Psychodynamic Therapy: Conceptual and Empirical Foundations, Vol. 1 » (1st Edition)

Steven K. Huprich, Ph.D., is assistant professor of psychology at Eastern Michigan University.

Psychodynamic Therapy reintroduces psychoanalytic and psychodynamic theory to the practice of clinical psychology in ways that are easily understandable, practical, and immediate in their application. Huprich readily demonstrates that, contrary to what is misconstrued and taught as relic and historical artifact, Sigmund Freud’s ideas and their evolution offer a comprehensive, useful framework from which clinical psychology and psychiatry can benefit.

There are more theories and approaches to psychotherapy today than ever before. Psychodynamic Therapy attests to the fact that psychoanalytic and psychodynamic theory has more to offer clinicians and patients than any other theory. Through this book, readers will gain a greater appreciation for what psychodynamic theory offers and how they may apply these ideas toward effective clinical practice.

Preface ix

1 Introduction 1

The Case of Mr. Shelby 2

The Case of Ms. Murdock 4

Basic Psychodynamic Ideas 4

Section I Theoretical Underpinnings

2 Basic Principles of Psychoanalytic and Psychodynamic Theory 13

A Brief Background and History on the Career and Culture of Freud 14

The Early Topographical Model 17

The Structural Model and Drive Theory 19

Oedipal and Electra Complexes 23

Treatment: Making the Unconscious Conscious and the Obstacles Therein 24

Psychoanalysis in Disrepute and Disrepair 28

Summary 34

3 The Evolution of Theory I: Drive, Ego, Object, and Self 37

An Expanded View of the Psychosexual Stages 37

The Oral Stage 38

The Anal Stage 41

The Phallic Stage 42

Latency 44

The Genital Stage 44

Ego Psychology 44

Heinz Hartmann 45

Jacob Arlow and Charles Brenner 51

Margaret Mahler 52

Edith Jacobson 54

Object Relations 56

Melanie Klein 56

Michael Balint 59

Donald W. Winnicott 59

William R. D. Fairbairn 61

Harry Guntrip 64

Harry Stack Sullivan 64

Self Psychology 65

Summary 67

4 The Evolution of Theory II: Integration and Expansion 69

Integrating Theoretical Models: The Contribution of Otto Kernberg 69

Anaclitic and Introjective Configurations of Development and Psychopathology 72

Sadomasochism and Two Systems of Self-Regulation 75

Attachment Theory 78

Mentalization and Reflective Functioning 83

Intersubjectivity: Two-Persons and Constructed Reality in Psychotherapy 85

Cognitive Experiential Self-Theory 86

Summary 88

Section II Treatment Principles and Empirical Support

5 Basic Principles of Treatment 93

Ways of Practicing within a Psychodynamic Approach 93

Types ofPsychoanalytic and Psychodynamic Therapies 93

The Expressive and Supportive Continuum of Interventions 96

Brief Dynamic Therapies 100

Major Principles of Psychoanalytic and Psychodynamic Psychotherapy 101

The Therapeutic Alliance 101

Goals of Psychoanalytic and Psychodynamic Therapy 104

Free Association 106

Transference 108

Countertransference 109

Interpretation 111

Resistance 113

Summary 116

6 Empirical Studies of Psychoanalytic and Psychodynamic Psychotherapy 117

Does Psychoanalytic and Psychodynamic Treatment Work? 120

Therapeutic Alliance 129

Transference 131

Countertransference 133

Patient Characteristics 135

Summary 137

7 Theories and Empirical Studies of Therapeutic Action 139

How and Why Treatment Works from a Psychoanalytic/Psychodynamic Perspective 139

Therapeutic Action in and outside of Psychoanalytic and Psychodynamic Theory 145

Empirical Studies of Therapeutic Action 148

Summary 155

8 Cognitive Neuroscience 157

Basic Concepts in Cognitive Science 158

Unconscious Processes: Integrating Cognitive Neuroscience and Psychodynamic Theory 162

Selected Empirical and Case Studies Demonstrating Unconscious Processes 163

Differences between the Psychoanalytic and Cognitive Unconscious and Their Reconciliation 170

Summary 174

Section III Therapeutic Process

9 Diagnosis and Assessment 179

Psychodynamic Diagnostic Manual 181

Assessing Patients 188

Biological and Temperament Factors 193

Life Situation 194

Personality Organization 195

Defenses 196

Ego Functioning 197

Object Representations 198

Self-Representations, Esteem, and Agency 200

Insight and Reflective Functioning 201

Sociocultural Factors 203

Summary 204

10 Case Study 207

Introduction 207

The Case of Eric 208

Discussion 216

Early Loss and Dependency 217

Self-Regulation 219

Sexual Identity Development 221

Conclusions 225

References 229

Index 267