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Depression Help (Home) > Depression Types > Psychodynamic Theory Psychodynamic: Theories and Treatment Psychodynamic' refers to 'movement in the psyche; theories of the mind that allow movement'. The Penguin Dictionary of Psychology defines psychodynamic as 'all those psychological systems and theories that emphasize processes of change and development; in short psychological theories that deal with that which is dynamic will be included'. Psychodynamic ideas have transformed since their original development by Sigmund Freud. However, many of his ideas still remain as cornerstones for today's thinkers and practitioners of psychodynamic therapy. Freud's theories were fundamentally 'drive' theories, based on the idea that the human psyche strives to fulfill a biological or physiological drive. Later theoreticians, such as Melanie Klein, Donald Wainscot and Wilfred Bion, have all emphasized the prime importance of human relationships in the development of emotional health. These theories, dealing with both external relationships and internal representations of relationships or 'objects', became known as object relations theories. They offer not only a theory about how to cure an ill, but, of equal importance and maybe primarily, theory about emotional health and therefore about mental life. Psychodynamic theories, therefore, are of importance for anyone whose work involves human relationships. They can fit together in flexible way with other theoretical models, such as developmental and behavioral models, and are closely linked with attachment theory. Psychodynamic theories fit well with the holistic ethos of occupational therapy and can inform therapists in all areas of occupational therapy. It is important, for example, for a therapist working in the field of paralysis, to understand the process of denial when faced with loss, or the dynamics of projective identification in the patient-therapist relationship. Therapists may deal with the physical needs of the patient and not address these issues directly, but their understanding of these processes will help patients, intern, to feel understood and therefore less isolated. The occupational therapist working in the field of child and adolescent mental health may use psychodynamic psychotherapy as a form of treatment. This is the case especially when the difficulties the child is experiencing are of such nature that it is considered they cannot be helped by other forms of shorter therapies, anywhere the therapist has had further specialist training. Most occupational therapists in this area see themselves as using play therapy or other forms of creative activities therapies. Telford & Ainscough (1995) have pointed tithe link between Axline's eight principles of play therapy (Axline 1989) and psychodynamic ideas. Where Axline provided a technique that many feel comfortable with, psychodynamic thinkers have given an understanding of the technique. This understanding allows therapists to make more accurate assessments and to be more realistic about aims of therapy. In addition, a theoretical underpinning offers the therapist a certain amount of protection in providing framework to make sense of what can beamed sense of, but also acknowledging the importance of staying with that which cannot be understood for often long periods of time in therapy. This is not an exhaustive account of psychodynamic theory, rather it is a personal exploration of the ideas the author has found most useful inhere clinical work with children and young people. This chapter aims to elicit an appetite in the reader that will allow further exploration of these and other related ideas. Many students, and indeed clinicians, fear that these theories are too complex to understand and apply. The hope is to allay this fear and to demonstrate that by starting from the beginning, in developmental terms, human communication can be understood in stages. The language may be new but, as we are all humans, the basic concepts are not. The chapter begins by discussing the importance of the early parent-infant relationship and the psychodynamic understanding that can be derived from this. This includes a discussion about the development of play in the young child. Links will be made between this and the therapeutic relationship before moving on to further theoretical ideas that need to be considered specifically in therapy. TreatmentDuring therapy, psychodynamic therapists tend to emphasize the importance of insight and interpretations within what is referred to as a "frame." This "frame" is emphasized in all forms of theoretical orientation, though to a lesser degree than with psychodynamic therapies. The frame is described as being the setting and boundaries such as meeting time, place, length of each session, and other pertinent information. It is believed that if you cancel an appointment, a force greater than simply your car breaking down is at work within you. Although there may be some truth to this, it is not felt that it is to the degree that is emphasized within the psychodynamic therapy plan. The fact that the basis of psychodynamic therapy is transference makes the frame much more important than in other types of psychotherapy. The possibility exists that the patient may be engaging in some type of transference that needs analyzed by the therapist and quite possibly interpreted. Both psychodynamic and psychoanalytic therapists cam be said to be the best in interpretations and listening. As noted with the missed appointment, the fact that that the therapist was reading more into the situation than was there can be classified as an interpretation. After all, an interpretation is no more than offering a reason or explanation to the patient concerning that person's behaviors, thoughts, or feelings. If an interpretation is properly conducted, it leads to the patient being able to understand the unconscious motivation for his former actions, reactions, feelings, or thoughts. Of course, other therapists do interpretations as well, but psychodynamic therapists perform the best interpretations.
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