Outline and Evaluate one or more alternative therapies from either Psychodynamic or cognitive approaches (30 marks) The psychodynamic model of abnormality makes a number of assumptions in relation to the causes of abnormal behaviour. Firstly the model assumes that abnormal behaviour is primarily caused by unconscious conflicts and anxieties that have origins in the past, usually, it is assumed, from childhood. One method of investigating and treating these abnormalities is psychoanalysis.
The purpose of psychoanalysis is to gain insight into the causes of psychological disturbances and to make the “unconscious conscious”. This therapy places importance on childhood and repressed impulses and conflicts. The patient is called the analysand and a number of different methods are employed to bring the analysand’s unconscious to the surface. One such method is free association, which allows a free flow of feelings, thoughts and images. The analysand is encouraged to talk about whatever comes to mind without feeling embarrassed or ashamed.
They are relieved of any responsibility for what they say and so this way the internal ‘censor’ will relax, allowing unconscious material to emerge. During free association four stages may occur, firstly there may be ‘resistance’ from the analysand in which they attempt to delay progress, for example by being late or changing the subject. Another stage that may occur is ‘transference’, in which the analysand treats the analyst as though they were someone from their past.
The next stage then is ‘interpretation’ in which the analyst interprets the hidden meaning of what the analysand has said. Finally the last stage is ‘insight’ in which the analysand gains self knowledge and understanding, this can take a long time to develop however. Linked to free association is word association in which the analyst will read a list of neutral and emotionally charged words to the analysand to which they have to say the first word which comes to mind.
The analyst looks for unusual responses, hesitations and mental blocks to determine where potential problems lie. With psychoanalysis analysts may also use projective tests when they show the analysand inkblots and asking them to describe what they see. Analysts may also use dream analysis in which the analyst tries to uncover latent (hidden) content of a dream for example, the analysand may dream of a lollipop which may be an unconscious dream about a penis.
There are however several limitations of psychoanalysis, firstly it is not appropriate for everyone. Psychoanalysis is regarded as unsuitable and ineffective for many psychological disorders such as schizophrenia and is more suitable for problems labelled as ‘neuroses’ such as anxiety disorders, depression and eating disorders. Comer also identifies that free association may be detrimental to those with obsessive-compulsive disorder because it may inadvertently encourage the person’s tendency to ruminate and over-interpret.