This assignment will be focusing on the Psychodynamic and Person-Centred perspectives. The aim will be to compare, contrast and provide criticisms for both perspectives. Also, the effectiveness of the Psychodynamic and Person-Centred Approaches will be mentioned, all with the use of past literature. Following that will be a conclusion that will summarise the essay.
Person-centered therapy took a while to develop its name with this approach seen as one of the humanistic therapies which focus on the person or client. It was founded and developed by Carl Rogers In the 1940s who believed that each person had the tools to solve problems themselves and control their own lives. He also believed it was the therapist’s job to guide and help them find the answers within themselves. The aim is for clients to be independent but if there is an issue or an illness within the client it needs to first be solved so they can be normal or whole and left to their own devices. Also, humans possess the ability to control their own choices and direct their lives in a constructive way. (Thorne & Lambers, 1998)
Rogers wrote at different stages throughout time on many topics such as reflective therapy, non-directive therapy, and relationship therapy which is when he developed all the ideas that support his approach. Client-centered therapy is just that, it always focuses on the client and they become the center of the work. This set apart rogers’ and his approach from the current models and perspectives of his time. This included medical, analytical, and behavioral approaches which he believed saw the client as just a set of behaviors or symptoms which needed to be treated, modified, or solved. (Dryden, et al, 2011)
The Psychodynamic perspective focuses on the unconscious, subconscious, and pre-conscious desires and wishes a person may have but are unaware of. The Psychodynamic perspective was originated by Sigmund Freud between the 1890’s-the 1930s. Freud believes things that happen in one’s childhood are essential in shaping adult personalities. He later developed a model to marry with his original ideas of the unconscious because he believed that the topographic model explained many things but not why some people develop psychological disorders, while other people do not. This model consisted of three mental structures called the ID, ego, and superego. The ID is your instincts, the ego is your reality and the superego is a person’s morality. Freud believes you attain these from family and the culture that you were raised in. If you refer to the structural model, it suggests that our personality influences the three psychic structures, and therefore our personality traits depend on which of the three psychic structures is the most predominant. (Bornstein, 2020)
Contemporary Psychotherapists are influenced by four major schools. These are Ego Psychology, Object Relations theory, Self-Psychology, and Attachment theory. They each present theories of personality formation, change, and psychopathology formation which help perform therapies. (Richard, et al, 2009)
When looking at both perspectives, we can see the similarities and differences between the two. While both theories have the clinician as an active person in the therapeutic process, Person-Centred therapy focuses on relational experience and how the patient’s capacity to gain an understanding of their own illness develops. They also look at how this impacts the relationships around them. On the other hand, the Psychodynamic theory also has the clinician be active in the therapeutic process, but they create a therapeutic union in an empathetic way. Both perspectives offer therapeutic frameworks which are essential supporting structures and ultimately aid the therapist to be able to emotionally heal the client. They both also act to make feelings of vulnerability disappear because their main and final goal is to increase their client’s skills, and their sense of self, but most importantly to help them reach self-actualization. The therapeutic union which includes the dynamics of transference and countertransference provides an experience that aims to counteract something that may be harmful to the client from the Psychodynamic Perspective. Whereas, within Person- Centred therapy, the therapist pays close attention to the transference and countertransference which develops in the environment, and with the use of the corrective potential of the relationship they help the client reach self-actualization (Cerone, 2019)
There may be many similarities between the Psychodynamic and Person-Centred perspectives but that does not stop them from being incredibly different. While Person-Centred therapy is humanistic, the Psychodynamic perspective is not. One of the main differences is what the perspective's aims are. While the Psychodynamic perspective aims to find out why the client is ill and fix that illness, Person-centred therapy aims to improve what the client currently already has. As well as this, the Psychodynamic or Psychoanalytic perspective looks at the development over a client’s childhood and the therapists often work with interpretations that they hope will help the client’s attitudes and behavior in the present with their gained insight into the past. Instead, Person-centred looks at the span of a client’s whole lifetime. (Kahn, 2010)
Contemporary psychoanalysts are contrasted with Person-centred therapy in that they do not restrain their own voices with patients. It is the therapist’s belief that the feelings which are recalled to the conscious mind during the therapeutic sessions with the client can be an essential source of knowledge and can be useful to the patient when it is deemed to be appropriate. Relational psychoanalysis ends up being significantly different from Person-Centred therapy as well as self-psychology. This is because relational analysts do not avoid confrontations between themselves and the patient’s subjectivity which is influenced by personal feelings, tastes, or opinions. (Kahn, 2012)
In the case of the Person- Centred approach, the effectiveness of the therapy depends solely on the clinician’s effectiveness in treatment. Things such as the therapists’ attitude toward the client and the way they can understand them to determine the outcome and effectiveness when delivering therapy. (Cloninger, et al, 2011)
More evidence that supports the effectiveness of Person-Centred therapy comes from a study combining CBT, Psychodynamic and Person-Centred therapy. There have not been as many studies to examine all the approaches, but there is evidence that supports the success and how effective at least some varieties of PCT have been. (Stiles, 2007)
Effectiveness will be produced when a therapist can validate the client's description of the situation they are in. This happens simultaneously while they also remain eager to know about the client's concerns and hopes which have not yet been expressed, along with this they are curious about the unnoticed resources. (O’Leary, 2011)
When reviewing the literature on occupational therapy, it was clear to see that it yielded very few studies examining the effect of Client-centred practice. Therefore, the review was expanded, and more disciplines were examined. Among the research findings was evidence that proves that when the therapist provides supporting and respective services within the Client-centred therapy, it leads to better client satisfaction. Also, among these is information exchange and various practices which enable client professional partnerships and are proved to be significantly helpful. The development of a client-therapist partnership has also proved to lead to client participation increasing and the client's ability to produce the desired result. (Law, et al, 1995)
There have been many studies and much evidence to show that the psychodynamic approach has been effective and detrimental in helping clients with the various issues that have arisen in their lives. Clinical trials showed the effectiveness of the psychodynamic perspective provided with mood and anxiety disorders. While there has been evidence to support brief, focused, and active treatment such as short-term psychodynamic psychotherapy, there has not been as much evidence to support long-term psychodynamic psychotherapy which is extremely limited and solely based on non-randomized studies. During follow-up studies, the short-term effects of Psychodynamic Psychotherapy were shown to be balanced and even increased. (Knekt, et al, 2007)
There have been several other reviews regarding long-term psychotherapy which have proven how effective it can be to help people. A meta-analysis took place which was comprised of 27 studies where they conducted a systematic literature review. Their review showed that of the two, psychoanalysis was more effective than Psychodynamic treatments which therefore means that the hypothesis they estimated provided a valid contribution to the prior probability. (Roseborough, et al, 2011)
Regardless of how effective both perspectives are, neither Psychodynamic nor Person-Centred therapy can be favored by all. In fact, there are many criticisms of both perspectives by people who think there are ways the perspectives can be improved. Person-centered therapy is criticized by people because they believe it is not complex in the theoretical sense. They also believe that the way Rogers explains the psychological developments of people tends to be naïve and even too simplistic. Person-centered therapy has often been the “tea and sympathy” perspective which means that they are seen to be there to offer support and kindness instead of real therapeutic help. This is a shock to many people because, in his inception, Rogers’ used much scientific language and terms to describe psychological relationships. (McMillan, 2004)
Person-centered therapy also receives criticism because instead of focusing on the demands of a group or community, they instead concentrates on the client’s individual growth. The approach is deemed to be too over-optimistic in that Roger seems to completely ignore the possibility that humans can be malevolent and cause destruction by instead focusing on the positives of human nature. (Dryden, et al, 2013)
The Psychodynamic perspective has also received many criticisms. One of the general ones is that Freud based his ‘man’ as he saw him in the area where he resided. This took place at the end of the last century and was influenced by the Western European culture of the time and this was supposed to represent the universal, biological man. Freud assumed that men had natural unconscious drives, which is where he believed all their impulses and emotions derived from. Therefore, instead of figuring out how to develop mature individuals, Freud instead viewed social problems as a relentless battle to discipline and control fixed antisocial impulses. He was also criticized because people deemed his views as far too deterministic. Freud believed that all behavior is predetermined which means that people have no free will, a belief that many people disagree with. (Guntrip, 2018)
Another criticism aimed at the Psychodynamic perspective is how little evidence there is for their belief about the unconscious processes of the mind. Some people believe the psychodynamic views to be unprovable and impractical. (Bachkirova, et al, 2011)
Among the criticisms are many others about Freud himself. People believe that his long-time use of cocaine when he was at the peak of his prominence led to logical confusion within his theory. It was also believed that he forcibly put an end to an extremely important empirical discovery and instead chose to pursue the unconscious because he knew it would be more socially acceptable than what he had discovered. (Thornton, 2020)
To conclude, when we compare the two perspectives it is clear to see that the Psychodynamic and Person-Centred therapies have many similarities as well as differences. They both have an active therapist during the therapeutic process and offer frameworks that are essential support structures and ultimately aid the therapist so they can help emotionally heal their clients. They also aim to make clients' feelings of vulnerability evaporate because both perspectives' main goals are to help their patients reach self-actualization.
On the opposite side of the spectrum, there are many differences between the Person-Centred approach and the Psychodynamic perspective that warrants mentioning. While both perspectives have an active clinician in the therapeutic process, PCT focuses on relational experience and the development of the patient’s capacity to gain insight into their own illnesses. On the other hand, the Psychodynamic theory instead creates a therapeutic union in an empathetic way. As well as this, the aim of both therapeutic perspectives differs too. While the Psychodynamic perspective's aim is to find out why the client is ill and tries to fix that illness, Person-Centred therapy instead aims to improve what the client already has.
No matter how similar or different the perspectives are, there has been much evidence to show the effectiveness of them both and there have been many studies. For example, from the Psychodynamic perspective, there were studies and clinical trials which showed the effectiveness this approach provided with mood and anxiety disorders. During follow-up studies, the short-term effects of this perspective were shown to be balanced and even increased. There have been many other reviews for long-term psychotherapy which prove how effective it has been to help people. A meta-analysis that was compromised of 27 studies showed that of the two, psychoanalysis was more effective than psychodynamic treatments.
Regarding PCT, also has much evidence to support its effectiveness. This depends solely on the therapists’ effectiveness in treatment with things such as the clinicians’ attitude towards their clients and the way they try to understand them which determines the outcome when delivering therapy. It can also be seen when the therapist is able to validate the client's description of their current situation. This happens when they remain eager to know about the client's concerns and hopes which have not yet been expressed.
Despite all the similarities, differences, and effectiveness of the perspectives, they both received many criticisms. Among the psychodynamic criticisms received was one of the most general ones which was that Freud based his ‘man’ as he saw them in the area he grew up in at the end of the last century. His views were largely influenced by the western culture of the time and this was supposed to represent the universal, biological man. His views were also seen as too deterministic because Freud believed that all human behavior was predetermined which means people have no free will. There is little evidence to support the belief Freud had about the unconscious processes of the mind and some people believe the views to be unprovable and impractical.
Person-centered therapy also receives many criticisms and one of those is the belief that it is not theoretically complex enough. They also believe Rogers’ views to be too simplistic and at times, naïve. As well as this, people believe that the perspective offers no real therapeutic help but instead is only there to offer support and kindness. People deem the perspective to be too over-optimistic because it seems that Rogers completely ignores the possibility for humans to have the capacity to be malevolent and cause destruction.
One thing that is clear to see is how there need to be more studies on long-term effects for both perspectives. There also needs to be more studies on Person-Centred therapy and more information about the perspective, especially in a comparative sense against other perspectives.