Psychotherapy: Psychodynamic & Gestalt Approaches

Video Transcription

Hello, class.

Today we're going to be talking about two different approaches to psychotherapy, as well as the theory behind them, the rationale, and the different practices that each one of them might employ. You might recognize these two terms from our explanation of psychological theories. The first one we're going to be talking about is psychodynamic theory, and the second one is Gestalt theory.

Under psychodynamic theory, if you recall, it places the importance on the role of the unconscious, and internal forces and conflicts on our mental states and our behaviors. This is the approach that Freud took. Freud, again, being a very recognizable figure in psychology. And if you recall his analogy, our mind, as he said, is a bit like an iceberg. Which is to say, the part that's sticking out of the water, or our conscious mind, is actually only a very small part of the entire thing. And what's going on under the water, or what he referred to as our unconscious mind, is just as important. In fact, much bigger and broader.

If you recall, Freud's original theories were referred to as psychoanalysis. Freud was himself a therapist to begin with, and so a lot of his theories were developed as a result of the treatment of these different patients that he had, and they're different neuroses and hysteria, as they called them at the time. These psychological problems, as we referred to, are caused by different repressed memories from the past, different unconscious memories and conflicts they might have. For example, different sexual or aggressive feelings that they might be repressing in their own conscience. And these cause different self-defenses to build up, or self-defeating behaviors, which cause the person to have any kind of psychological harm in their conscious minds. So the goal is to reduce the internal conflict.

Since these sorts of things are unconscious, how do we bring them to the conscious mind? How do we treat them? Freud used a series of different tools. The first and most important to remember is free association. Free association essentially is to have a person say whatever comes to mind, regardless of how embarrassing or how unimportant the person might think them to be. Freud employed a series of tools to help people along with this. Things like word association tests, where 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, and the thematic aptitude test, where the patient is shown a neutral picture, and asked to create a story, and to impress their 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 to understand what sorts of things we're underlying people's conscious behavior.

There are different sorts of content that he saw, as well. There was manifest content, which is to say, things in the dreams that were directly connected to the problems that the people were having, as well as latent content, or symbols, that might have some sort of clues to help Freud understand what's going on.

Now at times, the therapist would note that a patient will exhibit resistance. This is when a person refuses to talk or think about a subject that is especially sensitive or problematic. They're not able to freely associate anymore. So the therapist's job, when they met resistance, was to bring these sorts of things to the patient's attention, so they could deal with them, because these were the things that were really important, and at the heart of their psychological issues.

Freud also noted an occurrence of transference, which is to say that the client would transfer their feelings onto the therapist for important figures in they're different pasts. Generally these were feelings that were negative. Things like anger, rejection, or criticism of the therapist himself, when the patient isn't actually feeling those sorts of feelings directly toward him.

One of the big criticisms in psychoanalysis was the amount of time that it took. Generally, it took a patient years and years of therapy before they would come to some kind of resolution.

A lot of current psychodynamic theory employs what's called brief psychodynamic therapies, which is to say a smaller amount of time that's placed, and techniques that are used to bring about quicker insights into the unconscious. An example of this is what's called interpersonal psychotherapy, or IPT, which is designed to help people improve their relationships with other people. These therapies are generally about 12 to 16 weeks long, and they help people to understand their emotions, that they're having towards figures in their lives, and help to develop empathy towards those people. Oftentimes it uses role playing. For example, the therapist might role play the role of the father or the mother in a person's life, and have them get out their feelings about those kinds of people, so they can understand what kinds of unconscious feelings are underlying their current psychological problems.

Moving on to our other theory for today. Gestalt theory, as you might recall, comes from a word that means the whole shape or form of something. It refers to the psychology of understanding the entirety of an experience, not reducing it down to its component parts. The therapy, as you can imagine, is likewise oriented. The idea is to help rebuild people's thinking, feeling, and acting in a connected, or a whole, kind of way. Or as we refer to it, filling in the gaps. It's supposed to integrate different kinds of fragmented experiences in people's lives. Now generally, a lot of these fragmented experiences are negative, and the emotions that they carry for different people are ones that people generally try to avoid. For example, the death of a loved one. The people that have these kinds of experiences might try to distance themselves, or forget about those kinds of feelings. And the goal of Gestalt psychotherapy is to bring those people back to those feelings, and to have them experience them.

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 the client actually feel or experience the emotions that they are missing in their lives. The idea is to sort of be in the present, with Gestalt psychology, instead of trying to understand and cognitively rationalize those experiences.

In this way, both of these theories try to help out people when they are having psychological issues that are more difficult to address.