Assessing the Fruitfulness of Defense Analysis in brief Focal Psychotherapy in the Intervention of Marital Therapy

 

Vidya Bhagat¹* , Shivalingappa B. Javali²

¹Profesor, University Sultan Zainal Abidin, Faculty of Medicine, Kuala Terengganu 20400, Terengganu Malaysia

²Associate Professor, International Medical Programme, Nehru Nagar, Belgaum, Karnataka, India

 

ABSTRACT:

The psychoanalytical approach in the couple patients becomes significant when the psychological parameters causing sufferings are unconscious. The technique, analysis of defense mechanisms is proven useful in understanding the unconscious roots of marital disturbances in gaining insight into problems. Thus the study objective focuses on analysis and interpretation of defenses, to find out the fruitfulness of defense analysis. This is a case study research design used for analyzing defense mechanisms used by patients in situational aspects of their life discussed in the clinical interview to find unconscious roots disturbing their marriage. Universal sampling was used for sample selection from Nitte psychiatry center, private patients and couples attended camps from 2007 to 2014. The intervention provided was brief focal psychotherapy, defense analysis and its interpretation was used as a tool for gaining insight into problems faced by the subjects in their marriage. There was high prevalence among patient couples who had unconscious roots in their past causing disturbances in their marriage. Of the 100 sample couples only 40 patient couple indicative for defense analysis and other 60 were excluded. Defense used by patient couple was interpreted to gain insight into problem behaviours thus improved interpersonal relationships among the marital couple. End of the intervention they were rated on 3 point scale measuring satisfaction levels that evaluate therapeutic success. More than 50% of sample population found to be highly satisfied and none of them spelt dissatisfaction. The collected data were presented with frequency and parentages, statistically analyzed by using Chi-square with Yates's correction test for association. The statistical software used is SPSS 20.00 version. The statistical significance was set at 5% level of significance (p<0.05).The present study has proven the hypothetical view that deeply rooted unconscious causes of marital disturbances among the patient couple shown its interventional success and fruitfulness of defense analysis.

 

 

 

 

 

 

INTRODUCTION:

Marital or couple therapy is a form of psychotherapy designed to psychologically modify the interaction of two persons who are in conflict with each other because of the issues involved with some of the psychological parameters. The psychological parameters which are distressing inter personal relationship in marriage are: social, sexual, economic and emotional. Types of Couple Therapies commonly used for marital disharmony are individual therapy, individual couples Therapy, conjoint Therapy, four-Way Session, group psychotherapy, combined therapy which take a base on psychological therapies. Ex: psychoanalytical, behavioral, cognitive behavioral.¹

Systemic thinking is the foundation of couple and family psychology (CFP) research and practice that has been systematically theorized that provides a set of principles that has been adopted by the clinicians for helping the couple to conceptualize and understanding human behavior.²

 

Couple therapy is a type that looks to aid communication and facilitate change within an intimate relationship. Typically the term couples counselling is applied when the therapy is specifically designed for two people within a relationship. Indeed, counsellors commonly keep this fact in mind in offering this form as a therapy, thchnically they should have the relevant training to help them work with the dynamics of a couple. According to Sigmund Freud, the founder of psychoanalysis, marital partner choice, as well as marital relationships, is defined much before marriage was concluded. Relationship with marital partner is determined by relationships with parents and important persons in one's childhood. Marital relationships are repetitions of relationships with parent’s patterns from childhood.¹

 

Psychological therapies generally fall into the following categories: behavioural therapies, which focus on cognitions and behaviours, psychoanalytical and psychodynamic therapies, which focus on the unconscious relationship patterns that evolved from childhood, humanistic therapies, which focus on self-development in the 'here and now', arts therapies, which use creative arts within the therapeutic process and couples counselling, which looks to resolve issues experienced by couples.

 

Psychodynamic is an insight-oriented therapy focuses on unconscious processes as they are manifested in a person’s present behavior. The goals of psychodynamic therapy are a client’s self-awareness and understanding of the influence of the past on present behavior. In its brief form, a psychodynamic approach enables the client to examine unresolved conflicts and symptoms that arise from past dysfunctional relationships. One of the most common approach evolved from psychoanalytic theory is a brief psychodynamic psychotherapy have been clinically applied to a wide range of psychological conditions. Number of researches has been supported the efficacy of these approaches. Freud’s Psychodynamic therapy is the oldest of the modern therapies. The healing and change process envisioned in long-term psychodynamic therapy typically requires at least 2 years of sessions.²

 

In the present there are quite a few offs hooted of psychoanalytical therapies, like Brief Focal Psychotherapy, Time Limited psychotherapy and short-term dynamic psychotherapy and short tterm anxiety pravoking psychotherapy. Practitioners of brief focal psychotherapy believe that some changes can happen through a more rapid process or that an initial short intervention will start an ongoing process of change that does not need the constant involvement of the therapist.⁷

A central concept in brief focal psychotherapy is that there should be one major focus for the therapy rather than the more traditional psychoanalytic practice of allowing the client to associate freely and discuss unconnected issues. the therapist is expected to be fairly active in keeping the session focused on the main issue. Having a clear focus makes it possible to do interpretive work in a relatively short time because the therapist only addresses the circumscribed problem area.²

 

The benefits of psychodynamic psychotherapy have been proven by empirical and evidence based measures. The scope for the psychodynamic psychotherapy is as enormous as those reported for other therapies, which have been actively promoted with empirical and evidence based support. There is no doubt patients who receive psychodynamic therapy maintain therapeutic gains and appear to continue to improve as it comes to treatment culminations. The perception that psychodynamic approaches lack empirical support does not accord with available scientific evidence may reflect in discerning propagation of research findings.

 

Empirical evidence supports the efficacy of psychodynamic therapy. Effectiveness of psychodynamic therapy are as large as those reported for other therapies that have been empirically supported, the patients who receive psychodynamic therapy maintain therapeutic gains, they also appear to continue to improve after treatment ends.³

 

No psychodynamic therapies may be effective in part because the more skilled practitioners utilize techniques that have long been central to psychodynamic theory and practice. The perception that psychodynamic approaches lack empirical support does not accord with available scientific evidences.³ Thus marital therapy which has emotional parameters in the sufferings of marital couple the significance of psycho dynamic psychotherapy gains a prim importance.⁷

 

Psychodynamic therapy encourages exploration and discussion of the full range of a patient’s emotions with their insight.  The therapist helps the patient describe and put words to feelings, including contradictory feelings, feelings that are troubling or threatening, and feelings that the patient may not initially recognize made to gain intellectual insight.⁶

Intellectual insight carried along the emotional insight, which resonates at a deep level and leads to change thus analytical therapy is indicated for intellectual and psychologically minded people that they are able to explain the reasons for their difficulties, yet their understanding does not help them overcome those difficulties.⁶

 

The therapy also helpful in exploring defenses, analysing and interpreting them to gain thge insight thus they can make sense of experience, avoids aspects of experience that interferes with a potential capacity to find greater enjoyment and meaning in life.⁷ These days, psychologists and other clinicians focus on restoring sexual functioning and pleasure. They have developed effective treatments for many common conditions.⁴ This psychological techniques are used in marital therapy in some cases the dynamic therapy becomes an indication. Emotional rooting in the unconscious is commonly seen in the analytical cases. Thus marital therapy which has emotional parameters in the sufferings of marital couple the significance of psychdynamic psychotherapy gains a prim importance. Inthe present study the psychodynamism has been made understood through defense analysis as a thchnique of dynamic therapy.

 

OBJECTIVE OF THE STUDY:

•      To assess the fruitfulness of defense analysis in couple therapies

•      To assess the patient satisfaction regarding therapeutic approach

 

MATERIALS AND METHODS:

Hypothesis of the Study:

Defense analysis and its interpretation of unconscious elements work as an aid to attain insight into the roots of suffering in a couple patients.

 

Interview method used for finding out unconscious element in the selection of the sample.

Free Association a clinical method was used for defense analysis of couple patients.

Likert’s 5 point scale was used to measure the level of satisfaction using this approach.

 

This is a casestudy research design used for analyzing defense mechanisms used by patients in situational aspects of their life discussed in the clinical interview to find unconscious roots disturbing their marriage. Universal sampling was used for sample selection from Nitte psychiatry center, private patients and couples attended camps from 2007 to 2014. The intervention provided was brief focal psychotherapy, defense analysis and its interpretation was used as a tool for gaining insight into problems faced by the subjects in their marriage. There was high prevalence among patient couples who had unconscious roots in their past causing disturbances in their marriage. Of the 100 sample couples only 40 patient couple indicative for defense analysis and other 60 were excluded. Defense used by patient couple was interpreted to gain insight into problem behaviours thus improved interpersonal relationships among the marital couple. End of the intervention they were rated on 3 point scale measuring satisfaction levels that evaluate therapeutic success.

 

RESULTS:

Defense used by patient couple was interpreted to gain insight into problem behaviours and paved a way to improving interpersonal relationships among the marital couple. More than 50% of sample population found to be highly satisfied and none of them spelt dissatisfaction. The collected data were presented with frequency and parentages and statistically analyzed by using Chi-square with Yates's correction test for association. The statistical software used is SPSS 20.00 version. The statistical significance was set at 5% level of significance (p<0.05).The present study has proven the hypothetical view that deeply rooted unconscious causes of marital disturbances among the patient couple shown its interventional success and fruitfulness of defense analysis.

 

 

 

 

 

Table: Association between age groups and interventional success

Age group	Couple patients	Interventional success
		Not satisfied	%	Satisfied	%	Very satisfied	%
28- 32yrs	29	0	0.00	5	17.24	24	82.76
33-36yrs	11	0	0.00	7	63.64	4	36.36
Total	40	0	0.00	12	30.00	28	70.00
Chi-square with Yates's correction =  6.1142  P = 0.0132*

*p<0.05

 

 

 

 

 

Out of a total of 40 case studies, in which, 12 (30.00%) satisfied and 28 (70.00%) are very satisfied. In 12 (30.00%) satisfied, 7 (63.64%) are belongs to 33-36 years of age group and 5 (17.24%) are belongs to 28-32years of age group.  However, in 8 (70.00%) are very satisfied, 4 (36.36%) are belongs to 33-36 years of age group and 24 (82.76%) are belongs to 28-32years of age group.  The association is found to be statistically significant at 5% level of significance (p=0.0132). 

 

The bar diagram depicts association between age groups and interventional success supprting the study hypothesis.

 

 

Figure 1: Graphic presentation of association between age groups and interventional success

 

DISCUSSION:

Marital therapy is probably the best single thing that people in troubled marriages can do to help heal their marriages.⁸ Defense analysis is one of the most effective technich that supports the matitall problems with unconsious strins.⁹ More than 50% of sample population found to be highly satisfied and none of them spelt dissatisfaction and all the subjects showed good motivation in their followup sessions. Seeing the age group the youner group were highly setisfied than that off elder age group though none spelt about dissatisfaction. Studis  suppurts behavioural related that in functional connectivity suggest several behavioral consequences seen fster in youner age than the old. In the present study 83.00%  younger age group were highly satisfied than that of  older age group who found with 36% eith high satisfaction. However, study results has been supporting the hypothetical views that has showed the association between theraputic intervention using defense analysis technique statistically significant at 5% level.

 

CONCLUSION:

Patient with unconscious string with psychological parameter causing marital disturbances may get benefited by focal psychodynamic therapy in the intervention of marital therapy using most effective defense analysis thechnique to reach patients unconsious and bringout  the uncontious strings with intelectual insights. Study concludes that it has an sinificance when couple suffer from marital problems basing unconsious conflict evaluated in the clinical interview paves a way to focal psychotherapy in the intervention as a treatment of choice. Fruitfulness of defense analysis as a theaputic techniqe is evidensed in the present study.

 

REFERENCES:

1.     Marković Z, Psychoanalytic Conceptions of Marriage and Marital Relationships, The scientific journal FACTA UNIVERSITATIS: Philosophy and Sociology 2000, Vol.2, No 7,  379 – 389 http://facta.junis.ni.ac.rs/pas/pas2000/pas2000-08.pdf

2.     Haggerty J, Psychodynamic Therapy, Published on PsychCentral.com. 2013 http://psychcentral.com/lib/psychodynamic-therapy/

3.     Shedler, Jonathan, The efficacy of psychodynamic psychotherapy. Am Psychol. 2010; 65(2):98-109 http://psycnet.apa.org/journals/amp/65/2/98/

4.     Kazvin AE, Treatment for sexual problems, Encyclopedia of Psychology: 2000,8(4128) http://www.apa.org/topics/sex/treatment.aspx

5.     Jonathan Shedler, The Efficacy of Psychodynamic Psychotherapy, Achakra, 2014,(p.98) http://achakra.com/2014/07/10/the-efficacy-of-psychodynamic-psychotherapy-jonathan-shedler/

6.     Jonathan Shedler, the Efficacy of Psychodynamic Psychotherapy. https://www.apa.org/pubs/journals/releases/amp-65-2-98.pdf

7.     Bhagat .V (Psychotherapies in Psychiatric Treatment, Penerbit UniSZA. 2015, P. 159

8.     Dombeck. M (2006) Marital Therapy Concepts. Relationship Problems Mentalhealp.net

9.     Ralph R. Greenson ()The Technique and Practice of Psychoanalysis, 2004, Vol. 1. 1st Edition Intl Universities Pr Inc

10.   Do Something Diffe`rent ; mHealth creates strategic and impactful behaviour change https://dsd.me/healthcare/

 

 

 

Accepted on 04.02.2018        © RJPT All right reserved

Research J. Pharm. and Tech 2018; 11(8): 3585-3588.