PSYCHODYNAMIC: explanation and therapy

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  • Created by: ava.scott
  • Created on: 12-05-15 09:46
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  • PSYCHODYNAMIC
    • THERAPY
      • AO1
        • Focuses on analysing unconscious conflicts so as to understand them leading to catharsis.
        • free association
          • when the patient talks feely and without editing to the therapist, in hope to identify unconcious associations with depression.
        • dream analysis
          • therapist will look for signs of repressed anger and a strive to be perfect in the dreams as these can lead to depression..
        • transference
          • patient associate the loss or anger at a parent onto the tehrpaist, and then they will work it out.
            • this can lead to dependency,
        • psychoanalysis
          • can take years
          • intense, many sessions a week,
          • lying on couch.
        • psychoanalytical therpay
          • less sessions a week
          • more face to face.
      • Research
        • Burnand
          • 74 patients
          • Found that combing PT and drugs was more successful than just drugs.
          • doesn't control how PT relieves depression.
            • may just be social support/ stress relief.
          • shows that psychotherapy is more effective than just drugs, and so an integrated approach may be useful.
        • Driessen
          • found no difference between the success rates of CBT and PT.
            • after 16 weeks of treatment.
          • 341 pateints
          • 22.7% relapse rate for both PT and CBT.
          • Both may be a social support and stress relief, rather than a understanding of negative thought processes/ unconscious conflicts.
          • CBT is a very widely used therapy, and this study shows that PT is just as effective, therefore supporting its role.
      • wider evaluation
        • efficacy
          • Research
            • Burnand
              • 74 patients
              • Found that combing PT and drugs was more successful than just drugs.
              • doesn't control how PT relieves depression.
                • may just be social support/ stress relief.
              • shows that psychotherapy is more effective than just drugs, and so an integrated approach may be useful.
            • Driessen
              • found no difference between the success rates of CBT and PT.
                • after 16 weeks of treatment.
              • 341 pateints
              • 22.7% relapse rate for both PT and CBT.
              • Both may be a social support and stress relief, rather than a understanding of negative thought processes/ unconscious conflicts.
              • CBT is a very widely used therapy, and this study shows that PT is just as effective, therefore supporting its role.
        • appropriateness
          • slow
            • takes a long time so may not be suitable for severe depressives
          • dependency
            • the patient may become reliant on their therapist, leading to less autonomy.
          • engaging
            • the therapy requires the pteint to turn up and engage with the therapist.
              • depressed people may not be able to do this,
          • harmful
            • invasive and brings up past issues
              • could worsen depression, and create a greater risk of depression.
          • looks at root cause
            • good because doesn't treat symptoms.
            • doesn''t teach any coping strategies, just hopes that catharsis will occur!
        • good because iw as the first treatments that recognized mental illness.
    • EXPLANATION
      • AO1
        • Freud
          • The loss, or perceived loss, of a parent or caregiver causes depression.
          • Anger at death is turned inwards and causes self-hatred.
        • Further explanation
          • inconsistent or unloving parenting leads to a unstable and fearful childhood environment.
            • confusion and fear turns to anger at self, for being unworthy of love.
              • This creates a constant striving to be perfect to achieve love.
                • Love is never received, leading to disappointment and a feeling of failure and guilt.
        • ANACLITIC depression
          • constant grief over a loss, or the risk of losing someone close to them.
        • INTROJECTIVE depression
          • Constant feeling of failure at not being able to meet targets as set by themselves or others.
      • RESEARCH
        • Bifulco
          • 250 women lost their mothers before the age of 17.
          • found they were 2x more likely to be depressed.
            • those who experienced loss before 6 were even more likely to get depressed.
          • This supports the theory because its shows how a childhood loss may create a susceptibility to depression, due to anger turned inwards.
          • The research does not establish cause and effect
            • the loss of mothers may have been very stressful, leading to greater cortisol levels, and therefore depression.
            • Mothers may help the teaching of adaptive thinking, and therefore the loss would lead to more negative thinking and silent assumptions.
        • Beck and Ward
          • found no signs of repressed anger or frustration in dream analysis of depressed people.
            • dream manifestation is a key aspect in Freud's theory, sop this absence highlights an inconsistency.
          • However- depressed people may not report their dreams accurately, so anger may be three, but just not expressed clearly.
        • Bonanno
          • Only 10% of people who lose a parent develop depression.
            • This doesn't support the theory because the majority of those who lose a parent do not get depression.
              • The interaction of adults after the death may be more important than the actual loss itself.
          • Low control-- we haven't observed their childhood.
        • Weissman
          • found that depressed people were hostile and aggressive to other, not just themselves.
            • The theory suggests all anger is turned inwards, and accompanied by a constant need to  please.
            • however- they may still be very self-critical and angry, so doesn't disprove the mechanism.
        • wider evaluation
          • good
            • first explanation of depression that resulted in treatment.
            • focus of relationships is realistic and may help many cases.
          • bad
            • blames parents
            • deterministic
              • says that everyone who experiences loss or unaffectionate childhood will later experience depression.

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