A number of Freud’s ideas can be seen as coming from Darwin (Ellenberger, 1970; Sulloway, 1979), although Freud emphasized sexual selection over natural selection. For Freud, the sexual instinct (libido) is the major driving force for human life and interaction. Freud was also influenced by the suggestion of the neurologist John Hughlings Jackson that in our brains we find more primitive areas underlying more advanced ones. Thus, it is quite possible for the psyche to be in conflict with itself or at least to have different layers representing different processes.
Hans Strupp
© Courtesy of Vanderbilt University
For Freud, higher cortical processes could inhibit the experience of lower ones, a process that would come to be called repression. Anxiety is the result of society and culture having inconsistent rules for the expression of sexuality and aggression. This anxiety and our inability to acknowledge these instinctual experiences lead to defense mechanisms and neurosis. Freud believed that the brain was basically a blank slate upon which experiences become connected with one another driven by instinctual processes of sexuality and self-preservation. The human psyche for Freud becomes the real-life laboratory in which nature and nurture struggle.
Treatment for Freud was based on the search for ideas and emotions that are in conflict and the manner in which the person has relationships with other people. His specific treatment came to be called psychoanalysis. One basic procedure was free association, in which an individual lay on a couch with the therapist behind him or her and said whatever came to mind. It was the therapist’s job to help the client connect ideas and feelings that he or she was not aware of. One thing Freud was searching for was connections within the person’s psyche when external stimulation was reduced. Dreams were also analyzed in this way, since they are produced outside of daily life.
psychoanalysis: treatment developed by Freud based on the search for ideas and emotions that are in conflict on an unconscious level
Other aspects of psychoanalysis included examining resistance, or what the client is unwilling to say or experience, and transference, or the manner in which a person imagined how another person thought about him or her or sought a certain kind of relationship with that person. Freud has greatly influenced therapies based on insight. Insight therapy, which has been used to treat disorders such as anxiety and depression, is based on the principle of bringing patterns of behavior, feelings, and thoughts into awareness. In order to do this, it is necessary to discuss past patterns and past relationships to determine how they are being replayed or are influencing the present.
A number of dynamically orientated therapies have been shown to be effective (Barber, Muran, McCarthy, & Keefe, 2013). One empirically supported therapy based on dynamic principles was developed by Hans Strupp and his colleagues. Strupp embodied the dynamic principles in a therapy of a few months’ duration (Strupp & Binder, 1984). The focus of this therapy is the relationship between the client and other individuals in her life. It is assumed that the client’s problems are based on disturbed relationships. The therapeutic relationship between the client and the therapist offers an opportunity to see disturbed relationships in a safe environment. Transference is an important mechanism in which the client tends to see the therapist in terms of significant others in her life. As the client talks with the therapist, she will replay prior conflicts and enact maladaptive patterns.
The role of the therapist in this approach is mainly to listen. As the therapist, you listen to a client, seeking to understand what she is saying and how she feels as she describes her world. You would note to yourself when she finds talking to you difficult or experiences distress as she talks about her life. On a larger level, the therapist is looking for themes and patterns that came from the client’s past. In a relaxed, nonjudgmental manner, it is the task of the therapist to help the client understand the patterns and to see how they interfere with living and having rewarding relationships with others. Different versions of dynamic psychotherapy have been shown to be effective for a number of disorders, especially the personality disorders.
existential-humanistic perspective: psychological therapy that focuses on the experience of the person in the moment and the manner in which he or she interprets the experiences
Existential-Humanistic Perspectives
The existential-humanistic perspective begins by asking, what is the nature of human existence? This includes both the positive experiences of intimacy and the negative experiences of loss. Historically, two clinicians influenced by Freud—Carl Jung and Karen Horney—helped to set the stage for the existential-humanistic movement in that they emphasized the value of internal experience.
Carl Rogers
© Roger Ressmeyer/Corbis/VCG
Karen Horney
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As the existential-humanistic movement grew, a number of themes became critical. The first is an emphasis on human growth and the need for a positive psychology that moves beyond the discussion of stress and neurosis seen in the psychodynamic approaches. A second emphasis is the idea that psychological health is more than just the absence of pathology. Not having a problem is not the same as finding meaning in one’s life. The third theme stresses the importance of considering not only the external world and a person’s relationship to it, but also the internal world. In the humanistic-existential perspective, the internal world of a person and his or her experiences are valued. With the emphasis on experience, you will also see the therapies that developed from this approach referred to as humanistic-experiential therapies.
Carl Rogers brought the humanistic movement to the forefront by creating client-centered therapy, also referred to as person-centered therapy. Rogers considered psychotherapy to be a releasing of an already existing capacity in a potentially competent individual. In fact, Rogers emphasized the relationship between the therapist and client as a critical key to effective therapy.
client-centered therapy: a treatment approach in psychology characterized by the therapist’s empathic understanding, unconditional positive regard, and genuineness
There are three key characteristics of the client-centered approach. The first is empathic understanding. As the therapist reflects back what the client says, the client begins to experience his innermost thoughts and feelings. The second is what Rogers referred to as unconditional positive regard. That is, the therapist accepts what the client says without trying to change the client. For some individuals who had experienced significant others in their lives as critical of them, to be accepted by the therapist is a new experience. The third characteristic is for the therapist to show genuineness and congruence (agreement). In this way, the therapist models what interactions between two real people could be like.
A number of humanistic-experiential–orientated therapies have been shown to be effective (Elliott, Greenberg, Watson, Timulak, & Freire, 2013). One of these empirically supported therapies based on humanistic principles was developed by Leslie Greenberg and his colleagues. This approach is known as emotion-focused therapy or process-experiential therapy (Greenberg, 2002). In this therapy, emotion is viewed as centrally important in the experience of self. Emotion can be either adaptive or maladaptive. However, in either case, emotion is the crucial element that brings about change. In therapy,
