Classical psychoanalysis in its original form was instrumental in shaping the way we view the unconscious and the concept of defense mechanism. While it may not be popular in its original form, it has made way for some impressive psychodynamic therapy interventions, and this post will cover a few of them. The purpose of this post is to explore treatment and interventions that are based on psychoanalysis and psychodynamic theory, but the actual theory itself will be covered in another post. If you would like a refresher on the theory you can read about it here. You can expect for the EPPP to have a variety of questions of different therapeutic interventions and treatment styles, and you will be expected to have a knowledge of a variety of different techniques. Treatment, Intervention, Prevention, and Supervision covers 14% of the exam. The information is best used in collaboration with your own knowledge and what you have already been taught, your previous notes or textbooks, and research if you need more information on a particular topic. Or you can check out the product reviews page.
Developed by Sigmund Freud in the 1890’s, and based on the assumptions that early childhood events affect development, thoughts and behaviors are affected by the unconscious, this can create defense mechanisms, which causes mental disturbances, and is treated by bringing the unconscious into consciousness. The personality is comprised of 3 parts: 1) the Id, which is the primitive and instinctual, lacks organization and disreagrds reality, operates on the pleasure principle and is not concerned about long term consequences. 2) the Ego, which is aware of reality and the consequences of its behavior, has the ability to put off immediate gratification in favor of long term gratification, and its main task is to suspend id impulses with rational means. 3) the Superego, which is the conscious and internalized standards, it is the ideal standard of perfection and has an internalized set of rules, it forces the ego to satisfy the id in an ethical way.
Freud also identifies 2 types of processing. Primary process is the use of dreams as a form of tension reduction, and can occur outside the constraints of reality. Secondary is what people think and say, and has the responsibility of meeting reality and delaying gratification. When the urges of the id become too strong for the ego to manage, rational methods are no longer effective and the individual turns to defense mechanisms. Theodore Millon takes this concept one step further and relates individual personality disorders to specific defense mechanisms, which you can learn more about here. The basis for treatment is to bring what is unconscious into consciousness, which is typically done through free association.
Alfred Adler studied under Freud, but broke away over difference of ideas. His main difference of opinion was that people are influenced primarily by social rather than sexual urges, and stressed the importance of social connectedness and the individual need for personal competence. He agreed with Freud regarding the importance of the early years on development, and early feelings of inferiority can either motivate mastery or create neurosis. He believed birth order to have a significant impact on child development. The therapeutic intervention focus on encouraging the client, and influencing them to form a more positive attitude done through education and problem solving. Adlerian psychology has significant applications to parenting, recommending the parents value the child’s contribution and use natural consequences. You can read more about this intervention here.
Otherwise know as analytic psychology and created by Carl Jung in the 1910’s, after Jung split away from Freud. Jung believed the psyche includes the conscious ego, the personal unconscious, and the collective unconscious, and saw evidence for this is dreams and myth rather than natural science. Central to the concept of collective unconscious is Jungian archetypes, which are patterns or images that have transcended time and recur throughout folklore.
The therapists job is to merge the clients consciousness with the collective consciousness through interpretation of the symbolic meaning of dreams and folklore. Rather than focusing on free association like Freud, the sessions are much more direct and relationship dependent. Also the focus tends to be less on childhood and more on adult development. Read more about Jungian psychology here.
Based on Freud’s work and has similar assumptions, mainly that the individual responds to internal forces while interacting with the external world. The ego is what manages impulses and adapts to reality, and this can result in either normal or pathological development. Here we will go over a few important names, you can read more about ego psychology here.
During the mid 1930’s Anna Freud focused mainly of the ego and defense mechanisms, and argued that the clinician should always be focused on these defensive functions. It is the clinicians role to identify and explore the defenses as the client talked and brought up unconscious associations. The interpretation of these associations was not the focus, but rather how the ego was keeping them out of consciousness and the problems this may cause the client.
Hartman based his theory on the idea that the id and the ego developed at the same time, rather than the ego developing in order to control the id. This changes the underlying force that drives people, in that it is not only instinct but also reasoning. He believed conflict between the ego and id still existed and could be seen in conversion disorders, the clinicians job is to neutralize conflict by understanding the nature of the conflict and helping the individual to adapt to their environment.
Erikson combined ego psychology with developmental psychology, and he believed the environment the child grew up in is critical in healthy development. The stages of development were not necessarily related to age in Eriksons theory, but rather focused on the sequence of development. For example the stage of trust vs mistrust must occur before the child progresses to autonomy vs shame. You can read more about Erikson, including the life stages here.
This theory is based on the assumption that they way people relate to others in adulthood is strongly influenced by their early experiences with their own family. These early experiences create images of events and people, and in the unconscious become what the theory refers to as “objects”. For example, one of the first objects is usually an image of one’s mother, and in healthy development this objects relationship usually involves satisfying hunger and the need and the need for food.
The clinicians role is to help the client experience a new object-relation that may be different than what was experienced in childhood. Forming a realistic attitude toward others, and determining a clear sense of self. This process involves integrating any detached parts of the self back into the whole object representation. You can read more about the theory here.
Klein identified splitting as a significant defense mechanism present in early development. Two important part of development are unconscious phantasy (the mental life which eventually connects with reality) and projective identification (a defense mechanism against anxiety). Early life stages are labelled as the paranoid schizoid position followed by the depressive position, which you can read further about here. Klein worked a great deal with children, and utilized play therapy and free association, utilizing techniques similar to adult analysis.
Neo-Freudians built on Sigmund Freud’s original ideas and incorporated the impact of social and cultural factors. The theory is based on the assumption that mental health problems are a result of poor learning, and these problems are evident when the client shows faulty interaction with the environment. Treatment involves developing a relationship with the client, then labeling and correcting the clients misinterpretations of others behavior. You can read more about this theory here.
Horney based her theory on the assumption that neurosis is not necessarily negative and occurs continually throughout the lifespan. Childhood development is the key to a person’s neurosis, particularly the child’s perception of events despite the parents actions or intentions. Horny identified 10 neurotic needs which are coping strategies, and can be condensed into 3 categories of needs: compliance, aggression, and detachment. Therapeutic interventions involve identifying the clients unconscious pursuit of safety, you can read more about this theory here.
Fromm’s theory is significantly influenced by Marx and the way existential philosophies view sociocultural conditions. He believed most people are frightened by freedom, and people have 8 basic needs such as rootedness and effectiveness. There are 2 modes of living, the “having” mode and “being” mode, the latter being the healthier of states to live in. Due to this theories philosophical nature it may be a little more difficult to comprehend so I recommend reading more about it here.
Harry Stack Sullivan
Sullivan’s theory is based on the assumption that interpersonal relationships and cultural forces are mostly responsible for mental illnesses, specifically the pursuit of satisfaction via personal involvement in an effort to avoid loneliness. He based his theory on developmental theory and believed childhood development created the “self-system,” which is a configuration of personality traits. He identified 3 modes of development: The prototaxic (birth to 7 months) , parataxic (8-11 months), and the syntaxic (12 months-2 years). you can read more about Sullivan here.
Interpersonal therapy was developed based largely on Sullivan’s work. It is a brief, attachment focused therapy typically involving 16 sessions. It is based on the idea that relationships and life events impact mood and vice versa, focusing primarily on the here and now rather than past relationships. It is considered especially effective with depression, and you can read more about it here.
***There are many other interventions and treatments based on psychoanalysis and psychodynamic theories such as Heinz Kohut, David Rapaport, Donald Winnicott, Margaret Mahler, Harald Schultz-Hencke, and others. Its hard to say which theory will be tested on the EPPP, so it is in your best interest to have an understanding of multiple approaches (which will most likely also be helpful in your future work as a psychologist). Please comment below if you have any other psychoanalytic or psychodynamic interventions or treatments, or if you have any study tips or tricks you would like to share.
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