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Psychoanalytical
Adlerian
Person-Centered
Gestalt
Behavioral
Cognitive Behavioral
Choice/Reality

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Psychoanalytical Theory

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3) Free Association

A key part of learning to conduct psychoanalytic psychotherapy involves developing skills and techniques aimed at accessing and understanding unconscious processes.

This includes facilitating the client's free association, where the client expresses whatever thoughts or feelings come to mind without censorship. As unconscious ideas and emotions emerge, the therapist helps the client explore and make meaning of them.

Free association is a psychoanalytic term used to describe the free association of ideas that can give an insight into the unconscious mind of the patient.

In free association, the patient is encouraged to speak freely and to verbalize anything that comes to mind. In this way the patient may be able to bring content to the surface that has previously been censored by the ego.

This technique involves a therapist giving a word or idea, and the patient immediately responds in an unconstrained way with the first word that comes to mind. The analyst then offers an interpretation of the relationship observed.

It is hoped that fragments of repressed memories will emerge in the course of free association, giving an insight into the unconscious mind.

Free association may not prove useful if the client shows resistance, and is reluctant to say what he or she is thinking.

On the other hand, the presence of resistance (e.g., an excessively long pause) often provides a strong clue that the client is getting close to some important repressed idea in his or her thinking, and that further probing by the therapist is called for.

Freud reported that his free-associating patients occasionally experienced such an emotionally intense and vivid memory that they almost relived the experience. This is like a "flashback" from a war or a rape experience.

Such a stressful memory, so real it feels like it is happening again, is called an abreaction. If such a disturbing memory occurred in therapy or with a supportive friend and one felt better-relieved or cleansed-later, it would be called a catharsis.

Frequently, these intensely emotional experiences provided Freud a valuable insight into the patient's problems.

4) Dream Analysis

According to Freud, the analysis of dreams is "the royal road to the unconscious." He argued that the conscious mind is like a censor, but it is less vigilant when we are asleep.

In dream analysis, the analyst attempts to unravel and interpret the symbolic nature of the patient's dreams. The true concerns of the patient are often disguised in their dreams and may be experienced symbolically, i.e. they dream about something that represents their concern, rather than dreaming directly about the concern itself. The true concerns of the patient are often disguised in this symbolic form to protect the conscious mind from developing full awareness of the underlying concern.

As a result, repressed ideas come to the surface - though what we remember may well have been altered during the dream process.

As a result, we need to distinguish between the manifest content and the latent content of a dream. The former is what we actually remember.

The latter is what it really means. Freud believed that very often the real meaning of a dream had a sexual significance and in his theory of sexual symbolism, he speculates on the underlying meaning of common dream themes.

5) Transference Analysis

Another core technique is examining transference, which refers to how the client relates to the therapist in ways that unconsciously reflect early important relationships, and countertransference, the therapist's own unconscious reactions to the client that can give insight into the therapeutic relationship dynamics.

So, trainees learn to attend carefully to the emotional interchanges within the therapy relationship as a source of insight into both parties' unconscious relational patterns stemming from their developmental histories.

Of key importance in psychoanalytic therapy is transference. Freud had originally noticed that his patients sometimes felt and acted toward him as if he were an important person from the patient's past.

Sometimes, these feelings were positive, but sometimes they were negative and hostile. Freud assumed these were relics of attitudes held toward these important persons in the patient's past.

Freud felt that this transference was an inevitable aspect of psychoanalysis, and used it to explain to patients the childhood origins of many of the concerns and fears.

In psychoanalysis, transference is seen as essential to a complete cure. Analysts use the fact that transference is developing as a sign that an important repressed conflict is nearing the surface.

Countertransference

In psychoanalysis, countertransference refers to the emotional reactions and unconscious biases a therapist might have towards a patient, often influenced by the therapist's own past experiences or unresolved feelings.

It's the therapist's emotional response to the patient's transference.

Clinical Applications

Psychoanalysis (along with Rogerian humanistic counseling) is an example of a global therapy (Comer, 1995, p. 143) which has the aim of helping clients bring about a major change in their whole perspective on life.

This rests on the assumption that the current maladaptive perspective is tied to deep-seated personality factors. Global therapies stand in contrast to approaches which focus mainly on a reduction of symptoms, such as cognitive and behavioral approaches, so-called problem-based therapies.

Psychoanalytic therapy has been seen as appropriate mainly for the neurotic disorders (e.g. anxiety and eating disorders) rather than for psychotic disorders such as schizophrenia. It is also used for depression although its effectiveness in this area is more questionable because of the apathetic nature of the depressive patients.

A related problem is the greater likelihood of transference in depressive patients undergoing psychoanalysis. They are likely to show extreme dependency upon important people in their life (including their therapist) and more likely to develop transference (Comer, 1995).

Anxiety disorders such as phobias, panic attacks, obsessive-compulsive disorders and post-traumatic stress disorder are obvious areas where psychoanalysis might be assumed to work.

The aim is to assist the client in coming to terms with their own id impulses or to recognize the origin of their current anxiety in childhood relationships that are being relived in adulthood. Svartberg and Stiles (1991) and Prochaska and DiClemente (1984) point out that the evidence for its effectiveness is equivocal.

Salzman (1980) suggests that psychodynamic therapies generally are of little help to clients with specific anxiety disorders such as phobias or OCDs but may be of more help with general anxiety disorders.

Salzman (1980) expresses concerns that psychoanalysis may increase the symptoms of OCDs because of the tendency of such clients to be overly concerned with their actions and to ruminate on their plight (Noonan, 1971).

Comer also suggests that psychoanalysis may not be appropriate for patients suffering from obsessive-compulsive disorder in that it may inadvertently increase their tendency to over-interpret events in their life.

Depression may be treated with a psychoanalytic approach to some extent. Psychoanalysts relate depression back to the loss every child experiences when realizing our separateness from our parents early in childhood. An inability to come to terms with this may leave the person prone to depression or depressive episodes in later life.

Treatment then involves encouraging the client to recall that early experience and to untangle the fixations that have built up around it. Particular care is taken with transference when working with depressed clients due to their overwhelming need to be dependent on others.

The aim is for clients to become less dependent and to develop a more functional way of understanding and accepting loss/rejection/change in their lives.

Shapiro and Emde (1991) report that psychodynamic therapies have been successful only occasionally. One reason might be that depressed people may be too inactive or unmotivated to participate in the session. In such cases a more directive, challenging approach might be beneficial.

Another reason might be that depressives may expect a quick cure and as psychoanalysis does not offer this, the client may leave or become overly involved in devising strategies to maintain a dependent transference relationship with the analyst.

Critical Evaluation

Therapy is very time-consuming and is unlikely to provide answers quickly.

People must be prepared to invest a lot of time and money into the therapy; they must be motivated.

They might discover some painful and unpleasant memories that had been repressed, which causes them more distress.

This type of therapy does not work for all people and all types of disorders.

The nature of Psychoanalysis creates a power imbalance between therapist and client that could raise ethical issues.

There has been criticism in recent years that if psychoanalysis is of benefit to people, it is only of benefit to those who possess certain qualities. The acronym YAVIS has been used to indicate that patients who are young, attractive, verbal, intelligent, and successful would be the ones most likely to benefit from psychoanalysis.

Few studies appear to support the first three of these suggestions, although as well as the latter two suggestions there is evidence that psychoanalysis also works best with those clients who are highly motivated and have a positive attitude towards therapy.

Eysenck (1952) delivered the most damaging indictment of psychoanalysis when he reviewed studies of therapeutic outcomes for neurotic patients. He found that about half recovered within two years. What was so damning for psychoanalysis was that for similar patients who received no treatment at all (waiting list controls), the figure was about two thirds.

Critics of Eysenck's findings discovered that he had made a number of arbitrary judgements about 'recoveries' that were unfavorable to the groups that received psychoanalytic treatments.

Bergin (1971) found that by selecting different outcome criteria, improvement in the psychoanalytically treated group rose to 83% whilst the percentage of control group patients showing significant improvement dropped to 30%.

Fisher and Greenberg (1977), in a review of the literature, conclude that psychoanalytic theory cannot be accepted or rejected as a package, "it is a complete structure consisting of many parts, some of which should be accepted, others rejected and the others at least partially reshaped."

Eysenck's claims against the effectiveness of psychoanalysis showed the difficulties of evaluation in this area. Individual differences in patients and therapists, and the relationship between them, might confound attempts to measure the effectiveness of a particular type of treatment. Measuring the outcome of treatment may also present problems in defining what is meant by 'cure'.

Corsini and Wedding (1995, 2013) claim that, depending on the criteria involved, estimates of 'cure' as a result of psychoanalysis range from 30% to 60%.

Although changes in the occurrence of symptoms might be a suitable way of measuring the effectiveness of behaviorist techniques, the effectiveness of psychoanalytic therapy, which typically spans several years, is more subjective, measurable only by the extent to which the clients themselves feel that their condition has improved .

Fonagy (1981) questions whether attempts to validate Freud's approach through laboratory tests have any validity themselves.

Freud's theory questions the very basis of a rationalist, scientific approach and could well be seen as a critique of science, rather than science rejecting psychoanalysis because it is not susceptible to refutation.

The case study method is criticized as it is doubtful that generalizations can be valid since the method is open to many kinds of bias (e.g., Little Hans).

However, psychoanalysis is concerned with offering interpretations to the current client, rather than devising abstract dehumanized principles.

Anthony Storr (1987), the well-known psychoanalyst appearing on TV and Radio 4's "All in the Mind", holds the view that whilst a great many psychoanalysts have a wealth of "data" at their fingertips from cases, these observations are bound to be contaminated with subjective personal opinion and should not be considered scientific.

Neo Freudians

Subsequent psychoanalytic theorists built upon but also challenged Freud's drive theory.

Object relations theory shifted focus to relationships and attachment, with key figures like Melanie Klein, Donald Winnicott, and John Bowlby emphasizing how internal working models of self/other based on early caretaker relationships shape personality and relational patterns.

Harry Stack Sullivan and interpersonal psychoanalysis highlighted social and cultural factors influencing mental health. Heinz Kohut's self-psychology focused on empathy, attunement, and disorders of the self like narcissism.

Intersubjective and relational psychoanalysis theories view the client's and therapist's subjectivities as co-created in an intersubjective field, with attention to enactments and dissociated self states, especially for trauma survivors.

Attachment Theory vs Psychoanalysis

Attachment theory, developed by John Bowlby, and psychoanalytic theory, developed by Sigmund Freud, offer complementary perspectives on human development and relationships.

While attachment theory reacted against some psychoanalytic views, like drive theory, the two approaches converge on many topics. Both see early childhood experiences as shaping internal models that influence adult relationships and behavior.

Attachment research provides empirical evidence that unresolved issues from childhood perpetuate across generations, a key psychoanalytic claim. Concepts like internal working models and secure base align with psychoanalytic ideas like transference and the therapeutic relationship fostering insight.

However, attachment theory more strongly emphasizes the impact of actual childhood events, whereas psychoanalysis highlights inner reality and fantasy.

Both offer useful frameworks for understanding how relational patterns persist or change across the lifespan. Their differences can spark productive dialogue on the roles of inner and outer reality in development.

Training

Psychoanalytic education also involves the trainee undergoing extensive personal therapy, where through experiencing the therapy process directly they gain firsthand insight into their own psychological conflicts, attachment history, unconscious reactions, and clinical blind spots.

This helps develop self-awareness and attunement needed to understand and respond helpfully to clients' unconscious communications.

Finally, cultural competence requires analysts to engage in ongoing self-examination around differences and power dynamics related to their own and their clients' sociocultural identities and experiences.

Unconscious assumptions, biases, stereotypes etc. rooted in culture and privilege/oppression influence clinical perceptions and relationships, so their ongoing reflection upon is considered imperative.

The multiple layers of self-exploration around unconscious processes in one's personal therapy, clinical work, supervision, and sociocultural context form the bedrock of psychoanalytic clinical education and skill development.

Learning Check: You are the Therapist

A young man, 18 years old, is referred to a psychoanalyst by his family doctor. It seems that, for the past year, the young man (Albert) has been experiencing a variety of symptoms such as headaches, dizziness, palpitations, sleep disturbances - all associated with extreme anxiety.

The symptoms are accompanied by a constant, but periodically overwhelming fear of death. He believes that he has a brain tumor and is, therefore, going to die.

However, in spite of exhaustive medical tests, no physical basis for the symptoms can be identified. The doctor finally concludes that Albert's symptoms are probably psychologically based.

Albert arrives at the analyst's office accompanied by his parents. He describes his problems and depicts his relationship with his parents as "rosy" - though admitting that his father may be "a little on the strict side."

It emerges that his father will not permit Albert to go out during the week, and he must be home by 11 pm at weekends.

Additionally, he successfully broke up a relationship between Albert and a girlfriend because he thought they were getting "too close." In describing this, Albert shows no conscious resentment, recounting the events in an emotional, matter of fact manner.

During one session, in which Albert is encouraged to free associate, he demonstrated a degree of resistance in the following example:

This passage is fairly typical of Albert's recollections.

Occasionally, Albert is late for his appointments with the therapist, and less often he misses an appointment, claiming to have forgotten.

During one session, Albert reports a dream in which his father is leaving on a train, while Albert remains on the platform holding hands with both his mother and his girlfriend. He feels both happy and guilty at the same time.

Sometime later, after the therapy sessions have been going on for several months, the analyst takes a two weeks holiday. During a session soon afterward Albert speaks angrily to the therapist.

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Psychoanalysis: Freud's Psychoanalytic Approach to Therapy

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Psychoanalysis is a therapeutic approach and theory, founded by Sigmund Freud, that seeks to explore the unconscious mind to uncover repressed feelings and interpret deep-rooted emotional patterns, often using techniques like dream analysis and free association.

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Person-Centered Theory

https://www.goodtherapy.org/learn-about-therapy/types/person-centered

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Non-directive, client-centered, and person-centered. These are terms used to describe the therapeutic approach developed by Carl Rogers.

It can be quite confusing what the difference is between these three terms. The way I see it is that they represent a historical development of the approach.

It was in 1942 that Carl Rogers published Counseling and Psychotherapy: Newer concepts in practice. It was here that he introduced the idea of non-directive therapy.

Rogers described it as non-directive therapy because it was the therapist's task to follow the client's lead. Rather than the therapist directing the course of therapy by using interpretative methods or reinforcement schedules to derive solutions for the patient, Rogers' turned the notion of the therapist as the expert upside down. The therapist followed the client, helping them to uncover their own solutions. This idea of non-directive therapy was a direct challenge to the then dominant therapist-directed approaches of psychoanalysis and behaviorism.

Almost a decade after his 1942 book on counseling and psychotherapy, in 1951 Rogers published Client-Centered Therapy, in which he presented his more refined ideas. Most notably, Rogers had had replaced the term non-directive with the term client-centered.

Essentially, the terms non-directive and client-centered refer to opposite sides of the same coin. But whereas non-directive refers to what it is the therapist aspires not to do, that is to challenge the client's agency over their own feelings and perceptions, the term client-centered refers to what the therapist aspires to do, which is to support the agency of the client and go with their direction in terms of understanding what hurts and what is needed.

Over the subsequent years, Rogers' began to apply his ideas derived from client-centered therapy in other contexts, such as education, conflict resolution, and encounter groups. In order to recognize the broader applicability of his approach the term person-centered came to replace the term client-centered, as the term client would not be fitting for many of these other contexts. As such, person-centered is the term widely used today to describe the applications of the approach.
References
Rogers, C. R. (1942). Counseling and psychotherapy: Newer concepts in practice.

Boston: Houghton Mifflin.

Rogers, C. R. (1951). Client-centred therapy: It's current practice, implications and

theory. Boston: Houghton Mifflin.

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Non-directive, client-centered, and person-centered. These are terms used to describe the therapeutic approach developed by Carl Rogers. It can be quite confusing what the difference is between these three terms. The way I see it is that they represent a historical development of the approach.

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Gestalt Theory

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The Gestalt Principles | Basics for Beginners

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Adlerian Theory

https://www.youtube.com/watch?v=auMjeIAyhi0

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Adlerian therapy proceeds in four stages:

1. Engagement, or creating a collaborative relationship with your therapist

2. Assessment of your personal history, with an emphasis on birth order and early childhood memories

3. Insight, wherein the therapist helps you view your situation from a different perspective

4. Reorientation, wherein the therapist suggests active steps you can take outside of therapy to reinforce newly developed insights and perhaps learn even more about yourself and your capabilities

Overall, the focus is on reframing the attitudes, beliefs, and lifestyle choices that block success, so that you are more effective at reaching your desired goals.

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Adlerian therapy is a short-term, goal-oriented, and positive psychodynamic therapy based on the theories of Alfred Adler-a one-time colleague of Sigmund Freud. Adler focused much of his research on feelings of inferiority versus superiority, discouragement, and a sense of belonging in the context of one's community and society at large.

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Cognitive Behavioral Therapy
-Short term
-Anxiety, stress, grief, mindset
-Change destructive patterns or habits

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Empathy-Putting yourself in other's shoes.
Understanding- Being able to relate.
Active Listening-Nodding, responding throughout, comprehending.
Positive Regard-Supportive environment.
Genuineness- Honesty and sincerity.
Kinesics-Body language.
Proxemics-Comfortable distance for a safe environment.
Paralanguage- Vocal cues that enhance communication.
Questioning- Open ended and close ended questions.
Paraphrasing- Summary of scenario in your own words.
Reflection- Understanding and to encourage the person's elaboration on certain details.
Summarization-Taking all concepts and focusing on a theme for the scenario.

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Choice Theory/Reality

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What is Reality Therapy? (Choice Theory)

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Behavioral Theory
-Human Behavior

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All right, the behavioral theory is what we're going to be talking about next. And the behavioral theory says that personality is a result of the interaction between an individual and their environment. So here's our person. And then, this is the environment. Whether it's society-- We'll draw a few houses here. There you go. You get the picture. So basically, what I've drawn here is one island, and another island, and a bridge connecting both. And you'll see why did that in a second. OK, so the behavioral theory says that we interact with our environment. And it's also focused on observable and measurable behavior, rather than mental or emotional behaviors. So there are different types of behaviors. And different theories focus more on one type of behavior over the other. So when looking at this, if this is the behavioral theory-- is this island right here. I guess we can say the psychoanalytic theory over here would be the most opposite because this theory focuses on the mental behavior rather than observable behavior. And behavioral theorists don't care for theories that take thoughts and feelings into account. So let's talk about two important theorists of the behavioral theory, and the first is Skinner. So Skinner was a strict behaviorist. And he's associated with the concept of operant conditioning, which you may have heard of before. So operant conditioning uses rewards and punishments to increase or decrease a behavior. And another behaviorist, Pavlov, who was a Russian physiologist, and he's also considered by many as the father of behaviorism, he's associated with classical conditioning. And he used his famous dog example, the Pavlov Dog Experiment, to show what classical conditioning was. It basically places a neutral stimulus with an unconditional stimulus to trigger an involuntary response. So in the case of the dogs, ringing a bell in the presence of food is what caused the dogs to begin salivating. It triggered that involuntary response. So these theorists, Skinner and Pavlov, believed that the environment determines the behavior. So that's why I put ourselves in our environment. We're shaped by the environment. And people have consistent behavior patterns because we have particular kinds of response tendencies. But these responses can change if we encountering new situations. And that's why our personality develops over our entire lifespan. It's constantly evolving and changing. Now, what is this bridge in the middle connecting one extreme of behaviorism to the other, the mental approach to the behavioral approach? Now, it's not to say one is right over the other. They're just two different approaches of personality. OK, so back to this, the bridge. The bridge the middle is what we're going to call the cognitive theory. And the cognitive theory is considered a bridge between classic behaviorism and other theories that emphasize thinking and behavior, such as the psychoanalytic theory. And it's because the cognitive theory treats thinking as a behavior and has much in common with the behavioral theory. So Albert Bandura combines the concepts of observing, thinking, and behaving in the social cognitive theory, which we'll take a look at next.

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Behavioral theory (video) | Behavior | Khan Academy

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All right, the behavioral theory is what we're going to be talking about next. And the behavioral theory says that personality is a result of the interaction between an individual and their environment. So here's our person. And then, this is the environment. Whether it's society-- We'll draw a few houses here.

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Carl Rogers, Unconditional Positive Regard & Servant Leadership! - Dr Neil Hawkes