Types and Application of Psychotherapy

00:01 Now let's take a look at different psychotherapies that are available.

00:05 I want you to have some familiarity with the broad topics and what they mean.

00:09 So starting off with the definition of psychotherapy. This is an interpersonal treatment often referred to as talk therapy which is rooted in psychological principles.

00:21 There are different types of psychotherapies and they are ever evolving and changing starting with psychodynamic or psychoanalytic.

00:30 There's interpersonal therapy, cognitive behavioral, motivational interviewing, and dialectical behavioral therapy. So let's talk a little bit about psychoanalysis or psychodynamic therapy. This is based on Freudian tradition and the therapy reveals unconscious aspects of a patient's life through transference and also countertransference. Resistance, free association, dreams and all of this is aimed at identifying repressed experiences and feelings that are causing some distraction or problems in a person's current life.

01:09 So some of the concepts in psychodynamic therapy are dream interpretation, the countertransference and free association, transference, the therapeutic alliance and also looking at resistances. So what is a transference? I've referred to this a few times.

01:27 Well, it's the unconscious redirection of feelings and desires about important people in the patient's life and projecting them onto the therapist.

01:36 So, there is a woman who's angry at her therapist for running late.

01:40 This is a classic example of transference. So patient has repressed feelings about neglect and abandonment from her father and so she becomes irate when her therapist is just running a few minutes late for the appointment. So, I already gave you the answer but here are a few choices to think about, and of course, she's exhibiting transference and the reason here is that she has basically transferred the negative feelings she had about her father onto her therapist which allows her to get so angry at the therapist because she actually fears he may abandon her too. Now what is countertransference? This is the therapist's redirection of unconscious feelings about important figures in his or her life onto the patient. So this has the potential to actually interfere with the objectivity of the therapist unless they're aware of their countertransference.

02:33 So this is why it's very important for therapists themselves to really kind of check themselves and be very aware of what they're feeling towards the patient and be curious within themselves about why they're feeling that. Psychodynamic therapy is insight oriented.

02:50 The best patients to avail of this therapy are young adults who have a history of stability in relationships and daily living who are highly intelligent and also curious, not psychotic.

03:03 The patient will typically lie on a couch during sessions while the therapist is out of view, and this allows for free association or for the patient to completely get lost in their thoughts and just share freely while the psychiatrist behind the scenes is interpreting things and linking together the train of thinking so they can identify areas of resistance and also patterns.

03:28 So this brings us to free association which is the undirected expression of conscious thoughts and feelings as a means of gaining access to the unconscious process.

03:40 And how about dream interpretation? Well, dreams are seen to represent conflict between urges and fears, interpretation of dreams by the psychiatrist is actually used to help a patient achieve their therapeutic goals and resolve conflict. What about resistance? Resistance is those forces within the patient, conscious and unconscious, that oppose the purpose of the patient's evaluation and the goals of the treatment.

04:13 Resistance varies and sometimes talking about it with the patient can really help to reduce it.

04:19 There are subtypes of psychodynamic therapy such as classical, ego psychology, object relations, and self-psychology. Let's look at them more closely. So classical psychotherapy is really Freudian.

04:34 It emphasizes that unresolved conflicts can lead to psychopathology including depression and anxiety.

04:41 Ego psychology is best known by Anna Freud, who talked a lot about it.

04:48 This considers how an individual interacts with the external world as well as responds to internal forces.

04:55 It takes defense mechanisms into consideration and is rooted in Freud's id-ego-superego model of the mind. Object relations. The two people best known for this are Melanie Klein and Donald Winnicott. This is the process of developing a psyche in relation to others in the environment during childhood. The first object is really the internalized image of one's mother.

05:24 Winnicott is known for his concept of the transitional object and also what he called the good-enough mother. Self-psychology was coined by Heinz Kohut.

05:38 Here the goal is to understand the patient from inside their subjective experience via vicarious introspection and drawing on empathy, mirroring and idealizing.