MODALITIES REVIEW

Modalities Review

Modalities Review: Adlerian Therapy

Psychodynamic Therapy

Psychodynamic therapy is based on the premise, first suggested by Sigmund Freud (1856-1939) in his psychoanalytic approach to personality, that the primary sources of abnormal behavior are unresolved past conflicts and the possibility that unacceptable unconscious impulses will enter a person's consciousness. To guard against this anxiety-provoking possibility, individuals employ defense mechanisms, psychological strategies to protect themselves from those unconscious impulses.

Classic Freudian psychodynamic therapy, called psychoanalysis, tends to be a lengthy and expensive affair. Patients typically meet with the therapist an hour a day, four to six days a week, for several years. When using the method of free associations, psychoanalysts tell the patients to say aloud whatever comes to mind, regardless of its apparent irrelevance or senselessness, and the analyst attempts to recognize and label the connections between what a patient says and the patient's unconscious (Capuzzi & Gross 2005, 31-48). Therapists also use dream interpretation, examining dreams to find clues to unconscious conflicts and problems. Because of the close, almost intimate interaction between patient and psychoanalyst, the relationship between the two often becomes emotionally charged. Patients may eventually think of the analyst as a symbol of a significant other in their past. This phenomenon is known as transference.

Although modern psychodynamic therapists have modified Freud's techniques so that it takes less time and is much more direct, they use interpretation of dreams, free association, positive and negative transference, and resistance to help patients reveal their unconscious concerns. (Mc Williams 2004, 82-98)

Psychodynamic therapists face the challenge of finding a way to assist patients' attempts to explore and understand the unconscious. The technique basically consists of guiding patients to consider and discuss their past experiences, in explicit detail, from the time of their first memories. This process assumes that patients will eventually stumble upon long-hidden crises, traumas, and conflicts that are producing anxiety in their adult lives. They will then be able to “work through” understand and rectify those difficulties. (Capuzzi & Gross 2005, 31-48)

Humanistic therapies focus on the conscious mind and subjective experience to help clients gain insights. They emphasize the subjective interpretation of experience and the human capacity for self-deter-mination. They seek to reduce blocks to growth that can create a poor self-concept. Humanistic therapists believe that clients who are more accepting will be better able to solve their own problems. The two most common therapy styles based on humanistic theory are Carl Rogers's person-centered therapy and Fritz Perls's gestalt therapy (Kirschenbaum & Henderson 1989, 5-12).

Evaluation

The effectiveness of psychodynamic therapy focuses on unconscious processes as they are manifested in the client's present behavior. The goals of psychodynamic therapy are client self-awareness and understanding of the influence of the past on present behavior. In its brief form, a psychodynamic approach enables the client to examine unresolved conflicts and symptoms that arise from past dysfunctional relationships and manifest themselves in the need and desire to abuse substances.

Several different approaches to brief psychodynamic psychotherapy have evolved from psychoanalytic theory and have been clinically applied to a ...