132 - Jonathan Shedler: Freud, Psychoanalysis, and Psychodynamic Psychotherapy
Aug 25, 2023
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Jonathan Shedler, Clinical Professor, and Robinson discuss the clinical side of psychoanalytic theory, its evolution, and misconceptions. They explore the distinction between psychoanalysis and psychotherapy, the role of free association and transference, and the effectiveness of psychodynamic therapy. They also delve into different theories in psychoanalysis, the concept of two-person psychology, and the contrast between psychodynamic therapies and instruction manual therapies. A fascinating exploration of mental health treatment!
Psychoanalysis is a flexible approach that focuses on internal conflicts and co-creating experiences in relationships.
Contemporary psychoanalysis incorporates various theories and techniques to cater to individual needs.
Psychodynamic therapy prioritizes deep understanding, exploration of patterns, and transforming internal and relational dynamics.
Deep dives
Psychoanalysis: A rich body of knowledge, range of treatments, and a unique way of thinking about mind and behavior
Psychoanalysis encompasses three key components: a rich and complex body of knowledge that has developed for over a century, a range of treatments informed by this knowledge, and a unique way of thinking about mind and behavior. The term psychoanalysis is used to refer to an extensive literature and a range of treatments, plural, rather than just one specific approach. It is also recognized as a certain sensibility or attitude towards understanding and treating the mind. Psychoanalysis emphasizes the recognition that humans are not fully aware of their own minds and operates on the idea that through self-exploration and gaining insight, individuals can become more whole, freeing themselves from repetitive patterns. This approach focuses on internal conflicts, relational dynamics, maintaining a coherent sense of self, and how individuals co-create experiences in relationships. Psychoanalysis is not limited to a specific school or set of theories, but rather incorporates a wide range of perspectives to cater to the unique needs and experiences of each individual.
From Freud to Contemporary Practice: Evolution and Misconceptions
The word psychoanalysis is often misunderstood and equated with Sigmund Freud's work from over a century ago, which creates misconceptions about the field. However, psychoanalysis has evolved significantly since then, with major changes in theories, techniques, and perspectives. Freud's ideas have become deeply ingrained in our understanding of human psychology, even if we do not recognize their origins. The contemporary practice of psychoanalysis incorporates various theories and approaches, such as drive theory, ego psychology, object relations, self-psychology, and relational psychoanalysis. These different currents of thought address elements like drives, desires, conflicts, relational patterns, and the construction of the self. Rather than adhering strictly to a single theory, therapists focus on understanding and addressing the unique psychological preoccupations and challenges of each patient. The aim is to bring about meaningful growth and changes in individuals' lives by helping them gain insight, navigate internal conflicts, and develop a realistic and coherent sense of self.
Psychodynamic Therapy vs. Instruction Manual Therapies: Contrasting Approaches
Psychodynamic therapy stands in contrast to what is known as instruction manual therapies, which are often advertised as evidence-based therapy. Instruction manual therapies typically follow a standardized approach outlined in a manual and aim to be brief, lasting only eight to twelve sessions. However, psychodynamic therapy emphasizes a more flexible and individualized approach. While instruction manual therapies focus on meeting predetermined outcome goals within a limited time frame, psychodynamic therapy prioritizes deep understanding, exploration of patterns, and the transformation of internal and relational dynamics. The assumption that following a strict manual leads to better treatment outcomes is unfounded, as there is no scientific evidence supporting such claims. Psychodynamic therapy recognizes the complex nature of human experiences and focuses on tailoring treatment to the unique needs and goals of each individual.
Psychodynamic Therapy and Unconscious Patterns
Psychodynamic therapy recognizes that individuals acquire patterns of behavior and ways of relating to others fairly early in life. These patterns, often invisible to us, shape our lens through which we view ourselves and others. In therapy, these patterns become manifest in the relationship between the therapist and patient, creating an opportunity for recognition, discussion, understanding, and reworking of these patterns. By bringing these patterns to light, individuals can break free from self-defeating behaviors and repetitive patterns, allowing for personal growth and healthier relationships.
Evidence-Based Therapy and Duration
Evidence-based therapy often focuses on short-term symptom relief, but the research shows that for meaningful psychological change to occur, therapy typically takes about six months to a year. However, many evidence-based therapies are much shorter in duration and fail to address the deeper issues that individuals may be facing. Research also reveals that the effectiveness of these therapies is often exaggerated, with the majority of people not experiencing meaningful improvement. In contrast, psychodynamic therapy has been empirically shown to be as effective as the so-called evidence-based therapies, providing a more holistic approach to addressing relational, emotional, and personal growth needs.
Jonathan Shedler is Clinical Professor in the Department of Psychiatry and Behavioral Sciences at the University of California, San Francisco and a faculty member at the San Francisco Center for Psychoanalysis. He is a psychologist and psychotherapist. In this episode, Robinson and Jonathan discuss the clinical side of psychoanalytic theory. They begin by describing just how different contemporary practice is from its beginnings with Freud a hundred years ago, before detailing how psychodynamic therapy compares to other forms of treatment for mental illness.
Robinson Erhardt researches symbolic logic and the foundations of mathematics at Stanford University. Join him in conversations with philosophers, scientists, weightlifters, artists, and everyone in-between.
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