Psychoanalytic approach of counselling

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• Subject Name : Psychology

Psychoanalytic approach of counselling

Introduction

Counselling is simple term can be referred to as ‘talk therapy’ (Spurling, 2017). It is a talking therapy that requires a trained therapist to listen, helps and guide clients on a professional basis to resolve their personal, social or psychological difficulties and problems. Counselling by a trained professional can help a person to find different ways to deal with their emotional issues. Counselling is an approach that helps to highlight the emotional and intellectual experience of a person; that is how a person is feeling what he thinks about the problem he has sought help for (Lancaster & Stead, 2017). The counsellor gives the person the opportunity to express difficult feelings like, anger, guilt, fear, resentment in a confidential environment. A person who is psychologically disturbed might often avoid talking freely to his family or friends with a fear of being judges and opinion biasness. Thus, the role of the counsellors is very important in this context, as they are the people who listens to their clients patiently without any bias. The therapist will use approaches for talk therapy like psychodynamic counselling also called psychoanalytic counselling, interpersonal counselling, humanistic/client-centered counselling, existential therapy, cognitive-behavioural therapy, reality therapy, narrative therapy, creative therapy, etc (Cowie & Pecherek, 2017). Along with these talk therapies, nowadays counsellors use many of alternative therapies in combination with above approaches like art therapy, music therapy, integrative therapy, sand therapy, child centred play therapy, etc. 

The counselling approach which can be applied to work with client Danni in the given case study is the psychoanalytic counselling. The presented article explains this approach of psychoanalytic counselling elaborately used in the case of Danni.

Psychoanalytic or Psychodynamic approach

A therapy or an approach is a set of principle, method, or a set of idea which address a specified concern. These approaches provide a guide to a counsellor’s behaviour or a framework that helps in understanding a client’s behaviour in a meaningful way. 

The psychodynamic approach is also referred to as a psychoanalytic approach. This psychodynamic approach is based Sigmund Freud theories, who is considered to be one of the founders to the field of psychology and psychoanalysis (Garrett, 2018).

The principle behind this approach explores how the unconsciousness mind impacts thoughts of a person and his behaviour, and offers insight and resolution to the client seeking therapy. The psychoanalytic approach involves analysing the experiences from early childhood to see if these events have affected the individual’s life, or potentially contributed to current concerns (Spurling, 2017). The basic rationale to the backdrop of this approach is that human behaviour is primarily determined by the psychic energy and by early experiences and unconscious motives and conflicts is dominant in the present behaviour of a person. 

Psychanalytic therapy is a long-term therapy, and can continue for long periods depending on the criticality of the concern being addressed. Differing from several other types of therapy, psychoanalytic therapy aims to make impactful changes in personality development along with emotional development. 

The principle of this approach is that early development of personality is of critical importance because later personality problems have their roots in repressed childhood conflicts (Geldard, Geldard & Foo, 2019). Normal personality development is achieved through successful integration of psychological stages of development. Faulty personality development is caused due to inadequate integration and resolution at some specific stage. Anxiety is a result of repression of basic results and unconscious processes is mostly related to current behaviour. 

The basic goals or aims of this approach can be underlined as follows:

• To bring the client from unconscious thought process to conscious thought process

• Help the client work through a development stage and fix a problem that was not resolved in the earlier stage

• The basic principle of this approach is to assist the clients in relieving the early experiences of childhood and adolescents and the inner conflicts which have been repressed

• Psychodynamic approach also aims to help the client to achieve intellectual awareness, self-awareness and help the client to except the norms of the society and adjust to the demands of the present situation

In this technique the client is taught how to focus on oneself and develop projections towards self. The focus of this approach is to reduce the resistance behaviour in client and establish a rational control of self (Howard, 2018). The counsellor conducts long-term analysis of the client and the client engage in free talks and association, discuss and speaks about the inner conflicts. The analysts or the counsellor thus gains insight into client’s problem by talking. The counsellor makes interpretations of the client that the current behaviour related to past experiences and makes the client aware of these situations. This approach or design of therapy helps the client gain access to their unconscious conflicts, which enables the client to gain insight and assimilation of the new self into conscious. This therapy facilitates change by enabling the client to learn about the past childhood event and how these experiences from early life could be affecting now.

The client Danni, in the given case study is a 16-year-old teenage who had a disturbed childhood due to her parents getting divorced when she was 6 years old. She lived with her mother Crystal after divorce, but things became worse for her when she had to see her mother suffering from cancer and pass away because of it. Post her mother’s demise, she moved in to live with her father Jack who had then settled down with his new family. Danni since then has remained isolated from her father and does not wish to be a part of the new family. All these conditions and her difficult childhood had caused an emotional breakdown within Danni and thus, she could not settle into her new family and new life. 

The psychodynamic approach can be used for counselling of Danni. As described earlier, this therapy enables a client to overcome his psychological disturbances due to his past experiences and cope up with the present situation; this is an appropriate approach which will also help Danni to cope with her present life. This therapy works on the rationale that is insight driven and helps to foster change in Danni by making her realize how the past experiences are affecting her present life (Flanagan & Flanagan, 2018). 

As Danni is in her teenage years, therapy sessions might vary according to her assimilation. But most of the time of therapy will be given to free talking i.e. talking to her freely in a safe and non-judgemental environment. This free talking is very important for Danni, because the tragic past experiences of her childhood have inflicted pain in her. Also, it has created some kind of conflict towards her father as she had witnessed her mother’s separation from him followed by her illness. She has associated the cause of her mother’s illness and her demise to her father, and hence resists talking to him and remains isolated. Since, she was living with her mother after her parent’s divorce she was more attached to her mother then her father, and now moving with her father is a difficult situation for her. Thus, talking to Danni freely is very important to understand these feelings of conflicts and loneliness. Though she is talking to her friends, she might not wish to discuss these feeling with her peer group under the fear of being judged and opinion biasness. Here, our role as counsellor is very important to create an environment for Danni to completely express herself (Holm-Hadulla, 2018). 

The psychoanalytic approach involves the use techniques like free association technique, analysis of transference, dream analysis, analysis of resistance (Hill et.al, 2019). The two techniques of this approach that we can use to facilitate change in Danni are the techniques of free association and analysis of transference. 

• Free association- it involves the client talking about things which are present into their mind without editing or censoring any kind of memories (Lothane, 2018). The initial sessions will be based on more general friendly talks with Danni, to develop a trust relationship with her. After this trust development, the next sessions will be based on analysis of the past experiences and incidents of Danni. During such sessions, at times the patients might experience emotional breakdowns like anxiety, crying, anger, etc. Expression of such psychological behaviours is also important in counselling therapy because it greatly reduces the intensity of the inflicting pain in the patient. We as the counsellor will listen to Danni and her concerns carefully and look for any events or pattern of events that are of significance. According to Schachter (2018), principle for this therapy is explains that unconscious feelings and experiences of the childhood impact the current behaviour.

• Transference- this technique can also help in healing process of Danni. Transference is a technique which explains the way a client transfers his thoughts or feelings which are related to important and influential people of their life like parent, siblings, etc. onto the therapist (Paulicke et.al., 2019). Discussing this transference with Danni help us to take a further understand and analyse the way Danni deals with people and situations in her daily life. 

The key principle the counsellor should follow for this type of therapy is to keep interpreting while the patient is talking and ‘reading between the lines. While the patient will talk freely the therapists will occasionally interject with interpretations and thoughts about the topic of discussion. Such a kind of psychoanalytic and talk therapy with Danni, will help her realise how her past experiences are actually hindering her psychological and conscious development, and creating obstacles in her new life. This therapy will also help Danni to accept her mother’s demise and her new life with father and his family. The therapy will help her accept the present self in her conscious and aid in her psychological development. 

Applications of the approach

Psychoanalytic therapy can be used by counsellors for healing process of patients with specific emotional concerns like for children and young teenagers (McMahon, 2018). It is also applied for treating adult people having emotional and anxiety concerns related to family issues. In some cases, it is also used for people who simply want to explore themselves. Awareness about self often brings with it a greater sense of well-being. This therapy is considered to be a long-term therapy and may not prove to be useful for people looking for quick solutions. This therapy is a long-term process that involves time but, the results of this therapy are found to be effective and life-changing. 

Due to the approach psychoanalytic therapy is used for general issues like anxiety, relationship issues within family members, self-motivation issues and issues of low self-esteem. This therapy is often used by the counsellors to address concerns like certain kind of phobias, social shyness or social isolation, and difficulties in sleeping. Also, the therapy can also be used in treatment of obsessive-compulsive disorders, panic attacks and for post-traumatic stress disorders. Counsellors also use this approach for treatment of depression. Depression in many cases is linked to childhood experiences like separation of parents, as in the above case. An inability to except this fact may leave a person prone to depression and psychoanalytic counselling helps for treatment of this depression. This therapy in rare cases is also applied in psychoanalysis of group setting or of a group of people, like it may be applied for the analysis of a family (Lopes & Cutcliffe, 2018). In such analysis, the therapy brings together psychoanalytic approach with interpersonal functions. This therapy takes place with a group of people together like a family, instead of an individual and counsellor’s one-to-one session. Conducting therapy in a group environment have many benefits like it offers and supports networking which provides opportunity to meets other people who are facing similar concerns. 

Conclusion

The process of counselling enables a disturbed client to explore aspects of their life and feelings by freely and openly talking to the therapist and sharing their feeling. For such a help therapy a counsellor employs a number of therapies as per the client’s condition, difficulties and needs. Psychodynamic counselling or psychoanalytic counselling is an approach that stresses the importance of the past experiences and the unconsciousness in shaping the behaviour of present. This approach focuses on client-therapist relationship in general and the most common techniques used in this approach is the technique of free association and transference. This approach involves a series of action that facilitate a change or development, which in turn encourages personal growth by bringing together the emotional, physical, psychological or mental and spiritual aspects of a person as a whole within a safe environment.

References

Cowie, H. & Pecherek, A. (2017). Counselling: Approaches and issues in education. London: David Fulton Publishers. 

Flanagan, J.S & Flanagan, R.S. (2018). Counselling and psychotherapy theories in context and practice: skills, strategies, and techniques. New Jersey: Wiley Inc.

Garrett, V. (2018). Effective short-term counselling within the primary care setting: Psychodynamic and cognitive-behavioural therapy approaches. New York: Routledge. 

Geldard, K., Geldard, D., & Foo, R. Y. (2019). Counselling adolescents: The proactive approach for young people. California: Sage Publications. 

Hill, C.E., Kline, K.V., O’Connor, S., Morales, K., Li, X., Kivilghan, D.M., & Hillman, J. (2019). Silence is golden: A mixed methods investigation of silence in one case of psychodynamic psychotherapy. Psychotherapy, 56(4), 577-587.

Holm-Hadulla, R.M. (2018). The art of counselling and psychotherapy. New York: Routledge. 

Howard, S. (2018). Psychodynamic counselling in a nutshell. London: Sage. 

Lancaster, T. & Stead, L.F. (2017). Individual behavioural counselling for smoking cessation. Retrieved from: www.cochranelibrary.com

Lopes, J. &Cutcliffe, J.R (2018). Psychodynamic and psychoanalytic theory, approaches and clinical relevance: applying the psychoanalytic principles and practices to mental health nursing. Retrieved from: http://doi.org/10.1007/978-3-319-31772-4_7

Lothane, H.Z. (2018). Free association as the foundation of psychoanalytic method and psychoanalysis as a historical science. A Topical Journal for Mental Health Professionals, 38(6), 416-434.

McMahon, M. (2018). Narrative career counselling: A tension between potential, appeal, and proof. Introduction to the special issue. Australian Journal of Career Development, 27(2), 57-64.

Paulicke, D., Buhtz, C., Meyer, G. & Jahn, P. (2019). Counselling approaches to assistive technologies in nursing care for people with dementia- a focus group study with informal carers. Europe PMC, 32(6), 315-323.

Schachter, J. (2018). Free association: From Freud to current use-the effects of training analysis on the use of Free association. 

Spurling, L. (2017). An introduction to psychodynamic counselling. England: Palgrave.