From the intervention section of the ASWB exam outline, let's look at psychoanalytic and psychodynamic approaches and how they may appear on the social work exam. Both psychoanalysis and psychodynamic psychotherapy are rooted in the work of Sigmund Freud and emphasize the influence of the unconscious mind on behavior. Although often used interchangeably, there are distinctions between them.
In a nutshell, psychoanalysis focuses on intensive exploration of the unconscious mind, childhood experiences, and internal conflicts through techniques like free association and dream analysis, often in long-term therapy. Psychodynamic psychotherapy, derived from psychoanalysis, is typically shorter-term and more flexible, emphasizing current relationships, emotional expression, and social factors while still considering unconscious influences.
Here's an overview of both approaches:
Psychoanalytic Approach
Core Concepts:
- Unconscious Mind: Central to Freud's theory; includes thoughts, memories, and desires outside of conscious awareness but influencing behavior.
- Psychosexual Stages: Developmental stages (oral, anal, phallic, latency, genital) where pleasure focuses on different body areas. Fixations at any stage can influence adult personality.
- Structure of the Mind: Divided into the id (primitive desires), ego (reality-oriented mediator), and superego (moral conscience).
- Defense Mechanisms: Unconscious strategies the ego uses to reduce anxiety by distorting reality (e.g., repression, denial, projection).
- Dream Analysis: Interpreting dreams to uncover unconscious desires and conflicts.
- Free Association: Encouraging patients to verbalize thoughts without censorship to explore the unconscious.
Therapeutic Techniques:
- Transference: Patients project feelings about important figures in their lives onto the therapist.
- Countertransference: Therapist's emotional reaction to the patient.
- Interpretation: Analyzing the meanings of patients' words and behaviors to uncover unconscious content.
Psychodynamic Approach
Core Concepts:
- Unconscious Influence: Continues to emphasize the role of the unconscious but may include more focus on the impact of early relationships and social factors.
- Interpersonal Relationships: Greater emphasis on how past relationships influence current behavior and relationships.
- Attachment Theory: Incorporates ideas about the importance of early attachment experiences (e.g., John Bowlby, Mary Ainsworth).
- Object Relations Theory: Focuses on internalized relationships with significant others (objects) and how they shape one's self and interactions (e.g., Melanie Klein, Donald Winnicott).
- Self Psychology: Emphasizes the development of the self and the importance of empathy and mirroring in therapeutic settings (e.g., Heinz Kohut).
Therapeutic Techniques:
- Exploration of Past Experiences: Similar to psychoanalysis but with a broader focus on relationships and patterns.
- Focus on Emotional Expression: Encouraging patients to express and understand their emotions.
- Use of Empathy: Building a strong therapeutic alliance through understanding and validating the patient’s experiences.
- Short-term Psychodynamic Therapy: More structured and time-limited than traditional psychoanalysis.
Differences Between Psychoanalytic and Psychodynamic Approaches
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Duration and Frequency:
- Psychoanalytic Therapy: Often long-term, involving multiple sessions per week.
- Psychodynamic Therapy: Can be shorter-term and less frequent, with more flexibility in treatment duration.
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Focus:
- Psychoanalytic Therapy: In-depth exploration of unconscious processes, childhood experiences, and internal conflicts.
- Psychodynamic Therapy: Broader focus on present relationships, emotional expression, and social factors, while still considering the unconscious.
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Techniques:
- Psychoanalytic Therapy: Intensive techniques like free association and dream analysis.
- Psychodynamic Therapy: Techniques may be more integrative and pragmatic, often tailored to individual needs.
Both approaches aim to uncover underlying psychological issues affecting current behavior and mental health. However, while psychoanalysis remains more traditional and intensive, psychodynamic therapy has adapted to be more practical and accessible, integrating insights from various psychological theories and focusing more on current functioning and relational patterns.
Freud’s Psychosexual Stages
While we're on the subject, let's review Freud's psychosexual stages of development.
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Oral Stage (0-1 years)
- Focus: Mouth
- Activities: Sucking, biting, chewing
- Key Conflict: Weaning from breastfeeding or bottle
- Potential Fixations: Over-dependence, oral habits like smoking or nail-biting, and issues with dependency or aggression.
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Anal Stage (1-3 years)
- Focus: Anus
- Activities: Bowel and bladder control
- Key Conflict: Toilet training
- Potential Fixations: Anal-retentive traits (orderliness, stinginess) or anal-expulsive traits (messiness, destructiveness).
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Phallic Stage (3-6 years)
- Focus: Genitals
- Activities: Genital stimulation
- Key Conflict: Oedipus complex (boys) and Electra complex (girls)
- Potential Fixations: Issues with authority, sexual dysfunction, and confused sexual identity.
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Latency Stage (6 years to puberty)
- Focus: Dormant sexual feelings
- Activities: Development of social and communication skills, intellectual pursuits
- Key Conflict: Repression of earlier stage conflicts
- Potential Fixations: Lack of sexual fulfillment, difficulty forming close relationships.
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Genital Stage (puberty onward)
- Focus: Genitals
- Activities: Sexual interests mature
- Key Conflict: Establishing intimate relationships, contributing to society
- Potential Outcomes: Well-balanced relationships, or unresolved earlier conflicts leading to neuroses.
In Freud's theory, successful resolution of each stage leads to a healthy personality, while fixation at any stage can result in specific personality traits or behaviors associated with that stage.
On the Exam
How might this material look on the social work licensing exam? Picture this:
- Which of the following is a primary focus of psychoanalytic therapy?
- In psychodynamic therapy, which concept refers to the unconscious redirection of feelings from one person to another, especially from the patient to the therapist?
- Which of the following is a common technique used in psychoanalytic therapy to explore the unconscious mind?
The questions may be in vignette form, but what's being asked--and what you need to know to answer correctly--will be simpler.
For practice questions on this topic and many, many others, get started with Social Work Test Prep's full-length practice exams. You'll be glad you did.
