Theory Application
Introduction:
In introducing the main assumptions and tenets of both psychoanalytic and cognitive-behavioral theory it is important to account for the underlying principles that each is built upon. In order to contrast and compare these basic principles and how they focus on the underlying changes that are evident in the clients there is a need to develop an effective method for considering the cases that are available. The challenge in doing so is indicated by the underlying tenets of each theory. In regards to psychoanalytic theory, there is a need to understand the unconscious mental processes that occur. In cognitive-behavioral theory, on the other hand, the importance lies rather in the ability to link together observable behavior with the mental processes that create them. These principles present the major considerations that should be given to each of these theories.
Psychoanalytic therapy is primarily concerned with the development of psychological processes. These methods attempt to utilize various inferences that were made by Sigmund Freud regarding the underlying makeup of the human psyche. There inferences were generally geared towards attempting to understand the mind of the individual in regards to the processes that resulted in their personalities and unconscious processes that happen in the mind. One of the major tenets of psychoanalytic theory is that it attempts to understand psychological processes through the analysis of childhood experiences and other events that might have occurred early in the subject's life. It also attempts to account for the underlying sexual processes that impact personality as well as the aggressive tendencies that underlie these processes. One of the major strengths of psychoanalytic therapy is the capability that it provides in understanding why different people react in different ways. This shows the extent to which this form of therapy is based on the cognitive processes of the individual and the ability to distinguish these processes based on particular judgments concerning the early development of their personalities. “Psychoanalysis is primarily concerned with subjective events, which are known directly only to the experiencer (and only partially even to her or him) and which can be known to others only through inferences from what is observer” (Bucci, 2000, p. 2). Application of techniques to effect change in psychoanalytic models will therefore be geared towards those thoughts or personality traits that are outside the bounds of conscious understanding. This is a major strength of this approach in psychology. One of the major accomplishments of Freud's theory was that it was able to account for the “operation of mental processing outside of awareness” (Bucci, 2000, p. 6). The underlying construction of though processes and the relationships that different ideas or concepts have to one another and the importance these relationships are given in the minds of the subjects are essential to account for in this type of therapy. The theory therefore demonstrates that “it is not the dimension of awareness or lack thereof that is most significant in understanding psychic functioning, but the form and organization of thought” (Bucci, 2000, p. 6). Psychoanalytic theory is therefore concerned with the ability to better understand the underlying causal factors behind specific personality disorders and other psychological processes.
Cognitive-behavioral therapy, on the other hand, focuses primarily on the underlying processes that determine specific physical behaviors and changing those processes to promote desired behaviors and limit those that are not wanted. One of the major positions of this model is therefore that the underlying psychological processes of an individual can be observed, changed, and adapted in order to effect the observable behavior. This is due to the fact that behaviors, within this model, can be understood as the result of various outcomes of learning processes. This type of therapy is therefore used to treat both psychological and physical disorders. The application of cognitive-behavioral approaches is mainly to develop a way to effectively determine and alter the behaviors of the subjects. This is done through various physical and nonphysical methods. Although this form of therapy might utilize physical techniques such as breathing or meditating in order to promote relaxation, it is “theoretically unified by principles of learning theory and information processing” (Beck, 1998, p. 64). This demonstrates an entirely different approach in how this method views the point of change in the results of client's mental and physical behaviors. The major steps in outlining and developing methods to treat mental or physical illnesses within cognitive-behavioral therapy begin with first identifying the behaviors that are deemed critical to alleviating specific problems. Then it is essential to determine whether these behaviors are causing issues because they are occurring too often or not often enough. In determining a baseline value of these behaviors through analysis of specific factors such as intensity, duration, and frequency of problems the therapy model can help to provide insight into the realities of the patient's physical and mental ailments. Finally, applying these findings to whether the behavior was seen to be in excess or in deficit is understood as being the most important factor that can provide solutions to the problem.
Summary of Cases:
In developing a brief summary of the two cases selected the major ideas and concepts associated with each will be highlighted. Furthermore, the theories that have been chosen to be applied to each case demonstrate the way in which they can be understood through application to specific clinical issues. While the use of psychoanalytical theory will be applied to the case of Markieff in an attempt help him with the physical and mental challenges that he faces the case of Laura will utilize cognitive-behavioral theories in order to better establish the extent to her psychological condition.
The case of Markieff presents the oldest boy in a family of six children who was inured playing basketball. Due to his average grades, he was making an attempt to help his family with their finances by playing professional basketball. After being alienated by many of his family and friends after his accident, and expressing sorrow over the fact that he had been looked up to, Markieff seems to be developing depression and maybe even suicidal thoughts. This demonstrates the need to establish the underlying conditions that he is experiencing. The application of psychoanalytic therapy in this case can help to get to the underlying root cause of his mental anguish. Through analysis of his various psychological processes and questioning him about his past and childhood, a better idea of how to establish his current mental health status can be achieved.
The case of Laura presents a similarly young individual who seems to be having issues regarding their future career, opportunities, and dreams. Having achieved a PhD, she is having difficulty finding a job. The major issue is not simply that she was able to achieve so much, but that her family seems to have made sacrifices in order for her to do so. While she might want to go home, she seems to be reticent to do so due to the fear of letting down her family and community. The level of certainty that she is facing has presented her with the onset of major anxiety and fear regarding her future. These are the essential characteristics of her case. The use of behavioral therapy, to not only better understand the underlying processes that are affecting her behavior, but to also provide her with a source of alleviation from her concerns will be adapted in this case. In reviewing the fears and concerns that she is going through and correlating these fears with specific actions, this form of therapy can help to provide insight into the potential causes of her underlying emotional responses as well as help her to develop new behaviors in order to alleviate her stress.
Application of Theories:
Markieff:
In applying the theories to each case the results will help to explain what can be considered the primary issues that are faced by the clients. Developing the application of techniques for Markieff will involve the establishment of the basic principles that underlie psychoanalysis to his case. One major problem that can be seen in the case of Markieff is the depression that he is feeling due to the injury that he has sustained and the pain that it causes him. This seems to be an important issue that has led to the further development of mental issues concerning his predicament. Another major problem that can be seen in this case is the fact that he is having thoughts of self-harm. In applying psychoanalysis to the case these will be the major factors that are focused on.
For this reason, it is important to establish the techniques associated with each theory that can help to alleviate these challenges. The primary techniques that the theory that has been developed would likely recommend include the establishment of counseling sessions as well as analysis of the personal development of the client's childhood. Psychoanalytic theory would likely recommend uncovering the unconscious, instinctual, and biological drives that motivate his need to feel as though he is responsible for his younger siblings. This theory would define his actions as being the result of various processes that he does not have control over. Rather, they are the result of the construction of his personality over his lifespan.
Laura:
For the case and theory combination that has been established regarding Laura it is important to analyze her specific situation in relation to the context of cognitive-behavioral theory. For this reason, it is essential to provide an analysis that can help to explain the primary problems associated with the case. One major problem that can be seen in the case of Laura is the onset of her panic attacks, which began when she was in Graduate School. This seems to be an essential problem to be alleviated as it presents the major factor that seems to be associated with her psychological issue.
The availability of techniques belonging to the cognitive-behavioral approach presents the need to establish those that would be most effective. The techniques that this particular theory would likely recommend using with the client is the observation of her behavior in order to get an idea of the relationship that these behaviors have with the mental processes that they are associated with. By taking part in both cognitive restructuring, in order to redevelop her mental images and attitudes alongside behavioral activation, which could help her to enjoy the time that she has available to her instead of spending it worrying about things that are out of her control. The reason why this particular theory has been selected for Laura is the fragility of her mental states and the level to which her behavior seems to be a factor in it. The techniques that the cognitive-behavioral theory would likely apply for therapy would be the establishment of analysis regarding the underlying mental processes that lead to the physical manifestations of her panic attacks.
Problems and Difficulties Encountered:
After having applied these two selected theories to their designated cases, the one that I would feel the most confident or comfortable using is the cognitive-behavioral approach. I would be much more comfortable in applying the cognitive-behavioral theory to the case of Laura than the psychoanalytic theory to the case of Markieff. This is due to the ability of psychoanalysis to point out the physical manifestations of various psychological processes. Within psychoanalysis, the focus is mainly on the underlying psychological processes that would be going through his head. These processes would likely be difficult to determine without long periods of counseling. Furthermore, the establishment of relevant data regarding the manifestations of these unconscious processes is difficult to determine. In Laura's case, it would be much more efficient to apply cognitive-behavioral therapy, as there are specific observable behaviors that can be used in order to help focus the aims of the therapy sessions.
In looking at which one appears to have the most likely chance of a successful outcome with the selected client it is apparent that this would also be the case with the cognitive-behavioral approach. Cognitive-behavioral therapy would likely be much more effective in helping both clients. In the case of Laura, it is evident in the physical manifestations of her anxiety that she has major issues regarding her roles and responsibilities. Through changing specific lines of thought or rational decisions that she has made these symptoms can likely be eliminated. This demonstrates the major strength of cognitive-behavioral therapy. Psychoanalytic theory, on the other hand, would have much less observable success. This would make it difficult to apply this theory to either case. Furthermore, in the case of Markieff, it would seem evident using a cognitive-behavioral approach that he could potentially alter many of the underlying assumptions that he has about his role in his family and the capacity that he has to be a role-model. This could likely lead to perceivable change in his attitudes, perceptions, and actions.
Once the selected theories had been applied to the actual cases, it was evident that there were various difficulties that would be inevitably encountered. The major difficulty was in applying the psychoanalytic approach to the case of Markieff. The case itself does not provide in-depth information regarding his past or the underlying assumptions that he has regarding his position in family and school. This made it much more difficult to apply the psychoanalytic process to develop a therapeutic model in this case. A major critique that has been levied against Freud's psychoanalytic model is that it relies heavily on the underlying psycho-sexual processes of the individual. In many cases the manifestations of these problems are difficult to determine. The ideas presented by the notion of the unconscious are considered fairly metaphysical. For this reason, it has been argued that psychoanalytic theory itself is too simple to explain the abstract complexity of the human mind. In regards to the cognitive-behavioral approach, a major challenge is to develop a method to ascertain the major differences between the actual mental processes that are causing the behaviors and the onset of the behaviors themselves. In this sense, it is difficult to establish grounds to justify the various considerations that are made regarding the specific mental processes that the subjects going through this type of therapy.
Results:
The experience of applying these theories to specific cases was able to provide me with important insight regarding the most effective theories and my personal ability to leverage them for specific purposes. While I had assumed that psychoanalytic practices would be able to provide helpful insight into the underlying unconscious thoughts that lead to cognitive processes. However, it proved much more difficult to apply this theory without the benefit of having the patient for further in-depth questioning. This seemed to be a major weakness of this approach. It is difficult to develop a strong framework for psychoanalysis with simple descriptions or summaries of cases. Instead, this form of therapy relies heavily on the ability to develop a line of questioning or analysis that can help to delve deeper into the sub-conscious processes of the patient. In this case, there was simply not enough information to develop a coherent rationale regarding Markieff's unconscious thoughts.
In regards to the cognitive-behavioral theory, it is evident that I am much more adept at discerning the possible connections between mental processes and physical behaviors. This is due to the objective nature of the behaviors that are being observed. This helps to provide a framework for the development of further insight into the specific logic of the patient's thought processes. Through the development of these insights a more cohesive understanding of the relationship between thought and action can be understood. This helped to provide a better framework for understanding the issues that were relevant to the cases that were analyzed. Through analysis a more effective means of of overcoming the challenges that the patients are facing can be achieved.
In looking at whether or not the research into these theories has provided any claims of effectiveness or success there were various points of view that became evident. These included claims of success for both theories. The research provided various claims regarding the effectiveness or success of the theories. In regards to psychoanalysis the major claim of success is in its ability to provide insight into the various unobservable processes that were going on in the minds of the patients. The major success of psychoanalysis is therefore in its ability to understand the “operation of mental processing outside of awareness” (Ehde, 2014, p. 157). In this way, the major success of this theory is in the capacity that it has to account for the nonphysical manifestations of unconscious behaviors.
The theory's effectiveness is therefore predicated on its ability to provide insight into these processes, whereas other theories fall short in their ability to account for all but the physical characteristics of their patient's behaviors. In regards to the adoption of cognitive-behavioral theory it is apparent that the major strength is in the adaption of observable processes to the mental awareness of these individuals and their inner psychological rationales The effectiveness cognitive-behavioral therapies, therefore, lies in its ability to treat issues such as pain. In this sense, it is evident that this method could be effectively applied to Markieff's case due to his injuries. It is for this reason that “cognitive-behavioral therapy has become a first-line psycho-social treatment for individuals with chronic pain” (Ehde, 2014, p. 153). The major strength is therefore in developing applicable methods to those that are suffering from observable symptoms.
References
Beck, R. & Fernandez, E. (1998). Cognitive-Behavioral Therapy in the Treatment of Anger: A Meta-Analysis. Cognitive Therapy and Research, Vol. 22, No. 1, 63-74.
Bucci, W. (2000). The Need for a “Psychoanalytic Psychology” in the Cognitive Science Field. Psychoanalytic Psychology, Vol. 17, No 2, 203-224.
Ehde, D.M., Dillworth, T.M., & Turner, J.A. (2014). Cognitive-Behavioral Therapy for Individuals With Chronic Pain. American Psychologist. Vol. 69, No. 2, 153–166.
