Counseling Theories Thesis

Pages: 8 (2699 words)  ·  Style: APA  ·  Bibliography Sources: 10  ·  Level: College Senior  ·  Topic: Psychology

Counseling Theories

"…There is no single, definitive, unchanging, final narrative that can qualify as the correct understanding of the patient's psychic life"

Schafer (as cited in Wolitzky, 2007, Definitions of…section, ¶ 2).

In 1896, at the age of 40, Sigmund Freud, Austrian physician who lived from 1856-1939, perceived to be the founder of psychoanalysis, coined this term, still used today. Freud's fundamental idea asserts "that all humans are endowed with an unconscious in which potent sexual and aggressive drives, and defenses against them, struggle for supremacy, as it were, behind a person's back" (Gay, 2009, ¶ 2). Some, however, historically and even today, challenge Freud's theory and mark his reported insight to constitute a romantic, scientifically unproven notion. Many perceived Freud's contention that the catalog of neurotic ailments humans are susceptible to, typically evolved from sexual maladjustments; that erotic desire does not begin in puberty, but in an individual's infancy, as almost obscene. Freud's evocation of a universal Oedipus complex, according to a number of critics, did not merit recognition as a thesis worth consideration by scientific rationale.

During this paper, the researcher presents an overview of psychoanalytic therapy, along with samples of research conducted that explores efficacy of the psychoanalytic therapy. Psychoanalytic therapy interests the researcher for a number of reasons, which filer from personal and professional observations. The researcher's primary interest, albeit, encompasses concerns that one may determine to only subscribe to psychoanalytic therapy or another similar theory without researching other available options. In light of Schafer's assertion, reflected in the quote introducing this study, the researcher similarly asserts that a number of definitive, changing narratives exist that may, in fact, qualify as one of number of appropriate tools to help the patient better understand his/her psychic life. This paper relates some of those other options.

Currently, a number of therapists regularly perform psychoanalytic psychotherapy that modifies the frequency and techniques of psychoanalysis. In the journal publication, "Cognitive therapy and psychoanalytic psychotherapy," Natsuko Hiroshima (2007), Department of Psychiatry, School of Medicine, Showa University, explains that psychoanalytic psychotherapy consists of a long-term therapy. Hiroshima (2007) purports that the application of the unique theories and techniques of Cognitive therapy and psychoanalytic psychotherapy are regularly confirmed to effective for the treatment of psychiatric problems, including mood and anxiety disorders. This therapeutic mechanism, according to Hiroshima, aims to:

Emphasize transference, in which a patient's past object relations and emotions are projected onto the therapist, as well as countertransference, which occurs in the therapist in response to transference, and to identify a patient's unconscious conflicts that are related to symptom formation. (Hiroshima, 2007, ¶ 1)

Bertram P. Karon (2005), Professor of Clinical Psychology at Michigan State University, recommends treating psychotic depression without medication, and notes that if the therapist prescribes medication, it should be withdrawn when the patient can tolerate the discontinuation of medication. In the majority of Karon's publications, he repeatedly stresses that schizophrenic patients may be effectively treated with psychoanalytic therapy without medication. In his Detroit project, Karon confirmed the effectiveness of psychoanalytic therapy with randomized assignment and blind evaluations. Findings confirmed that this treatment "led to a much greater improvement in the thought disorder and a more human life in a variety of ways, and consequently a much lower rate of rehospitalization" (Karon, 2005, ¶ 1). The effectiveness of psychoanalytic therapy, nevertheless, Karon concludes, is not reserved for those experiencing schizophrenia, but also serves to effectively treat other deeply disturbed individuals.

In the journal publication, "The role of clinical inference in psychoanalytic case," Dr. David L. Wolitzky (2007), New York University, seeks to demystify psychoanalytic clinical inference. In his study, Wolitzky explicates the nature and processes of various psychoanalytic theories and examines ways different psychoanalytic theories may lead to varying clinical inferences. Wolitzky explains that the process of clinical inference "refers to the clinician's cognitive-affective experience as he or she observes, scans, selects, organizes, and gives psychological meanings to the patient's verbal and nonverbal behavior and affective tone in the context of stored memories of the patient" (Wolitzky, 2007, Definitions of…section, ¶ 1). The lenses of the clinician's views, however, of the dynamics of general mental life and of the particular patient filter the patient's material,

Some clinicians assert that this the process ideally involves the therapist empathically making a transient identification with the patient, while being alert to possible counter-transference reactions and theory-driven reactions. Freud concluded, albeit, that: "The doctor should be opaque to his patients and, like a mirror, should show them nothing but what is shown to him" (Sigmund Freud, 2009). Both Freud and others, nevertheless, agreed that the complex operations of the patient's mind concealed intriguing mysteries, and lay concealed in the of the mind (Gay, 2009; Hiroshima, 2007; Karon, 2005; Wolitzky, 2007).

Wolitzky (2007) asserts that perceptions promoting the theory of psychoanalysis no longer prove valid. Instead, when the clinician formulates a case, he/she creates a narrative structure that is influenced by a preferred theoretical orientation. This particular structure aims to develop a "coherent, comprehensive, plausible, and hopefully accurate account of the individual's personality and current functioning based on his or her life history, as that history is told, lived, and retold by the patient (and analyst) in the course of the psychoanalytic encounter" (Wolitzky, 2007, Definitions of…section, ¶ 2). Hence, as Schafer stressed, a single, definitive, exact understanding of the individual's psychic life does not exist. Wolitzky also asserts, however, that to some degree, the clinician needs to engage in clinical inference for case formulation to extend past a statement of the patient's manifest problems and symptoms. He encourages the examination of whether or not the explication of the implicit rules of clinical evidence do in fact, facilitate the clinician's work.

Cyril Levitt (2008), psychoanalyst and member of the Canadian Psychoanalytic Society, reviews work by Dr. Waska in the journal publication, "Comment on Waska's "Is it psychoanalytic?." Levitt asserts that Waska recommends that therapists need to return to Freud's original emphasis; to help mentally ill individuals obtain freedom from their psychological prisons. Levitt argues: "Psychoanalysis cannot eliminate conflict; it can help the patient manage the conflict with increasing ego strength and with greater mutative understanding and insight into reality and the distortions of reality, and the acceptance of reality demands and consequences" (Levitt, 2008, ¶ 3). Levitt recounts that Waska concludes that the only differences between traditional psychoanalysis and psychoanalytic psychotherapy involves the use of the couch and the frequency of sessions per week.

Dr. Howard a. Bacal (2007), Analyst at the Institute of Contemporary Psychoanalysis, Los Angeles, reports that the principles of specificity theory may be categorized into the four following groups:

1. Broadening the range of therapeutic responsivity [sic]

2. Particularization

3. Reciprocity

4. Limitations to therapeutic responsiveness (Bacal, 2007, ¶ 4).

In the journal publication, "Discussion of Judy Pickles's case presentation from the perspective of psychoanalytic specificity theory," Bacal (2007) argues that the psychoanalytic specificity theory mirrors the perception that the therapeutic process consists of "the operation of a unique, complex, reciprocal relational system for each analyst-patient couple. It recognizes that what each therapist distinctively offers a particular patient includes, but also transcends, considerations of both theory and technique" (Bacal, 2007, ¶ 1). Specificity theory stresses the significance of the therapeutic fit between the patient's particular therapeutic needs and the analyst's ability to effectively to respond to/address the patient and his/her needs.

Heike Westenberger-Breuer (2007), Lohrgasse, Frankfurt-am-Main, Germany, discusses goals in psychoanalytic treatment contends in the journal publication, "The goals of psychoanalytic treatment: Conceptual considerations and follow-up interview evaluation with a former analyst." Westenberger-Breuer points out that a number of analysts argue that psychoanalysis ought to be goalless. The growing number of outcome studies, however, indicates the need for a generally accepted set of criteria for treatment results to be measured. Westenberger-Breuer contends that the need also exists for the definition of the goals of psychoanalysis to cover the following four areas:

1. The alleviation of symptoms and complaints,

2. changes in life adjustment,

3. changes in personality structure, and

4. procedural goals such as the resolution of the transference neurosis. (Westenberger-Breuer, 2007, ¶ 1).

One benefit evolving from these categories may be that various definitions in the literature could be grouped under them. Another benefit could be to attempt to "make it clear that the particularly psychoanalytic goal of treatment is precisely the claim that all four components are to be taken together" (Westenberger-Breuer, 2007, ¶ 13). The prompt decline of symptoms ought not constitute the only achievement of psychoanalytic treatment, but also a decrease that corresponds with or is adjunct to knowledge of the causes and interrelations of symptoms to help achieve enduring change within the individual's personality.

In the journal publication, "Renewing psychoanalysis for the 21st century," Dr. Neil Altman (2007), Associate Clinical Professor in the Postdoctoral Program in Psychotherapy and Psychoanalysis at New York University, considers opportunities and perils psychoanalysis currently faces in the United States. Altman asserts that psychoanalysis, not largely favored by society, is extensively regarded to be antiquated, ineffective and irrelevant, "…iif not self-indulgent,… [END OF PREVIEW]

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