Further Therapies

Other therapies used by the psychodynamic model include the famous Rorschach inkblot test. Developed by Hermann Rorschach in 1918, after noticing that patients diagnosed with schizophrenia made radically different associations to the Klecksographie inkblots than normal people. He developed the Rorschach test as a diagnostic tool for schizophrenia. The Rorschach test involves looking at a set of cards containing pictures of inkblots that have been folded over on themselves to create a mirror image.

The test is what psychologists call a projective test with the idea that when a person is shown an ambiguous or meaningless image i.e. the inkblot, the unconscious mind will work hard at imposing meaning on the image. By asking the person to tell you what they see in the inkblot, they are actually telling you about themselves, and how they project meaning on to the real world. However the Rorschach inkblot test has been criticised by some psychologists who have argued that the testing psychologist also projects his or her unconscious world on to the inkblots when interpreting responses.

For example, if the person being tested sees a bra, a male psychologist might classify this as a sexual response, whereas a female psychologist may classify it as clothing. It has also been criticised for its validity, is it measuring what it says it is measuring? Rorschach was clear that his test measured disordered thinking as found in schizophrenia and this has never been disputed. But whether it accurately measures personality as well is up for debate. Finally, critics have suggested that the Rorschach lacks reliability as two different testers might come up with two different personality profiles for the same person. The controversy about its reliability and validity has been present since its conception. Today most psychologists in the UK think the Rorschach inkblot test is nonsense.

Another therapy is Gestalt Therapy, which focuses on the whole of an individual’s experience, their thoughts, feelings and actions and concentrates on the ‘here and now’ or simply what is happening from one moment to the next. Roughly translated from German, Gestalt means ‘whole’ and was developed in the 1940’s by Fritz Perls. The main idea of this approach is for the individual to become more self-aware, taking into account their mind, body and soul.

A therapist will constantly promote the client’s awareness of themselves and often uses experiments that are created by the therapist and client. These experiments can be anything from creating patterns with objects and writing to role-playing. Promoting self-awareness is the main objective of gestalt therapy but other areas such as improving the ability to support ones emotional feelings are also important. Gestalt therapy is influenced by psychoanalytic theory and therapists will concentrate on ‘here and now’ experiences to remove obstacles created by past experiences.

Strengths of the Psychodynamic approach: One of the major strengths of the approach is the fact that it tries to get to the root cause of the problems faced by patients unlike the biological and behaviourist model where the symptoms of the patient are treated rather than the actual cause, the psychodynamic approach reflects the complexity of human behaviour. It has been very useful in highlighting the fact childhood is a critical period in development as who we are and become is greatly affected by our childhood experiences.

Ideas put forward by Freud have greatly influenced the therapies used in treating mental illness, Freud was the first to recognise that psychological factors could be used to explain physical symptoms such as paralysis. Psychoanalysis has been widely used to help people overcome psychological problems. Another strength of the psychoanalysis is that it uses case studies as its methodology.

Freud conducted clinical interviews with his patients, listening to his patients and exploring their problems allowed him to develop his theories of human behaviour. The study of Little Hans helped develop his theory of the ‘Oedipus Complex’. Another advantage of case studies is that highly detailed and in depth data is provided which other models tend to neglect, such as feelings, emotions and personal experiences.

There is evidence that treatment is effective, Bergin (1971) in a huge study of 10,000 patients found that 80% of patients found the treatment beneficial compared with 65% from therapies based on a number of different approaches. Tschuschke et al (2007) reported that the longer treatment lasts the more effective it will be. Others support the idea of early experiences effecting later psychological health, Kindler et al (1996) found that twins separated from a parent in early life were more prone to depression and to alcoholism later in life. Comer (2001) reported a link between childhood trauma and adult psychological disorders but to nothing like the extent that Freud would have predicted.

The fact that psychoanalysis is used today, even in the NHS proves that it is effective for some patients. Studies such as the one by Brown & Harris (1978) concluded there was a link between life events and the onset of depression, the study found children who had lost their mother, especially girls were vulnerable to depression. The study supports Freud’s idea that depression in adults is linked to loss in childhood.

Weaknesses of the Psychodynamic approach: The model is subjective and lacks any sort of scientific validity as Freud’s theory was developed from his own interpretations of his patient’s thoughts and cannot be verified using objective or scientific research. The methods used by the psychodynamic are especially questionable as most ideas are based on case studies which as we’ve already seen provide lots of detailed information about a case but are particularly difficult to generalise and in some cases impossible to prove or disprove. In interpreting dreams, if the patient agreed with Freud’s interpretation this would be seen as supporting evidence.

If the patient did not agree then Freud saw this as the patient’s denial or inability to come to terms with the nature of their repressed thoughts. Similarly if a patient behaves as expected this would be seen as support, if they behaved differently this would be proof of the existence of defence mechanisms. Freud places too great an emphasis on childhood experiences whilst ignoring more recent adult events and similarly, according to later psychodynamic theorists places too great an emphasis on sex.

Erik Erikson (1963) describes psychosocial stages of development rather than psychosexual and believes that emotional conflict can arise from adult events just as much as childhood events. The components of personality, the stages, libido Eros and Thanatos are all hypothetical constructs, impossible to define or to study objectively and only manifest themselves through a subjective analysis of a patient.

A major criticism of Freud’s theory is that it is difficult to falsify, where as a good theory is one that can be tested to see if it is wrong. Popper (1935) argued that falsification is the only way to be certain, in other words, you can’t prove that a theory is right you can only falsify a theory. Many of Freud’s predictions are questionable, an example of this was his view that all men have repressed homosexual tendencies cannot be disproved, but if you do find men who have no repressed homosexual tendencies then it could be argued that they have them as they are so repressed they are not apparent.

In other words, the prediction cannot be falsified. However, while it is difficult to generate testable hypotheses from Freud’s theory of personality, it is not impossible. For example, research has looked at the relationship between guilt and wrongdoing Freud predicted an inverse relationship, and MacKinnon (1938) did find that individuals who cheated at a task tended to express less guilt when questioned about life in general than those who did not cheat. Another criticism of the theory is False Memory Syndrome where patients undergoing therapy have supposedly recalled long lost traumatic memories from childhood.

Many of these have involved abuse by a parent, relative or friend. Psychoanalysis assumes that childhood memories can be recalled in this way and actively encourages this in order to access the unconscious mind. In fact there is little evidence to suggest that childhood memories can be accessed in this way leading some to suggest that memories have been inadvertently implanted by the therapy.

In 1986, Nadean Cool a nursing assistant in Wisconsin, sought therapy from a psychiatrist to help her cope with her reaction to a traumatic event experienced by her daughter. The psychiatrist used hypnosis and other suggestive techniques to uncover buried memories of abuse that Cool herself had experienced, Cool became convinced that she had repressed memories of having been in a satanic cult, eating babies, being raped, having sex with animals and being forced to watch murder of her 8-year-old friend. Cool came to believe that she had more than 120 alter personalities. Cool eventually came to believe that false memories had been implanted and sued the therapist for malpractice, in March 1997 after 5 weeks of trial, her case was settled for $2.4 million.

In psychoanalysis a therapist would have a patient lie on a couch, relax and talk freely about their past, childhood, dreams, personal experiences and memories that they feel are affecting them while the therapist takes notes and tries to interpret …

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One psychological therapy of depression in Psychodynamic Interpersonal Therapy, this therapy was developed by Hobson, and focuses mainly on the relationship between the therapist and patient. When a comfortable relationship is established, past events that could be the cause of …

One psychological therapy of depression in Psychodynamic Interpersonal Therapy, this therapy was developed by Hobson, and focuses mainly on the relationship between the therapist and patient. When a comfortable relationship is established, past events that could be the cause of …

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