issues that may be harder to address.
Source: This work is adapted from Sophia author Erick Taggart.
Style of therapy the believes in the unconscious and uses past experiences to explain present discomfort. Does not necessarily follow the theories of Freud.
Technique of Freud's to elicit unconscious desires; "say the first word that comes to you".
Freud's system of therapy based upon his theories of development and the mind. Generally long-term therapy.
Refusal to become aware of or discuss unpleasant subjects; censoring oneself in therapy.
Imposing the traits of someone else onto the therapist.