Psychodynamic and Humanistic Frames of Reference

Psychodynamic and
Humanistic
Frames of Reference
OT 460A
Background
 Roots in psychoanalysis
 Freud, Jung
 Principle developers: Gail Fidler and Anne Mosey
 Neo-Freudian/ humanistic/existential theory base
 Height of use- 1950-1970’s when hospitalizations
were lengthy
 Goal: for patients to gain insight into their
behavior through analysis of metaphor, mental
states and general “inner life”.
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Definition
 Perceptions, thoughts and feelings both conscious and
unconscious influence one’s selection of, participation in,
and satisfaction with occupation
 Humans create a relationship with the nonhuman and
human environment satisfying needs, interests, and
purpose
 Therapeutic activity facilities healthy emotional
experiences, enhances self awareness.
 PD For can be used in a restorative model where some
aspect of the person is expected to change. Can also be
used to identify compensatory strategies, such as
caregiver education, environmental/task adaptations.
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Psychodynamic Frame of
Reference
 Is the theoretical approach that views
persons, media and activities as objects
invested with psychic energy.
 Projective and functional tasks are used to
promote self-awareness and identification of
intrapsychic content
 Interaction with these objects is necessary to
satisfy personal needs.
 Once basic needs are satisfied, energy is
available for personal expression and balance
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Psychodynamic FOR (cont’d)
 Activities are selected for their utility in enhancing
interpersonal communication and facilitating healthy
emotional experiences
 Activities are designed to lead to an understanding of
patient needs, conflicts, feelings and behaviors
 Azima and Fidler as well as Mosey (1970) used
it to describe an eclectic approach that included
Jung, Freud, Humanistic and Existential
influences from psychology and medicine
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Applications of the
psychodynamic approach
 Means for understanding feelings, thoughts,
behaviors
 Alters the therapists styles of relating within
occupation
 Provides a framework for understanding how
occupation becomes meaningful to all persons
underscoring the “person’s experience of illness”
and their perceptions of occupational choices
 Speaks to the significance of therapeutic
relationship
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Applications of the
psychodynamic approach
 Proper use requires specialized training
 Helps therapists work with people who have
a psychodynamic explanation for their
behavior. (e.g. anxiety, PTSD, abuse,
dissociative disorder, eating disorders,
borderline personality disorder)
 Useful means for OT’s to evaluate confusing
behavior or to understand the “why” behind
a behavior
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Defense Mechanisms
 Understanding the function of defense
mechanisms is useful in therapeutic
relationships
 Individuals may protect selves from anxiety by
using “defense mechanisms”
 Some defense mechanisms are healthy and
some are not
 Defense mechanisms are grouped into a
hierarchy according to phases of maturity
associated with them
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Defense Mechanisms
 Narcissistic mechanisms:
 Denial: failure to acknowledge the existence
of some aspect of reality (e.g., substance
abuse) that is apparent to others
 Projection: Attributing attributes or
unacknowledged feelings, impulses or
thoughts to others
 Splitting: Rigid separating of positive and
negative thoughts and feelings
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Defense Mechanisms
 Immature mechanisms:
 Passive-aggression: aggression towards
others which is indirectly or unassertively
expressed
 Regression: returning to earlier stage of
development to avoid the tension and conflict
of the present one
 Somatization: Conversion of psychological
symptoms into physical illness
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Defense Mechanisms
 Neurotic mechanisms
 Rationalization: creating self-justifying
explanations to hide real reason’s for own or
another’s behavior
 Repression: blocking painful memories and
anxiety provoking thoughts from memory
 Displacement: redirecting emotions or
reactions from one object to a similar but less
threatening one
 Reaction Formation: switching of unacceptable
impulses into its opposite
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Defense Mechanisms
 Mature mechanisms:
 Humor: using comedy to express feelings and
thoughts without provoking discomfort in self
and others
 Sublimation: redirecting energy from socially
unacceptable impulses to socially acceptable
activities, e.g., sports
 Suppression: Consciously or semi-
consciously avoiding thinking about disturbing
problems, thoughts, or feelings
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Defense Mechanisms
 Psychotic
 Delusional projection, distortion, psychotic denial
 Immature defenses: Personality Disorders
 Projection, fantasy, hypochondriasis, passive
aggression, acting out
 Neurotic defenses: Anxiety Disorders
 Displacement, isolation of affect (intellectualization),
repression, reaction formation
 Mature defenses
 Altruism, sublimation, suppression, anticipation,
humor
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Early Model of OT
(Psychodynamic):
 Projective activities
 Therapeutic milieu/ community
 Task oriented group: purposeful activities
 Activity dynamics and awareness
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Current Concepts in OT:
 Mix psychodynamic and humanistic
 Person and behavior
 Dynamic Energy System
 Psychodynamic beings and Choices
 Process of Self Actualization
 Implications for Research
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The role of the OT:
 Mutual Responsibility
 Behavior Awareness through Activity
 Participant Observer
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Role of Activities in Humanistic
FOR:
 Appropriate expression of feeling
 Activity Process
 Regaining a sense of control
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Role of activities (Cont’d)
 Improving Ego function-
 Through gaining proficiency and skills.
 Offering a Choice
 Seeing Oneself in a new way
 Processing the activity

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Theoretical Assumptions of the
Humanistic FOR:
 pt. is valuable
 pt is capable of logical thinking and
increased understanding
 pt’s perception of his/her reality is more
valid than a diagnosis
 pts most pressing needs must be dealth
with first
 pt’s sense of wholeness though
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Treatment in the
Psychodynamic FOR:
 Goals:
 Therapist Responsibility:
 Specific Tx Objectives
 Impact of Group Process in Treatment
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Contributions of the
psychodynamic FOR:
 Provides a vocabulary for understanding
the subjective nature of clients with regard
to their history, past experiences,
meaning, etc...
 Positive emphasis
 Emphasizes the importance of the
therapeutic relationship- supports client-
centered care
 Increased understanding of behavior
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Limitations of Psychodynamic
and Humanistic approaches
 May take longer
 Research needed to evaluate outcomes
 Risk drawing false conclusions if not
checked with client
 Client needs capacity for insight
10/4/12 OT 460A 22

Psychodynamic and Humanistic Frames of Reference

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Psychodynamic and Humanistic Frames of Reference

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Psychodynamic and

 Therapeutic milieu/ community

 Task oriented group: purposeful activities

 Activity dynamics and awareness

 Behavior Awareness through Activity

 Regaining a sense of control

 Seeing Oneself in a new way

 Processing the activity

 Impact of Group Process in Treatment

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