Freud
deserves some credit. Freud
kicked off this whole idea of mental health
in a way that nobody had ever really tried to understand it before.
Before, other than people like Hippocrates who
thought there might be something biological going on, but was talking
about
humors and things that he obviously didn't have the
scientific apparatus to verify, was thinking there might be a biological
underpinning to people's experiences of distress,
most people didn't even go there. They thought it had something to do with being
punished by God
or to be possessed by demons or to have just been born unlucky.
Things that you had no control over.
Nobody tried to understand how you developed as a human being,
how you came into a personality, how you came into being in such a way that might
actually
exacerbate troubles you would encounter in the world.
Until Freud tried to lay it out. Now, he gets a lot of knocks and a lot of those knocks
are
well-deserved knocks, but you look at it in the context of when he was developing the theories,
the fact that almost nothing existed prior to that of any systematic nature,
he helped propel us towards a better scientific understanding of mental health.
And, in that sense, he deserves credit. So he wanted
to analyze unconsciousness, unconscious thought. Because you remember from the
personality chapter,
he thought that's what's driving everything in your experience.
That you have this unconscious almost universe inside yourself
that's really driving the ship, and you have this kind of
thin veil of consciousness
that rationalizes everything, uses defense mechanisms to become
blissfully unaware of the deep-seated
impulses found in the unconsciousness. So for him, if you are experiencing problems,
it had to come from an imbalance of these psychodynamic forces between
the id, the ego, and superego, and to get
at the heart of that, you are going to have to go down to the unconscious level, right? And really
start to examine things that most people aren't even aware exist.
Well, that would be a very tall order, and so it proved to be.
He thought it had to do with conflicts with parents, childhood issues,
sexuality, and traditionally therapy could be done
weekly for years on end at high-cost
without much hope for success because the way they approached it
typically didn't produce a lot of success. Nor did Freud himself hold out a lot of hope for
change
because he figured you were pretty much who you were
by the time you reached puberty and right in that area of teenage development.
So they wouldn't expect you to make radical
alterations in your world because you're kind of stuck.
But here are some of his techniques
that, for better or worse, depending on which one it is are still around.
Free association means I say something, you say whatever comes to mind,
anything! I say 'tree,' you say...
I say 'mom,' you say... the idea is he's trying to get past our normal
inhibitions. We have this social barrier
where we always filter what we say to each other, right?
We don't just say what we think all the time because that would be
painful to a lot of people, right? You know how you act to people and you're like,"yeah, yeah, it's good to see you."
And you're like," God Almighty,
bless his heart." That's right, you can say anything in the south
bad about somebody as long as you say 'bless their heart' at the end of it, right?
"Oh my God, I can't believe...bless his heart."
He's trying to get you to get past that social filter
and get down to where you were really expressing what you
actually thought and this was more or less a thought game
to help you kind of prime yourself into being more real
with the therapist, talking to them about what's going on.
He believed in this thing called catharsis because he has an
energy model, right? It's almost like a hydraulic model.
He's got this pressure in the id. This pressure in the super ego.
And you got the ego in between trying to balance these pressures.
And when they get out of whack there's too much pressure in one, it is going to cause
issues. So if you can release some of that energy, release some of that tension,
if you could discharge aggressive impulses, for example,
well then you would reduce the pressure and things should be cool for awhile.
It'll build back up and then you're going to have to release it again. So if you have
these
problems with repression and you're not dealing with some traumas,
the idea is that you need to bring them back up and you need to re-experience them so
you can discharge the pressure
that's being repressed and help the person work through
to get to a better place. Turns out, at least for aggression, that doesn't work
scientifically.
Right? Getting people to act aggressively doesn't actually make them
less aggressive. Getting people to act aggressively makes them,
on average in laboratory and reality settings,
more aggressive. It primes aggression. Doesn't seem to have a cathartic affect
where it lowers aggression, but that was just something waiting to be tested and
eventually it got tested and it got debunked.
Something that is thoroughly debunked is dream analysis.
Dream analysis is bullshit. Right up
all the way to the top because I don't know what your dreams mean.
There's no magic person that knows what your dreams mean.
You know who knows what your dreams mean most?
If anybody, it's you!
Now it doesn't mean you couldn't use dreams in therapy,
but I'm not going to be a therapist
who examines your dream content and tries to figure out symbolism and what that means
unconsciously.
The old-school psychoanalytics did because they thought the dreams were the
window to the unconscious world.
They were looking for all kinds of symbolism, but you can go to any used bookstore
and buy a dictionary of dreams and find all the symbolism.
You can get it in varying thicknesses. "Oh, water? You dreamed about water, that means sex."
Seriously? Couldn't it just mean water?
Couldn't it just be a scene or a setting? But if you have like recurring dreams now
that bother you, certainly you could talk about that in
therapy, but the therapist wouldn't be telling you what they mean.
The therapist would be helping you process through what you think
that recurrence of that dream means to you because it might be
symbolic, but the therapist wouldn't know what the symbolism was.
But they can help you work through whether or not it's a meaningful thing
to examine
for yourself. So when I say it's 'bullshit' what I mean is
old-school dream analysis trying to figure out symbols in people's dreams
is out. No research support whatsoever.
Helping people understand their own dreams that bother them is perfectly legit.
But you're not supplying them with interpretations of their dreams as a
therapist.
Transference does exist.
It's a nebulous thing, hard to measure, but it has been scrutinized
scientifically and it's at the basis of all therapy training.
People who come in to see the therapist don't know the therapist.
We ain't going to be buddies. You ain't paying for a friend,
right? You're seeing someone who is professionally trained to help you work through your
own stuff and you don't know them and that's weird,
to start talking to a stranger, being guaranteed confidentiality except under
certain circumstances which have to be disclosed at the outset,
right? Talking to them about your deepest, darkest issues
is a strange thing, but what you find is that people will start treating you
in certain kinds of ways that are consistent with how they see the world,
because if the world is a macrocosm, then the therapy situation is a microcosm.
They don't become different people when they walk in the door.
So, how they treat other people is likely how you're going to get treated as a therapist
and that could be indicative
of symptoms. For example, if a person is really, really, really shy,
or really, really assertive or aggressive, and they treat
the therapist that way, that could be helpful to the therapist, to understand that
person's experience,
that maybe they don't engage life fully because they're shy,
reticent to engage others, or maybe they put other people off because they're so
abrasive
and in people's faces, cause they're doing it right here and they don't even know you.
So, there's that as an issue to be aware of. These people bring their stuff in
and they lay it on you even though you didn't necessarily do anything to elicit that,
it just is there. But, keep in mind,
you've got your own stuff and you're going to lay it on them
and that ain't cool anymore than it's cool to go over
in a class. We left off with counter-transference which is the idea that
therapists bring their own baggage, their own selves,
their own issues, into a therapy situation.
So, you have to be trained. Not just anybody is allowed to do therapy.
You have to have some formal training post bachelor's degree,
at least a master's degree to get licensed.
Under certain circumstances and criteria having been met,
the licensure insures that the public
welfare is taken care of, that you don't have people doing stuff where they
might actually damage somebody cause they don't know what they're doing.
One thing that can be damaging is to put your own things on to other people.
People don't come to hear about your problems as a therapist. Your therapist shouldn't
be talking about their problems. In fact,
they have them. All people have them and a therapy
relationship is a pretty intimate thing where people are sharing their deepest, darkest
issues with somebody they just met. Confidentiality is assured
but, you know what, it's not a two-way street. It's a one way street. These people
are paying
to get the services of a trained professional and the trained professional
had better know their own issues.
They had better know their own biases because they have them. All human beings do.
They better know their own values, their own beliefs, and they better learn to hold
those things
independent. Their job isn't to judge other people.
Their job is to provide a space in which people can come
and feel accepted and supported while they work on change for themselves,
and so to be able not to put your own issues on to somebody else
is something that you have to learn how to do. It's a training process and so
you want to avoid counter transference.
The next issue is resistance. That's also a Freudian concept
that actually seems to hold water. People do have resistances
to dealing with stuff that affects them. Hangups,
issues that they have that they've been avoiding.
In fact, avoidance of those issues oftentimes causes problems. Now, you may remember back
to when we were talking about
personality development and unconscious processes,
and defense mechanisms, and Freud was talking about repression keeping things
deep down
et cetera. Well, the idea of defense mechanisms is there are certain kinds of anxieties that we cannot
really deal with that well
and the defense mechanisms do a pretty good job of masking them.
But they don't get rid of them. They just got kind of cover them over.
But they're still there. So, working through traumas, for example, working through
hangups and issues, that kind of
stuff takes courage. It takes effort. It takes persistence, and you have to face
things that you may have been much more comfortable not facing,
and so resistance is the idea that some people just don't want to go there. Well,
from a psychodynamic
point of view, that's exactly where you want to go
because that's where your defense mechanisms are most active.
So, from a Freudian perspective, that's where your biggest hangups will be,
and so a resistance in a Freudian psychodynamic model would say that
if somebody doesn't want to talk about something, that's probably where you
should direct the therapy to
anyway. Supportive fashion, but you want to challenge the people to work
through their stuff.
Now you fast forward to a Rogerian client-centered model,
resistance still exists but you get this idea of rolling with resistance where you
now don't force people to go where they don't want to go.
They're the one's paying. They're using you as a resource,
So instead of them being considered a patient, they're considered a client.
And if they say, well I don't really want to talk about that, you don't go, why I think you ought
to.
You say, fine, if you don't want to talk about that, that's perfectly fine.
It's up to you. If you do come to a point where you do want to talk about it
realize that that's perfectly legitimate
and I'd be happy to have that discussion with you when and if you're ready.
So you let the client decide when and if they want to deal with their own
resistance. You might
highlight it to them as a potential point of future
interaction in a therapeutic situation but you wouldn't push or pressure them
into talking about things that they wouldn't want to talk about. Now,
over time, these old schools psychodynamic therapies
have been updated. They aren't every day of the week,
every week of the year, for years on end. That's not practical. Who can afford that,
and in the old, old model, it wasn't very effective anyway.
We're moving through scientific processes, where I've told you before,
one of the values of Freud was that he provoked a lot of people
into doing research to see what what of his theories held water and what did not.
And so, in a big sense, he helped push the research movement behind
therapy, which is how we now know that it's affective.
There's a very similar movement with medicine and always has been since we
developed the scientific method
and used it regularly, right? Where you have to have some basis of evidence to
say that something
does good. Certainly want to do no harm.
That's a fundamental principle. But, in psychology, in
the American Psychological Association code of ethics, we actually have to do
good.
It's not sufficient just to not harm a patient or a client.
You actually have to do something to benefit them. Otherwise, you have no
business
meeting with them. And so, all the therapies being
updated, scrutinized with the research, and et cetera, you now have
what we would psychodynamic approaches
that are more modernized, briefer versions,
and they tend to focus now more on current issues in relationships than things that
happened in your early childhood, for example.
Things that are deep down in your unconscious and they help people to
recognize conflicts that they have,
internal conflicts that they have. We just aren't that good
at analyzing ourselves it seems. You've heard that saying, doing the same thing over and
over again,
again and again, and expecting a different result is the definition of
insanity.
I wouldn't say that's the definition of insanity. But that's pretty much what people do.
They do what they know. If you remember back when we were talking about cognitive processes and thinking
outside of the box,
problem analysis and solution analysis, people tend to get in a groove and
they've survived through childhood into adulthood
and whatever coping strategies they ever developed in childhood through
adolescence into adulthood are the ones they're kind of stuck with.
They might have been affective at one point in life and become ineffective as adults
or they might have been ineffective as children and still ineffectual.
But we can we can scrutinize ourselves and when we realize
what our issues might be, that's called insight.
And so a lot of these are called insight therapies because the first part is to realize
what your issues are, right? You can't do anything until you know what you're
starting with.
And then, to resolve conflicts to improve one's life.
So, that's kind of the psychodynamic model. It's not the old school
model it used to be.