Psychodynamic & Psychoanalytic Psychotherapies

Introduction to psychodynamic and psychoanalytic psychotherapy

1. Psychodynamic &
Psychoanalytic
Psychotherapies
An introduction
16
th
February 2024
Birgit de Cnodder
Clinical Psychologist
Psychoanalytic & Systems Psychotherapist

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3. Wood huma n fig ure
What is
your first
association with
psychoanalysis

5. “Psychoanalyticpsychotherapyisbestdefined
asagroupoftreatments,somewithgreater
specificationthanothers,thatfocusonhuman
subjectivityandit'sinterplaywithboththe
externalandinternalenvironments.It
incorporatesadevelopmentalperspective,
unconsciousconflict,internalrepresentations
ofrelationships,defensemechanisms,the
complexmeaningsthatareattachedto
experience,andthesearchforauthenticityand
trustaboutself.”
`
Glen Gabbard
So, what is it then?

6. Psychoanalysis
=
Umbrella term
for treatments rooted in the same basic
theoretical background
developed over time

7. Relational analystsTransference focused PT
Mentalisation
based
treatment
Fonagy
FREUD

8. Psychoanalysis
=
Umbrella term
for treatments rooted in the same basic theoretical
background
developed over time
some with greater specification than others

10. Psychoanalysis
=
Umbrella term
for treatments rooted in the same basic theoretical
background
developed over time
some with greater specification than others
executed in different settings

11. High frequency
Long term
Medium to low frequency
Medium long to short
Classic Psychoanalysis Contemporary Psychoanalytic Psychotherapy
Setting

12. on huma n subjectiv itya nd it's interpla y with both the externa l a nd interna l env ironments
on human subjectivity
and it's interplay with both
the external and internal
environments
A fbeelding met schets, tek ening , cirk el, clipa rt
A utoma tisch g eg enereerde beschrijv ing

13. a developmental perspective
unconscious conflict
internal representations of relationships
defense mechanisms
the complex meanings that are attached to
experience
the search for authenticity and trust about self

14. a developmental perspective
unconscious conflict
internal representations of relationships
defense mechanisms
the complex meanings that are attached to
experience
the search for authenticity and trust about self

15. Developmental perspective
Suffering comes from events one experienced in the past
that are vivid in the present
via internal representations through which one sees oneself and others,
and has expectations of the interaction
The effect of these experiences varies because of
predisposition e.g. temperament
circumstances e.g. poverty
The representations are kept alive through repetition(because we
repeat what we know)
a lot of it is unconscious
How to understandpsychopathology and suffering
Moderating
Causal
Maintaining

16. a developmental perspective
unconscious conflict
internal representations of relationships
defense mechanisms
the complex meanings that are attached to
experience
the search for authenticity and trust about self

17. The unconscious
Freud observed that we do not
fully know ourselves, and that
what we don’t know about
ourselves does influence us.
We are not master of our own house

19. How to explore the unconscious & conflicts?
Can be exploredby
free association and technical neutrality
dreams
Comes out by actions (enactments)
It has beenresearched!
Conceptual research (is there evidence that it exists?) e.g. Ariane Bazan
Technique

20. a developmental perspective
unconscious conflict
internal representations of
relationships
defense mechanisms
the complex meanings that are attached to
experience
the search for authenticity and trust about self

21. internal representations of
relationships
Arepresentation is
a (distorted) lens through which one is looking at oneself and the other
a predictionof how things will go between oneself and the other, and it is
affective laden
developed in interactions with important others
mostly unconscious

22. Internal
representations
22
Zelf
Ander
Zelf
REPRESEN
TATIE
Ander
REPRESEN
TATIE

23. Transference: what the client is making of you
A fbeelding met schets, tek ening , cirk el, clipa rt
A utoma tisch g eg enereerde beschrijv ing
Transference and countertransference
Due to the (unconscious) internal representations

24. Transference
What is made of
you as a therapist

25. Transference: what the client is making of you
Countertransference: what the therapist is
experiencing in contact with the client
Therapist use it to serve the clients process
A fbeelding met schets, tek ening , cirk el, clipa rt
A utoma tisch g eg enereerde beschrijv ing
Transference and countertransference
Due to the (unconscious) internal representations

26. a developmental perspective
unconscious conflict
internal representations of relationships
defense mechanisms
the complex meanings that are attached to
experience
the search for authenticity and trust about self

27. the complex meanings that
are attached to experience
Our first thousand days
we arerightbrain mammals
we feelfirst & experience is pre-verbal at start
Then we develop words, try to understand it etc., left
brain
Allan Shore

28. a developmental perspective
unconscious conflict
internal representations of relationships
defense mechanisms
the complex meanings that are attached to
experience
the search for authenticity and trust about self

29. Defense mechanisms
What we use in order to not feel painful feelings
Are linked to how we conceptualize
suffering,
personality

30. Personality conceptualization
id, ego & superego
mature –immature organization
underlying dynamics for the symptoms
& personalitystyle
Testmaterial
Interviews
Projective tests
Questionnaires
Who is this person suffering from this symptoms at this moment in time?

31. Defense mechanisms
Mature or immature →converging or splitting
Defenses need to be tackled because in the end, they
bother us
Main question for the therapist:
What is defended against, how and when?
A fbeelding met schets, tek ening , cirk el, clipa rt
A utoma tisch g eg enereerde beschrijv ing

33. a developmental perspective
unconscious conflict
internal representations of relationships
defense mechanisms
the complex meanings that are attached to
experience
the search for authenticity and trust about self

34. Remember the technical neutrality!
It is easier to tackle difficulties in life, if
you know different sides of yourself as
much as possible.
the search for authenticity
and trust about self
We are not master of our own house, but we can inhabit it a bit more
Possible outcomes
symptom reduce
more honest with
yourself
know yourself
better
better relationships

35. affect awareness, emotional insight & processing
creating meaning and historical reconstruction
transference & enactments
therapeutic alliance, containment & rupture and repair
changes in defense mechanisms & representations
Mechanisms of change?

36. When is psychodynamic therapy indicated?
A variety of symptoms: self-esteem, anxiety,
depression, sexual problems, relational problems, etc.
When one is suffering from a pattern that is repeated
over time
When a symptom focused therapy did not bring
enough relief
Personality problems

37. Working a bit longer, in depth and in the
therapeutic relation
Good frame for conceptualisation of the
clients suffering & understanding of
dynamics underlying the symptoms
It helps often when symptom-focused
treatments did not work

38. evidence for the efficacy of the therapy?
FACTSHEETS

40. Psychoanalysis is the oldest theory of mental functioning
The unconscious is the core business
Suffering and personality are understood in a developmental
perspective
From its roots sprout a lot of different treatments, some
recognized as a treatment for personality disorders
It is well researched lately

41. ‘psychoanalysis’
What do you
think about
it now?
Wood huma n fig ure

42. Want to learn more?
Summer University
Psychoanalyse
https://psychoanalysesummer.nl/

43. More information
•English
•https://www.ipa.world
•https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/psycho
analysis#what-is-psychoanalysis
•Dutch
•https://www.nvpp.nl/
•https://npav.nl/
•linkedIn: page: ‘psychoanalyse dichtbij’
•www.psychoanalytischeverhalen.eu
•www.pyschoanalyseleeft.nl

44. Some usfullyoutubevideo’s
•History about the development of psychoanalysis
https://www.youtube.com/watch?v=KO7WPPJeSS8&list=PL8Olezl_yoi67Q6rb7kRmVvgktxrg9exb&index=8&t=16s
https://www.youtube.com/watch?v=VMupSaMoPK8&list=PL8Olezl_yoi67Q6rb7kRmVvgktxrg9exb&index=23&t=280s
•Defenses
https://www.youtube.com/watch?v=fTnjJ105ze4&list=PL8Olezl_yoi67Q6rb7kRmVvgktxrg9exb&index=32&t=255s
https://www.youtube.com/watch?v=ShsDyWIeEas
•Transference
https://www.youtube.com/watch?v=4LDET6VyjMU&list=PL8Olezl_yoi67Q6rb7kRmVvgktxrg9exb&index=30&t=41s
•Psychodynamic therapy recent developments
https://www.youtube.com/watch?v=ZU6KwISB86c&t=3069s

45. Some usfullyoutubevideo’s
•On research
https://www.youtube.com/watch?v=zfJo0RePg8M&list=PL8Olezl_yoi67Q6rb7kRmVvgktxrg9exb&index=1&t=3414s
https://www.youtube.com/watch?v=i10h6bLX_LI&list=PL8Olezl_yoi67Q6rb7kRmVvgktxrg9exb&index=6&t=13s

46. Some usfull youtube channels