Mostrando entradas con la etiqueta psychoanalysis. Mostrar todas las entradas
Mostrando entradas con la etiqueta psychoanalysis. Mostrar todas las entradas

domingo, 10 de agosto de 2014

Reading evidence for Psychoanalysis and Psychodynamic Psychotherapy


A review of meta-analyses of studies testing and comparing psychoanalysis and psychodynamic psychotherapy.


These are publicly available studies and people interested in the subject can go ahead and read them, but if one is not used to reading them with a critical mind and at least a basic knowledge of statistics and research methodology, the author/narrator of the video guides you through it all.

Most interesting are, for example, the effect size of long-term psychoanalytic therapies (PsAT) for mild and moderate symptoms (.78) versus severe personality symptoms (.94) which are established as the most difficult to treat. 

Another result is that CBT, drugs and Psycodynamic therapy were somewhat similar at end of the treatment period of the studies, but months after, particularly 4 months, patients relapse at a high rate for drugs and CBT. A conclusion from an analysis done in Scotland about 10 studies is that, "Psychological therapy services need to recognize that anxiety disorders tend to follow a chronic course and that good outcomes for CBT over the short term are no guarantee of good outcomes over the long term." This is also backed up by other, very interesting studies done in other countries.

On the other hand, other studies that test PsAT, show that the results of
Psycodynamic therapy are maintained over time and in fact increase.

sábado, 17 de marzo de 2012

Where did Freud’s ideas on the sexual ætiology of neurosis come from?

Freud’s early ideas on the aetiology of hysteria were not extracted mysteriously, but in fact they came in quite a pedestrian way:

(1) His female patients spoke them verbatim to him. By the way, not only to him, but also his contemporaries. The difference between them and Freud is, the majority of other clinicians were appalled and simply kept silence on the unbecoming subjects brought up by their patients and by the evidence itself.

(2) Then he searched his own recollections and uncovered repressed memories through clues from what he did not repress and what elders recalled from his youth, and sheer detective logic. He discovered that what the hysterics reported, through hypnosis first and free association later, coincided what he discovered in himself. Then he asked others, and started to treat literature (especially Goethe, Shakespeare and Æschylus) and found leads that suggested the same. Question: Why did he do such a thing, why did he follow this heterodox method? Because people were not straightforwardly telling him. The premise is that the products of human culture are products of the human mind, not exactly an outrageous assumption.

And another important reason, which is critical in this matter, is that he proceeded as archaeologists and anthropologists did. He also had Darwin’s example. Darwin didn't do experiments! He had his observational powers and sheer English logic. For that matter, neither do anthropologists, and a great part of research relies on methods other than laboratory experimentation. This is valid in science, and the behavioristic demand that it all should proceed from a lab is simply absurd and contradicted by actual scientific field studies. So Freud was right in his methods at this pioneering stage, and not being right every time is expectable. It would be nonsensical to point out the items in Freudian psychoanalysis that do not hold accurate in other research modalities, as evidence of the general wrongness of Freud’s deductions.

Now these are the early theoretical developments. As the psychoanalysts’ research went on subsequently, the concept of psychosexuality caught on, meaning not only what one would suppose, the relations of sexuality and psychology, but a modification of the concept of sexual ætiology. From early on, Freud was accused of “pansexuality”, in other words, that his theory of the entire human motivation was based on, let’s say camouflaged presentations of sexual gratification. The idea of psychosexuality is the notion that motivation is primarily the procurement of pleasure including sexual gratification. This is not a concession to prudishness, as sexuality is not put on par with other motvations, but instead sexuality must be seen as belonging in a continuum with instinctual-based modes of hedonic gratification. What Freud and his followers mean is that the motivation for cultural behavioral developments such as generosity, artistic sensibility, writing, teaching, driving vehicles, or any other one may think, are not motivational autonomies, but derivations from basic biological drives.

The fact that our cultural behavioral achievements are derivatives of biological drives, may or may not be true, but this is a far cry from “pansexuality”. Yet another theoretical stage is when Freud proposed the categorization of sexual drives, on the one hand and ego-drives, on the other, i.e., drives directed towards the preservation of the species versus drives directed towards the survival of the individual. This placed Freud further even from pansexualism. Freud’s last theoretical arrangement was the opposition Eros and death instinct. This is, the duality of the drives in favor of life and those in favor of the dissolution of life. This has not been accepted by all psychoanalysts, some rejecting it in favor of Freud’s previous conception, others discarding it altogether, and yet others modifying the understanding of it.