Psychoanalytic-Psychodynamic-and Adlerian Theories

Introduction

Psychoanalytic and Psychodynamic Theories

Psychoanalysis, developed by Sigmund Freud, is considered the bedrock of most modern counseling theories. Freud believed that human nature is determined by unconscious motivations, instinctual drives, biological drives, and irrational forces. His concept of the personality was that it consisted of three parts: the id, ego, and superego. Each part has specific tasks, which direct a person’s psychological functioning. Freud also contributed an understanding of consciousness and unconsciousness and how these levels of mind influence personality and problem behaviors. Ego-defense mechanisms were identified as particular, adaptive ways in which people managed anxiety in order to avoid overpowering the ego. Some ego-defense mechanisms include regression, repression, reaction formation, projection, denial, and displacement (Corey, 2013).

 

Freud also emphasized the significance of early childhood development, suggesting that a person’s personality was well defined by age six. Although a person will experience the psychosexual stages of development, the first three stages—oral, anal, and phallic—were most influential. They are the basis upon which subsequent personality development is built.

The main goals of psychoanalytic therapy are to bring the material in the unconscious mind to the conscious mind and to strengthen the ego. The most common interventions used in psychoanalysis are: free association, dream analysis, analysis of transference, analysis of resistance, and interpretation (Corey, 2013).

Although the traditional Freudian psychoanalytic approach is rarely used today, empirical evidence supports the use of psychodynamic therapy. Psychodynamic therapy refers to a range of treatments that focus on the exploration of thoughts and feelings that may have been avoided, identifying recurring themes and patterns, and discovering aspects of the self that are not fully known, particularly as they are brought to life in the therapeutic relationship (Shedler, 2010). Several contemporary theories have emerged from psychoanalysis, including object-relations theory, relational psychoanalysis, and brief psychodynamic therapy.

Adlerian Theory

Alfred Adler was a collaborator with Freud in the development of psychoanalysis. After many years of working with Freud, Adler developed his own beliefs about human nature, personality development, and theory. He developed the theory of individual psychology, based on the premise that people have specific concerns and needs for social interest. Adlerian counselors tend to have a phenomenological approach to therapy, and they emphasize holism and collaboration. Adler emphasized the importance of ordinal family positions and the role socialization and encouragement played during one’s childhood. The fundamental principles of Adlerian psychology are purposiveness, social interest, and holism. Adler found that client problems revolve around work, friendship, and family; the goal of counseling is to help clients find a sense of belonging. The primary interventions in Adlerian counseling are lifestyle analysis and encouragement from the counselor. Adlerian approaches are widely practiced in schools and mental health settings. The theory tends to be flexible and is effective with individuals, groups, and families (Capuzzi & Gross, 2003).

References

Capuzzi, D., & Gross, D. (2003). Counseling and psychotherapy: Theories and interventions (3rd ed.). New Jersey: Prentice Hall.

Corey, G. (2013). Theory and practice of counseling and psychotherapy (9th ed.). Pacific Grove, CA: Cengage-Brooks/Cole.

Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. American Psychologist65(2), 98–109.

 

Objectives

To successfully complete this learning unit, you will be expected to:

    1. Evaluate Adlerian and psychodynamic theories in practice.
    2. Evaluate the concepts, principles, and assumptions of Adlerian and psychodynamic theories.
    3. Apply psychodynamic or Adlerian theory to the given case study.

 

Learning Activities

Unit 2 Study 1

Studies Readings

Use your Theory and Practice of Counseling and Psychotherapy text and the library to complete the following:

Optional Readings

The following articles are recommended but not required for this unit:

    • Agrawal, H. R., Hauser, S. T., Miller, M., & Penn, H. (2003). “My father did this to me!”: The psychodynamic treatment of an angry, sad, and violent young man. Harvard Review of Psychiatry11(4), 194–209.
    • Conway, F. (2012). Psychodynamic psychotherapy of ADHD: A review of the literature. Psychotherapy49(3), 404–417.
    • Gregory, R. J., & Remen, A. L. (2008). A manual-based psychodynamic therapy for treatment-resistant borderline personality disorder. Psychotherapy: Theory, Research, Practice, Training45(1), 15–27.
    • Portrie-Bethke, T. L., Hill, N. R., & Bethke, J. G. (2009). Strength-based mental health counseling for children with ADHD: An integrative model of adventure-based counseling and Adlerian play therapy. Journal of Mental Health Counseling31(4), 323–337.
    • Watts, R. E. (1996). Social interest and the core conditions: Could it be that Adler influenced Rogers? Journal of Humanistic Education and Development34(4), 165–170.

 

Unit 2 Study 2

Theories of Counseling Chart

Complete the Theories of Counseling Chart for the theories covered in this unit. Add notes about key concepts, notions of what changes and why, interventions the counselor may employ, and roles of the counselor and client. Explore the Web links for each theory to see the activities of its contemporary practitioners. Add references for your favorite scholarly resources providing evidence for its efficacy.

You will work on this chart throughout the course and post it in Unit 5 and in Unit 10 as discussion posts. You will be able to refer to this chart throughout your classes, into your fieldwork, and later as you study for licensure exams.

Refer to the Web Sites and Readings for Theories of Psychotherapy document to assist you in completing the Theories Chart.

Multimedia

Before updating the Theories of Counseling Chart, view the two Theories in Action multimedia presentations on Psychoanalysis and Adlerian Therapy to inform your work.

 

Theories in Action

Psychoanalysis

Tim Seibles
Psychoanalysis proposes that are personality develops through a complex interaction between the expression of our instincts and our early childhood environment, where the child encounters and internalizes shame and guilt. It is an in-depth therapy that assumes much of our behavior is unconsciously driven and that there is value in bringing unconscious motivations to awareness. In this approach, the therapist is experienced as a parent figure and therapy ideally evolves as a more positive parenting process.

This process occurs over a long period of time as the client builds what is called a transference relationship with the analyst. This transference relationship mimics early family relationships and offers rich material for the client to examine. The transference relationship allows the client to acknowledge forbidden and repressed thoughts and feelings in a safe environment and to integrate these into conscious awareness.

The alternative is that the latent unconscious content remains destructive to the client’s sense of well-being and personal relationships, manifesting in such symptoms as anxiety, depression, conflicts or addictions. The interpretation of dreams in free association became two of Freud’s primary therapeutic techniques for accessing repressed material from the past. Let us take a look at how Dr. Paula Justice uses dream analysis in her work with Jeannie as she examines some repressed feelings regarding the death of her father.

Dr. Paula Justice
Hi! Good to see you again.

Jeannie
Thanks.

Dr. Paula Justice
(Suggesting Dream Exploration) Last session, I know you said you had a significant dream that we did not have time to really process, I was wondering if you would like to start with that today.

Jeannie
I will really would, because it is still with me and it feels like a really big dream. It starts off in a sense of, I have been invited to this wedding and I am aware that I am talking to—I think it is the grandfather, and I am aware—again, when I say grandfather, he is more like my age. So it is not white beard or—this is a man—and I am aware that there is such a masculine feeling talking to him. I am aware that his son is also present and the grandson. The wedding is about the daughter.

But I am looking at him and I am talking with the grandfather, and there is just all three man. But the grandfather, he is so masculine. I am aware that he is handsome, that all of the man in the family are; that there is a sense of strength. I am just fairly attracted to the whole family.

Dr. Paula Justice
These three generations sort of strong masculine handsome man.

Jeannie
Yes.

Dr. Paula Justice 
(Clarification/Reflection) And this is the wedding of the daughter.

Jeannie
Right. And what seems to be so special about this is that the daughter gets to have the wedding exactly the way she wants to. And in fact, it is almost as if she—I do not want to say spoiled because I do not think that it is just spoiled, but she has all this incredible attention by all the men in the family. And she is told that she can have it exactly the way she wants, and it is an extraordinary request that she has asked for.

Dr. Paula Justice 
(Question Encouraging Depth Work) Now these three men, did they remind you of anyone?

Jeannie
Now that you are saying that, I know that when I see them in my mind’s eye, they remind me somewhat of my brothers—my brothers are very handsome. So there is the sense of the father or the grandfather, unaware, I mean, he looks kind of like my brothers as well. There is that sense of the handsome strong male.

Dr. Paula Justice 
(Interpretation) So you are the sister in a way to these handsome men.

Jeannie
Yes.

Dr. Paula Justice
And then in the dream, the sister is marrying. And you said she has a very special request, what was that request?

Jeannie
She wants to jump from an airplane onto a stallion into the ocean in her wedding dress.

Dr. Paula Justice 
(Exploration/Clarification) And what kind of airplane is this?

Jeannie
Well, it is kind of like a cargo I guess you would call it—a cargo plane because the back-end opens up, and it is like, there is a ramp, I see her in my mind’s eye again, I can see her in her wedding dress on this beautiful stallion. The ramp goes down and she leaps into the ocean and the horse’s hoof catches on the ramp.

Dr. Paula Justice
So there is sort of a stumble as she comes out of the plane.

Jeannie
Out of the plane.

Dr. Paula Justice 
(Encouraging Insight) OK. And this leaping out of a plane over water, does this remind you of anything?

Jeannie
Well, the part that really grabs me the most, is the one that she gets to have it her way, so to speak. The ocean, I have loved the water, that the father has allowed her to do this. This gift—Having given her this gift—so she can have this way.

Dr. Paula Justice 
(Encouraging Exploration of Past) And what about your own father?

Jeannie
Just when I was—I think it like that. Yes. Strange. I just remember that my father who – and again, I am going back and forth in my head and I ask a several different things as a daughter. And he was a pilot. And—

Dr. Paula Justice 
(Highlighting Father Issues) I remember you are saying he died when you were very young.

Jeannie
I was wondering if you had remembered that I had told you that I was four and he was flying, he is in the air force, and flew over—he was lost actually, off the Gulf of Mexico. His ejection seat went off.

Dr. Paula Justice 
(Suggesting Dream/Father Connection) So he sort of jumped out of the plane.

Jeannie
What you are making me think about is the connection with this good-looking grandfather too, and the whole masculine piece of it that I feel like I missed in my life. And as you know, my husband—I had a terrible accident recently, and I am aware that I did not have my father to walk me down the aisle. I am aware that I have always wanted to be a daughter. I am aware that I love this sense of my husband, who was of the first time of my life, I think a very strong masculine force. And I have felt protected by him, and now he is wounded.

And you know, the idea of that horse stumbling, the ramp reminds me of how my husband is now paralyzed and he has to get away—the only way he can get around—I am sorry. The way he can get around is by a van, which has a ramp on it. And so, he is now wounded.

Dr. Paula Justice
So the dream really brings up that longing for the strong masculine, for the father that you lost so early in life, and the masculine strength that you had in your husband but in a way that has been a little lost with his disability, his accident.

Jeannie
You know, and that is why I think the dream impacted me so much because of that sense of longing and the sorrow that comes up—wells up in me. And I had not made that connection with my loss of my dad. And you know what, it is so funny even to say the word dad, I speak of him as a father because I did not call him dad or I do not remember that or daddy.

Dr. Paula Justice
All right.

Jeannie
So when I think of a strong masculine, and I had it for a while and the courage—he was a jet pilot—and here is my husband, a motorcyclist and a spelunker. All of the loves of the physical, and that is I think what I do connect with the masculine being, strong and adventurous, courageous and—

Dr. Paula Justice 
(Death Wish) And then in the dream, you sort of leap as the daughter figure, you leap—she leaps from the plane into the water which is where your father was lost in reality, over the water. So you almost wish to join him.

Jeannie
You know, I think part of that longing or now that you bring that up, it is probably what I would call on, they will feel like sort of a questioning of be here. When I have to suffer so much lost to join him—which is what you are saying—there is probably some kind of longing for me to join with him. Wow. OK, that makes sense.

Dr. Paula Justice
And that would be sort of magic to be able to join with that strong masculine, have your father back, have your husband whole again.

Jeannie
If only.

Dr. Paula Justice 
(Reframing Shameful Feelings) And that wish of course does not mean that you are spoiled.

Jeannie
Thank you for that one. I think that there is that piece if I could have it my way. If I could have the masculine protect me, to give, to support me. If I had a father, what would that had been like for me?

Dr. Paula Justice
(Encouraging Insight) And knowing that, knowing that you have those feelings that this dream has surfaced for you, how does that sort of inform your waking life today?

Jeannie
You know, in telling you and you asking me some of these questions when I am really a sense of aware of, I have started breathing better. I think there is a comfort—it bring some sort of comfort knowing that there is a connection in this way. That I can make that connection that I know that I had longed for that. So, thank you.

Dr. Paula Justice
Well, thank you for sharing that.

Jeannie
Well, I feel much better. Thank you!

Dr. Paula Justice
Good.

Dr. Ed Neukrug
Well Paula, I first need to say how I moved there by that session and I guess, as I was watching you, maybe I have some of my own issues that came up as I was watching, you worked with Jeannie. I was very impressed with the depth of the relationship that you have with her.

At the same time, I am thinking, you just showed us a very small piece, a very long-term in-depth type of therapy, and to get to some of the levels that you got with her must mean that you have built a relationship with her and have talked through some issues to her previously.

Dr. Paula Justice
Of course.

Dr. Ed Neukrug
I was very interested in watching you work with her, around the dream analysis, and I was fascinated to see how much of the dream, how much of the analysis was really done by her, and you really kind of gave her the space to take the dream into depths that she was able to take it to. So what is your thought of that, the role of that analysis and interpretation play in dream analysis? How much are that is, building relationship and just listening versus actually giving feedback in interpreting?

Dr. Paula Justice
Well traditionally in psychoanalysis, the client who chooses that type of therapy usually is interested in their own introspection and self-analysis and the therapist is guiding them rather than doing a lot of the work, directive work in interpreting. So Jeannie represented a client who is very capable of that self-introspection, so I did not to do a lot of interpretation but rather, sort of to create a relationship. Provide the environment and direct her in certain ways where she could see the wish fulfillment piece of the dream and the transference of the father relationship into the characters in the dream, that sort of my role in that situation.

Dr. Ed Neukrug
Tell me about the wish fulfillment piece, I was really fascinated in that.

Dr. Paula Justice
Well, the traditional forte in interpretation of dreams of course is that dreams represent a forbidden wish fulfillment. And the interpretation of the dream is really the exposing of the latent content, the wish that we are not supposed to have in this case. The longing to have the father figure again, the strong masculine who would protect us and take care of us.

Dr. Ed Neukrug
All right. The longing to join with the father.

Dr. Paula Justice
Yes.

Dr. Ed Neukrug
Also, I think I saw a piece of a death wish in there where she is longing to join with the father through death.

Dr. Paula Justice
Yes.

Dr. Ed Neukrug
And so, can you talk a little bit about that?

Dr. Paula Justice
With her husband’s recent accident, of course, her life has become much more difficult in terms of having to work and take care of him and so obviously, there would be times when she might just want all this all to go away, and perhaps join her father who died a long time ago.

Dr. Ed Neukrug
Great. Well, I was fascinated by the whole session, again, even though it was a short session, there was so much depth to it. And I guess, I am also thinking that it would change a great client, will this work with other types of client and is there certain type of person that this type of therapy works for the best?

Dr. Paula Justice
Well traditionally, psychoanalysis is a lengthy therapy. And so someone has to be interested in exploring those depths for a period of time, and not all clients are oriented in that direction, they are more focused on perhaps immediate problem-solving. So it definitely takes a certain kind of client to choose this particular type of therapy.

Dr. Ed Neukrug
Well again, that was so interesting, and personally moving from me.
I want to thank you for your fine work with Jeannie.

Dr. Paula Justice
Well thank you very much. I enjoyed being here.

 

Theories in Action

Adlerian Therapy

Mr. Tim Seibles
Alfred Adler posited that we develop styles of life that compensate for innate feelings of inferiority. To overcome such feelings, he stated we strive for a sense of superiority defined as a desire to achieve emotional health and completeness. However, Adler believed that individuals are often victims of faulty assumptions or inaccurate perceptions of their pasts. These faulty assumptions and the poor choices we make which are based on them are often a function of our childhood memories, which are affected by our family constellation and birth order. Adler believed that emotional wellbeing could be gauged by an individual’s degree of social interest or sense of connectedness to others into a worldwide community. Considered a psychodynamic theory because of its focus on understanding the dynamic forces that shape one’s psyche, Adlerian Therapy has also been described as one of the first to apply humanistic and systemic concepts.

This is because Adler believed that people are influenced by family relationships but not shackled by past events, and can make new meaning in life by being goal directed. Adler’s saw therapy as occurring through a series of stages that included establishing a collaborative relationship, analyzing the clients problems, sharing insights, helping the client reorient to new ways of living and re-enforcing and evaluating the change process. Adlerian Therapists will often show empathy, conduct a lifestyle assessment, examine early recollections and dreams, communicate respect and confidence, focus on strengths and encourage clients, help clients combat faulty assumptions, and focus on goals.

Let us see how Dr. Gilchrist uses some of the above techniques to help Shannon examine how early recollections of her family have affected her need to be perfect and how striving for perfection results in a fair amount of stress in her life.

Dr. Sylinda Gilchrist
Hi Shannon, and what brings you to counseling?

Shannon 
Well, just recently, I have been feeling really overwhelmed and stressed about—I feel like I have so many obligations in my life that pull me in just so many different directions that I am not able to give my all to each of those areas.

Dr. Sylinda Gilchrist
So how long have you been feeling that way?

Shannon 
Actually, I said recently but when I think about it, probably as long as I can remember.

Dr. Sylinda Gilchrist
Okay. Since you were a child?

Shannon 
Yes.

Dr. Sylinda Gilchrist
Can you tell me a little bit about your childhood?

Shannon 
Sure. I grew up with my mom and my younger brother. He is four years younger than I am. My parents divorced when I was eight. So for the longest time, it was just my mom, my brother and I, the three of us kind of bounced around a lot. She worked two jobs to support the two of us as a single mom.

Dr. Sylinda Gilchrist
So you have been feeling overwhelmed for a long time now.

Shannon 
Yes, and actually, I would say probably even before I was eight, before they got divorced because my dad is an alcoholic, so even when they were together, it was just chaotic and I always wanted to protect my brother and help my mom. So—

Dr. Sylinda Gilchrist
Help your mom? How so?

Shannon 
Just around the house and helping out with my younger brother, taking care of him. I really did not have a childhood I guess because I did a lot of kind of adult things at a young age.

Dr. Sylinda Gilchrist
Adult things like?

Shannon 
Doing the dishes, cooking dinner, staying and to watch my brother while all my friends are outside playing at the park and stuff, those sorts of things, I guess.

Dr. Sylinda Gilchrist
So it sounded like you had a lot of responsibility for taking care of your younger brother. What did you do for you?

Shannon 
For me? That is an interesting question. I guess for me, I got straight A’s.

Dr. Sylinda Gilchrist
That is an accomplishment.

Shannon 
Yes, but I really stressed myself out in doing that to—

Dr. Sylinda Gilchrist
How do you stress yourself out?

Shannon 
Just feeling like I have to make straight A’s and not even only in school. I do that at work. I have to be the best employee. I do that at home. I do that with my friends and roommates and even in relationships, like romantic relationships.

Dr. Sylinda Gilchrist
So it seems like you strived to be perfect in school and in other areas. You might even be striving to be the best client.

Shannon 
Yes, yes I guess.

Dr. Sylinda Gilchrist
It sounds like you have this need to be perfect. Is that stressful?

Shannon 
It is. It is because I feel very disappointed if I do not do my best. I would beat myself up over that, so it is really stressful.

Dr. Sylinda Gilchrist
Who placed the expectation on you?

Shannon 
I guess I do, but in order to make people proud of me I guess.

Dr. Sylinda Gilchrist
Okay. Can you tell me your earliest recollection of maybe not being perfect?

Shannon 
Yes and actually, when you said that, that came to me immediately. I am in 7th Grade, I got my first B and I was extremely upset, and I cried the whole way home and I just—it was an awful feeling. It was awful.

Dr. Sylinda Gilchrist
Okay, and so, you said that it made you feel really awful.

Shannon 
Yes. I just felt—I had made straight A’s up until that point in that first B. I was so disappointed like I had just let myself down completely in what I expected of myself.

Dr. Sylinda Gilchrist
Since childhood, you have always been striving to be perfect. How is that working for you?

Shannon 
It is really, really stressful and sometimes it even makes me sick, like physically sick. Like I will stress myself out to the point where I have a stomachache or a really bad headache that I cannot get rid of. So I guess it is really not working.

Dr. Sylinda Gilchrist
And so it seem like this stress, the need to be perfect is really causing physical symptoms as well as adding to your stress level.

Shannon 
Yes, and then when I get sick, it takes away time that I need to be using for studying or working things, so it creates a cycle in that way.

Dr. Sylinda Gilchrist
It adds more stress. So what would it be like for you to act as if you are still that hard worker, you still have high goals but not stressed, not necessarily striving to be perfect, but to still be that hard worker and have high goals?

Shannon 
That is a new concept for me. I guess I would have to act differently and rationalize to myself that it is good and okay to be a hard worker although I may not be perfect in everything.

Dr. Sylinda Gilchrist
Okay. And you know, we have talked about a lot today. We have talked about your childhood and how you have always strived to be perfect. Then how you really want to help out your mother as much as possible so you kind of focused a lot of attention on your brother, trying to make sure he was taken care off. And in the midst of striving to not causing any harm or anything to your mother, you have developed this need to be perfect

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Psychoanalytic-Psychodynamic-and Adlerian Theories

Psychoanalytic-Psychodynamic-and Adlerian Theories

ANSWER


Introduction

Psychoanalytic and Psychodynamic Theories

Psychoanalysis, developed by Sigmund Freud, is considered the bedrock of most modern counseling theories. Freud believed that human nature is determined by unconscious motivations, instinctual drives, biological drives, and irrational forces. His concept of the personality was that it consisted of three parts: the id, ego, and superego. Each part has specific tasks, which direct a person’s psychological functioning. Freud also contributed an understanding of consciousness and unconsciousness and how these levels of mind influence personality and problem behaviors. Ego-defense mechanisms were identified as particular, adaptive ways in which people managed anxiety in order to avoid overpowering the ego. Some ego-defense mechanisms include regression, repression, reaction formation, projection, denial, and displacement (Corey, 2013).

 

Freud also emphasized the significance of early childhood development, suggesting that a person’s personality was well defined by age six. Although a person will experience the psychosexual stages of development, the first three stages—oral, anal, and phallic—were most influential. They are the basis upon which subsequent personality development is built.

The main goals of psychoanalytic therapy are to bring the material in the unconscious mind to the conscious mind and to strengthen the ego. The most common interventions used in psychoanalysis are: free association, dream analysis, analysis of transference, analysis of resistance, and interpretation (Corey, 2013).

Although the traditional Freudian psychoanalytic approach is rarely used today, empirical evidence supports the use of psychodynamic therapy. Psychodynamic therapy refers to a range of treatments that focus on the exploration of thoughts and feelings that may have been avoided, identifying recurring themes and patterns, and discovering aspects of the self that are not fully known, particularly as they are brought to life in the therapeutic relationship (Shedler, 2010). Several contemporary theories have emerged from psychoanalysis, including object-relations theory, relational psychoanalysis, and brief psychodynamic therapy.

Adlerian Theory

Alfred Adler was a collaborator with Freud in the development of psychoanalysis. After many years of working with Freud, Adler developed his own beliefs about human nature, personality development, and theory. He developed the theory of individual psychology, based on the premise that people have specific concerns and needs for social interest. Adlerian counselors tend to have a phenomenological approach to therapy, and they emphasize holism and collaboration. Adler emphasized the importance of ordinal family positions and the role socialization and encouragement played during one’s childhood. The fundamental principles of Adlerian psychology are purposiveness, social interest, and holism. Adler found that client problems revolve around work, friendship, and family; the goal of counseling is to help clients find a sense of belonging. The primary interventions in Adlerian counseling are lifestyle analysis and encouragement from the counselor. Adlerian approaches are widely practiced in schools and mental health settings. The theory tends to be flexible and is effective with individuals, groups, and families (Capuzzi & Gross, 2003).

Psychoanalytic-Psychodynamic-and Adlerian Theories

References

Capuzzi, D., & Gross, D. (2003). Counseling and psychotherapy: Theories and interventions (3rd ed.). New Jersey: Prentice Hall.

Corey, G. (2013). Theory and practice of counseling and psychotherapy (9th ed.). Pacific Grove, CA: Cengage-Brooks/Cole.

Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. American Psychologist65(2), 98–109.

 

Objectives

To successfully complete this learning unit, you will be expected to:

    1. Evaluate Adlerian and psychodynamic theories in practice.
    2. Evaluate the concepts, principles, and assumptions of Adlerian and psychodynamic theories.
    3. Apply psychodynamic or Adlerian theory to the given case study.

 

Learning Activities

Unit 2 Study 1

Studies Readings

Use your Theory and Practice of Counseling and Psychotherapy text and the library to complete the following:

Optional Readings

The following articles are recommended but not required for this unit:

    • Agrawal, H. R., Hauser, S. T., Miller, M., & Penn, H. (2003). “My father did this to me!”: The psychodynamic treatment of an angry, sad, and violent young man. Harvard Review of Psychiatry11(4), 194–209.
    • Conway, F. (2012). Psychodynamic psychotherapy of ADHD: A review of the literature. Psychotherapy49(3), 404–417.
    • Gregory, R. J., & Remen, A. L. (2008). A manual-based psychodynamic therapy for treatment-resistant borderline personality disorder. Psychotherapy: Theory, Research, Practice, Training45(1), 15–27.
    • Portrie-Bethke, T. L., Hill, N. R., & Bethke, J. G. (2009). Strength-based mental health counseling for children with ADHD: An integrative model of adventure-based counseling and Adlerian play therapy. Journal of Mental Health Counseling31(4), 323–337.
    • Watts, R. E. (1996). Social interest and the core conditions: Could it be that Adler influenced Rogers? Journal of Humanistic Education and Development34(4), 165–170.

 

Unit 2 Study 2

Theories of Counseling Chart

Complete the Theories of Counseling Chart for the theories covered in this unit. Add notes about key concepts, notions of what changes and why, interventions the counselor may employ, and roles of the counselor and client. Explore the Web links for each theory to see the activities of its contemporary practitioners. Add references for your favorite scholarly resources providing evidence for its efficacy.

You will work on this chart throughout the course and post it in Unit 5 and in Unit 10 as discussion posts. You will be able to refer to this chart throughout your classes, into your fieldwork, and later as you study for licensure exams.

Refer to the Web Sites and Readings for Theories of Psychotherapy document to assist you in completing the Theories Chart.

Multimedia

Before updating the Theories of Counseling Chart, view the two Theories in Action multimedia presentations on Psychoanalysis and Adlerian Therapy to inform your work.

Psychoanalytic-Psychodynamic-and Adlerian Theories

Theories in Action

Psychoanalysis

Tim Seibles
Psychoanalysis proposes that are personality develops through a complex interaction between the expression of our instincts and our early childhood environment, where the child encounters and internalizes shame and guilt. It is an in-depth therapy that assumes much of our behavior is unconsciously driven and that there is value in bringing unconscious motivations to awareness. In this approach, the therapist is experienced as a parent figure and therapy ideally evolves as a more positive parenting process.

This process occurs over a long period of time as the client builds what is called a transference relationship with the analyst. This transference relationship mimics early family relationships and offers rich material for the client to examine. The transference relationship allows the client to acknowledge forbidden and repressed thoughts and feelings in a safe environment and to integrate these into conscious awareness.

The alternative is that the latent unconscious content remains destructive to the client’s sense of well-being and personal relationships, manifesting in such symptoms as anxiety, depression, conflicts or addictions. The interpretation of dreams in free association became two of Freud’s primary therapeutic techniques for accessing repressed material from the past. Let us take a look at how Dr. Paula Justice uses dream analysis in her work with Jeannie as she examines some repressed feelings regarding the death of her father.

Dr. Paula Justice
Hi! Good to see you again.

Jeannie
Thanks.

Dr. Paula Justice
(Suggesting Dream Exploration) Last session, I know you said you had a significant dream that we did not have time to really process, I was wondering if you would like to start with that today.

Jeannie
I will really would, because it is still with me and it feels like a really big dream. It starts off in a sense of, I have been invited to this wedding and I am aware that I am talking to—I think it is the grandfather, and I am aware—again, when I say grandfather, he is more like my age. So it is not white beard or—this is a man—and I am aware that there is such a masculine feeling talking to him. I am aware that his son is also present and the grandson. The wedding is about the daughter.

But I am looking at him and I am talking with the grandfather, and there is just all three man. But the grandfather, he is so masculine. I am aware that he is handsome, that all of the man in the family are; that there is a sense of strength. I am just fairly attracted to the whole family.

Dr. Paula Justice
These three generations sort of strong masculine handsome man.

Jeannie
Yes.

Dr. Paula Justice 
(Clarification/Reflection) And this is the wedding of the daughter.

Jeannie
Right. And what seems to be so special about this is that the daughter gets to have the wedding exactly the way she wants to. And in fact, it is almost as if she—I do not want to say spoiled because I do not think that it is just spoiled, but she has all this incredible attention by all the men in the family. And she is told that she can have it exactly the way she wants, and it is an extraordinary request that she has asked for.

Dr. Paula Justice 
(Question Encouraging Depth Work) Now these three men, did they remind you of anyone?

Jeannie
Now that you are saying that, I know that when I see them in my mind’s eye, they remind me somewhat of my brothers—my brothers are very handsome. So there is the sense of the father or the grandfather, unaware, I mean, he looks kind of like my brothers as well. There is that sense of the handsome strong male.

Dr. Paula Justice 
(Interpretation) So you are the sister in a way to these handsome men.

Jeannie
Yes.

Dr. Paula Justice
And then in the dream, the sister is marrying. And you said she has a very special request, what was that request?

Jeannie
She wants to jump from an airplane onto a stallion into the ocean in her wedding dress.

Dr. Paula Justice 
(Exploration/Clarification) And what kind of airplane is this?

Jeannie
Well, it is kind of like a cargo I guess you would call it—a cargo plane because the back-end opens up, and it is like, there is a ramp, I see her in my mind’s eye again, I can see her in her wedding dress on this beautiful stallion. The ramp goes down and she leaps into the ocean and the horse’s hoof catches on the ramp.

Dr. Paula Justice
So there is sort of a stumble as she comes out of the plane.

Jeannie
Out of the plane.

Dr. Paula Justice 
(Encouraging Insight) OK. And this leaping out of a plane over water, does this remind you of anything?

Jeannie
Well, the part that really grabs me the most, is the one that she gets to have it her way, so to speak. The ocean, I have loved the water, that the father has allowed her to do this. This gift—Having given her this gift—so she can have this way.

Dr. Paula Justice 
(Encouraging Exploration of Past) And what about your own father?

Jeannie
Just when I was—I think it like that. Yes. Strange. I just remember that my father who – and again, I am going back and forth in my head and I ask a several different things as a daughter. And he was a pilot. And—

Dr. Paula Justice 
(Highlighting Father Issues) I remember you are saying he died when you were very young.

Jeannie
I was wondering if you had remembered that I had told you that I was four and he was flying, he is in the air force, and flew over—he was lost actually, off the Gulf of Mexico. His ejection seat went off.

Dr. Paula Justice 
(Suggesting Dream/Father Connection) So he sort of jumped out of the plane.

Jeannie
What you are making me think about is the connection with this good-looking grandfather too, and the whole masculine piece of it that I feel like I missed in my life. And as you know, my husband—I had a terrible accident recently, and I am aware that I did not have my father to walk me down the aisle. I am aware that I have always wanted to be a daughter. I am aware that I love this sense of my husband, who was of the first time of my life, I think a very strong masculine force. And I have felt protected by him, and now he is wounded.

And you know, the idea of that horse stumbling, the ramp reminds me of how my husband is now paralyzed and he has to get away—the only way he can get around—I am sorry. The way he can get around is by a van, which has a ramp on it. And so, he is now wounded.

Dr. Paula Justice
So the dream really brings up that longing for the strong masculine, for the father that you lost so early in life, and the masculine strength that you had in your husband but in a way that has been a little lost with his disability, his accident.

Jeannie
You know, and that is why I think the dream impacted me so much because of that sense of longing and the sorrow that comes up—wells up in me. And I had not made that connection with my loss of my dad. And you know what, it is so funny even to say the word dad, I speak of him as a father because I did not call him dad or I do not remember that or daddy.

Dr. Paula Justice
All right.

Jeannie
So when I think of a strong masculine, and I had it for a while and the courage—he was a jet pilot—and here is my husband, a motorcyclist and a spelunker. All of the loves of the physical, and that is I think what I do connect with the masculine being, strong and adventurous, courageous and—

Dr. Paula Justice 
(Death Wish) And then in the dream, you sort of leap as the daughter figure, you leap—she leaps from the plane into the water which is where your father was lost in reality, over the water. So you almost wish to join him.

Jeannie
You know, I think part of that longing or now that you bring that up, it is probably what I would call on, they will feel like sort of a questioning of be here. When I have to suffer so much lost to join him—which is what you are saying—there is probably some kind of longing for me to join with him. Wow. OK, that makes sense.

Dr. Paula Justice
And that would be sort of magic to be able to join with that strong masculine, have your father back, have your husband whole again.

Jeannie
If only.

Dr. Paula Justice 
(Reframing Shameful Feelings) And that wish of course does not mean that you are spoiled.

Jeannie
Thank you for that one. I think that there is that piece if I could have it my way. If I could have the masculine protect me, to give, to support me. If I had a father, what would that had been like for me?

Dr. Paula Justice
(Encouraging Insight) And knowing that, knowing that you have those feelings that this dream has surfaced for you, how does that sort of inform your waking life today?

Jeannie
You know, in telling you and you asking me some of these questions when I am really a sense of aware of, I have started breathing better. I think there is a comfort—it bring some sort of comfort knowing that there is a connection in this way. That I can make that connection that I know that I had longed for that. So, thank you.

Dr. Paula Justice
Well, thank you for sharing that.

Jeannie
Well, I feel much better. Thank you!

Dr. Paula Justice
Good.

Dr. Ed Neukrug
Well Paula, I first need to say how I moved there by that session and I guess, as I was watching you, maybe I have some of my own issues that came up as I was watching, you worked with Jeannie. I was very impressed with the depth of the relationship that you have with her.

At the same time, I am thinking, you just showed us a very small piece, a very long-term in-depth type of therapy, and to get to some of the levels that you got with her must mean that you have built a relationship with her and have talked through some issues to her previously.

Dr. Paula Justice
Of course.

Dr. Ed Neukrug
I was very interested in watching you work with her, around the dream analysis, and I was fascinated to see how much of the dream, how much of the analysis was really done by her, and you really kind of gave her the space to take the dream into depths that she was able to take it to. So what is your thought of that, the role of that analysis and interpretation play in dream analysis? How much are that is, building relationship and just listening versus actually giving feedback in interpreting?

Dr. Paula Justice
Well traditionally in psychoanalysis, the client who chooses that type of therapy usually is interested in their own introspection and self-analysis and the therapist is guiding them rather than doing a lot of the work, directive work in interpreting. So Jeannie represented a client who is very capable of that self-introspection, so I did not to do a lot of interpretation but rather, sort of to create a relationship. Provide the environment and direct her in certain ways where she could see the wish fulfillment piece of the dream and the transference of the father relationship into the characters in the dream, that sort of my role in that situation.

Dr. Ed Neukrug
Tell me about the wish fulfillment piece, I was really fascinated in that.

Dr. Paula Justice
Well, the traditional forte in interpretation of dreams of course is that dreams represent a forbidden wish fulfillment. And the interpretation of the dream is really the exposing of the latent content, the wish that we are not supposed to have in this case. The longing to have the father figure again, the strong masculine who would protect us and take care of us.

Dr. Ed Neukrug
All right. The longing to join with the father.

Dr. Paula Justice
Yes.

Dr. Ed Neukrug
Also, I think I saw a piece of a death wish in there where she is longing to join with the father through death.

Dr. Paula Justice
Yes.

Dr. Ed Neukrug
And so, can you talk a little bit about that?

Dr. Paula Justice
With her husband’s recent accident, of course, her life has become much more difficult in terms of having to work and take care of him and so obviously, there would be times when she might just want all this all to go away, and perhaps join her father who died a long time ago.

Dr. Ed Neukrug
Great. Well, I was fascinated by the whole session, again, even though it was a short session, there was so much depth to it. And I guess, I am also thinking that it would change a great client, will this work with other types of client and is there certain type of person that this type of therapy works for the best?

Dr. Paula Justice
Well traditionally, psychoanalysis is a lengthy therapy. And so someone has to be interested in exploring those depths for a period of time, and not all clients are oriented in that direction, they are more focused on perhaps immediate problem-solving. So it definitely takes a certain kind of client to choose this particular type of therapy.

Dr. Ed Neukrug
Well again, that was so interesting, and personally moving from me.
I want to thank you for your fine work with Jeannie.

Dr. Paula Justice
Well thank you very much. I enjoyed being here.

Psychoanalytic-Psychodynamic-and Adlerian Theories

Theories in Action

Adlerian Therapy

Mr. Tim Seibles
Alfred Adler posited that we develop styles of life that compensate for innate feelings of inferiority. To overcome such feelings, he stated we strive for a sense of superiority defined as a desire to achieve emotional health and completeness. However, Adler believed that individuals are often victims of faulty assumptions or inaccurate perceptions of their pasts. These faulty assumptions and the poor choices we make which are based on them are often a function of our childhood memories, which are affected by our family constellation and birth order. Adler believed that emotional wellbeing could be gauged by an individual’s degree of social interest or sense of connectedness to others into a worldwide community. Considered a psychodynamic theory because of its focus on understanding the dynamic forces that shape one’s psyche, Adlerian Therapy has also been described as one of the first to apply humanistic and systemic concepts.

This is because Adler believed that people are influenced by family relationships but not shackled by past events, and can make new meaning in life by being goal directed. Adler’s saw therapy as occurring through a series of stages that included establishing a collaborative relationship, analyzing the clients problems, sharing insights, helping the client reorient to new ways of living and re-enforcing and evaluating the change process. Adlerian Therapists will often show empathy, conduct a lifestyle assessment, examine early recollections and dreams, communicate respect and confidence, focus on strengths and encourage clients, help clients combat faulty assumptions, and focus on goals.

Let us see how Dr. Gilchrist uses some of the above techniques to help Shannon examine how early recollections of her family have affected her need to be perfect and how striving for perfection results in a fair amount of stress in her life.

Dr. Sylinda Gilchrist
Hi Shannon, and what brings you to counseling?

Shannon 
Well, just recently, I have been feeling really overwhelmed and stressed about—I feel like I have so many obligations in my life that pull me in just so many different directions that I am not able to give my all to each of those areas.

Dr. Sylinda Gilchrist
So how long have you been feeling that way?

Shannon 
Actually, I said recently but when I think about it, probably as long as I can remember.

Dr. Sylinda Gilchrist
Okay. Since you were a child?

Shannon 
Yes.

Dr. Sylinda Gilchrist
Can you tell me a little bit about your childhood?

Shannon 
Sure. I grew up with my mom and my younger brother. He is four years younger than I am. My parents divorced when I was eight. So for the longest time, it was just my mom, my brother and I, the three of us kind of bounced around a lot. She worked two jobs to support the two of us as a single mom.

Dr. Sylinda Gilchrist
So you have been feeling overwhelmed for a long time now.

Shannon 
Yes, and actually, I would say probably even before I was eight, before they got divorced because my dad is an alcoholic, so even when they were together, it was just chaotic and I always wanted to protect my brother and help my mom. So—

Dr. Sylinda Gilchrist
Help your mom? How so?

Shannon 
Just around the house and helping out with my younger brother, taking care of him. I really did not have a childhood I guess because I did a lot of kind of adult things at a young age.

Dr. Sylinda Gilchrist
Adult things like?

Shannon 
Doing the dishes, cooking dinner, staying and to watch my brother while all my friends are outside playing at the park and stuff, those sorts of things, I guess.

Dr. Sylinda Gilchrist
So it sounded like you had a lot of responsibility for taking care of your younger brother. What did you do for you?

Shannon 
For me? That is an interesting question. I guess for me, I got straight A’s.

Dr. Sylinda Gilchrist
That is an accomplishment.

Shannon 
Yes, but I really stressed myself out in doing that to—

Dr. Sylinda Gilchrist
How do you stress yourself out?

Shannon 
Just feeling like I have to make straight A’s and not even only in school. I do that at work. I have to be the best employee. I do that at home. I do that with my friends and roommates and even in relationships, like romantic relationships.

Dr. Sylinda Gilchrist
So it seems like you strived to be perfect in school and in other areas. You might even be striving to be the best client.

Shannon 
Yes, yes I guess.

Dr. Sylinda Gilchrist
It sounds like you have this need to be perfect. Is that stressful?

Shannon 
It is. It is because I feel very disappointed if I do not do my best. I would beat myself up over that, so it is really stressful.

Dr. Sylinda Gilchrist
Who placed the expectation on you?

Shannon 
I guess I do, but in order to make people proud of me I guess.

Dr. Sylinda Gilchrist
Okay. Can you tell me your earliest recollection of maybe not being perfect?

Shannon 
Yes and actually, when you said that, that came to me immediately. I am in 7th Grade, I got my first B and I was extremely upset, and I cried the whole way home and I just—it was an awful feeling. It was awful.

Dr. Sylinda Gilchrist
Okay, and so, you said that it made you feel really awful.

Shannon 
Yes. I just felt—I had made straight A’s up until that point in that first B. I was so disappointed like I had just let myself down completely in what I expected of myself.

Dr. Sylinda Gilchrist
Since childhood, you have always been striving to be perfect. How is that working for you?

Shannon 
It is really, really stressful and sometimes it even makes me sick, like physically sick. Like I will stress myself out to the point where I have a stomachache or a really bad headache that I cannot get rid of. So I guess it is really not working.

Dr. Sylinda Gilchrist
And so it seem like this stress, the need to be perfect is really causing physical symptoms as well as adding to your stress level.

Shannon 
Yes, and then when I get sick, it takes away time that I need to be using for studying or working things, so it creates a cycle in that way.

Dr. Sylinda Gilchrist
It adds more stress. So what would it be like for you to act as if you are still that hard worker, you still have high goals but not stressed, not necessarily striving to be perfect, but to still be that hard worker and have high goals?

Shannon 
That is a new concept for me. I guess I would have to act differently and rationalize to myself that it is good and okay to be a hard worker although I may not be perfect in everything.

Dr. Sylinda Gilchrist
Okay. And you know, we have talked about a lot today. We have talked about your childhood and how you have always strived to be perfect. Then how you really want to help out your mother as much as possible so you kind of focused a lot of attention on your brother, trying to make sure he was taken care off. And in the midst of striving to not causing any harm or anything to your mother, you have developed this need to be perfect