Psychoanalytic Psychology: Not Dead Yet

Myths in Clinical Psychology v Freud –Sexual Abuse, Hysteria, Women theorists –(Horney, Anna Freud, Mahler, Jacobson) v Psychoanalysis is dead v Psychoanalytic Psychotherapy, also known as Psychodynamic Psycho- therapy, is dead v Evidence only for CBT

Divisions in American Psychological Association v 54 Divisions v Examples: Experimental Psychology, Developmental Psychology, Personality and Social Psychology v Division 39 Psychoanalysis: “ represents, within the broad field of psychology, professionals who identify themselves as having a major commitment to the study, practice and development of psychoanalysis and psychoanalytic psychotherapy

Sections in Canadian Psychological Association v 30 Sections v Section: Psychoanalysis and Psychodynamic Psychology: This section was formed in 2002 to provide a place for those interested in psychoanalytic theory, research, and practice to share ideas.

v We are represented at the CPA’s annual convention, provide a forum for membership exchange, publish a newsletter, and sponsor international awards in psychoanalytic and psychodynamic leadership, scholarship, and student achievement.

Myths in Clinical Psychology v None of early psychodynamic (e.g., Freud) theories or components of theories are in use today v Psychodynamic/Psychoanalytic non empirical

Journals Publishing Empirical Work on Psychoanalysis and Psychodynamic Psychology v APA: Psychoanalytic Psychology American Journal of Psychoanalysis International Journal of Psychoanalysis Psychoanalysis

Bornstein (2005) Psychoanalytic ( ) v Unconscious memory v Primary process thought v Object representation v Repression v Preconscious processing v Parapraxis v Repetition compulsion v Ego v Ego defense Revision or reinvention v Implicit memory v Spreading activation v Person schema v Cognitive avoidance v Preattentive processing v Retrieval error v Nuclear script v Central executive v Defensive attribution

Myths in Clinical Psychology v Empirical support only for Behavioral treatments or Cognitive Behavioral treatments

Myths in Clinical Psychology v Projectives, like Rorschach or TAT, are not appropriate for use and not used in clinical psychology

Watkins et al. (1995) Camera et al. (2000) N = 179 Clinical Interview1 (95%) Not included in study Wechsler Adult Intel. Scale2 (93%)1 (85%) MMPI-23 (85%)2 (77%) Sentence Completion4 (84%) TAT5 (82%)6 (60%) Rorschach6 (82%)4 (69%) Bender – Gestalt7 (80%)5 (63%) Drawing Tests8 (80%)8 (36%) Beck Depression Inventory9 (71%)10 (30%) Weschler Intell Scale for Kids10 (69%)3 (75%) Wide Range Achievement Test-7 (48%) Wechsler Memory Scale-9 ((32%) Rank Order of Tests Used in Internship Sites

Myths in Clinical Psychology v Clinical psychologists essentially same as psychiatrist or other mental health professionals

Shedler: That was Then, This is Now v Important Points: –1. Misconception –2. Not one psychoanalysis –3. Major Features u Unconscious u Conflict u Past Influences Present u Transference u Defense u Psychological Causation v

Shedler Seven Features v Focus on affect v Exploration of attempts to avoid v Identification of themes and patterns v Past experience v Focus on interpersonal relations v Focus on therapy relationship v Exploration of fantasy life

Goals of Psychoanalytic Psychotherapy v Therapeutic Relationship v Change to personality and character structure v Aid in bringing relevant unconscious material to consciousness v Supportive or exploratory

Vehicles for Change v Observation, Interpretation, & Confrontation v Transference v Resistance

Contemporary Psychodynamic or Psychoanalytic Psychotherapy v Focus not on impulses but on interpersonal or attachment styles v Attempt to have people become aware of their interpersonal styles and their impact on others and themselves

Nancy McWilliams Video

Commonalities Among Psychodynamic Therapies v Psychopathology, signs, and symptoms derive from personality and character. –Psychic Determinism v Early development of relationships –Genetic Principle v Unconscious v Emotion/Affect

v Relating to others and self –Transference & Counter-transference

v Object Relations v Self Psychology

Psychoanalysis v Sigmund Freud –One of the first to believe abnormal behaviour result of psychological rather than physiological problems –Developed own form of treatment called psychanalysis (along with Joseph Breuer) v Based on premise that unconscious impulses will enter the conscious part of a person’s mind v Need to obtain insight

Psychoanalysis v Permits a release of tensions and anxieties v Uses: –Free association –Dream analysis –All done to get access to unconscious

Triangles of Adaptation & Object Relations Defense Triangle of Adaptation Triangle of Object Relations Anxiety Attachment Need/ Interpersonal Style Current Therapist/ Group Past From: Tasca, Mikail, & Hewitt (2001)

Blagys & Hilsenroth (2000) v Features of Psychoanalytic Psychotherapy: –1. Affect and affect expression –2. Avoidance of distressing thoughts and emotions –3. Recurring themes and patterns –4. Past experience –5. Interpersonal Relations –6. Therapy Relationship –7. Fantasy –8. Presence of positive capacities and resources v

Meta Analysis: Example v CBT vs Control v 10 Studies v 7/10 positive findings (i.e. cbt > control) v 3/10 negative (i.e., cbt <= control) v Pretty Good

Effect Size in Meta Analysis v Convert findings of treatment studies into standard deviation units Mean (posttreat) – Mean (pretreat) Mean (posttreat) – Mean (pretreat) (SD1 + SD2)/2 (SD1 + SD2)/2 v Reflects the difference between the treatment group and control (or other) group

Effect Size Values v Effect Size.80 is large effect size.50 is moderate effect size.20 is small effect size

Effect Size of Psychotherapy Treatment v Numerous meta analyses done v Roughly.75

Efficacy of Psychoanalytic Psychotherapy v Shedler (2010). The efficacy of psychodynamic psychotherapy. American Psychologist, 65,

Various Effect Sizes v Psychotherapy in general

Various Effect Sizes v CBT

Various Effect Sizes v Antidepressant Medication

Various Effect Sizes v Psychodynamic

Hypnosis - Myths v 1. All a matter of good imagination v 2. Same as relaxation v 3. Willful faking v 4. Dangerous? v 5. Sleeplike state? v 6. Lose control? v 7. Relive the past?

v 8. Remember more accurately v 9. Led to things incongruent with morals v 10. Forget what happened v 11. Perform impossible feats.

Hypnosis Demonstration v Do not participate : –1. If you are planning to simply observe –2. If you are currently experiencing some significant personal distress (i.e., depression, anxiety, marked distress) –3. If you have any proneness to psychosis –4. If you are planning to leave early from the demonstration (i.e., in the middle of the demonstration.

v Cell phones off v Leave early, tell me now v Distressed, do not participate