D171 TMA 01 Part 1: Compare and contrast how the psychodynamic and person-centred approaches to counselling understand the

person, and how these two approaches explain psychological distress experienced by individuals. The psychodynamic approach has its roots in Freudian psychoanalysis, dating back to the 1890s. Thus, it is one of the oldest counselling approaches, and has had many contributions and modifications since its conception by the father of modern psychology Sigmund Freud (Storr, 2001). In contrast, the person-centred approach is a recently emergent humanistic school of therapy, gaining prominence in the 1950s-60s, developed by the American psychologist Carl Rogers. Born of different historical eras and of different philosophical groundings, these approaches contrast in many ways. Yet, having trained himself as an analyst, much of the foundation of person-centred theory is built on psychodynamic concepts, thus comparisons between the approaches can be made (McLeod, 2008). In this essay I shall discuss the differences and similarities of these approaches, in the context of how they view the clients mental life and how psychological distress arises and is perpetuated by this psychology. (148 words) The basis of psychodynamic theory is that, as Wordsworth (1888) said the Child is father of the Man. Most psychodynamic approaches are centred around the concept that neuroses and relational difficulties are preceded by formative childhood experiences. Maladaptation develops early in life, is due to the introjection of parental images, is mostly unconscious and is the root cause of later discord. Psychodynamic therapies focus on revealing and resolving these unconscious conflicts that are driving their symptoms. Freud and his successors developed a dense conceptual framework to explain and interpret the causes of psychological distress (McLeod, 2008). Freud described three driving forces of the mind: the id (it), the ego (I) and the superego (above I). The id drives the person by creating unconscious impulses which seek discharge, a striving to bring about the satisfaction of instinctive needs subject to the observance of the pleasure principle (Freud et al., 1900). The ego describes the rational, partly conscious psyche, which copes with external world. It processes instinctual prompting from the id and is influenced and modified by the superego (the conscience), a bank of introjected parental images and societal rules and taboos. The superego is an agency within the mind that devotes itself to self-observation; deciding whether or not the ego is performing to the ego-ideal. Freud viewed mental life as a tug of war between the id and the superego, mediated by the ego (McLeod, 2008; Storr, 2001). Freud postulated that child development proceeded due to libidinal influences. He proposed biologically based stages of development as follows: oral, anal, phallic (Oedipal/Electra), latency and genital. He believed that over-indulgence or frustration of the needs associated with these regions results in fixation, which leads to a personality syndrome, e.g. anal retentive (McLeod, 2008; Storr, 2001). This theory of psychosexual development has since been rejected or modified by many of his successors in favour of a

relationship orientated theory. One such example is Erik Ericksons theory of psychosocial development, outlined in table 1. His theory emphasises the workings of the ego rather than the unconscious drives of the id and interpreted Freuds stages of development in a social context. Resolution of the central crisis of each stage results in development and movement to the next developmental task (Milne, 2010). Arrested development at a particular psychosexual/psychosocial stage results in psychological issues.

Table 1 Erik Ericksons stages of psychosocial development. Modified from Baucum et al. (2004)

Ego defence mechanisms are another aspect of child development central to psychodynamic theory. These defences are acquired as a means of coping with the relational challenges, frustration of needs and the unconscious family drama which occurs in early life. In later life, difficult or shameful desires, memories and emotions are controlled by employing these same defence mechanisms: repression (motivated forgetting), denial (motivated negation), projection (displacement outwards), displacement (redirection of impulses), reaction formation (asserting the opposite), sublimation (finding an acceptable substitute), regression (developmental retreat), projective identification and splitting (McLeod, 2008). These defences can be identified through the therapist-client transference relationship and interpreted to gain insight into the hidden feelings causing distress. Malans (1999) triangle of conflict illustrates this below.

Figure 1 Triangle of conflict (Malan, 1999)

Malans triangle of insight models the relationship between the cause and effect of psychological distress, and how it can be interpreted in the client-therapist transference relationship (figure 2). Psychodynamic theory maintains that the childhood episodes instigating psychological trauma need to be revisited to be overcome. Insight into these causative factors of distress is required for the client to develop a mature coping capacity (McLeod, 2008) - the individual will have the compulsion to repeat until the unconscious element is brought into consciousness (Storr, 2001).

Figure 2 Triangle of Insight (Malan, 1999)

In contrast to psychodynamic theory, the phenomenological approach of person-centred theory has relatively little to say about child development. There is major emphasis instead on experiential processes in the here and now over childhood experiences. Instead of a number of stages of psychosexual/ psychosocial development, Rogers

proposed that only two main needs must be fulfilled in human development: to become self-acutalised and to be valued by others. He believed that human nature is inherently good and is motivated by a drive to achieve one's fullest potential the base of his animal nature, is positive in nature is basically socialized, forward moving, rational and realistic. This is a stark contrast to Freuds view of a person primarily made up of instincts which would, if permitted expression, result in incest, murder and other crimes and in a constant struggle to hold these forces in check in a wholesome and constructive manner, rather than in the costly fashion of the neurotic"(Rogers, 1967). Whereas psychodynamic theory creates an image of the person troubled by internalised childhood objects and introjected images of parental figures, person-centred theory instead believes that childhood influences create internal values and self concepts. According to person-centred theory, development is blocked due to exposure to conditions of worth which may lead the person to become incongruent. A state of incongruence arises when the persons self concept is distorted or denied by exposure to the demands of others. These conditions of worth imposed upon the person, can result in them losing touch with their innate organismic valuing system, which under optimal circumstances aids the person towards self-fulfillment. When experiencing a state of incongruence, the person often has an external locus of evaluation, developed from exposure to parental opinions and conditions during childhood, and this is at odds with their personal self concept. The aim in person-centred therapy is to help the client rediscover their inner referent and to help them filter the world through an internal locus of evaluation, rather than the assimilated attitudes of others, aiding them in achieving autonomy. Clearly, the person-centred approach does not deny the fact that childhood experiences are the root of adult psychological distress as the psychodynamic approach insists. However, the focus in person-centred therapy is forward, towards fulfillment, rather than behind on past experiences as in psychodynamic theory (McLeod, 2008). (1,000 words) Part 2: Reflect on and write about which of the two models appeals most to you and why? I can see merits and weaknesses in both approaches. The psychodynamic approach has an extensive conceptual framework, and thus the psychodynamic therapist has many tools in their arsenal to help make sense of psychological suffering. However, I have gained the impression that Freud viewed people as little more than bags of neuroses, their ego struggling to keep their primal urges in check. He seemed to focus strongly on pathology and paid little heed to creativity, spirituality, philosophy or existentialism. I believe that there is much more to a persons mental life than he took into consideration and therefore this aspect of the psychodynamic approach sits uneasily with me. For this reason, on a personal level, the person-centred approach resonates more. I agree with Rogers assertion that common psychological issues arise mainly due to a persons

inability to express their true selves, for fear of rejection by their peers (Rogers, 1967). The empathic, accepting, unconditional positive regard of the person centred therapist is clearly something that too few of us experience in everyday life, and I can see how this relationship could be transformative for people experiencing common psychological distress due to life transitions. However, the paucity of theory available to the person centred therapist causes me to have reservations about whether this approach would be sufficient in cases of severe psychological trauma, or pathological disorders. In this context, an integrative approach appeals most. (233 words) References Baucum, D., Smith, C., Kagan, J., Segal, J., & Havemann, E. (2004). Kagan and Segal's Psychology: An introduction (9th ed.). Belmont, CA: Thomson/Wadsworth. Freud, S., Strachey, J., Freud, A., Rothgeb, C. L., & Richards, A. (1900). The standard edition of the complete psychological works of Sigmund Freud. London: Hogarth Press. Malan, D. (1999) Individual Psychotherapy and the Science of Psychodynamics (2nd ed.). Oxford: Butterworth-Heinemann. McLeod, J. (2008) Introduction to Counselling [Ed. D. Langdridge]. Maidenhead/ Milton Keynes: Open University Press/ The Open University. Milne, A. (2010) Understand Counselling (4th ed.). London: Hodder Education/ Hachette UK. Rogers, C. R. (1967). On becoming a person: a therapist's view of psychotherapy. London: Constable. Storr, A. (2001) Freud: A Very Short Introduction. New York: Oxford University Press. Wordsworth, W. (1888) The Complete Poetical Works. London: Macmillan and Co., 1888; Bartleby.com, 1999. www.bartleby.com/145/