Psychodynamic Psychotherapy: Principles and Reasoning
Authors: Ryan Widmer Erik Fraunberger Reviewers: Brooke Fallis Yan Yu* Dr. Margaret Oakander* * MD at time of publication
Childhood Experiences
Early life experiences, positive or negative, reinforce personality traits and relational patterns
Patterns and traits solidify as unconscious attitudes, thoughts, and emotions that drive behaviour
Conflict between egocentric, immediate gratification and societal expectations or moral standards produces psychological tension, creating maladaptive thoughts, emotions, and behaviors toward external stressors
Defense Mechanisms
Psychological coping strategies that attempt to rectify anxiety between internal conflict and external stressors
Regression: Returning to an earlier stage of development (ie. Adopting child-like behaviours)
Projection: Qualities felt about one person are directed towards another
Denial: Refusing to admit unpleasant emotion/experience
Repression: Blocking a threatening memory from entering consciousness
Maladaptive thoughts include worthlessness, hopelessness or grandiosity
Maladaptive emotions include explosive anger or extreme self-loathing
Maladaptive behaviours include passive aggressiveness or withdrawal from others
Recognition of maladaptation to external stressors motivates patient to engage in therapeutic process
Patient and therapist attempt co-construction of connections between maladaptive behaviours and past experiences
Initiation of therapy challenges patient’s unconscious psychic equilibrium
Transference
Patient’s transfers thoughts on therapist rooted in emotions from previously important individuals
Counter-transference
Therapist’s thoughts and feelings about the patient hinders co-constructive therapeutic process
Resistance
Interferes with therapy due to subjective sense of shame and judgement
Patient and Therapist work through therapeutic barriers
Supportive interventions
include advice and praise, psychoeducation, and empathic validation
Expressive interventions
include clarification, confrontation, and interpretation
Patient accepts therapist’s connection
Patient gains insight into how they feel and think and can then make better choices about their lives
Patient continues to engage in therapeutic processes, utilizing strategies to reduce maladaptive responses
Legend:
Pathophysiology
Mechanism
Sign/Symptom/Lab Finding
Complications
Published December 9, 2021 on www.thecalgaryguide.com