Principles of psychodynamic therapy

The term ‘depth psychology’ was introduced in 1910 by the Swiss psychiatrist Eugen Bleuler in his publication Die Psychoanalyse Freuds. Sigmund Freud first used the term in his publication Das Interesse an der Psychoanalyse in 1913, intending to distinguish his ideas from the psychology of conciousness which was dominant at that time (Pongratz, 1983).

Today, the term ‘depth psychology’ encompasses several different schools of psychotherapy, which are based on similar assumptions. The terms ‘psychoanalytically orientated psychotherapy’ or ‘psychodynamic therapy’ are generally considered synonyms. Psychoanalytically orientated therapy is based on the following assumptions:

• the significance of the unconcious for mental functioning and individual behaviour;

• the importance of drives for the determination of human behaviour;

• the importance of developmental phases during which libidinous energy, i.e. drives are variably expressed;

• the belief that symptoms are caused by conflicts determined by specific developmental phases; these symptoms in turn influence the manner in which an individual adapts to his environment;

• the concept of transference, by which the patient projects past emotions and experiences on the therapist, who then interprets the material.

Further common ground between the psychoanalytically orientated schools is discussed in more detail by Pongratz (1983), Greenson (1966) and Brenner (1955). This chapter uses the structural model suggested by Rapaport (1973), in which he distinguishes between several different theoretical aspects of psychoanalytic theory (Table 5.1) (Remschmidt, 1992; Remschmidt and Heinscher, 1988).