Summary: Psychodynamic Therapies

Psychodynamic approaches analyze the energies or movements (dynamics) within the individual's mental world or psyche. Such approaches are distinguished by an emphasis on personal history and unconscious motivations.

A patient named Bertha Pappenheim (called Anna. O. in the literature) gave Sigmund Freud the idea for his "talking cure." Freud never actually met Anna O.; she was a patient of Freud's colleague Joseph Breuer. Breuer found that Bertha's symptoms disappeared when she remembered (with great emotion) a specific traumatic incident that led to the first appearance of a symptom. Freud and Breuer concluded that "hysteria was caused by reminiscences."

Freud tried Breuer's method without hypnosis and it worked. This led to the classic "cathartic method" of therapy, in which a patient attempts to remember traumatic events of earlier life at the urging of the therapist. When traumatic incidents are remembered with great emotion, their hold on the patient seems to loosen or go away, and symptoms are relieved.

Freud claimed that he found memories of childhood sexual abuse in his first eighteen cases. Then he decided these memories were false. Some present-day scholars regard this as a huge mistake, because childhood sexual abuse does occur. Others point out that Freud pressured his patients to remember incidents of abuse, and false memories can occur under such conditions.

"Windows to the unconscious" are techniques for detecting conflicts or repressed thoughts. Free association was used by Jung before he met Freud. Freudian slips are accidental, revealing errors. Freud thought other errors such as losing things or having "erroneous ideas" could also be revealing. Freud regarded dream interpretation as the richest source of material of all, the Royal Road to the Unconscious.

Carl Jung's therapy emphasized complexes. Jung said every patient has a story. The therapist must discover this story and share it with the patient.

Alfred Adler believed that neurotics were troubled by deficient styles of life that were set up in early childhood as ways of coping with felt inferiorities. Adler used early memories, dream interpretation, and observation of a person's way of dealing with social situations to diagnose the style of life. Adler believed human misery involved problems in friendship, work, and love. He encouraged activities oriented toward helping others as a way of turning away from excessive self-interest, a characteristic of neurosis.

Karen Horney was unique among early analysts in recommending self-analysis. She said it was revealing to look for exaggerating reactions to life events, unconscious motivations, or feelings (in dreams, for example) that we might prefer to ignore. She emphasized that the goal of therapy was not just to make a clever analysis but to cultivate the ability for growth and change.


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