Defenses, Attachment, and the Unconscious: What You Can Gain in Psychodynamic Consultation
By Chris Campassi
Have you wondered what ‘Psychodynamic’ Clinical Consultation looks like? Does the term ‘psychodynamic’ just seem too nebulous to make sense of, and bring up thoughts of Freud and his psychosexual theory? If so, it stands to reason that you might feel hesitant and wonder, “how could this possibly help me with my clients?”
What is Psychodynamic Theory?
Psychodynamic theory is a vague term to describe a number of different modalities that, in very general terms, rely on the basic tenet that our problematic behavioral patterns are the result of adverse childhood experiences and attachments, as early as our pre-verbal (0-3 years of age) stage.
By gaining insight into these behavioral patterns and their origins through talk therapy, it is believed that the client will be better able to recognize the “repetition compulsions” they are playing out, and thus be better equipped to intervene and modify their behaviors.
Psychodynamic Theory versus Psychoanalytic Theory
Many people get confused by the terms ‘psychodynamic’ and ‘psychoanalytic’. Simply put, psychodynamic theory is the umbrella term for many different modalities, some of which specifically identify themselves as ‘psychoanalytic’ in nature.
To really parse through the nuances of each theory would be exhaustive, but most important to note is that psychodynamic is the more general term for a set of theories, and psychoanalytic is more specific to the various institutes of psychoanalysis.
What is Attachment Theory?
The role of attachment is critical to our psychological and emotional development. Humans are innately disposed to attachment, as this is the most critical method of survival for infants, children and adolescents. During our first 3 years of life, the preverbal phase, infants make every effort available to them to survive.
Because they rely so heavily on their caregivers, they seek trust and safety, in addition to food, warmth and nurturing. Because this is a time of extreme vulnerability, the way in which the caregivers meet their children’s needs has a great impact on how the child learns to interact with the world.
When children’s needs are met in a nurturing and safe manner, they tend to develop a trusting attachment to their caregivers. However, if their needs are not met, they will develop an insecure attachment. When children are insecure in their attachments, they do not trust that the caregiver will meet their needs, and they develop patterns of behavior that adapt to the neglect. While these behaviors are adaptive to the situation, they can often become problematic and maladaptive later in life.
Attachment Theory: How it Works
For example: a child of a single mother may not get their needs met due to their mother having to work many hours per week. The mother may feel exhausted by the end of the day and be able to only barely muster the energy to cook dinner, but not much more. The young child, wanting their mother’s attention, may learn that the only time they are able to get attention is when they are sad or not feeling well, as these are the few times their mother acts in a more nurturing way.
Over the course of their childhood, adolescence and adulthood, this behavior that was adaptive to getting their needs met as a child becomes problematic. The individual may seek attention from others in ways that may seem “needy” or “attention seeking”. This may lead to people shunning the individual, which may then lead to an escalation of these behaviors. All of this is in an effort to prevent any sense of abandonment, which often actually leads to the loss of friendships, as they cannot provide the soothing the individuals needs in relationships.
As a result, the individual may internalize that they are a bad person, deserving of abandonment, or undeserving of love and nurturing. As that narrative strengthens, the individual often unconsciously interacts with people in ways that reinforce these beliefs, essentially “setting themselves up” to be disappointed, abandoned or rejected.
As this belief system is reinforced, the individual often becomes isolated, depressed, anxious with new attachments, and may notice an increase in substance use or other compulsive behaviors.
Defense Mechanisms in Psychodynamic Theory
Defense mechanisms can probably be best described as patterns of behavior that have been developed to protect someone from the negative feelings, or potential negative feelings, induced by certain people, places or situations. Defense mechanisms tend to operate unconsciously. In the above scenario, the individual might develop a pattern of shutting down, avoiding or “cutting off” relationships with people they perceive to be upset with them or aloof towards them.
The person may begin to find excuses to not spend time with those they perceive as upset with them, and avoid confronting these perceptions, preventing them from the possibility that they will be rejected. In doing so, however, they are unable to allow themselves to have genuine and authentic connections with others, as they are often operating from a protective stance.
Defense mechanisms act much like the walls that we build in the world. While they initially are designed to protect us from outside threats, when built too closely and too high, they begin to isolate us from the world, and estrange us from authentic social connection.
As therapists when we work with clients, it is important to be able to recognize a defense mechanism as an originally adaptive survival strategy that has become problematic and no longer necessary to get their needs met. Gaining insight into these patterns moves these responses from the unconscious into the conscious, giving the client greater control over these patterns of behavior. This allows them to begin making a choice to respond in different ways.
As a client is able to move the unconscious reactions prescribed by the defense mechanism, they can begin to develop a language to describe the feelings associated with these unconscious responses. In doing so, they can begin to better understand the reason for these responses. This can be very powerful in affirming that the client is behaving as they were socialized, AND that they are not inherently bad people. Such a realization allows the client to begin considering an alternative approach, as they begin to feel more empowered.
The ‘Unconscious’ and What It Means
You may see the word “unconscious” and wonder, what exactly is the “unconscious”, and is that the same as the “subconscious”? The concept that there are things going on in our mind and body that we are not aware of can at times seem abstract and “hokey”, at best, and downright frightening and disempowering at worst.
It may also beg the question, how can I as a therapist understand a client’s unconscious needs, if the client is not even conscious of these needs. I have heard the comment that “if the client cannot tell me what they need, I don’t know how to help them.”
Unconscious, subconscious or subcortical?
These are all reasonable questions and responses. The “unconscious” is called by a lot of different names, depending on the theoretical approach being taken. “Subconscious” or “subcortical” are terms that are used to describe a similar concept. Defense mechanisms and “repetition compulsions” are terms used to describe the barriers to growth that lie within the unconscious. Or put simply, they are functions the unconscious uses to protect ourselves from past wounds, or as an attempt to resolve past problems, in the here and now.
The unconscious can be understood as the mechanism within the mind, and body, that interact in the world and influence the way we perceive and think about things, people, places and situations, that is not readily available to our pre-frontal, cognitive thinking. Because most of us spend much of our time in thought, reflection and problem-solving, it can be difficult to entertain the idea that there is a whole different system operating within us, that we do not feel full control of.
That “Gut Feeling” and What It Means
The unconscious, however, is a powerful force that lies within us, it is where our intuition lies, and it is connected to the concept of our “gut feeling”, which many of us can definitively say we have experienced, but often struggle to explain with our cognitive mind.
The term “trusting your gut” speaks to the existence of the “enteric nervous system”, the part of our nervous system that communicates between the gut and the brain, a critical mechanism in ensuring that we keep our body safe. Our “gut feelings” are function of the gut communicating to the brain concerns of a possible threat.
Most important to understand about the unconscious is that it holds in our bodies all of the memories, and associated responses, that our cognitive memory cannot always recall, most especially those experiences during our preverbal stage, from birth until 3 years of age. Because we have no language during this time, our memories are stored at a subcortical, or unconscious level. We cannot recall these memories cognitively because memories are connected so closely to language.
Threat Detection and Response
The most basic function of the unconscious is to protect us from threat. Our nervous system is designed to scan the environment for cues of threat and safety, taking in information from the entire body, literally every second of our existence. As we adapt to our environment, our unconscious develops reflexive, automatic responses to perceived threats.
Severe trauma and adverse childhood experiences will often lead to a more sensitive threshold for these automatic responses, which explains the reports of so many that they “did not think about what was happening, I just reacted” when they react with extreme irritability or anger to a seemingly non-threatening situation. At the unconscious level, once a threat has been perceived, the body responds before the prefrontal cortex can process the situation and respond more appropriately.
How do Psychodynamic Themes Show Up in Clinical Consultation?
One of the most important components of great clinical consultation is the ability of the supervisor to create a parallel process, a relationship between the consultant and consultee that will reflect the relationship between the consultee and their clients. As a therapist struggles with a client, the consultant first helps the therapist explore their own reactions to the client or the feeling of “being stuck” with the client.
The clinical consultant can work with the therapist to identify their reactions to the client. Through this process, the therapist may consider if they are experiencing any of their own countertransference with the client, and if these feelings are drawing up any of their own defense mechanisms.
As the therapist is able to recognize their own defense mechanisms and process these with their clinical supervisor, they feel more free and a sense of relief that the barrier to working with the client is within their own control to rectify. This often leads to the therapist feeling less stuck, more able to connect with the client and the client’s distress, and then feel more creative and empowered to help the client grow.
Like everyone else, we as therapists bring our own attachment styles and struggles, defense mechanisms and unconscious reactions into every day. We, too, often find ourselves unable to understand why we feel so frustrated with a client, or just in general. And like everyone else, it is most difficult to recognize in ourselves, as we are inherently biased to avoid our blindspots.
For this reason, it is critical that therapists utilize others in the field to help us examine our own biases and work through these issues so that they do not have a negative impact on the work we are doing with our clients, as well as our own mental health.
Psychodynamic Approach to Consultation
If you are interested in a psychodynamic approach to consultation, whether in group or individually, I will work with you in a way that will support you in better understanding yourself as a therapist, as well as how to monitor yourself for any blindspots that emerge with clients.
We will work together to better understand your unconscious, defense mechanisms and attachment style that may come up in the room with your client, and to utilize these insights as tools to connect with the client, rather than hindrances to doing good work. As you begin to better understand yourself, you will more seamlessly be able to attune to the client’s defenses, attachment needs and unconscious. As you attune to these signs, you will feel more able to follow an intuitive path towards your client’s healing process, one that is collaborative, genuine and authentic.
How we can help
If you are interested in exploring more about psychodynamic approach to consultation, work with Chris today! Check out his page and schedule a free phone consultation with him.
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Author Bio
Chris Campassi is an Approved Clinical Supervisor (ACS) and Program Coordinator of Firelight Supervision. He is a licensed psychotherapist in Colorado and North Carolina, blogger, and clinical supervisor for provisionally-licensed and independently licensed therapists. Chris enjoys helping men, medical professionals, and former athletes manage their anxiety and stress so they can live fulfilled and balanced lives. Follow Firelight Supervision on Instagram.
