PSYCLIN Handout: Psychotherapeutic Traditions

Dr. Seann Mansukhani

I. PSYCHOANALYSIS (Sigmund Freud)

Goal: Removal of debilitating neurotic problems through INSIGHT.
Insight: means total understanding of the unconscious determinants of one’s irrational feelings,
thoughts, or behaviors that are producing so much personal misery.
Insight is etched into the client’s consciousness by the WORKING-THROUGH PROCESS: a
careful and repeated examination of the client’s conflicts and defenses operating in
different areas of life.

Techniques of Psychoanalytic Intervention:

1. Free Association
Rule: say anything and everything that comes to mind – no censoring
Patterns of associations emerge over many sessions, then the analyst sort out repetitive themes.
Associations are outgrowths of unconscious forces that determine the direction of one’s associations.

2. Dream Analysis
Dreams are supposed to reveal the nature of the unconscious because they are regarded as heavily
laden with unconscious wishes, albeit in symbolic form (focused on: sex and aggression).
Dreams are the royal road to the unconscious; perform the function of symbolic wish fulfillment.
Levels of dream: Manifest content of a dream is that which actually happens during the dream;
Latent content refers to the symbolic meaning.

3. Resistance
- defenses used by the client against therapy progress which may be consciously or unconsciously
done. Why does client use resistance?
• Change, which is the therapeutic goal, always involves the unknown
• Habits: client does not want to give up the familiar albeit dysfunctional
• Pain: involved in discussing or getting in touch with vital issues

Forms of Resistance:
1) Speech
- quantity (too much or too little); quality (repeated material/topic, intellectual discussion); omissions

2) External interferences (e.g., tardiness, cancellation, forgetting appointment, sudden illness)

3) Psychological wellness in light of attacking client’s defenses

• Intensification of symptoms (“don’t make me confront things, I’m getting worse.”)
• “Flight into health” (“I don’t need to deal with these matters, I’m getting better.”)

4) Use of defenses
e.g., acting out – attempts to escape anxiety generated in therapy by indulging in irrational acts or
engaging in potentially dangerous behavior (e.g., drugs, mountain climbing); intellectualization

Ways of Handling Resistance:

1) Noting but disregarding
2) Minor adaptation – lessening emotional impact by not pushing; change the pace by slowing down;
supporting and accepting behavior to convey therapist’s understanding of client’s difficulty.
3) Temporary diversion – talk about something else
4) Direct manipulation – reflecting back and focusing on the feeling of resistance (e.g., “You seem to be
afraid of talking about __ “) or interpreting the resistance
5) Direct confrontation (e.g., “You are afraid of [sex]”)

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4. Transference - phenomenon where client feels & behaves toward the therapist as a representation of
important figures from childhood; provides important clues to the nature of the client’s problem
- positive and negative transference (admiration, love, dislike, anger, dependence; unrealistic roles
ascribed to therapist as powerful authority, giver of affection, ideal model of living, rival or competitor)
- its interpretation is used for insight and change of client’s behavior (in the real world).
Ways to Cope with Transference: limit appointment, as needed; bring up the transference with client;
don’t respond or accommodate overtures.

Countertransference - unrealistic & inappropriate emotional responses of therapist to client.

Kinds of Countertransference:
a) Negative countertransference (e.g., uneasiness, lacks energy with every appointment; encourages
client’s attachment in unproductive manner)
b) Positive countertransference (e.g., excitement towards appointment; pleasure in client’s comments)

Catharsis - the release of repressed emotional energy as a consequence of insight into the unconscious
causes of one’s psychological problem.

II. Behavioral Tradition

Behavior Therapy – the therapeutic application of the principles of learning to change maladaptive
behaviors (e.g., classical conditioning, operant conditioning, social learning)

A. Classical Conditioning Therapy

1. Counterconditioning
- Systematic desensitization (for phobia) – Joseph Wolpe

2. Aversion Therapy
- making a formerly pleasurable but maladaptive behavior unpleasant

B. Operant Conditioning Therapy

1. Positive Reinforcement (e.g., token economy)

2. Punishment

3. Extinction (e.g., flooding through exposure to stimulus

C. Social Learning Therapy

- participant modeling

D. Cognitive-Behavioral Therapy

1. Rational-Emotive Behavioral Therapy (Albert Ellis)

- forcing the client to give up irrational beliefs based on the ABC theory of emotion
- people believe that A causes C to happen
A = activating event (e.g., fail exam)
B = irrational belief (e.g., “I must be perfect”)
C = emotional consequence (e.g., depression)

2. Cognitive Therapy (Aaron Beck)

- elimination of exaggerated negative beliefs about self, the world, or the future (esp. for depressives)

3. Stress-Inoculation Training
- designed to build “psychological antibodies” or coping skills, and to enhance resistance through
exposure to stimuli that are strong enough to arouse defenses without being overwhelming.

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II. PHENOMENOLOGICAL-HUMANISTIC TRADITION

A. Client-centered Therapy (Carl Rogers)

- helps clients to find their own answers to their problems in a nondirective manner.
- assumption: the person is the best source of information about himself
- Rogers’ view of psychotherapy “releasing of an already existing capacity in a potentially competent
individual, not the expert manipulation of a more or less passive personality” through the use of 3
therapist characteristics: Accurate empathy; Unconditional Positive Regard (UPR) - personal warmth,
acceptance, nonjudgmental attitude, respect and liking for the client as a human being: Congruence -
genuineness honesty, sincerity

B. Gestalt Therapy (Fritz Perls)

- emphasis: present experience – “NOW” (Now = experience (real) = awareness = reality), Responsibility;
~ immediate awareness of emotion and action (“being in touch” with feelings)
- central idea: conceptualization of the person as an organized whole
- anxiety is the gap between now and later (future preoccupation)
- dialogue technique from different viewpoints (e.g., empty chair technique)

IV. TRANSPERSONAL PSYCHOLOGY

- accepts the full spectrum of human consciousness, working with the body, emotions, mind, and spirit.
- accepts spiritual insight as a legitimate part of the healing process; it includes realms of experience,
wisdom and creativity beyond the personality, such as mystical experience, ecstasy, enlightenment.
- Practitioners use: dreamwork, guided imagery, Eastern meditative practices, as well as traditional
therapeutic techniques.

Sample Transpersonal Therapies:

1. Jungian analysis
- According to Jung, psychological growth involves an “active, ongoing dialogue between the conscious
mind (the ego) and the Self, the transpersonal center of the personality that lies hidden in the depths of
the unconscious. Revealing itself to us through dreams and symbols, the Self guides us along a path in
which we become the complete human beings we are destined to be (individuation).”
- Approaches to establish a healthy relationship with the unconscious: dreamwork, active imagination,
creativity, sensitivity to the invisible world.

2. Psychosynthesis (Roberto Assagioli)

- recognizes the importance of unifying the conscious and the unconscious aspects of our being.
- superconscious – from which originate our most evolved impulses; here dwells the Transpersonal Self.
-integrating or unifying subpersonalities around a personal center
- align with Transpersonal Self through guided imagery, movement, meditation, Gestalt, journal-keeping,
exercises to develop the will

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 STYLES OF DISTORTED THINKING

1. FILTERING – taking the negative details and magnify them while filtering out all
positive aspects of a situation.
• I would’ve enjoyed the show except that the person next to me kept talking to his
companion.
2. POLARIZED THINKING – things are black or white.
• Unless I write an outstanding thesis, I’m a failure as a student.
3. OVERGENERALIZATION – arriving at a general conclusion based on a single
incident or piece of evidence.
• Ever since my ex, I’ve never wanted to go into a relationship again.
4. MIND READING – you know what people are feeling and why they behave even
without people saying so.
• She’s always smiling, but I know she doesn’t like me.
5. CATASTROPHIZING – expecting disaster; thinking “what if”.
• get jealous when I see my partner talking excitedly with the opposite sex.
6. PERSONALIZATION – thinking that everything people say or do is a reaction to
you. Comparing self to others.
• Quite a few people here seem smarter than I am.
7. CONTROL FALLACIES – if external control, self is a helpless victim of fate; if
internal control, you are responsible for the pain and happiness of everyone
around you.
• A working mother concludes after a particularly busy day at work and not spending
time with her children: “I’m a terrible mother.”
8. FALLACY OF FAIRNESS – resentment because you know what’s fair but other
people won’t agree with you.
• It isn’t fair that you go out and have fun while I’m stuck taking care of the baby.
9. BLAMING – you hold other people responsible for your pain, or blame yourself for
every problem.
• It’s your fault we’re always late for class.
10. SHOULDS – having a list of rigid rules about how you and others should act.
Anger or guilt with breaking rules.
• You should never ask people personal questions.
11. EMOTIONAL REASONING – you believe that what you feel must be true
automatically.
• I feel depressed. Life must be pointless.
12. FALLACY OF CHANGE – expecting others to change if you pressure or cajole
them. You need to change others because your hopes for happiness seem to
depend entirely on them.
• If you would be more sexually willing, we’d have a much happier relationship.
13. GLOBAL LABELING – generalizing one or two qualities into a negative global
judgment.
• He was a loser from the first day he showed up here.
14. BEING RIGHT – you are continually on trial to prove that your opinions and
actions are correct. Being wrong is unthinkable and you try hard to demonstrate
that you are right.
• I haven’t seen my girlfriend for two weeks and I think the relationship is falling apart.
15. HEAVEN’S REWARD FALLACY – expecting all sacrifice and self-denial to pay off,
then, feeling bitter when the reward does not come.

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• After all I did for my friends, look what thanks I got.

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