Freud's psychodynamic theory is known as the first of the traditional forces that have shaped and defined counseling and psychology in the last century. Many others have built upon this theoretical model, including Jung, Adler, Bowlby, Ainsworth, and Erikson. Is Freud's theory still useful today, or is it just too cumbersome unless you have unlimited hour-long sessions with a person who really wants to explore their past at great length? There are problems with Freud's original theory as well, which I'll bring up below.
The basic keys of Freud's psychodynamic theory are: -the significant role the unconscious plays in a person's psychological development -the use of defense mechanisms that a person uses to cope w/anxiety and stress -the effect that past experiences have on a person's sense of mental health and personal well-being -"the past is often a prelude to the future" meaning that lasting change won't happen unless a client has some sense of how their present actions relate to their past experience. Freud believed that behavior is determined by the need to gratify biological needs and instincts. Therefore, interventions/actions are directed at the roots of a client's behaviors, emotions, and present thinking patterns.
Another key phrase to mention regarding Freud is "Object Relations", which refers to the relationships each of us has developed w/important people in our lives and the continuing impact these rational experiences have on our lives.
And, of course, Freud is famous for the concepts of the Id, Ego, and Superego, which he describes as the 3 main psychic components of being. The Id is a person's basic drives and needs, the unconscious, instinctual processes. It is potentially destructive unless controlled and channeled. The Superego is the internalized rules and expectations generated by one's family and cultural history. This develops as we mature, especially as children. Freud believed that a person's conscience, ideals, and values all are part of the superego, which includes gender roles, acceptable social behaviors, cultural values, and such. The Ego is the mediator between the superego and the id, and is often described in traditional Freudian theory as "being at the mercy" of the two. More modern psychodynamic theorists have other views of the ego. The ego operates at all three levels of experience, the conscious,preconscious, and unconscious.
So, we have the id (unconscious rebellion) struggling against the superego (unconscious absorption of ideals, rules, expectations) with the ego attempting to act as mediator. Freudian psychodynamic theory basically says, "you learned this a long time ago, to change it, we have to go the roots, examine it detail, understand it, and you have to be invested in the outcome."
Freud's theory suffers from the white, European middle class heterosexual, male point of view. As many have pointed out, this weakens his theory considerably. Is there any value in his particular brand of psychodynamic theory? He laid the foundation for the many talented and innovative theorists who came after him. Important concepts are contained in psychodynamic theory, including roots of a person's behavior and present thinking patterns. I see the value with many of my clients who can tell me why they do things a certain way, or have certain beliefs and want to change, and why it's a struggle, and I incorporate some psychdynamic theory in with my techniques. But, this is from later theorists, not Freud. Psychodynamic therapy by itself seems so cumbersome and there are so many better ways of getting results. I've never had the luxury of unlimited sessions, everything is fast paced and I can offer the suggestion that the person think about where that belief came from and how would they like to change it, and work from there. Personally, Freud is not a favorite of mine because he was so biased against women, but I am grateful for the work that he started with this theory.
Karyn, what a thoughtful post! Excellent Work. You know when we think of Freud, there seems to be this image of Frued sitting back in his chair meeting his client and exploring their challenging process. It's hard to imagine this "Eurocentric modality" to have a positive impact on clients today. However, I would argue that it is. We can't deny the past. Team, with your clients the past is going to surface. There is no way around it. So, I challenge you to bring your practice sites to life and look hard at your practice and think of ways you have or can infuse some of the concepts of this modality in your practice.
I always tell you all to understand and respect these theories in their purest form and I tell you this because they are all so vital to all of our practices. And I think if solely focus on theories on being Euro focused or whatever limitations they have, it inhibits us from garnering everything we can get out of that theory. By no means am I saying not to consider weaknesses of the various modalities because this is important as well.
Taking the LICSW exam confirms this is well because it wants you to look at these theories at face value and not to over think them
I have always found it ironic that the clinical program at UW places so much emphasis on psychodynamic theory given that it takes at least 15-20 sessions for "brief psychodynamic therapy" according to most theorists, that it is such a Eurocentric model, and that it is in many ways the antithesis of a strengths-based approach.
Economic realities today in the U.S. place psychoanalysis out of reach for all but the very wealthy, with its twice-weekly 2-3 year commitment - to what? Freud himself is said to have been very pessimistic about the potential for human happiness, seeing a low-level neurosis and dissatisfaction as a functional norm. And he was terrified of - and labeled as infantile – the meditative states (or oceanic realms) associated with with mindfulness-based approaches proving so effective today. Many writers have suggested that while Freud was brilliant, he was neither very happy nor emotionally evolved himself. Also, it is hard to overlook his endorsement of cocaine, a drug whose enormous destructive power we see daily in hospital settings.
Nevertheless, it is impossible to deny his influence on the way I work, both as a therapist and in the hospital.
Freud’s concept of “evenly hovering attention” is vital to how I work with clients, trying to be in the moment with them - without judgment - and attuned to their perspective. This enables an examination of transference and counter-transference, both of which can be useful tools, but also significant barriers if not seen clearly. For example, how many of us have not encountered a situation with a client that triggers something from our own family life? This can seriously undermine our effectiveness if we are not able to see it clearly and hold it skillfully. The stance of evenly hovering attention has also been shown to be a powerful healing component in itself. While the psychodynamic approach is often parodied as stiff, cool and distant – See Madmen or the Sopranos – we take a lot for granted, such as “rules” about self-disclosure, the use of silence, kinds of questions we ask. Mostly too, we take it as a given that people struggle with unconscious material, that they repress difficult memories, that we project our fears and hopes onto others. Its hard to imagine what our work today would look like without Freud, for better and worse.
I don't think we can discount Freduds theory and the impact it has on counseling today. It has shaped many of the other theories and I respect that for that reason. I also think that we can not say "I am not going to use psychodynamic theory because I am limited in sessions (or for whatever reason)". It is all about meeting the client where they are at, and if psychodynamic theory is applicable to the given cirumstances of a particular client, then it should not be excluded. WHen I think of this theory, I think of how it can work well in conjunstion with CBT. I think exploring the past is a critical component to working with clients, as their past experiences, thoughts and beliefs have shaped them in to who they are today. Just the other day, I had a pt who came in with S/I. She was also presenting with untreated PTSD from past abuse from her father (sexual). Without exploring this, how can she move on and past the horrible nightmares and vivid memories she continues to experience (as they were never treated). I work with alot of pt's who present with S/I, self harming behavior, panic d/o, anxiety d/o. Freud would hypothesize that all mental life exists on 2 levels, within the realm of consciousness and within a less accessible realm. Many of the above presenting sxs arise from a large part of the unconscious realm. In a case of self harm or destructive behaviors the id is acting out. Defense mechanisms such as reaction formation or denial are usually present in pt's who present with these types of issues as discussed above. Being able to identiy what defense mechanism they are utilizing and helping them to identify this is critical in moving past the emotions/feelings/beliefs that are allowing them to be "stuck" in their current situation. I start a new job as a therapist at the Moore Clinic (and eating d/o clinic) working in the day tx program. I look forward to implementing many of these theories that we have been talking about, and sharing cases with the group. In no way am I saying that psychodynamic theory is the best, and utmost end all of the theoretical modailities, but I do feel that we can not disregard it. And it is important to remember that it can last anywhere from 1-12 sessions (or more), but does not have to be lengthy as once thought. It would be thought of as "brief" psychotherapy if it were to fall under the shorter sessions. Again, it is all about meeting the client where they are at.
While I don't have a lot of clinical experience to draw from, I believe that one of Freud's greatest contributions to clinical practice in today's setting is his theory around defense mechanisms. Granted, Anna Freud, built upon this thinking and gave us 10 specific ego defense mechanisms, but Freud laid the groundwork for us to identify the tactics (healthy and otherwise) that individuals employ to protect their egos. While I do not believe Freud's treatment of the unhealthy defense mechanisms is sound or would necessarily surpass CBT in efficacy, his framework for assessing and understanding how/why defense mechanisms are employed and operate is still as relevant today as it was when he studied these patterns. Denial, repression, displacement, regression and reaction formation* are commonly employed by individuals, but as many of you have stated, as therapists in settings where we do not have the luxury of one-hour weekly meetings, we rarely experience working through these defense mechanisms with the clients we see.
*As a heads up for the test, there was a question or two about defense mechanisms on my LCSW exam.
Freud's psychodynamic theory is known as the first of the traditional forces that have shaped and defined counseling and psychology in the last century. Many others have built upon this theoretical model, including Jung, Adler, Bowlby, Ainsworth, and Erikson. Is Freud's theory still useful today, or is it just too cumbersome unless you have unlimited hour-long sessions with a person who really wants to explore their past at great length? There are problems with Freud's original theory as well, which I'll bring up below.
ReplyDeleteThe basic keys of Freud's psychodynamic theory are:
-the significant role the unconscious plays in a person's psychological development
-the use of defense mechanisms that a person uses to cope w/anxiety and stress
-the effect that past experiences have on a person's sense of mental health and personal well-being
-"the past is often a prelude to the future"
meaning that lasting change won't happen unless a client has some sense of how their present actions relate to their past experience. Freud believed that behavior is determined by the need to gratify biological needs and instincts. Therefore, interventions/actions are directed at the roots of a client's behaviors, emotions, and present thinking patterns.
Another key phrase to mention regarding Freud is "Object Relations", which refers to the relationships each of us has developed w/important people in our lives and the continuing impact these rational experiences have on our lives.
And, of course, Freud is famous for the concepts of the Id, Ego, and Superego, which he describes as the 3 main psychic components of being. The Id is a person's basic drives and needs, the unconscious, instinctual processes. It is potentially destructive unless controlled and channeled. The Superego is the internalized rules and expectations generated by one's family and cultural history. This develops as we mature, especially as children. Freud believed that a person's conscience, ideals, and values all are part of the superego, which includes gender roles, acceptable social behaviors, cultural values, and such. The Ego is the mediator between the superego and the id, and is often described in traditional Freudian theory as "being at the mercy" of the two. More modern psychodynamic theorists have other views of the ego. The ego operates at all three levels of experience, the conscious,preconscious, and unconscious.
So, we have the id (unconscious rebellion) struggling against the superego (unconscious absorption of ideals, rules, expectations) with the ego attempting to act as mediator. Freudian psychodynamic theory basically says, "you learned this a long time ago, to change it, we have to go the roots, examine it detail, understand it, and you have to be invested in the outcome."
ReplyDeleteFreud's theory suffers from the white, European middle class heterosexual, male point of view. As many have pointed out, this weakens his theory considerably. Is there any value in his particular brand of psychodynamic theory? He laid the foundation for the many talented and innovative theorists who came after him. Important concepts are contained in psychodynamic theory, including roots of a person's behavior and present thinking patterns. I see the value with many of my clients who can tell me why they do things a certain way, or have certain beliefs and want to change, and why it's a struggle, and I incorporate some psychdynamic theory in with my techniques. But, this is from later theorists, not Freud. Psychodynamic therapy by itself seems so cumbersome and there are so many better ways of getting results. I've never had the luxury of unlimited sessions, everything is fast paced and I can offer the suggestion that the person think about where that belief came from and how would they like to change it, and work from there. Personally, Freud is not a favorite of mine because he was so biased against women, but I am grateful for the work that he started with this theory.
Enough from me, what about you all?
Karyn, what a thoughtful post! Excellent Work. You know when we think of Freud, there seems to be this image of Frued sitting back in his chair meeting his client and exploring their challenging process. It's hard to imagine this "Eurocentric modality" to have a positive impact on clients today. However, I would argue that it is. We can't deny the past. Team, with your clients the past is going to surface. There is no way around it. So, I challenge you to bring your practice sites to life and look hard at your practice and think of ways you have or can infuse some of the concepts of this modality in your practice.
ReplyDeleteI always tell you all to understand and respect these theories in their purest form and I tell you this because they are all so vital to all of our practices. And I think if solely focus on theories on being Euro focused or whatever limitations they have, it inhibits us from garnering everything we can get out of that theory. By no means am I saying not to consider weaknesses of the various modalities because this is important as well.
Taking the LICSW exam confirms this is well because it wants you to look at these theories at face value and not to over think them
I have always found it ironic that the clinical program at UW places so much emphasis on psychodynamic theory given that it takes at least 15-20 sessions for "brief psychodynamic therapy" according to most theorists, that it is such a Eurocentric model, and that it is in many ways the antithesis of a strengths-based approach.
ReplyDeleteEconomic realities today in the U.S. place psychoanalysis out of reach for all but the very wealthy, with its twice-weekly 2-3 year commitment - to what?
Freud himself is said to have been very pessimistic about the potential for human happiness, seeing a low-level neurosis and dissatisfaction as a functional norm. And he was terrified of - and labeled as infantile – the meditative states (or oceanic realms) associated with with mindfulness-based approaches proving so effective today. Many writers have suggested that while Freud was brilliant, he was neither very happy nor emotionally evolved himself. Also, it is hard to overlook his endorsement of cocaine, a drug whose enormous destructive power we see daily in hospital settings.
Nevertheless, it is impossible to deny his influence on the way I work, both as a therapist and in the hospital.
Freud’s concept of “evenly hovering attention” is vital to how I work with clients, trying to be in the moment with them - without judgment - and attuned to their perspective. This enables an examination of transference and counter-transference, both of which can be useful tools, but also significant barriers if not seen clearly. For example, how many of us have not encountered a situation with a client that triggers something from our own family life? This can seriously undermine our effectiveness if we are not able to see it clearly and hold it skillfully. The stance of evenly hovering attention has also been shown to be a powerful healing component in itself.
While the psychodynamic approach is often parodied as stiff, cool and distant – See Madmen or the Sopranos – we take a lot for granted, such as “rules” about self-disclosure, the use of silence, kinds of questions we ask. Mostly too, we take it as a given that people struggle with unconscious material, that they repress difficult memories, that we project our fears and hopes onto others.
Its hard to imagine what our work today would look like without Freud, for better and worse.
I don't think we can discount Freduds theory and the impact it has on counseling today. It has shaped many of the other theories and I respect that for that reason. I also think that we can not say "I am not going to use psychodynamic theory because I am limited in sessions (or for whatever reason)". It is all about meeting the client where they are at, and if psychodynamic theory is applicable to the given cirumstances of a particular client, then it should not be excluded. WHen I think of this theory, I think of how it can work well in conjunstion with CBT. I think exploring the past is a critical component to working with clients, as their past experiences, thoughts and beliefs have shaped them in to who they are today. Just the other day, I had a pt who came in with S/I. She was also presenting with untreated PTSD from past abuse from her father (sexual). Without exploring this, how can she move on and past the horrible nightmares and vivid memories she continues to experience (as they were never treated).
ReplyDeleteI work with alot of pt's who present with S/I, self harming behavior, panic d/o, anxiety d/o. Freud would hypothesize that all mental life exists on 2 levels, within the realm of consciousness and within a less accessible realm. Many of the above presenting sxs arise from a large part of the unconscious realm. In a case of self harm or destructive behaviors the id is acting out. Defense mechanisms such as reaction formation or denial are usually present in pt's who present with these types of issues as discussed above. Being able to identiy what defense mechanism they are utilizing and helping them to identify this is critical in moving past the emotions/feelings/beliefs that are allowing them to be "stuck" in their current situation.
I start a new job as a therapist at the Moore Clinic (and eating d/o clinic) working in the day tx program. I look forward to implementing many of these theories that we have been talking about, and sharing cases with the group. In no way am I saying that psychodynamic theory is the best, and utmost end all of the theoretical modailities, but I do feel that we can not disregard it. And it is important to remember that it can last anywhere from 1-12 sessions (or more), but does not have to be lengthy as once thought. It would be thought of as "brief" psychotherapy if it were to fall under the shorter sessions. Again, it is all about meeting the client where they are at.
While I don't have a lot of clinical experience to draw from, I believe that one of Freud's greatest contributions to clinical practice in today's setting is his theory around defense mechanisms. Granted, Anna Freud, built upon this thinking and gave us 10 specific ego defense mechanisms, but Freud laid the groundwork for us to identify the tactics (healthy and otherwise) that individuals employ to protect their egos. While I do not believe Freud's treatment of the unhealthy defense mechanisms is sound or would necessarily surpass CBT in efficacy, his framework for assessing and understanding how/why defense mechanisms are employed and operate is still as relevant today as it was when he studied these patterns. Denial, repression, displacement, regression and reaction formation* are commonly employed by individuals, but as many of you have stated, as therapists in settings where we do not have the luxury of one-hour weekly meetings, we rarely experience working through these defense mechanisms with the clients we see.
ReplyDelete*As a heads up for the test, there was a question or two about defense mechanisms on my LCSW exam.