Large effectiveness: 1.38
What is Psychoanalysis?
1. Example: if a patient feels guilty, the analyst might explore what the patient has been
doing or thinking that causes the guilt, but not reassure the patient not to feel guilty. The analyst might also explore the identifications with parents and others that led to the guilt.
2. 1890s therapy
3. 50 minute sessions 4-5 times per week
4. Therapist is sitting just behind and out of sight of patient
5. Patient says free associations, fantasies and dreams
6. Therapist infers the unconscious conflicts causing patient’s symptoms and character
problems
7. Therapist confronts patient’s pathological defenses to gain patient insight8. Applicable to psychotic and near-psychotic patients.
8. These supportive therapy techniques include discussions of reality; encouragement to stay alive (including hospitalization); psychotropic medicines to relieve overwhelming depressive affect or overwhelming fantasies (hallucinations and delusions); and advice about the meanings of things (to counter abstraction failures).
9. A person’s development is determined by often forgotten events in early childhood, rather than by inherited traits alone
10. Human behaviour and cognition are largely determined by irrational drives that are rooted in the unconscious
11. Attempts to bring those drives into awareness triggers resistance in the form of
defense mechanisms, particularly repression
12. Conflicts between conscious and unconscious material can result in mental disturbances such as neurosis, neurotic traits, anxiety and depression
13. Unconscious material can be found in dreams and unintentional acts, including mannerisms and slips of the tongue
14. Liberation from the effects of the unconscious is achieved by bringing this material into the conscious mind through therapeutic intervention
15. The “centerpiece of the psychoanalytic process” is the transference, whereby patients relive their infantile conflicts by projecting onto the analyst feelings of love, dependence and anger.
Evidence:
1.27 large effect: across all outcomes in complex mental disorders (de Maat, de Jonghe, de Kraker, Leichsenring, Abbass, Luyten, & … Dekker, 2013)
1.52 large effect: improved symptoms in complex mental disorders (de Maat, de Jonghe, de Kraker, Leichsenring, Abbass, Luyten, & … Dekker, 2013)
1.08 large effect: improved personality characteristics in complex mental disorders (de Maat, de Jonghe, de Kraker, Leichsenring, Abbass, Luyten, & … Dekker, 2013)
1.46 large effect: across all outcomes in complex mental disorders at follow-up (de Maat, de Jonghe, de Kraker, Leichsenring, Abbass, Luyten, & … Dekker, 2013)
1.65 large effect: improved symptoms in complex mental disorders at follow-up (de Maat, de Jonghe, de Kraker, Leichsenring, Abbass, Luyten, & … Dekker, 2013)
1.31 large effect: improved personality characteristics in complex mental disorders at follow-up (de Maat, de Jonghe, de Kraker, Leichsenring, Abbass, Luyten, & … Dekker, 2013)
de Maat, S., de Jonghe, F., de Kraker, R., Leichsenring, F., Abbass, A., Luyten, P., & … Dekker, J. (2013). The current state of the empirical evidence for psychoanalysis: A meta-analytic approach. Harvard Review Of Psychiatry, 21(3), 107-137.
How To Therapy 