Current Psychotherapies (11th edition) Jenisha van Loo
Table of contents
Book chapters
o Chapter 2 Psychodynamic Psychotherapies p. 2
o Chapter 4 Client-Centered Therapy p. 8
o Chapter 6 Behavior Therapy p. 12
o Chapter 7 Cognitive Therapy p. 19
o Chapter 12 Mindfulness and Other Contemplative Therapies
p. 24
Appendix
o Table Comparison Table p. 32
Legend of in-text colors
= an example
= a keyword that is explained later
= an experiment
= an important person
1
,Current Psychotherapies (11th edition) Jenisha van Loo
Psychodynamic Psychotherapies
Chapter 2
Psychoanalysis
= a form of psychological treatment and a model of psychological functioning and
psychopathology. Sigmund Freud (1856-1939) is known as the founding father of
psychoanalysis, but it now consists of many different theories and treatment models that
have developed over time.
Basic principles of psychoanalysis
There are certain basic principles that tend to cut across different psychoanalytic
perspectives:
1. Unconscious motivation: all human beings are partly motivated by wishes,
fantasies or implicit knowledge that is outside of awareness.
2. Awareness: facilitating awareness of unconscious motivations, thereby increasing
individual choice.
3. Defenses: exploring ways in which we avoid painful or threatening feelings,
fantasies, and thoughts.
4. Ambivalence: humans are ambivalent about changing and exploring this
ambivalence is important.
5. Therapeutic relationship: the therapeutic relationship is important for exploring
clients’ self-defeating psychological processes and actions (both conscious and
unconscious) and for change.
6. Understanding: helping clients to understand the way in which their own
construction of their past and present plays a role in perpetuating their self-defeating
patterns.
1- vs. 2-person psychologies
Across a range of different psychoanalytic schools there has been a shift from Freud’s
classical one-person psychology to a two-person psychology.
One-person psychology = the idea that it is possible to understand the client’s
defense processes without consideration for the therapist’s own ongoing
contributions to the interaction.
Two-person psychology = the idea that assumes that both the therapist and client
contribute to everything that takes place in a therapeutic relationship.
History
Precursors
Traditional Freudian psychoanalysis was influenced by many cultural and scientific trends
in the late 19th- and early 20th-centuries and by Freud’s engagement with numerous
mentors, colleagues, and critics. Freud and colleagues began to experiment with more
‘talking’ therapies and the use of hypnosis instead of focusing exclusively on somatic
treatments.
Beginnings
There are several critical stages in the evolution of traditional psychoanalysis.
Free association
= a technique in which clients are encouraged to attempt to verbalize thoughts, images,
associations, and feelings without being self-critical and censoring. Because of problems
he saw with the reliability of hypnosis, Freud began to encourage patients to say
everything that came to mind without censoring.
Seduction theory
= the idea that sexual trauma always lies at the root of psychological problems. Freud
started from this belief but gradually abandoned it as he began to focus more on the role
of sexual instincts in the developmental process, emphasizing the role of fantasy and
instinctual drive. This became known as drive theory.
2
,Current Psychotherapies (11th edition) Jenisha van Loo
Drive theory
= the idea that organisms are born with certain psychological needs (drives) and that a
negative state of tension is created when these needs are not satisfied. When satisfied,
drive is reduced and there is homeostasis. There is a push to repeat experiences that
have become associated with tension reduction (pleasure principle).
Eugene Bleuler and Carl Jung
Bleuler and Jung began to use word-association tests to investigate response-times to
emotionally charged words in psychiatric patients. They began to account for their
findings using Freud’s theories about the nature of unconscious processes and argued
that delayed response times reflected unconscious functioning of complexes.
Complexes = affectively charged ideas that are repressed because they are
emotionally threatening.
Zurich Psychoanalytic Society (1907)
Many colleagues of Bleuler and Jung (at the Burghölzli Clinic in Zurich) began to show
growing interest in Freud’s work, spreading his ideas in the medical community around
the world. Jung met with Freud personally and together with Bleuler established the
Zurich Psychoanalytic Society.
Jung and Freud
Freud hoped that Jung would become his successor, leading the psychoanalytic
movement. However, there were theoretical tensions that grew over time and led to the
end of their collaboration: Jung believed that Freud was mistaken in viewing sexuality as
the most important motivational principle and that he failed to recognize the importance
of the spiritual and transpersonal aspects of the mind.
Structural theory (ego psychology)
= the idea that there are 3 agencies of the mind:
1. Id: instinctually based (immediate sexual gratification) and present from birth.
2. Ego: central controlling core that mediates between the id and the superego. It
evaluates suitability of satisfying instinctual desires and allows for a delay in
gratification or for findings other ways of satisfaction in socially acceptable ways.
3. Superego: embraces moral and social values and regulates drives, self-image, self-
esteem, and drive discharge. It can be overly harsh and demanding, leading to
feelings of guilt and rejection towards instinctual needs and wishes.
Object relations theory
= the idea that the basic human motive is to satisfy object (person) relationships. It
developed in Britain from the work of Melanie Klein and colleagues. Note that objects
are the things to which a person relates, which can be all kinds of things (people, places,
things).
British Independents/Middle Group
Next to Freudian and Kleinian groups, the British Independents/Middle Group started to
appear. They were influenced by both Freudian and Kleinian ideas but did not align
politically with either of them. The Middle Group specifically emphasized the importance
of spontaneity, creativity, therapist flexibility, and providing clients with a supportive and
nurturing environment.
Status in America
Unlike the British system embracing 3 different psychoanalytic traditions, the US was
centered around ego psychology only.
Interpersonal (relational) psychoanalysis
= the idea that the need for human relatedness is the most fundamental human
motivation, instead of sexuality. It was founded by Harry Sullivan, who diverged too
much from traditional ego psychology. The rise of relational psychoanalysis included
3
, Current Psychotherapies (11th edition) Jenisha van Loo
critiquing aspects of classical psychoanalysis, which was around the same time of other
important changes in society (behaviorism).
Conflict theory
= the view that emphasizes the centrality of human experience and intrapsychic
conflict. Contemporary ego psychology has evolved into this view over time, and
currently a variety of different traditions are embraced in America.
Intrapsychic conflict = ongoing conflict between unconscious wishes and defenses
against them.
Current status
Most psychotherapy forms that currently exist were either strongly influenced by or
developed partially in reaction to psychoanalysis. It is hard to compare psychoanalysis to
other psychotherapies because it is not just a form of therapy: it is a worldview.
Popularity of psychoanalysis
While psychoanalysis has been very popular for a period of time, its popularity has
declined over the years. This has many causes, including the increasing emphasis on
biological factors in psychiatry, the rise of cognitive-behaviorism, and growing emphasis
on evidence-based treatment.
Another factor influencing the decreasing popularity of psychoanalysis has been a
negative public reaction to the attitude of arrogance, insularity, and elitism that became
associated with it. Furthermore, psychoanalysis have lacked receptiveness of valid
criticism and empirical research.
Currently
Throughout the years, psychoanalysis has become more flexible, less authoritarian, more
practical, and more responsive to the needs of a wider range of diverse clients. Also,
there is a growing body of empirical evidence. In short, many problems have diminished.
However, many people are unaware of these changes and still have a stereotypical view
of psychoanalysis.
Personality
There is not one psychoanalytic theory of personality. The book briefly outlines a few of
the most influential psychoanalytic theories of personality.
Conflict theory
According to conflict theory, intrapsychic conflict plays a central role in the development
of one’s personality: it arises from the compromise between core wishes and
characteristic styles of defense that are used to manage them. Someone with narcissistic
personality defends against dependency wishes and fears of abandonment by projections
of grandiosity.
Object relations theory
According to object relations theory, internal representations (internal objects) influence
the way in which people perceive others, choose the people to establish relationships
with, and shape their own relationships. A famous model of object relations is known as
attachment theory.
Attachment theory (John Bowlby)
= the idea that all humans have an innate tendency to develop strong affectional bonds
and that threats to these bonds result in psychopathology. To maintain proximity to
attachment figures, infants develop internal working models. The internal models of
threatening actions influence one’s susceptibility for dissociating experiences and
feelings (aggression, anger, vulnerability) linked to them.
Internal working models = representations of one’s interactions with attachment
figures that allow for prediction of what type of actions will increase the possibility of
maintaining proximity vs. of what types will threaten the relationship.
Internalization
4
Table of contents
Book chapters
o Chapter 2 Psychodynamic Psychotherapies p. 2
o Chapter 4 Client-Centered Therapy p. 8
o Chapter 6 Behavior Therapy p. 12
o Chapter 7 Cognitive Therapy p. 19
o Chapter 12 Mindfulness and Other Contemplative Therapies
p. 24
Appendix
o Table Comparison Table p. 32
Legend of in-text colors
= an example
= a keyword that is explained later
= an experiment
= an important person
1
,Current Psychotherapies (11th edition) Jenisha van Loo
Psychodynamic Psychotherapies
Chapter 2
Psychoanalysis
= a form of psychological treatment and a model of psychological functioning and
psychopathology. Sigmund Freud (1856-1939) is known as the founding father of
psychoanalysis, but it now consists of many different theories and treatment models that
have developed over time.
Basic principles of psychoanalysis
There are certain basic principles that tend to cut across different psychoanalytic
perspectives:
1. Unconscious motivation: all human beings are partly motivated by wishes,
fantasies or implicit knowledge that is outside of awareness.
2. Awareness: facilitating awareness of unconscious motivations, thereby increasing
individual choice.
3. Defenses: exploring ways in which we avoid painful or threatening feelings,
fantasies, and thoughts.
4. Ambivalence: humans are ambivalent about changing and exploring this
ambivalence is important.
5. Therapeutic relationship: the therapeutic relationship is important for exploring
clients’ self-defeating psychological processes and actions (both conscious and
unconscious) and for change.
6. Understanding: helping clients to understand the way in which their own
construction of their past and present plays a role in perpetuating their self-defeating
patterns.
1- vs. 2-person psychologies
Across a range of different psychoanalytic schools there has been a shift from Freud’s
classical one-person psychology to a two-person psychology.
One-person psychology = the idea that it is possible to understand the client’s
defense processes without consideration for the therapist’s own ongoing
contributions to the interaction.
Two-person psychology = the idea that assumes that both the therapist and client
contribute to everything that takes place in a therapeutic relationship.
History
Precursors
Traditional Freudian psychoanalysis was influenced by many cultural and scientific trends
in the late 19th- and early 20th-centuries and by Freud’s engagement with numerous
mentors, colleagues, and critics. Freud and colleagues began to experiment with more
‘talking’ therapies and the use of hypnosis instead of focusing exclusively on somatic
treatments.
Beginnings
There are several critical stages in the evolution of traditional psychoanalysis.
Free association
= a technique in which clients are encouraged to attempt to verbalize thoughts, images,
associations, and feelings without being self-critical and censoring. Because of problems
he saw with the reliability of hypnosis, Freud began to encourage patients to say
everything that came to mind without censoring.
Seduction theory
= the idea that sexual trauma always lies at the root of psychological problems. Freud
started from this belief but gradually abandoned it as he began to focus more on the role
of sexual instincts in the developmental process, emphasizing the role of fantasy and
instinctual drive. This became known as drive theory.
2
,Current Psychotherapies (11th edition) Jenisha van Loo
Drive theory
= the idea that organisms are born with certain psychological needs (drives) and that a
negative state of tension is created when these needs are not satisfied. When satisfied,
drive is reduced and there is homeostasis. There is a push to repeat experiences that
have become associated with tension reduction (pleasure principle).
Eugene Bleuler and Carl Jung
Bleuler and Jung began to use word-association tests to investigate response-times to
emotionally charged words in psychiatric patients. They began to account for their
findings using Freud’s theories about the nature of unconscious processes and argued
that delayed response times reflected unconscious functioning of complexes.
Complexes = affectively charged ideas that are repressed because they are
emotionally threatening.
Zurich Psychoanalytic Society (1907)
Many colleagues of Bleuler and Jung (at the Burghölzli Clinic in Zurich) began to show
growing interest in Freud’s work, spreading his ideas in the medical community around
the world. Jung met with Freud personally and together with Bleuler established the
Zurich Psychoanalytic Society.
Jung and Freud
Freud hoped that Jung would become his successor, leading the psychoanalytic
movement. However, there were theoretical tensions that grew over time and led to the
end of their collaboration: Jung believed that Freud was mistaken in viewing sexuality as
the most important motivational principle and that he failed to recognize the importance
of the spiritual and transpersonal aspects of the mind.
Structural theory (ego psychology)
= the idea that there are 3 agencies of the mind:
1. Id: instinctually based (immediate sexual gratification) and present from birth.
2. Ego: central controlling core that mediates between the id and the superego. It
evaluates suitability of satisfying instinctual desires and allows for a delay in
gratification or for findings other ways of satisfaction in socially acceptable ways.
3. Superego: embraces moral and social values and regulates drives, self-image, self-
esteem, and drive discharge. It can be overly harsh and demanding, leading to
feelings of guilt and rejection towards instinctual needs and wishes.
Object relations theory
= the idea that the basic human motive is to satisfy object (person) relationships. It
developed in Britain from the work of Melanie Klein and colleagues. Note that objects
are the things to which a person relates, which can be all kinds of things (people, places,
things).
British Independents/Middle Group
Next to Freudian and Kleinian groups, the British Independents/Middle Group started to
appear. They were influenced by both Freudian and Kleinian ideas but did not align
politically with either of them. The Middle Group specifically emphasized the importance
of spontaneity, creativity, therapist flexibility, and providing clients with a supportive and
nurturing environment.
Status in America
Unlike the British system embracing 3 different psychoanalytic traditions, the US was
centered around ego psychology only.
Interpersonal (relational) psychoanalysis
= the idea that the need for human relatedness is the most fundamental human
motivation, instead of sexuality. It was founded by Harry Sullivan, who diverged too
much from traditional ego psychology. The rise of relational psychoanalysis included
3
, Current Psychotherapies (11th edition) Jenisha van Loo
critiquing aspects of classical psychoanalysis, which was around the same time of other
important changes in society (behaviorism).
Conflict theory
= the view that emphasizes the centrality of human experience and intrapsychic
conflict. Contemporary ego psychology has evolved into this view over time, and
currently a variety of different traditions are embraced in America.
Intrapsychic conflict = ongoing conflict between unconscious wishes and defenses
against them.
Current status
Most psychotherapy forms that currently exist were either strongly influenced by or
developed partially in reaction to psychoanalysis. It is hard to compare psychoanalysis to
other psychotherapies because it is not just a form of therapy: it is a worldview.
Popularity of psychoanalysis
While psychoanalysis has been very popular for a period of time, its popularity has
declined over the years. This has many causes, including the increasing emphasis on
biological factors in psychiatry, the rise of cognitive-behaviorism, and growing emphasis
on evidence-based treatment.
Another factor influencing the decreasing popularity of psychoanalysis has been a
negative public reaction to the attitude of arrogance, insularity, and elitism that became
associated with it. Furthermore, psychoanalysis have lacked receptiveness of valid
criticism and empirical research.
Currently
Throughout the years, psychoanalysis has become more flexible, less authoritarian, more
practical, and more responsive to the needs of a wider range of diverse clients. Also,
there is a growing body of empirical evidence. In short, many problems have diminished.
However, many people are unaware of these changes and still have a stereotypical view
of psychoanalysis.
Personality
There is not one psychoanalytic theory of personality. The book briefly outlines a few of
the most influential psychoanalytic theories of personality.
Conflict theory
According to conflict theory, intrapsychic conflict plays a central role in the development
of one’s personality: it arises from the compromise between core wishes and
characteristic styles of defense that are used to manage them. Someone with narcissistic
personality defends against dependency wishes and fears of abandonment by projections
of grandiosity.
Object relations theory
According to object relations theory, internal representations (internal objects) influence
the way in which people perceive others, choose the people to establish relationships
with, and shape their own relationships. A famous model of object relations is known as
attachment theory.
Attachment theory (John Bowlby)
= the idea that all humans have an innate tendency to develop strong affectional bonds
and that threats to these bonds result in psychopathology. To maintain proximity to
attachment figures, infants develop internal working models. The internal models of
threatening actions influence one’s susceptibility for dissociating experiences and
feelings (aggression, anger, vulnerability) linked to them.
Internal working models = representations of one’s interactions with attachment
figures that allow for prediction of what type of actions will increase the possibility of
maintaining proximity vs. of what types will threaten the relationship.
Internalization
4
