Compare and contrast the psychoanalytic and cognitive behavioural approach to the aetiology of psychological distress. When discussing the psychoanalytic model also make reference to psychodynamic approaches that developed out of psychoanalytic theory.

 

Psychoanalytic approaches have their roots in Freud’s model of personality development. Where he described human nature as deterministic and humans being driven by irrational forces, biological and instinctual drives which in turn lead to psychological distress. The emphasis was on the unconscious as the root of behavioural governance. Cognitive behavioural approaches on the other hand, seek to identify cognitive processes leading to negative thoughts and behavioural patterns which cause psychological distress. Psychoanalytic therapy typically is a long-term process often requiring years of therapy. Cognitive behavioural therapies have short term goals, typically requiring a few months of therapy.

Psychoanalytic principles incorporate an analogy of the mind as an iceberg, with the conscious mind being the portion appearing above the surface and the unconscious being the submerged, greater mass of the iceberg. The conscious mind harbours the thoughts which we are aware of and the unconscious those which we are unaware of and are perhaps repressed due to being too stressful or disturbing to bring to immediate attention. Freud constructed a topological model consisting of various psychosexual stages which required mastery to reach the subsequent, elevated level and thus a healthy psyche. Failure at any particular level resulted in detrimental behaviour and psychological distress.

The social aspect of the psyche in the psychoanalytic model comprises of the ID, ego and superego. With the ID driven by instincts and basic needs. The ego fulfils the ID’s requirements relative to the environment and the superego is the moral overseer. Each emerges in order at the very early stage of a child’s development.

Several theories built upon the psychodynamic model, such as objects relations theory which withdrew focus from biological impulses and gave prominence to family relationships. Particularly that of the mother and child.

Klein emphasised the mother-child relationship as being key to development of a psychotic disposition.

Winnicott highlighted the frailty of the young child and reliance on support from caregiver to provide a safe environment. If the caregiver fails to provide a sufficiently stress free environment and the baby’s emotional and biological needs are inadequately met then this leads to psychological distress which can become embedded in the developing child (Winnicott 1960). J. Bowlby reinforced to some degree the work of Klein and Winnicott. He also stressed the significance of the caregiver’s role in the mental health of the individual. He lacked the stable nurturing environment as a child and this undoubtedly reinforced his ideas and resolve as he investigated children who lacked the supportive environment provided by a primary caregiver and concluded that their behaviour and psychological temperament suffered as a result.

The behavioural model approach is underlined by the theory that behaviour is a direct consequence of conditioning via environmental queues and not a product of internal mentality as with the psychoanalytic approach. Therefore, it suggests that psychological distress is a result of dysfunctional learning patterns rather than deep rooted unconscious phenomena and biological urges. So if environmental conditioning is at blame for behavioural defects and psychological distress, then re-conditioning can also steer an individual away from such adverse syndromes.

The unconscious mind is the key component in psychological distress according to the psychodynamic model and is the main source governing behaviour(Blagys & Hilsenroth 2000). It exists beyond the immediate accessibility of the conscious mind, yet is responsible for a great deal of thought processes. Past memories and experiences reside in the unconscious and play a large role in influencing our thoughts, emotions and behaviour (Wilson 2013). It therefore is unsurprising that the psychoanalytic approach targets the unconscious as the root of psychological distress. Cognitive behavioural approaches on the other hand, target the cognitive biases accumulated as the result of conditioning. So the individual is encouraged to re-evaluate the sequence of events leading to psychological distress, with a focus on altering their distorted view in an attempt to reconfigure their cognitive biases towards a more positive outlook.

 

Wilson, T.D., (2013) Self-Knowledge and the Adaptive Unconscious. Neurosciences and the Human Person: New Perspectives on Human Activities Pontifical Academy of Sciences.

Winnicott, D.W. (1960) The Theory of the Parent-Infant Relationship. International Journal of Psycho-Analysis, 41:585-595

Blagys, M.D. & Hilsenroth, M.J. (2000). Distinctive Features of Short‐Term Psychodynamic‐Interpersonal Psychotherapy: A Review of the Comparative Psychotherapy Process Literature. Clinical Psychology Science and Practice 7(2):167 – 188