Lecture 3 – Psychodynamic Approach

Sigmund Freud: Founder of psychoanalytic/psychodynamic

Freud’s Early fascinations:

- Psychosexual development
- Unconscious sexual meaning of behaviors

Hysteria as main psych disorder

Used hypnosis and he felt like a miracle worker
Breur – The cure

Seduction Hypothesis: Child abuse > Hysteria

- Hysteria caused by premature sexual experience

Seduction Hypothesis > Oedipal Theory (Son rival dad)

Freud may have:

a. Abandon seduction hypothesis in favor of the power of fantasy
b. Abandon his sexually abused clients due to professional pressures
c. Twisted his clients’ stories and projected his own fantasies onto his client’s fantasies

- Freud
- Carl Jung
- Erik Erikson
- Karen Horney
- Alfred Adler
- Anna Freud
- Melanie Klein

Theoretical Principles:

- Freudian Theory
o “Giant theory” in developmental psych
o Aka museum theory
o One-person intrapsychic model
o Includes different approaches to thinking about human behaviour

1. The Dynamic Approach

o Aka drive/instinct theory
o Shifting mental or psychic energy that derives from:
 Eros (Life and sex) libido
 Thanatos (death and aggression)
o Is based off psychic determinism
 Nothing happens by chance
o Every impulse has an origin, aim, object and intensity
 o Repeated patterns may result in internal working model or repetition
compulsion

- Freud’s 3 ‘models’ of the mind

o Topographic model: different layers of mental life (iceberg)
o Structural model: Different conflicting mental agencies
o Developmental model: Stages of childhood/adolescent development

- Topographic model:
o 3 levels or layers of mental life:
 Conscious (tip of iceberg)
 Objects perceived, events recalled, conscious actions,
thoughts, plans
 Pre-conscious
 Memories, plans, ideas, information not present in
consciousness but ‘available upon request’
 Unconscious
 Underlying emotions, memories, conflicts, impulses,
motivations we are not aware of. Can become aware through
psychoanalysis

- Feud was convinced that personality mainly forms during 0-5 years of life
- Children pass through psychosexual stages, where their pleasure-seeking energies
focus on distinct pleasure-sensitive areas of body
- Eventually, this produces relevant behaviours and psychological features

- Developmental Stage Approach

o Explains how early childhood experiences influence later adult behaviors
 Oral: Birth to 1 years
 Anal: 1 to 3 years
 Phallic: 3 to 5 years
 Latency: 5 to 12 years
 Genital: Adolescence to adulthood

- Id, Ego,Superego
o Id: (Devil)
 Biological/instinctual drives (survival or sexuality aggressive)
 Psychological drives ( Desires, impulses, feelings, etc.)
 Pleasure principle “I want it all now” avoids non-pleasure

o Super-ego: (angel)
 Internalized values/‘musts’/ conventions of others/ society “it’s not
right to do that”
o Ego: (me)
 Balances ID and super-ego through defence mechanisms that protect
self-integrity
 Reality principle: ‘compromise wants and musts’
- Defence Mechanisms
o Repression:
 Mind’s active attempt at preventing painful thoughts/memories from
reaching conscious awareness
 E.g. Failure to remember death of loved one, humiliating childhood
incident
o Reaction formation (opposite)
 Replacing an anxiety provoking idea with its’ opposite
 E.g. Loving someone but believe/act as if you hate him
o Projection
 Denial of own unacceptable feelings/thoughts/desires and think as if
others have them
 E.g. You avoid meeting someone and think that they were avoiding
you
o Sublimation
 Channeling psychic energy from unacceptable to acceptable drive
 E.g. Diverting sex energy to produce work of art
o Rationalisation
 Creating acceptable reason for a behavior performed for less
embarrassing reason
 E.g. Avoiding relationships because fear of intimacy, but believing you
are too busy with work
o Denial
 Blocking external events from awareness, act as if they did not
happen
 E.g. Continuing calling your ex twice a day, as if nothing happened
o Displacement
 Externalising an impulse (e.g. aggression) to a substitute object (safer
regarding the consequences)
 Being frustrated with your spouse but kicking your dog instead
o Regression
 Moving back to previous psychological state to ‘avoid’ frustration with
present
 E.g. 8 yr old sucking thumb when new baby arrives

- Transference and counter-transference

o Transference
 Client reacts to therapist as he did earlier with his s/o
 Allows clients to experience inaccessible feelings
 Analysis of transference – allows client to achieve insight into
the influence of the past
o Counter-transference
 Reaction of therapists toward client may interfere with objectivity
  Not always detrimental to therapeutic goals; can understand
client’s world
 Countertransference reactions must be monitored so that they
are used to promote understanding of client and therapeutic
process

- Psychoanalytic Techniques
o Free Association
 without censoring any feelings/thoughts
o Interpretation
 Therapist points out, explains and teaches the meaning of whatever is
revealed
o Dream analysis
 Therapist uses the “royal road to the unconscious” to bring
unconscious material to light
 Latent Content (symbolic meaning)
 Manifest content (literal content of dream)

- Resistance
o Anything that works against the progress of therapy and prevents the
production of unconscious material
o Analysis of resistance
 Helps client see that cancelling appointments, avoiding therapy are
ways of defending against anxiety
 Interferes with ability to accept change which could lead to more
satisfying life

- Limitations of Classical Analysis

o May not be appropriate for all cultures/socioeconomic groups
o Deterministic focus does not emphasize current maladaptive behaviours
o Minimize role of environment
o Requires subjective interpretation
o Relies heavily on client fantasy
o Lengthy treatment may not be practical/affordable

Evolution and Development in Psychoanalytic Theory and Practice

o Anna and the ego: Psychoanalytic ego Psychology
 Anna studied children directly
 She studied fantasies and dreams
 Observed children’s unconscious mental processes through play
- Object Relations
o Focused on pre-oedipal dynamics
o There was conceptual reformation of psychoanalytic theory
o Dynamics and motivation: earlier parent child relationships
 Objects are not things
  Objects are internalized versions of people
 Therapy replaces bad internalized objects with goof objects

- Crème de la crème of defence mechanisms:

o Projective Identification
 Projecting your own internal object into the other, making them
believe they possess it and act accordingly
 Move from intra to inter-personal stance
 Functions of PI: Dependancy, power, sexuality, ingratiation
 Eg. Client tells therapist “you symbolize everything that’s
wrong with me”
 I hate my mom > she’s part of me > I hate myself

Self Psychology: Heinz Kohut

- Focused on the development of healthy narcissism in individuals
- Mirroring important therapy concept
o Eg admiration and attention
o Children have their accomplishments acknowledged to develop self-
appecitation when they get older
- Retraumatization as central client fear that leads to resistance and therapist’s
interpretation of resistance
- Therapists are imperfect and clients retreat from intimacy
- Making ‘optimal failures” and then working toward empathy is seen as basic
therapeutic unit leading to new self structure

Mirroring: In this type of transference, others serve as a mirror that reflects back a sense of
self-worth and value. Just as people use a mirror to check appearance, mirroring
transference involves use of the affirming and positive responses of others to see positive
traits within the self.  
Idealizing: Kohut believed individuals need people who will make them feel calm and
comfortable. An example of this can be seen in children who run to a parent for comfort
after falling and being injured. The external other is idealized as somebody who is calm and
soothing when one cannot provide that on their own.
Twinship/Alter Ego: Kohut suggested that people need to feel a sense of likeness with
others. For example, children want to be similar to their parents and mimic the behaviors
they observe. Over the course of healthy development, a child becomes more able to
tolerate differences.    

Erik Erikson
- Built on Freud’s ideas and extended his theory with psychosexual stages
- Psychosexual + psychosexual growth go together
- Crisis equivalent to turning point in life when we either progress or regress
- Ego psychology – Deals with both early and later developmental stages, as it
assumes that current problem is not limited to repetitious unconscious conflicts
from early childhood
Bowlby’s Theory of Attachment:
Key Aspects of Bowlby’s Attachment Theory
- Active role for infant > proximity-seeking behaviours
- Maternal deprivation hypothesis
- Internal working models

- Proximity seeking
Stage Age Behaviours

1 0-2 months Indiscriminate social responsiveness

Inbuilt emotional signals (smiling, crying) designed to draw mother
near
2 2-7 months Beginnings of attachment
Preferential orientation to discriminated other(s)
More likely to smile at/ be comforted by primary caregiver(s)
Strangers still accepted
3 7 months – 2 Locomotion – actively seeks proximity to attachment figure(s)
years Separation protest; fear of strangers
4 2-5 years Goal-corrected partnership  child begins to take account of other’s
needs – can wait while caregiver is absent with explanation
5 School age Proximity-seeking reduces. Relationship based on IWM
 - Maternal Deprivation Hypothesis
o Infant/young child experience warm, intimate and continous relationship
with mother (figure) where both find satisfaction and enjoyment
o Bowlby’s evidence
 Research with animals (eg Harlow monkey)
 Fear of stranger from around 9 months in human babies
 Observations of young children in hospital > display protest-despair-detachment
from parents
 Longitudinal study of “institutionalized” children
 Score poorly on intelligence and social measures

- Internal Working Models

o Cognitive structures/mental models/ schemes > represent day to day interacctions with
attachment figure
 Model of self
 Model of other
 Model of interaction between self and other
o Bowlby argues that IWMs endure relatively unchanged throughout lifespan
 Early attachment relationship as template for later relationships

Quality of Attachment
- Mary Ainsworth: Observational studies in Uganda, developed concept of secure base
o Young children balancing opposing needs to explore environment and maintain proximity
to attachment figure
o Maternal sensitivity (ie appropriate response to child) related to secure attachment
 Misreading hunger and disregarding/silencing them

- Attachment Theory
o Infants need a “secure base” (ie able to trust) as their primary caregiver
 Secure attachment leads to subsequent healthy development
 Insecure attachment leads to unhealthy development
o Attachment styles affect r/s through life

o Secure base: A responsive caregiver provides security to explore the environment

 If caregiver’s responses to child’s needs appropriately, child will feel confident to
explore strange environment, occasionally returning to caregiver for confirmation
 If inappropriate, child feels insecure, less likely to use caregiver as base to explore
strange environment
o Caregiver typically infant’s mother or someone who responds to infant’s needs

Attachment Styles
- Securely attached: Belief that caregiver will protect and provide for them
o Explore environment with parent
o Might protest separation from parent but smiles more when parent is present
o Shows pleasure at reunion with parent
o 65%
 - Insecure-Avoidant: Belief that caregiver will not protect/provide; caregiver not safe haven in
stressful circumstances
o Does not protest parent’s departure
o Respond the same to parent/stranger, or more positively to stranger
o Avoid parent upon return
o 20%

- Insecure-Resistant: Uncertainty of whether parent will protect/provide under stressful

circumstances
o Remain close to parent. Refuse to explore
o Distressed at separation of parent
o Mixture of approach and avoidance when reunited
o 10%

- Disorganized / Disoriented: No consisted way of dealing with stress

o Exhibits contradictory behavior at the strange situation
o Typical attachment style when infant is abused/neglected
o <5%

Attachment depends on:

- Parental psychopathology
o Depressed mother, lower quality interactions with infants
- Infants temperament
o Irritable infant + mother has no social support = insecure attachment

Hazan and Shaver: Bowlby’s attachment theory in the context of romantic r/s

- Similarities between infant&mom and adult romantic partners:

o Safe when other is nearby and responsive
o Engage in close, intimate, bodily contact
o Feel insecure when the other is inaccessible
o Share discoveries with one another
o Play with one anothers facial features and exhibit mutual fascination and
preoccupation with one another
o Engage in “baby talk”

Carl Gustav Jung

- Everything that irritates us about others can lead to an understanding of ourselves
- Most terrifying thing is to accept oneself completely
- Filling conscious mind with ideal conceptions is a characteristic of Western theosophy, but not
the confrontation with the shadow and world of darkness. One does not become enlightened by
imagining figures of light, but by making darkness conscious
 - Maintained that we are not merely shaped by past events, but we are influenced by our future as
well as out past
- Humans move toward fulfillment or realization of all their capabilities
- Achieving individuation – harmonious integration of conscious and unconscious aspects of
personality
- “ We are not what happened to us, we are what we wish to become”

Theory of Personality
- Divides ego into 3 parts
o Ego
o Personal unconscious -same as freud’s unconscioys
o Collective Unconscious – unconscious memories from ancenstral and evolutionary past

- Complexes
o Swirling pool of energy in the unconscious
o Complex: A pattern of suppressed thoughts and feelings that cluster around a theme
provided by some archetype

- Archetype (epitome)
o Shadow: Like id
 Animal in us
o Anima/ Animus
 Anima- psyche of male containing female aspects
 Animus- psyche of female containing male aspects
o The warrior, the hero, the great mother

- Development of Personality
o Individuation
 Persona and authenticity
 Making peace with dark side
 Integration of Anima and Animus
 Transcendence, wholeness, fully conscioys living

Lecture 5 - Behavioral Theory and Therapy

BF Skinner
- Operant Conditioning
- Thorndlike’s Law of Effect
- Negative and Positive Reinforcement

Operant Conditioning (BF Skinner)

- Applied behavioral analysis
o Clinical term referring to behavioral approach based on operant conditioning principles
- Operant conditioning is straightforward
o Behavior a function of its consequences
o Operant conditioning: a stimulus-response theory
 - John B. Watson and Little Albert
o Watson showed that Albert could develop phobia from classical conditioning

- Mary Cover Jones and Little Peter

o Jones showed fear could be extinguished through counterconditioning and/or social
imitation

Classical Conditioning
- Ivan Pavlov
- Classical conditioning aka associational learning
- Unconditioned stimulus that naturally produces a specific physical-emotional response
o Stimulus generalization
 Generalization of a conditioned fear response to new settings, situations, objects
o Stimulus discrimination
 Conditioned fear response not elicited by new or different stimulus
o Extinction
 Gradual elimination of conditioned response
o Counterconditioning
 New associative learning
o Spontaneous recovery
 Occurs when old response suddenly returns after having successfully extinguished
Joseph Wolpe
- Conditioning procedures used as means for resolving neurotic fear
- Conditioned negative emotional response replaced with conditioned positive
emotional response

Theory of Psychopathology
- Maladaptive behavior is learned and can either be unlearned or replaced with new
learning
- Scientific methods:
o Observe, assess client’s maladaptive beh
o Develop hypothesis about the cause
o Test beh hyp through application of empirically justifiable intervention
o Observe and evaluate results
o Revise and continue testing new hypotheses as needed

Practice of Behavior Therapy

- The behavioral Interview
o Common assessment procedure
o During it, beh therapists observe client’s beh; inquire about antecedents,
problem behaviors, and consequences; and operationalize the primary
therapy target

- Self-Monitoring
o Clients are trained to monitor own beh
o Inexpensice and practical
o Clients may not make accurate recordings of ther beh

- Standardized Quedtionnaire
o Used to determine outcomes
- Operant conditioning
o Contingency (future plan) management and token economy

- Relaxation Training
o Edmund Jacobson – Progressive Muscle Relaxation(PMR)
o PMR evidence-based treatment

- Systematic Desensitization
o Imaginal or In vivo exposure (within the living)
o SD, exposure treatment

- Virtual Reality Exposure (VRE)

o Has been empirically validated

- Interoceptive Exposure
o Similar to other exposure techniques but focuses on internal anxiety signals
or triggers
o 6 interoceptive exposures that reliably trigger anxiety:
 Hyperventilation
 Holding breath
 Breathing through a straw
 Spinning in circles
 Shaking head
 Chest breathing

- Other important exposure components:

o Response and Ritual Prevention
o Participant Modeling

- Skills Training
o Traditional skills targets include assertiveness and other social behavior as
well as problem solving

- Assertiveness and Other Social Beh

o Instruction
o Feedback
o Behavior rehearsal/role playing
o Coaching
o Modeling
o Social reinforcement
o Relaxation training

- Problem- solving therapy

o It is behavioral treatment with cognitive dimensions, focuses on:
  Problem orientation: teaching clients to have positive attitude
towards problems
 Problem-solving style: taught a rational problem-solving style

Lecture 6- CBT

3 key figures:
- Albert Ellis – Rational Emotive Behavior Therapy
o Focused on irrational thinking

- Aaron Beck – Cognitive therapy

o Focused on maladaptive thinking

- Donald Meichenbaum – Self-instructional therapy

o Inner speech and developed self-instructional training

Social Learning Theory

- Albert Bandura - Key figure
- Extension of operant and classical conditioning
- Includes stimulus-influence components (Classical conditioning), consequence-
influence components (operant conditioning), and a cognitive mediational
component
- Focuses on:
o Observational learning
o Person-stimulus reciprocity
o Self-efficacy

Cognitive Appraisal Theories

- Ellis attributes to Epictetues:
o People disturbed not by things, but view which they take of them
o Cognitive theory emphasizes ind. Organism’s processing of environmental
stimuli as force determining his response
o How one process environment then respond
- 5 basic components
1. People have irrational ideas and personal philosophies
2. Irrational ideas cause people great distress and sadness
3. Ideas can be set down to few basic categories
4. Can find irrational categories easily in client’s reasoning
5. Can teach clients how to give up irrational beliefs
- REBT: substitute irrational belief with rational belief

- ABCDEF Cognitive Models (Ellis)

o A – Activating Event
o B – Belief about activating event
o C – Consequent emotion and behavior linked to belief
o D – Disputation of irrational belief
 o E – Effect
o F – Feeling

- Beck’s Cognitive Theory

o Similar to Ellis’ REBT
 Cognition at the core of human suffering
 Therapist’s job is to help clients modify distress-producing thoughts
 “when you experience unpleasant feeling, try and recall thoughts you
have prior to this feeling”
o Components of Beck’s cognitive theory:
 Development of inaccurate/negative beliefs
 Self-schema
 People develop systematically distorted irrational thoughts
 Results in biased information processing cognitive content consistent
with mental disorders
 Modification possible via cognitive therapy

- Meichenbaum’s Self-instructional Theory

o Focus is on internal speech/verbal mediation
o Reciprocal model: Interactive r/s between individual and environment

Theory of Psychopathology
- REBT, psychopathology a direct function of irrational beliefs
- REBT approach to psychopathology is direct, straightforward and sometimes
offensive

Irrational ideas
- Lead to self-defeating beh.
- Eg. “I must get love and approval from everyone”

3 basic beliefs of REBT’s “Musterbation” (Ellis):

1. Ego must-approval by significant others
2. Must treat me fairlt
3. Must have good conditions

Beck Emphasized:
- Cognitive distortions
- Automatic thoughts
- Core negative beliefs or schema

Cognitive Triad: negative automatic thoughts center around our understanding of:
- Ourselves
- Others
- Future

Maladaptive belief
- Negative Triad Associated with Depression
 o Self – I am incompetent
o Others – no one cares about me
o Future – The future is bleak
- Negative Triad w/ anxiety
o Self – I will lose control
o Others – ppl will laugh ar me
o Future – it’s a matter of time before I am embarrassed

Building cognitive model:

- Core beliefs:
o Most fundamental
o Often regarded as absolute truth rigid and overgeneralize
o Eg I’m inadequate/hopeless

- Intermediate belief:
o Unarticulated and unwritten
 attitudes (it’s embarrassing)
 Rules (I must pls everyone)
 Assumtions (if I do something to pls her, she will like me)

- Automatic thoughts:
o Situation specific and most superficial lvl of cognition,
o not the result of deliberation and reasoning (automatic thoughts)
o Comes automatically, accompanied by unpleasant feelings

Practice of CBT
1. Access clients irrational/maladaptive thoughts
2. Instruct clients in more adaptive/rational thinking
3. Support clients as they apply these new and developing skills in their lives

Assessment Issues and Procedures:

- 2 primary goals associated with CBT assessment:
o Arriving at a diagnosis that best describes client symptoms
o Developing a tentative cognitive-behavioral treatment formulation that can
be used for treatment planning
- Assessment procedures:
o Collaborative interviewing
o Setting an agenda
o The problem list
o Self-rating scales (eg BDI)
o Cognitive self-monitoring
o Case-formulation

Cognitive-behavioral Self-Monitoring
 - Designed to help clients develop awareness on automatic thoughts and associated
emotions and behaviours
- Thought Record
o Date and time of emotional response
o Situation that elicited the emotional response
o Behaviors the client engaged in
o Emotions elicited
o Associated thoughts that occurred during situation

Case formulation
- Creating a problem list
- Identifying mechanisms underlying or causing disorders and problems
- Identifying precipitants equal activating current client problems
- Consideration of the origins of the client’s current problems

3 types of psychoeducation:
- For CBT rationale
- For client problems
- Rationale, client problems and procedures

Methods for exploring and identifying automatic thoughts and core beliefs:
- Guessing the thought
- Vertical Descent (Aka Downward Arrow)
o Uncovering underlying core beliefs
o Chasing cognitive distortions
- Conducting cost-benefit analysis
o Applying the double standard technique
- Specific therapy techniques:
o Virgorous and forceful disputing by Ellis
o Stress inoculation training (Meichanbaum)
 Conceptualization
 Skills acquisition and rehearsal
 Application and follow through

CBT and gender considerations

- Culture and gender affect symptoms that manifest in individuals
- Therapist think not of significance
- Hence, client feels blamed for symptioms caused by social forces

Evidence-based status
- CBT- mordenist research
- Positive therapy relationship is essential
- Ellis disagree
- Little doubt of CBT efficacy
- Philosophically and empirically, effective
Lecture 8 – Choice Theory and Reality Therapy (Glasser)

choice theory explains human behavior and reality therapy is the therapeutic model used in
assisting clients in meeting their needs and reconnecting with the world.

Historical context:
- Choice theory – humans are internally motivated
- Discard external control psychology and replace with choice theoru\y
- Ppl as victims vs choice theory

Reality therapy – teaching, planning and behaving

- Here and now
- Focus on choice, responsibility, commitment and willingness to change
- Counseling process starts with assessing the clients' relationships and unmet needs,
exploring what behaviors they are displaying that either assist or interfere with them
meeting their needs.

5 basic theoretical principal

- Glasser’s internal control or choice theory based on 5 basic human needs:
1. Survival
2. Love and belonging
3. Power
4. Freedom
5. Fun

Love and belonging - “if I were not hormonally attracted to this person, would he/she be
someone I would enjoy as a friend?”
Power and freedom – children strive for power and freedom when their need for love and
belonging are not met
People get preoccupied with power, freedom and fun for 2 reasons:
1- the need for love & belongingness is primary – when it is not fulfilled, efforts to meet
other needs get out of control
2. Some people incorrectly turn to external control theory to get their love & belongingness
needs met – so they turn to power and fun as they think more money/more toys will get
them love
FREEDOM – it concerns us when we feel that it’s threatened – e.g. teenagers see themselves
as being denied freedom by parents; creativity in human is related to freedom – if you’re
unable to freely express yourself, this creativity is channeled into something destructive;
people who experience hallucination is creatively expressing their pain and frustration
FUN – laughter – believes that the need for fun is built into our genes
Quality World
- Known as your world of wants
- Best thought of as mental ‘picture album’ that holds images of what we
value/possess or what we want to possess
- Can be someone, something or activities
- As therapist:
o Do your best in understanding client’s qual world
o Help client use choice theory ro improce life though client’s qual world
- 3 categories within qual world
1. People
2. Things or experiences or activities
3. Ideas or systems of beliefs
Everyone is different

Total Behavior
- From birth to death – we behave
- 4 distinct inseperable components
o Acting
o Thinking
o Feeling
o Physiology

Psychopathology
 - Glasser 3 primary principles
o No such thing as mental illness
 We choose our behavior
 Responsible for our own emtions
o Unhappy relationships
 Unhappiness usually caused by on trying to control the other
o 3 explanations for mental problems:
 Restraining anger
 Restrain anger by depressing
 Reality therapy- regain direct control
 Getting help
 Depressing as a way to get love, power, freedom we crave
 Avoiding things we don’t want to face
 Depressing, panicking to avoid difficult life situations

10 Axioms of choice theory

1. The only person who can control our behavior is our own
2. All we can give another person is info
3. All long-lasting psychological problems are r/s problems
4. Problem r/s is part of present life
5. We can satisfy pur basic needs rn and continue to do so in future
6. Can satisfy our needs by pictures in quality world
7. All we do is behave
8. All behavior is total behavior
9. All total behavior is chosen
10. All total behavior is designated

Building the therapy r/s with 7 caring habits:

1. Supporting
2. Encouraging
3. Accepting
4. Listening
5. Accepting
6. Trusting
7. Respecting
8. Negotiating differences

Reality therapy and confrontation

- Reality therapy is gently confrontational
- 7 deadly habits of choice theory
1. Criticizing
2. Blaming
3. Nagging
4. Complaininf
5. Threatening
6. Punishing
7. Bribing or rewarding to control
Practice of choice theory:
- Reality therapy is a cycle of counseling (counseling environment & procedures for
behavior change
o W – wants, explore wants, needs and perceptions
o D – Direction and doing, focus on what clients are doing and direction they
are headed
o E – evaluation, challenge self-evaluation in clients and their total behavior
(continual basis)
o P – Planning and commitment, assist in the formulation of realistic plans and
making commitment to carry out plans
- Eg.
- W - Chris states he wants to improve the quality of his relationship (W)
- D – He explained that he often creates tension by arguing, having to have the last
word, and always presenting an opposing view.
- E – Through a series of role-play activities, help Chris in understanding appropriate
responses but also helps him gain insight into how his girlfriend feels when he
responds with opposition .
- They continue discussing methods of how he can change these behaviors and move
closer to a more satisfying, meaningful relationship with his girlfriend and her two
children.

Practice of choice Theory

- Help client develop effective plans
- SAMICCC
- S – Simple
- A – Attainable
- M – Measurable
- I – immediate , effective plans can be enacted immediately
- C – controlled, controlled excessively by planner
- C – committed, clients need to commit to plan
- C – continuous – efflective plans are continuously implemented

Lecture 8 – Transactional Analysis

- Developed by Eric Bernes

- Post – Freudian
- It is:
o A theory of personality
o Systematic psychotherapy of personal growth and change
- It also offers
o A theory of communication
o Theory of child development
o Diagnostic system for many psychopathological disorders
 o Applied to education, management and communication training

- 3 philosophical premises of TA:

o People are OK; thus each person is valid and important, equality of respect
o Everyone has capacity to think
o People decide their story and identity, these decisions can change
- Hence,
o People can change
o We all have a right to be in the world and be accepted

Our Brain
- Determines what we think and how we act
- Acts like a tape recorder while recording:
o Events
o Associated feelings
- Has 3 distinct parts or ego states
o Parent
o Adult
o Child
- Ego state –
o Consistent pattern of feeling and experience directly correlating with pattern
of behavior

1. Parent ego state

a. Thoughts feelings, attitudes, behavioral patterns based on messages or
lessons learned from parents or other parental/authoritarian sources
b. Shoulds an should nots
c. Prejudicial views (not based on logic/facts):
 Religion, traditions, money, children…
d. 2 subdividions of parent ego states:
i. Nurturing parent
 Part of person that comforts, praises and aids others
ii. Critical parent
 Part of person that finds fault, displays prejudice, disapproves
and prevents others from feeling good about themselves
2. Adult Ego State
a. Thoughts, feelings, attitudes, behavioral patterns based on objective analysis
of info (data and facts)
b. Make decisions based on logic, computations and not emotions
c. Adult is rational and Organized

3. Child Ego State

a. Thoughts, feelings, attitudes, behavioral patterns based on child-like
emotions, impulses, feelings we experienced
b. Child-like examples:
 Impulsive, self-centered, angry, happy, fearful
c. 2 subdividions
 i. Natural (free) child - spontaneous, impulsive, feeling-oriented, self-
centred, pleasure loving
ii. Adaptive child – compliant part of personality that confoms to wishes
and demands of parental figures

Ego states
- Critical Parent - Lecturing, Judging, Traditions, Criticizing, Should & Don’t
- Nurturing parent - Consoling, Sympathy, Advising, Guides, Taking Care Of
- Adult - Objective, Data, Rational, Problem Solving, Less Emotion
- Adapted child - Manipulative, Submissive, Conform To Adult Expectations
- Natural child - Playful, Impulsive, Curious, Creative, Fun, Rebel

Transaction differences – contamination

- Contamination is overlap
- Overlap of parent and adult – prejudice, parental beliefs
- Overlap of adult and child –Delusion(grounded in fear)/Hallucination(abused as child)

Transaction differences – exclusion

- Parent contaminated Adult block child
- A person cannot play
- Unhappy, controlled childhood

Transaction differences – exclusion

- Child contaminated adult with blocked parent
o Person without conscious
o Extremely brutal parents
o No remorse
o Potential psychopath

Transaction differences – exclusion

- Blocked out adult
o Out of touch with reality
o Conflicting info gives up on being adult
o Psychotic
o Manic-depressive

Types of transactions:
- Transactions are unspoken psychological flow of communication that runs in parallel
- Occurs simultaneously (explicitly and psychologically)
- 3 types:
1. Complementary transaction
o The ego that asked = the ego answers
2. Crossed transaction
o The ego that asked, another ego answered
3. Ulterior transaction
 o Messages have double meaning
o Insuinating something else
o Hidden/ulterior agenda

Games people play

- Games: Series of interactions between people that are superficially plausible, but
have hidden agenda
- To achieve some sort of pay off
o Ie positive or negative strokes

- 3 models:

1. Karpman’s Drama Triangle

- Victim: Helpless, powerless
- Rescuers: Appear nice
- Prosecutor: Make you feel bad; ppl take this role to avoid being victim

2. Transactional analysis of game

- First-degree games:
o Played in social circles w/ anyone willing to participate
o Generally lead to mild upsets
- Second-degree games
o Occur when players go after bigger stakes
o Usually in more intimate circles
o End up in bad feelings
- Third-degree games
o Usually end up in tissue damage
o Players end up in jail, hospital or morgue
- 3. Formula G

Index of games from games ppl play

- Life games
- Marital Games
- Party games
- Sexual games
- Underworld games
- Consulting room games
- Good games
- Why don’t use yes but (YDYB)
- Se what you made me do:
o First degree SWYMD: intentional mistake when interrupted
o Second degree SWYMD: Refuse to make decision to avoid responsibility

By identifying the games ppl play, we can gain autonomy

- Ability to avoid getting hooked by others in playing games
- And vice versa
Lecture 9 – Gestalt therapy
- Fritz and Laura Perls
- “Lose your mind, come to your senses”

Existential and Gestalt Foundations:

- Individuals have self-actualizing potential
- Experiences can activate this potential

Self actualization and self-regulation

- Self-regulation is based on self-awareness, process:
o An initial state of equilibrium
o Disurption of equilibrium through emergence of need
o Taking actions
o Return to equilibrium
- With awareness you become aware of this self regulations
- In contrast, self-manipulation is called “conscience”

Gestalt
- Is german for unified whole
- Views mind-body as inseparable whole
- It is a physical, mental, emotional theory

Phenomenology
- Direct experiencing in therapy
- Naïve and full description of experience as possible

Field Theory:
- Individuals and environment tgt within a field of constant interaction
o Therapist not separated from field
o Field is organized, so therapist and client explore tgt
o Gestalt therapists work in immediate, present, here and now

Figure-Formation Process
- Everyone constantly shifts cognitive/perceptual focus.

I and thou
- Authentic therapist-client r/s
Here and Now
- Immediacy/ being present
What and How
- Emphasis on process over content
- Moment to examination of what is happening and how its happening
Contact
- Interacting with nature and with people without losing ones individuality
- Exchange between ind and surroundings

Resistance to contact
- Defenses we develop to prevent us from experiencing the present fully

Psychopathology can be viewed as contact or bpundary disturbance

- Occurs when natural processes of contact, excitement, self-regulation, new learning
is disturbed
- 5 diff types of boundary disturbances

5 major channels of resistance:

- Introjection – We passively incorporate what environment provides, duno wat we
need
o passive
- Projection – Avoid responsibility, put them on others
- Confluence- loss of distinction of self and environment (need to be liked)
- Retroflection- hold bac emotional response to others and substitute response to
ourselves
- Deflection – talk about anything else

Authentic growth (2 tools):

- Stick
- Hypnosis

Aim of gestalt is to mature

- Neurosis as growth disorder

Maturing
- Transcendence from environmental support to self support

Maturation process, child

-learns to overcome frustration
-get spoiled
-instead of using potential to grow, control and manipulate adults and environment

Unfinished business – feelings about past are unexpressed

- Resentment, rage, hatred, pain, grief, guilt, anxiety, abandonment..
- Feelings associated with distinct memories and fantasies
- Feelinfs not fully experienced linger in the background and interfere with effective
contact
Result
- Wariness, self-defeating behavior
- May result in physical symptoms

The practice of Gestalt Therapy

- Erving Polster identified 3 specific thereapeutic processes
o Encounter
 Dialogic relationship
 Interaction between patient and therapist in present moment
 I-thou
 Relational psychoanalysis = relational gestalt
 Both bring subjectivity into therapy and neither subjective
view is considered authoritative
o Awareness
 Self-awareness fostered through articulation of self-experience
 Therapists pays close attention
 Awareness of self
 Awareness of world
 Of what’s between
 Intermediate zone of fantasy prevents a person from being in
touch with himself and world
 Therapy- step by step to reown disowned part of personality
until person becomes strong enough to facilitate own growth

- X assessment
- I-thou collabotation
o Informed consent is crucial

- Body feedback
o Nonverbal beh
 Tightness in clients jaw
 Redness of neck
 Fists
- Language and voice quality
o From it/ you to i
o Past tense to present
o Questions to statements

- Unfinished business
o Here and now that’s all about there and then
o Bring forward the past
- Staying with the feeling
o Wht are u aware of now?
o Voice their feelings
 o Eg ‘stay with that…’

Empty char technique

- Internal conflict: act out 2 parts of self
- Contemporary interpersonal conflict
Reversal Technique
- Get in touch with denial parts
Exaggeration experiment
- Exaggerate subtle nonverbal behaviors
Gestalt approach to dreamwork
- Dreamer tells dream story
- Revives dream – Past to present tense
- Dreamer becomes director
- Dreamer acts out dream

• Gestalt therapy is about much more than just isolating sexual and aggressive
impulses, or altering reward schedules or errant cognitions. Gestalt therapy is about
living life to the fullest.
Lecture 11 – Family Therapy

Cybernetics
- How do systems communicate and use feedback loops to achieve regulation
- Double-bind theory (Bateson)
o Damned if you do and damned if you don’t
o Was developed to explain schizo symptoms
o Chilf may grow up not being able to relate to ppl or trust that people mean
what they say they mean

General system theory

- Consider subtle differences of human actors within systems
- Humans systems function more like organisms and less like machines
- Subsystems and Bronfenbenner’s Ecosystemic Model

Second order Cybernetics

- Family counselors became participant-observers
 - Circular causality
- Identified patient (IP)
- First and second order change
- Attending process and homeostasis

Attending to interaction patterns

- Subsystems: Based on age, relationship status and so on
- Boundaries: An ever-present forcs
- Rigid boundaries
- Diffuse boundaries
- Alliances, coalition, triangulation
o Alliance is connection or support from family
o Coalition is 2 family members side tgt against a third
o Tirangulation- dyad in conflict pull in 3rd party
- Rules and Roles
o Overt Rules - explicit
o Covert rules – hidden

Family Therapy Models:

1. Murray Bowen’s intergenerational Family Therapy

o Bowen’s 8 interlocking concepts
 Triangles
 Differentiation of self
 Nuclear family emotional system
 Family projection process
 Multigenerational transmission
 Emotional cut-off
 Sibling position
 Societal emotional process
o Underlying fact
 Chronic anxiety of tgtness/separation

2. Structural Family Therapy – Salvador Minuchin

- Key concepts:
o Fam beh is function of its structure, hence changing fam structure will
nurture growth of members
o Focuses on fam boundaries in order to understand structure
o Attend to boundaries between family members and between subsystems
o Conceptualizing family
 Who is scaprgoat/ip
 Who holds power
 What coalitions in place
 Where the source of conflict reside
o 3 techniques for structural family therap
 Unbalancing
  Therapy intentionally aligns with family member whose power
needs elevating in family hierarchy
 Intensufying
 Encourage heightened emotions
 Increase family’s discomfort so distress involved with change
becomes less than pain of remaining the same
 Reframing
 Restatement of fam prblems from another pov

3. Strategic family therapy – Jay Haley

a. Families can change by simply following counderlor’s suggested strategies
b. Role of counselor: - directive

- Key concepts:
o Needing to act, but failing to do so
o Need to stop acting, but failing to do so
o Solve problem at ineffective lvl
- Facilitating change
o Counselor interrupts old, ineffective solution patterns
 Ordeals – interrupt family patterns
 Positioning – Counselor endeavors to appear hopeless

4. Humanistic and Experiential Models – Virginia Satir, Carl Whitaker

a. R/s between fam and counsellot
b. Here and now
- Role of counselor
o Actively engaged
o Self-disclosure
o Congruence
- Key concepts
o Depathologize clients, seek to shift meaning of symptoms
o Human validation process model focuses on modifying communication
stances to help family move beyond inflexible rules and roles
 Placating
 Blaming
 Super-reasonable
 Irrelevant
 Congruent
o Facilitating change
 Freedom of expressions and new patterns of interaction
 Family sculpting

Contemporary Family Therapy Dev.

- Narrative Family Theray – Michael White and David Epston
o Stories we enact with one another are not about our lives, but rather are our
lives
 o Need to gain access to other stories, learn alternative ways of examining
their lives

Lecture 10 – Existential Therapy – Victor E Frankl

- Concerns rooted in individual’s existence

- Permission to Question
- TO know or not to know
- Meaning of life
- Existential vacuum
o Void in existential being, need to fill it
- Meaninf crisis
- Meaningless and Conformity
- Freedom and responsibility
o Ability to choose freedom
o Self awareness
- How do we find meaning?
o Experiential values
 Gained through experience
o Creative values
 Creating a piece of work, contributing to society, leving behind legacy
o Attitudinal values
 Attitude we take towards unavoidable suffering
o Transcendence
 Spiritual meaning

- Death
o Symbol of all things finite
- Isolation
- Transcience
o Temporal
- Authenticity
- The awakening/call of conscience
o Authentic part emerging
- Logotherapy
o Logo – meaning
o 3 main techniques:
 Paradoxical intention
 Dereflection
 Socratic dialogue

- Common existential commitment

 o The question of what it means to be a Human Being
o The question of Mineness
o The question of Existence
o The question of Grounding
o The question of Method
o The question of Wholeness
o The question of Truth and Authenticity

Adlerian tasks of life:

- Work or occupation
- Social relationships
- Love or marriage
- Self
- Spirituality
- Parenting and family

Theory of psychopathology:
- Defined as discouragement
- Feelings of inferiority are natural
- Inferirority complexes

Practice of Adlerian Therapy:

- Forming of therapeutic r/s
- Lifestyle assessment and analysis
- Interpretation and insight
- Reorientation
o Future autobiography
o Acting as if

 Forming the therapeutic relationship

 The relationship is egalitarian and characterized by listening and caring.
 The therapist is like a friendly teacher or business consultant.
 Clients are encourged to be active participants in therapy.

- Develop friendly r/s with client

- Us=dentify unhelpful beh, basic mistake
- Ask and get client permission to share insight
- Share repeating and unhelpful pattern
- Be open to discuss client’s reaction after spitting in his soup

Catching oneself
- Self-awareness and self-control
- Help clients become aware of maladaptive beh
- Help clients catch themselves when slip into old beh
Task setting and indirect suggestion
Paradoxical strategies
Advice suggestion direction