Brief Lecture Notes for Unit 11
Of the many approaches to counseling and therapy that exist, three influential models will be discussed: the psychodynamic, phenomenological, and behavioral schools. Not all forms of counseling belong to one of these three schools. Two other influential schools of thought, the cognitive and the biomedical, have had great impact on contemporary counseling practices but, in the interests of time (and to keep cognitive overload to a minimum for you), will not be covered in this course. If you're interested, consider signing up for PSY 309 in the spring.
You need to know five things about each school of thought. These represent ways in which the schools of thought can be meaningfully compared and contrasted:
1. The key idea (or ideas) that underlie this approach
2. What this school of thought says about the structure or nature of human personality
3. The source of emotional problems (known as the question of etiology)
4. The general solution to the problem, or the general outlines of the therapeutic approach associated with this school
5. Significant criticisms of this school of thought, particularly as might be put forth by other, competing schools of thought
The Psychodynamic School
Breaking this word into its component parts should give you an idea what this is going to be about. "Psycho" (as in psychology) refers, of course, to the mind or to internal mental processes. "Dynamic" means, in this context, conflict - often explosive conflict (the word dynamite comes from the same root). Hence, this school of thought emphasizes internal conflicts within the personality or between different aspects of the self.
1. The key idea in this school of thought is that of unconscious conflict or unconscious determinism. Most of who we are, according to this approach, is fixed early in life (perhaps as early as age five) and controlled largely by factors outside of our conscious awareness. Under normal conditions, insight into our true motives and emotional responses is limited; we are blind to much of the reality of who we are, and this fact shapes our behavior in ways we only infrequently recognize.
2. The structure of personality, as seen from within this school of thought, involves two different elements.
a. The first involves the notion of three different levels of consciousness: the conscious mind (what you are currently thinking, feeling, experiencing); the preconscious mind (memories that are not in current awareness but can be readily recalled); and the unconscious mind (memories that cannot, under normal conditions, be brought to awareness directly or voluntarily). Without too much distortion, you might equate the conscious mind with STM (remember Unit 7? I hope, since the final exam is cumulative?) and the preconscious mind with LTM. Unlike in the Atkinson-Shiffrin model, however, these two parts of the mind together comprise only about 10% of one's total mental contents. Most of the mind, from the psychodynamic perspective, is unconscious.
b. The other involves three personality structures: the id, ego, and superego.
(1) The id is the repository of the instinctive (inherited or innate) drives, motives, needs, and emotions; as the original system of the personality, it operates on the basis of the pleasure principle ("is this pleasant or unpleasant? do I want this?") and attempts to meet needs by way of the primary process (essentially equivalent to wish fulfillment or fantasy; note that the id, like a young child, has no capacity to distinguish between fantasy and reality, and hence no effective means of meeting its own needs).
(2) The ego is the rational, or "executive", part of the personality; it operates on the basis of the reality principle ("is this realistic/rational or unrealistic/irrational? will this course of action be effective?") and attempts to meet needs by way of the secondary process (essentially equivalent to developing and implementing plans and strategies and goals). The ego, unlike the id, can tolerate delayed gratification and can make short-term sacrifices in the services of long-term gains.
(3) The superego consists of the conscience and the ego ideal or idealized self; it operates on the basis of the moral principle ("is this right or wrong? can this action be ethically justified?"). Annoyingly for people like me who value intellectual symmetry, there is no tertiary process... but there should be, for the sake of completeness.
It's not unusual for there to be conflict between the goals, demands, and action strategies of the different personality structures. (Id: "I'm starving! Steal some food for me!" Ego: "But if I did that, you'd go to jail, and you wouldn't like that." Superego: "And besides, stealing is wrong.") This produces anxiety, and it's one of the ego's main jobs to handle (attempt to moderate, reduce, manage, or eliminate) anxiety. Oftentimes it can do so. When the ego cannot successfully manage anxiety, the resulting anxiety state is said to be traumatic. Some people are better able to manage anxiety than others, a personality variable known as ego strength.
3. Personality difficulties, from the standpoint of this school of thought, stem from the repression of anxiety (remember our discussion of repression in Unit 7?). Repression results from traumatic anxiety and has a short-term benefit (protects the integrity of the ego), but is problematic because it is self-maintaining. Memories and motivations that are repressed do not vanish, but continue to influence present-day behavior in indirect, symbolic, and often symptomatic ways. We may often be unaware of these elements of our behavior, and even when aware of them may well be at a loss to explain them.
4. If repression is the problem, then finding a way to undo or eliminate repressions is the heart of the solution. Access to unconscious material can be gained through free association, analysis of dreams, and analysis of transference reactions.
The latter represent a projection of unconscious, repressed motives onto the "blank slate" of (in this case) the therapeutic relationship. Any strong but inexplicable emotional reaction of any sort (e.g., to a person, group, event, experience) is presumably a transference reaction. Transference reactions are universal (remember the first "crush" you had on someone in middle school? or the way you respond, for good or ill, to authority figures today?), but are frequently problematic (impede reality-based responses). They can be recognized by their intensity and irrationality and general imperviousness to conscious, voluntary control. The therapist, of course, needs to keep her/himself from manifesting corresponding (counter-transference) reactions, but needs instead to remain neutral and analytical in the therapeutic process.
Elimination of repression leads to insight (awareness of the original unconscious roots of present-day problems) and catharsis (an emotional "reliving" of early childhood conflicts), which together give the individual an opportunity to work through old problems on a conscious level, this time with the advantages of adulthood (e.g., greater ego strength, a larger set of potential solution approaches or strategies).
5. This school of thought can be criticized in numerous ways. It relies heavily on unobservable, hypothetical constructs (the unconscious mind is, of course, unobservable by definition). As a form of therapy, it is lengthy and costly, and tends to benefit mostly people with certain characteristics (introspection, verbal skill, a moderate level of psychological disturbance). It is (rightly or wrongly) pessimistic about human nature, may diminish human responsibility and accountability, and (at least in the original formulation) is rather misogynistic.
The Phenomenological School
The term "phenomenology" refers to subjective experience. This school emphasizes respect for how individuals see or experience the world (the individual's "internal frame of reference").
1. As above, the key idea in this school of thought is respect for subjective experience and the internal frame of reference, counseling nondirectiveness, and the development of congruence (see below).
2. The structure of personality involves a distinction between aspects of yourself that you acknowledge, attribute to yourself, or label/identify as being "part of you" (self concept or subjective self), versus those which you deny, distort, fail to recognize, reject, or explain away as "not part of you". To the extent that your self concept is an accurate reflection of your objective self or who you really are in totality, you are congruent. To the extent to which your self perceptions are distorted or limited -- you are in denial about who you really are -- you are incongruent. There are degrees of congruence for the same reason that there are degrees of mental health (as noted in Unit 10); most of us, presumably, are moderately congruent. In simpler terms, congruence means knowing yourself well or fully, or being open to all aspects of experience.
3. Personality difficulties stem from incongruence, which in turn result from so-called conditions of worth -- statements (e.g., from parents to children) that indicate you have value only if you meet certain conditions ("you are worthwhile only if you..." or "I won't love you unless you..."). Such statements are external at first but later become internalized, producing inward incongruence as a way of coping with personal failure to meet the standards or conditions.
4. Enhancement of congruence is not a function of technical knowledge (what the therapist knows), but personal attributes, traits or qualities (who the therapist is). A person who is in relationship with another who has the necessary properties will automatically become more congruent. Essential properties of an effective people-helper include (naturally) congruence (you can't help others become more congruent than you are yourself), genuineness, empathy, and unconditional acceptance of others.
5. Critiques of this school of thought include the notion that it is too unduly optimistic about human nature, that it is too nondirective, that it can foster moral relativism or moral indifference.
The Behavioral School
We've already learned much about what behaviorism is (Units 1 and 6), so those fundamentals won't be repeated here, only details of how behaviorism can be applied to the therapeutic enterprise or context.
1. The key idea, not surprisingly, is one of situational or environmental determinism: behavior is caused by outward, not inward, factors (environmental contingencies, such as stimulus cues or reinforcers, as discussed in Unit 6).
2. There really is no way to talk about the "structure of personality" because "personality" refers to something inward and unobservable, something behaviorists are unwilling to countenance. Instead of focusing on "personality", these therapists focus purely on outward, observable, concrete behavior patterns.
3. Unlike the other two schools of thought, which presume that there are unique processes of development that underlie abnormal behavior, behaviorists would say that there is really no distinction between "abnormal" and "normal" behavior: all behavior is developed and maintained in the same way. Problem behaviors continue to exist because they are rewarded in some way, because they have never been adequately extinguished or counterconditioned, and so on: there is nothing special or different about abnormal behavior in this sense, no causes or processes that are different from those that determine normal behavior.
4. Behavior therapy relies on three significant steps:
a. Defining the problem -- and the goal, or desired change or solution -- in specific, measurable, observable, concrete, behavioral terms. (This is sometimes very easy to do, as when a client wants to stop smoking -- and sometimes very hard to do, as when a client wants to get over being depressed.)
b. Identifying the specific environmental (situational or stimulus) conditions that underlie, maintain, or reinforce the problem behavior.
c. Developing and implementing an intervention plan that changes the environment (adding or subtracting from the existing environmental contingencies), thus changing the behavior.
5. Criticisms include difficulties in applying the above program to problems that are vague, verbal, or clearly cognitive or affective (subjective) in nature; the problems of maintenance (it's easier to produce short-term than lasting long-term change) and of symptom substitution (getting rid of one problem, only to find that another problem has taken its place); and the reductionistic, mechanistic, and potentially dehumanizing nature of the behaviorist assumptions.
Overall Comparison and Contrast
I'm getting tired of typing, so let's use some abbreviations that will give my fingers a rest:
PSY = psychodynamic school of therapy
PHE = phenomenological school of therapy
BEH = behavioral school of therapy
Any two schools of thought have something in common that makes them different from the third one:
1. PSY and BEH are both deterministic and reductionistic, as compared to PHE's emphasis on human freedom and irreducible complexity.
2. PSY and PHE both emphasize internal (mental, unobservable) causes, including causes that are unique to psychopathology, as compared to BEH's emphasis on external (situational, environmental) causes that are universal in scope (equally explain "normal" and "abnormal" behavior using the same exact explanatory schema).
3. PHE and BEH emphasize the present (what a person is doing or choosing NOW) and find nothing unique or special about early childhood as such, while PSY places a strong emphasis on the past (early childhood influences) and the unique nature of the first years of psychosocial development.
A test of your understanding might be: Which of the three schools of thought do you favor the most? Least? Why? Opinions can sometimes be unfounded, but the lack of an opinion almost almost means that you don't yet understand well enough to have any feelings on the subject. Uninformed emotion can be dangerous, but uninformed apathy is fatal.