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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) specific traumatic incidents that led to first appearance of various symptoms. 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, based on "phantasies" which in Freud's system were forbidden id impulses.

Present-day advocates of recovered-memory therapies think Freud made a mistake because childhood sexual abuse is common and can be repressed. However, Freud pressured his patients to remember incidents of abuse, and false memories occur under such conditions. The truth may be somewhere in between: some of the memories may have been accurate, others confabulated.

Windows to the unconscious are tech­niques for detecting conflicts or repres­sed thoughts. Freud thought 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 said every patient has a story. The therapist must discover this story and share it with the patient. A person's story may feature complexes which are emotional themes in a person's life.

Jung used both dream interpretation and free association to uncover complexes. In free association, a person would pause or given an unusual association when a word hit upon a "psychic lesion."

Jung also encouraged patients to express their deep feelings in art. He suggested that people could communi­cate with hidden parts of their own personality by personifying those parts, treating them as imaginary people.

Alfred Adler believed that his therapy clients were often troubled by maladap­tive styles of life set up in early child­hood. 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 used early memories and a technique he called auto-estimation. This occurs when a people have an emotional reaction to their own image in a mirror or their own handwriting or creative products. Such reactions, Adler felt, could be revealing of how people really felt about themselves.

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 psychologically troubled people.

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 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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