Main Topics Notes
1. Historical & - since ever: Hippocrates (psychophysiol treatment, natural means), Hellenists (brain as source of
Contemporary Issues in knowledge but also madness); 1700s emerged as domain of science, now + w/ medical context
Psychotherapy - unconscious: discussed by Hellenist (skepticism, cynicism), and in 1600s w/ Leibniz (role of
subliminal perception), Herbert (1700s) mathematized the dynamics
Mesmer - (= captivating): doctor, Vienna, scientifically trained (electromagnetism…), then invisible mental
forces, hysteria patients (unexplained medical symptoms); magnetism is a force in mental world;
developed personal magnetism; 1st group treatment
- King asked for 1st systematic research into effect of psychotherapy, committee from Academy of
Sciences → no effects, large indiv diff (susceptible patients got convulsions with wrong tree) →
imagination without magnetism leads to convulsion, no animal magnetic fluidum (revealed
different mechanism of observed effect = 1st in experimental psychopathology)
- legacy: expectancies and placebo effect, early version of hypnotherapy (close to psychoanalysis
and CBT), rapport btw therapist and patient, unconscious in shaping beh, remission of disorders,
selective influential function of memories
19th Century's streams of (1) natural sciences empiricists: systemic, lab-bench: Fechner (theaters of waking, dream state,
investigation stimulus intensity for crossing threshold of unconscious), Helmholtz (unconscious inference);
organist tradition; Kraepelin: medicine could not find tools for psychiatric disorders, turned to
classifying, describing, prognosis (paradigm for DSM)
(2) psychologist-philosophers: greater long-term influence, Romantics philosophers (nature,
sentiment, beauty, unconscious), Schopenhauer (nonbio methods for curing fashionable disorders,
irrationalist, pessimistic), C.G. Carus (early schema for unconscious, communication also at
nonverbal, organic level, transference and countertransference), stage for Harmann and Nietsche
(implicit cognitions, defense mechanisms that embellish persona and self-image..)
(3) clinician researchers: Benedikt (clinically purging pathogenic secrets), Breuer, Dubois, Jung, Freud
Freud (1800s) - early research w/ cocaine, hypnotherapy (suggestive therapy, but created a lot of transference)
- Phase 1: neurosis is result of recent trauma (Anna O, talking cure); Phase 2: neurosis is result of
childhood trauma, seduction theory (incest theory); Phase 3: neurosis is result of imagined
trauma, classical Psychoanalysis (case of Dora - wish fulfilled of assault)
- until 1980s, main treatment; difficult to investigate, design comparison conditions → CBT
Impact of bio sciences - neural plasticity w/ experience (epigenetics in neuro-emotional systems - impact on perception
and experience of oneself), impossible to unlearn (find alternative substitute ideas to replace),
neural restructuring (learning process, adaptive changes); complex biocultural matrix (organicists
and dynamicists - nurture shaped by nature, and vice-versa - therapists responsible for both)
Cultural factors - demographics: changes, experiences, generational differences
- multicultural psychotherapy: complexities, awareness of differences, biases btw therapists and
client, environ factors, philosophical differences, weather
- language & metaphor: psychotherapy methodology basis should be developed by people from
culture itself, indigenized, congruent w/ local ethos; culture = collective personality
Faulty lines in EBT - empirically based treatments; but the context-dependent stochastologicals (tangle of variables,
internal & external… random contingencies, personal history, comorbidity, too much opacity)
- spontaneity and intuition: "throw-ins", o en unknown to therapist but makes profound effect;
"person of therapist is 8x more influential than theoretical orientation itself"; factor analysis
- 1952, Eysenck: psychotherapy has no effect; 1980s: treated individuals are better off than 75%
Manualization untreated, no differences in effect size btw different schools of psychotherapy (Dodo Bird Verdict)
- today, APA: Dodo Bird Verdict is not always true across the different psychopathologies;
pressure for cost-effective treatments, health insurance, mandatory treatment guidelines!
- algorithmized, phases, specified objectives and resources (only understand how variables lead to
improvement w/ more mature neurobiology
- there is much room for improvement… degree of effectiveness depends on experience and
expertise of clinician; art and science can go together, integrated health care teams
Psychotherapy = generic, encompassing various clinical procedures/ techniques intended to improve client's
well-being (solve behavioral and other psychological problems in humans)
- positive psychology: 2000s, Seligman, Csikszentmihalyi, Adler, self-actualization, Rogers,
Erickson, focus on potential for well-being, creative solutions to problems
- develop expertise in therapeutic approaches that suits one's personality
- many techniques with differences, but also common factors
, 2. Psychoanalytic - psych treatment & model of psych functioning, human develop, psychopathology; about looking
Psychotherapies for the logical in the illogical; about homeostasis, affect regulation, unconscious mechanisms
- Freud: founding father; based on clinical experience and theories (not 'scientific' origin!);
Darwin 1859 made sexuality central, bio x environ → id-psychology
- principles: unconscious motivation; interest in facilitating awareness of unconscious
motivation; explore ways we avoid psychic pain, and use therapeutic relationship as arena;
assume we're ambivalent about changing; help client understand how one's own history
constructs perpetuate self-defeating patterns
Basic Concepts - unconscious: 'we aren't masters of our own houses'; Freud: ego (hypothetical psychic agency), id,
superego; now: we're influenced by processes we're unaware of, and we avoid them for psych pain
- fantasy: psychic functions: need for regulating self-esteem and affect, for feeling safe, for
mastering trauma; mostly outside awareness
- primary (primitive form of psychic functioning, atemporal, diff experienced condensed into one
image/ symbol, infants, driven by <3 life) and secondary processes (associated w/ consciousness,
logical, orderly, reality); primary < secondary → creativity; primary ~ secondary → slips, intrusions;
prmary > secondary → delusions
- defenses: process to avoid <3 pain by pushing content out of awareness; intellectualization (<3
distance), projection, reaction formation (feel opposite), Klenian's splitting (infants, tolerance for
ambivalent feelings); unconscious, automatic, internal (vs coping mechanisms)
- transference: a template from the past into the present situation, ct out previous relationships in
therapy, help develop understanding of the influence in immediate emotional way
- shi from one-person (Freud's, therapist is blank) to two-person psychology (self-exploration of
therapist, understand own contribution to interaction to really understand client)
Other Systems - it's 1st modern Western system of psychotherapy; extended into social theory and cultural
critique; declined bc psychiatry became + biological, emphasis on EBT, negative public reaction
to arrogance & elitism & conservative (but earlier it challenged norms), now a distorted image;
contemp cultural biases (underestimation of complexity of human nature, emphasis on speed)
History - precursors: Charcot's splitting off of consciousness due to bio weakness in psychopathology
(hysteria); Breuer's assumption that patients' symptoms had psych meaning (<3) & the talking cure
Anna O
- beginnings: pursuit of truth, skeptical, counterindoctrination, free association, as scientific; from
seduction theory (sexual trauma is root of psych problems, linear) to drive/conflict theory (memory is
constructive, motivational model: to release libido, reduce tension, restore psychic equilibrium;
pleasure principle: push to repeat experiences associated w/ tension reduction, make aware of
defenses → ego-psychol); Jung and Bleuler (in Psychiatric Clinic) account their word association
findings to Freud (& <3 charged words reflect complexes), found Zurich Psychoanalytic Society;
Jung: Freud didn't account for spiritual and creative aspects, individuation → analytical psychology;
Structural Theory and Ego Psychology (id, ego manages and concerns reality, superego internalizes
norms); Object Relations Theory in Britain (Klein's play therapy, maturation involves creating
internal representation of relationship w/ others), influenced British Independents (importance of
spontaneity, creativity, nurturing environ)
defense mechanisms - primitive: denial, idealization/ devaluation =splitting; neurotic (repression, rationalization,
isolation of affect); adaptive (suppression, sublimation, humor)
- current status: now US is going towards Psychoanalytic Pluralism (not only classical Freud:
therapist thrive to be blank, psychosexual model of development, drive theory) → Sullivan's need
for human relatedness, two-person (internal psychoanalysis), Kohut (therapeutic empathy, develop
cohesive sense of self, inner vitality); Kleinian and Lacanian ('I' is an illusion, forged from
identification of self w/ desires of others; no true self, but a lack, sense of alienation from self)
traditions in Europe and Latin America
Personality Theories - Conflict Theory: central role of intrapsychic conflict, a compromise btw core wishes and styles of
defense; psychodynamic Ucs = too painful, we try to avoid, functions as primary process principles
- Object Relations Theory: internal working models (representations, of attachment theory - but no
Ucs role) are shaped by real experiences + unconscious; projective identification = feelings
experiencing as originating from other; form internal objects (unconscious fantasies of aggressive
etc others OR established when indiv withdraws from external reality bc caregiver is unavailable
or traumatizing), affects experience of the self, become part of internal structure too, shape
ongoing relationships, 'templates for love' (pathology as result of conflicts but + deficits in
parental care)
- Developmental Arrest Models: psych problems from failure of caregivers to provide optimal
environ, infant goes from state of subjective omnipotence to overadaptation to needs of others
