Modalities (1)

road sign illustrating psychotherapy as a way to deal with problems

Psychodynamic / psychoanalytic

Psychoanalysis which was created by Sigmund Freud, and Psychodynamic therapy, which was developed later, both incorporate various approaches enabling clients to bring their true and unconscious feelings to the surface.

Freud believed that many neuroses were of a sexual nature. Defence Mechanisms were developed to deal with consciously unbearable ideas and Dream Analysis or Free Association, uncovered the unconscious motivations. He detailed five psychosexual stages, focusing upon the first six years of life. Freud’s view of the personality was tripartite , consisting of the Id (primal urges), the Ego (preconscious and conscious) and the Superego (self imposed moral code).

Ego Psychology was developed mainly by Erik Erikson, Anna Freud and Margaret Mahler.

They focussed attention upon the Ego, as the central organising system, with treatment directed towards strengthening the Ego in relation to reality. Mahler also developed Objects Relations Theory, along with others including Melanie Klein and Heinz Kohut. They emphasised relationships between the self and objects as the major principle in people’s lives.

Psychoanalysis is a dynamic system of therapy but remains an interactive process between the therapist and client with Transference, Countertransference and Resistance seen as key concepts to success.


Alfred Adler ( 1870-1937 ) developed Individual Analysis therapy and was also a major contributor to the Psychodynamic approach. He believed that people are innately creative, self determinant and that social interests shape their development.

Personality is understood holistically and teleologically, as all human behaviour has a purpose and where a person is striving to go, is more important than from where they came. Social interest, or Gemeinschaftsgefuhl, was one of his most important concepts. This refers to an individual’s awareness of being part of the human community and how they deal with their world. As social interest increases, a person’s innate feelings of inferiority will decrease, but problems arise when feelings of inferiority persist and this could often be through early life experiences.

Adlerian therapists use early recollections as a diagnostic tool, along with family constellation and birth order. The client’s subjective frame of reference is taken to examine mistaken or conflicting goals and faulty assumptions. New patterns of behaviour are experimented with and there is a focus on re-education of the individual to live in society as an equal.


Carl Rogers (1902-1987) developed Person-Centred therapy in four stages, between the 1940s and 1980s. It is a humanistic approach that trusts in the client’s ability to move forward and to have the desire to achieve self-actualisation. People are seen as having an innate capacity to become fully functional and to have the ability to direct their own lives.

Rogers emphasises the relationship between the therapist and the client as prime determinants as to the therapy’s outcome. The therapist is there to provide an atmosphere of safety and trust, through the journey shared by them both, into the phenomenal world of the client. There are three important aspects to the therapist’s approach; congruence, unconditional positive regard and accurate empathic understanding. The therapist serves as a model of a genuine, if fallible human being, as well as a guide through their mutual journey.

Techniques are secondary in this style of counselling to the therapeutic relationship between client and therapist. By adopting an open and caring stance in the relationship, the therapist makes it possible for problems to be safely explored, client facades to be breached and for the client to become empowered to direct their own life.

Transactional analysis

Eric Berne (1910-1970), was the originator of Classical Transactional Analysis (TA). Other schools include Redecision created by Bob and Mary Goulding, which combines TA with Gestalt and Cathexis with Jacqui Schiff, which focuses on regression and reparenting.

In TA the contract between client and therapist, detailing the client’s goals, is paramount. It is believed that people decide their own destiny and have the power to change their internal scripts, or unconscious life plans, determined during childhood. People are seen as basically okay and capable. Each person has three ego states; Parent, Adult and Child, which make up their personality and thus determine how they react to a given situation. The Parent state contains attitudes and beliefs mainly acquired from one’s own parents, the Adult state gives direct responses to the current reality and problem solves and the Child state has needs, wants and feelings acquired during childhood.

Important concepts in TA include Strokes, which are a form of recognition needed for psychological development, Rackets, which are learned and inauthentic feelings and Games played by clients, which interfere with their growth. TA is a theory of personality development which provides techniques for clients to make changes, through self understanding.

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