PSYCHOTHERAPY Psychotherapies are nonmedical techniques used to try to help a client or patient overcome a problem or problem or problems. There are several different types of psychotherapy, but the concept of psychotherapy can probably be viewed as originating from the work of Sigmund Freud. His procedures formed the basis of psychoanalysis, perhaps the best-known of the psychotherapies. Psychoanalysis The bases of psychoanalysis were developed by Freud, who believed it was the therapist’s responsibility to help and guide the client, providing direction during the therapy sessions. Several aspects of the client’s responding during the sessions were considered most important. Developing out of what Freud and his partner Breuer called the “talking cure,” a major aspect of psychoanalysis is the process of free association. Free association means the client is expected to say whatever comes to mind, regardless of the distastefulness of apparent irrelevance of the statement. As the therapy progresses, the client often demonstrates what Freud called transference, the development of an emotional relationship with the therapist. Freud believed this relationship represented a reenactment of the association the person had with a parent while a child. When the client develops trust in the therapist, it becomes possible to explore more and more of the conflicts that have created the problem. The therapist directs the sessions try to encourage the person to recognize and evaluate these conflicts. However, as the crucial causes of the problem come to be expressed, client often exhibit resistance; that is, they are often unwilling to discuss the topic. If the resistance can be overcome, the therapy may be successful. Freud felt one way of generating ideas and expiring desires within the therapy setting was dream analysis. To Freud the dreams represented thoughts and wishes the client held but was unable to express consciously. Often, even the content of the dream did not express the message directly, but through symbolic representation. (Note: Symbolism in dreams has created some problems of interpretation because more than one possible explanation often can be suggested.) EXAMPLE The client may start a therapy session by relating the content of a recent dream. The therapist may pursue this in different manners, perhaps exploring the meaning of the dream of possibly using the dream material as the initial step in a free association series of thoughts. The therapist needs to recognize the possibility that the dream’s content may be symbolic and not something that can be taken at face value. Solved Problems 1) Is psychotherapy intended only for those with seriously abnormal personality problems? What is the purpose of psychotherapy? The aims of psychotherapy vary with each and every case. It is probably safe to say that all psychotherapy has as its overall aim helping the patient overcome a particular problem or problems. But the types of problems treated vary considerably. For example, abnormal personal frustrations, motivational conflicts, abnormal personality patterns, of current living situations may all be dealt with in the course of psychotherapy. Clearly, one does not need to have a seriously abnormal personality pattern to encounter these problems. 2) Is there more than one kind of psychotherapy? There are many different kinds of psychotherapy, including psychoanalytic, client-cantered, Gestalt, existential, group, play, and what are called “pop” therapies. It probably is reasonable to think that all of these therapies should give some credit to Freud because the psychotherapeutic movement started from his work. However, many other people have made major contributions to the development of the different techniques. Freud’s influence is seen directly in psychoanalytic therapy, and psychoanalysts are trained in what are called Freudian techniques. 3) What is free association, and what roles does it play in the therapeutic situation? Free association is a technique in which the patient in psychoanalysis lets each though lead to the next without restriction. The purpose of free association is to get the patient to consider all the different factors that might be creating problems. Speaking what comes to mind, without forethought, is supposed to facilitate the release of information from the unconscious. It is hoped that the person will express even those things that seem objectionable of irrelevant, and thus reveal fears or conflicts that cannot be reached through ordinary rational discourse. 4) Some patients in psychoanalysis have found themselves unwilling or unable to make use of free association. What is this phenomenon called, and what are possible explanations for it? This unwillingness is one aspect of what Freud called resistance. Presumably, the patient is in analysis or therapy because of painful conflicts that persist in the unconscious, and it stands to reason that the patient may resist exposing such conflicts, even through free association. In addition, the patient may have an inability to remember certain anxiety-laden events, or show resistance at an unconscious rather than a conscious level. Much of a psychoanalyst’s work may involve helping the patient overcome these resistances, recognize the sources of anxiety, and learn to cope with them. 5) When asked about how therapy is going, patients have been known to say, “I just love my therapist!” Some people don’t recognize that this may actually be true and an important part of the therapy situation. What is this called? Why might this be important in therapy situations? The situation described may represent transference, or the transfer of attitudes about one person to another. Quite frequently, such transference is the reenactment of a child-parent relationship, with the therapist substituting for the parent. In this problem, the situation illustrates positive transference, which often helps the patient overcome resistance. A patient who shows an aggressive or hostile attitude toward the therapist may be experiencing negative transference. Even this may help the therapist and patient understand what the difficulties are. 6) Therapists have been known to interpret dreams as evidence of wish fulfillment. What does this mean? Freud believed that thoughts which were too anxiety-provoking or threatening to be expressed directly, even in dreams may be disguised and symbolically represented in dreams. If these symbols can be correctly interpreted, they reveal particular urges that the person would like to fulfill. Thus, the concept of wish fulfillment represents what the person is able to accomplish symbolically in dreams, but not in actual behavior. 心理學入門-4 blog.yahoo/messiah-dog/articles/8805/category/%E5%BF%83%E7%90%86%E5%AD%B8%E5%85%A5%E9%96%80
Posted on: Mon, 30 Sep 2013 01:12:27 +0000
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