psychodynamic psychology research questions

Psychodynamic Approach In Psychology

Saul Mcleod, PhD

Editor-in-Chief for Simply Psychology

BSc (Hons) Psychology, MRes, PhD, University of Manchester

Saul Mcleod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.

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Olivia Guy-Evans, MSc

Associate Editor for Simply Psychology

BSc (Hons) Psychology, MSc Psychology of Education

Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.

On This Page:

The psychodynamic approach in psychology emphasizes unconscious processes and unresolved past conflicts as influences on behavior. Rooted in Freud’s theories, it explores the interplay of drives, desires, and defense mechanisms in shaping personality and behavior.

Key Takeaways

• The psychodynamic theory is a psychological theory Sigmund Freud (1856-1939) and his followers applied to explain the origins of human behavior.
• The psychodynamic approach includes all the theories in psychology that see human functioning based upon the interaction of drives and forces within the person, particularly the unconscious, and between the different structures of the personality.
• The words psychodynamic and psychoanalytic are often confused. Remember that Freud’s theories were psychoanalytic, whereas the term ‘psychodynamic’ refers to his theories and those of his followers.
• Sigmund Freud’s psychoanalysis was the original psychodynamic theory. Psychoanalysis is also the name given to the therapy derived from the theory of Sigmund Freud.
• The psychodynamic approach includes all theories that were based on Freud and his followers, including Carl Jung (1912), Melanie Klein (1921), Alfred Adler (1927), Anna Freud (1936), and Erik Erikson (1950).

Sigmund Freud (writing between the 1890s and the 1930s) developed a collection of theories which have formed the basis of the psychodynamic approach to psychology.

His theories are clinically derived – i.e., based on what his patients told him during therapy. The psychodynamic therapist would usually be treating the patient for depression or anxiety-related disorders.

Summary Table

Theoretical assumptions.

Theoretical assumptions in psychology are basic statements or beliefs that provide a framework for understanding human behavior. They also help researchers to develop new theories and to test existing theories.

Importance of the unconscious mind

The unconscious mind comprises mental processes inaccessible to consciousness that influence judgment, feelings, or behavior (Wilson, 2002).

According to the psychodynamic approach, the unconscious is the part of the mind that contains things we are unaware of, such as feelings, thoughts, urges, and memories.

According to Freud (1915), the unconscious mind is the primary source of human behavior. Like an iceberg, the most important part of the mind is the part you cannot see. Our feelings, motives, and decisions are powerfully influenced by past experiences and stored in the unconscious.

Most of the content of the unconscious is unacceptable or unpleasant and could cause feelings of pain, anxiety, or conflict if it becomes conscious.

For example, hysteria is an example of a physical symptom that has no physical cause though the ailment is just as real as if it had, but rather is caused by some underlying unconscious problem.

The unconscious is seen as a vital part of the individual. It is irrational, emotional, and has no concept of reality which is why its attempts to leak out must be inhibited.

The role of the unconscious mind is to protect the ego from this content. However, according to Freud, the content of the unconscious motivates our feelings, motives, and decisions.

Importance of early experience

Our behavior and feelings as adults (including psychological problems) are rooted in our childhood experiences.

The psychodynamic theory states that events in our childhood have a significant influence on our adult lives, shaping our personality. 

Personality is shaped as the drives are modified by different conflicts at different times in childhood (during psychosexual development).

Freud’s theory of psychosexual stages of development predicated that childhood experiences create the adult personality. Events that occur in childhood can remain in the unconscious and cause problems as adults, such as mental illness.

Psychic determinism

Psychodynamic theory is strongly determinist as it views our behavior as entirely caused by unconscious emotional drives over which we have no control.

Unconscious thoughts and feelings can transfer to the conscious mind through parapraxes, popularly known as Freudian slips or slips of the tongue. We reveal what is really on our minds by saying something we didn’t mean to.

Freud believed that slips of the tongue provided an insight into the unconscious mind and that there were no accidents, every behavior (including slips of the tongue) was significant (i.e., all behavior is determined).

Behavior can be explained in terms of the inner conflicts of the mind

Personality comprises three parts (i.e., tripartite): the id, ego, and super-ego . Parts of the unconscious mind (the id and superego) are in constant conflict with the conscious part of the mind (the ego). 

• The id is the primitive and instinctive component of personality. It consists of all the inherited (i.e., biological) components of personality present at birth, including the sex (life) instinct – Eros (which contains the libido), and the aggressive (death) instinct – Thanatos.
• The ego develops to mediate between the unrealistic id and the external real world. It is the decision-making component of personality.
• The superego incorporates society’s values and morals, which are learned from one’s parents and others. It has two components: the ego ideal, which sets the standards, and the conscience, which produces guilt. 

When unconscious conflicts between the id and the superego cannot be resolved by the ego, they create anxiety. To reduce this anxiety, we use defense mechanisms such as repression.

To be mentally healthy, the ego has to be able to balance the demands of the ego and the superego. If the superego is dominant, the individual might develop a neurosis e.g., depression. If the id is dominant, the individual might develop a psychosis e.g., schizophrenia.

According to the psychodynamic approach, the therapist would resolve the problem by assisting the client to delve back into their childhood and identify when the problem arose.

Having identified the problem, this can be brought into the conscious, where the imbalance can be resolved, returning equanimity between the id, ego, and superego.

Consequently, the defense mechanisms will only operate at the maintenance level, and the mental illness will be cured.

Key Figures

• Sigmund Freud : Freud is the founder of psychoanalysis and the psychodynamic approach. He developed many key concepts of psychodynamic theory, such as the unconscious mind, psychosexual development, and defense mechanisms.

Freudians and neo-Freudians both subscribe to the psychodynamic approach to psychology, which emphasizes the role of unconscious mental processes in human behavior and emotions.

Neo-Freudians expanded on or challenged Freud’s original theories. They were all influenced by Freud’s work, but they also developed their own unique theories about human behavior and personality. 

• Carl Jung :  Jung was a Swiss psychiatrist and one of Freud’s closest collaborators. However, he later broke away from Freud to develop his theory of personality, known as Jungian analysis. Jung’s theory emphasized the importance of the collective unconscious, a shared reservoir of knowledge and experience inherited from our ancestors.
• Alfred Adler : Adler was another Austrian psychiatrist who was a student of Freud’s. However, he later broke away from Freud to develop his theory of personality, known as individual psychology. Adler’s theory emphasized the importance of striving for superiority and belonging.
• Melanie Klein : Klein was a British psychoanalyst who contributed significantly to understanding early childhood development and child psychopathology.
• Karen Horney : Horney was a German-American psychoanalyst who was one of the first female psychoanalysts to be taken seriously. Her work focused on the impact of social and cultural factors on personality development. Horney believed that anxiety was the root cause of all psychopathology.
• Erik Erikson : Erikson was a German-American psychoanalyst who developed the theory of psychosocial development. Erikson’s theory describes the eight stages of development that people go through from birth to death.

Psychodynamic vs Psychoanalytic

Both psychodynamic and psychoanalytic theories originate from the ideas of Sigmund Freud, but they have different applications and emphases.

Psychoanalytic theory is the original theory of the unconscious mind, developed by Sigmund Freud. Freud believed the unconscious mind is a powerful force influencing our thoughts, feelings, and behaviors. He also believed that childhood experiences are critical in shaping personality and behavior.

Psychodynamic theory is a broader term that encompasses a variety of theories that are based on Freudian principles.

Psychodynamic theorists generally agree that the unconscious mind is important, but they may have different views on its role in human behavior and how it develops.

Some psychodynamic theorists also emphasize social and cultural factors more than Freud did. Some of the most notable Neo-Freudians include Carl Jung, Alfred Adler, Karen Horney, and Erich Fromm.

Historical Timeline

• Anna O, a patient of Dr. Joseph Breuer (Freud’s mentor and friend) from 1800 to 1882 suffered from hysteria.
• In 1895 Breuer and his assistant, Sigmund Freud, wrote a book, Studies on Hysteria . In it, they explained their theory: Every hysteria is the result of a traumatic experience, one that cannot be integrated into the person’s understanding of the world. The publication establishes Freud as “the father of psychoanalysis.
• By 1896, Freud had found the key to his own system, naming it psychoanalysis . In it, he had replaced hypnosis with “free association.”
• In 1900, Freud published his first major work, The Interpretation of Dreams , which established the importance of psychoanalytical movement.
• In 1902, Freud founded the Psychological Wednesday Society , later transformed into the Vienna Psychoanalytic Society .
• As the organization grew, Freud established an inner circle of devoted followers, the so-called “Committee” (including Sàndor Ferenczi, and Hanns Sachs (standing) Otto Rank, Karl Abraham, Max Eitingon, and Ernest Jones).

• Freud and his colleagues came to Massachusetts in 1909 to lecture on their new methods of understanding mental illness. Those in attendance included some of the country’s most important intellectual figures, such as William James , Franz Boas, and Adolf Meyer.
• In the years following the visit to the United States, the International Psychoanalytic Association was founded. Freud designated Carl Jung as his successor to lead the Association, and chapters were created in major cities in Europe and elsewhere. .
• Regular meetings or congresses were held to discuss the theory, therapy, and cultural applications of the new discipline.
• Carl Jung’s study on schizophrenia, The Psychology of Dementia Praecox, led him to collaborate with Sigmund Freud.
• Jung’s close collaboration with Freud lasted until 1913. Jung had become increasingly critical of Freud’s exclusively sexual definition of libido and incest. The publication of Jung’s Wandlungen und Symbole der Libido (known in English as The Psychology of the Unconscious) led to a final break.
• Following his emergence from this period of crisis, Jung developed his own theories systematically under the name of Analytical Psychology. Jung’s concepts of the collective unconscious and the archetypes led him to explore religion in the East and West, myths, alchemy, and later flying saucers.
• Melanie Klein took psychoanalytic thinking in a new direction by recognizing the importance of our earliest childhood experiences in the formation of our adult emotional world. .After becoming a full member of the Berlin Psychoanalytic Society in 1923, Klein embarks upon her first analysis of a child. 
• Extending and developing Sigmund Freud’s ideas, Klein drew on her analysis of children’s play to formulate new concepts such as the paranoid-schizoid position and the depressive position.
• Alfred Adler (1927) thought that the basic psychological element of neurosis was a sense of inferiority and that individuals suffering with the symptoms of this phenomenon spent their lives trying to overcome the feelings without ever being in touch with reality
• Wilhelm Reich (1933) was a psychoanalyst who developed a number of radical psychoanalytical and physical theories. An apprentice of Freud, he believed that neuroses, as well as physical illnesses such as cancer, derived from a lack of “orgone energy” in the body.
• Anna Freud (Freud’s daughter) became a major force in British psychology, specializing in the application of psychoanalysis to children.  Among her best known works are The Ego and the Mechanism of defense (1936).
• Erich Fromm , born in Frankfurt, was educated in Heidelberg and Munich before establishing a private psychotherapy practice in 1925. Fromm began as a disciple of Sigmund Freud, combining his psychological theories with Karl Marx’s social principle.

Issues and Debates

Free will vs determinism.

It is strongly determinist as it views our behavior as caused entirely by unconscious factors over which we have no control.

Nature vs. Nurture

Sigmund Freud believed both nature (innate drives) and nurture (early life experiences) played crucial roles in human development. For Freud, the interplay of nature and nurture was central to understanding human psychology.

He posited that individuals have inborn instincts and drives, like the id’s desires. Simultaneously, he emphasized the profound impact of early childhood experiences, especially within the family dynamic, on personality and behavior.

The psychodynamic approach argues that we are driven by innate biological instincts, represented by the Id (nature), but the ways these instincts are expressed are shaped by our social and cultural environment, such as early childhood experiences (nurture).

Holism vs. Reductionism

The psychodynamic approach is determinist as it rejects the idea of free will. A person’s behavior is determined by their unconscious motives which are shaped by their biological drives and their early experiences.

Idiographic vs. Nomothetic

Freud argued that human behavior is governed by universal processes that apply to everyone e.g. the tripartite structure of the mind (nomothetic).

However, he also proposed that the ways in which these processes manifest themselves in the individual is unique (idiographic).

Are the research methods used scientific?

The concepts proposed by Freud cannot be tested empirically . The theory is not falsifiable. If people behave in the way predicted by the theory, it is viewed as a support; if they don’t, it is argued that they are using defense mechanisms.

Critical Evaluation

The psychodynamic approach has given rise to one of the first “talking cure”, psychoanalysis, on which many psychological therapies are now based. Psychoanalysis is rarely used now in its original form, but it is still used in a shorter version in some cases.

Psychoanalytic therapy has been seen as appropriate mainly for the neurotic disorders (e.g. anxiety and eating disorders) rather than for the psychotic disorders such as schizophrenia. It is also used for depression although its effectiveness in this area is more questionable because of the apathetic nature of the depressive patients.

Bachrach et al., (1991) suggests that psychoanalysis may not be appropriate for patients suffering from obsessive-compulsive disorder in that it may inadvertently increase their tendency to over-interpret events in their life.

One of the very influential concept put forward by Freud is the lasting importance of childhood on later life and development. This has influenced Bowlby’s theory of attachment . John Bowlby (1952) was a psychoanalyst (like Freud) and believed that mental health and behavioral problems could be attributed to early childhood.

The greatest criticism of the psychodynamic approach is that it is unscientific in its analysis of human behavior.  Many of the concepts central to Freud’s theories are subjective and as such, difficult to test scientifically.

For example, how can scientifically study concepts like the unconscious mind or the tripartite personality?  In this respect, it could be argued that the psychodynamic perspective is unfalsifiable as its theories cannot be empirically investigated.

However, cognitive psychology has identified unconscious processes, such as procedural memory (Tulving, 1972), automatic processing (Bargh & Chartrand, 1999; Stroop, 1935), and social psychology have shown the importance of implicit processing (Greenwald & Banaji, 1995). Such empirical findings have demonstrated the role of unconscious processes in human behavior.

The concepts of id, ego and superego are very abstract and difficult to test experimentally, so evidence is obtained from case studies ( Little Hans , and Anna O ). However, the sample used in these case studies is mainly Austrian, so lacks population validity.

Kline (1989) argues that psychodynamic theory comprises a series of hypotheses, some more easily tested than others and some with more supporting evidence than others. Also, while the theories of the psychodynamic approach may not be easily tested, this does not mean that it does not have strong explanatory power.

The main problem here is that the case studies are based on studying one person in detail, and concerning Freud, the individuals in question are most often middle-aged women from Vienna (i.e., his patients). This makes generalizations to the wider population (e.g., the whole world) difficult.

Another problem with the case study method is that it is susceptible to researcher bias. Reexamination of Freud’s own clinical work suggests that he sometimes distorted his patients” case histories to “fit” with his theory (Sulloway, 1991).

The humanistic approach criticizes that the psychodynamic perspective is too deterministic. Freud suggests that all thoughts, behaviors, and emotions are determined by our childhood experiences and unconscious mental processes. This is a weakness because it suggests we have no conscious free will over our behavior, leaving little room for the idea of personal agency (i.e., free will).

The individual is not seen as responsible for their disorders however as the conflicts which lead to the disorder are unconscious there is nothing they can do about it without an analyst, they are disempowered.

The psychodynamic approach can be criticized for being sexist against women. For example, Freud believed that females” penis envy made them inferior to males. He also thought that females tended to develop weaker superegos and were more prone to anxiety than males.

Finally, it cannot explain the biological symptoms observed in some disorders, such as enlarged ventricles in schizophrenics.

Adler, A., Jelliffe, S. Ely. (1917). Study of Organ Inferiority and its Psychical Compensation: A Contribution to Clinical Medicine. New York: Nervous and Mental Disease Publishing Company.

Adler, A. (1927). Understanding human nature. New York: Greenburg.

Bachrach, H. M., Galatzer-Levy, R., Skolnikoff, A., & Waldron Jr, S. (1991). On the efficacy of psychoanalysis.  Journal of the American Psychoanalytic Association ,  39 (4), 871-916.

Bargh, J. A., & Chartrand, T. L. (1999). The unbearable automaticity of being . American psychologist, 54(7) , 462.

Bowlby, J. (1952). Maternal care and mental health.  Journal of Consulting Psychology, 16(3) , 232.

Erikson, E. H. (1950). Childhood and society . New York: Norton.

Freud, A. (1936). Ego & the mechanisms of defense .

Freud, S., & Breuer. J. (1895). Studies on hysteria . In Standard edition (Vol. 2, pp. 1–335).

Freud, S. (1896). Heredity and the etiology of the neuroses. In Standard edition (Vol. 3, pp. 142–156).

Freud, S. (1900). The interpretation of dreams . In Standard edition (Vols. 4 & 5, pp. 1–627).

Freud, S. (1909). Notes upon a case of obsessional neurosis. In Standard edition (Vol. 10, pp. 153–249).

Freud, S. (1909). Analysis of a phobia of a five year old boy. In The Pelican Freud Library (1977), Vol 8, Case Histories 1, pages 169-306.

Freud, S. (1915). The unconscious . SE, 14: 159-204.

Freud, A. (1936). The Ego and the Mechanisms of Defense . International Universities Press, Inc.

Fromm, E. (1959). Psychoanalysis and Zen Buddhism. Psychologia, 2 (2), 79-99.

Greenwald, A. G., & Banaji, M. R. (1995). Implicit social cognition: attitudes, self-esteem, and stereotypes. Psychological review , 102(1), 4.

Jung, C. G. (1907). Ueber die Psychologie der Dementia praecox. Psychological Bulletin, 4(6) , 196-197.

Jung, C. G. (1912). Wandlungen und Symbole der Libido: Beiträge zur Entwicklungsgeschichte des Denkens. F. Deuticke.

Jung, C. G., et al. (1964). Man and his Symbols , New York, N.Y.: Anchor Books, Doubleday.

Kline, P. (1989). Objective tests of Freud’s theories. Psychology Survey , 7, 127-45.

Stroop, J. R. (1935). Studies of interference in serial verbal reactions. Journal of experimental psychology , 18(6), 643.

Sulloway, F. J. (1991). Reassessing Freud’s case histories: The social construction of psychoanalysis. Isis , 82(2), 245-275.

Tulving, E. (1972). Episodic and semantic memory. In E. Tulving & W. Donaldson (Eds.), Organization of Memory , (pp. 381–403). New York: Academic Press.

Reich, W. (1933). On character analysis. The Psychoanalytic Review (1913-1957), 20, 89.

Wilson, T. D. (2004). Strangers to ourselves . Harvard University Press.

Is there a difference between psychodynamic and psychoanalytic?

The words psychodynamic and psychoanalytic are often confused. Remember that Freud’s theories were psychoanalytic, whereas the term ‘psychodynamic’ refers to both his theories and those of his followers.

What is psychodynamic in simple terms?

Sigmund Freud highlights the role of the unconscious mind, the structure of personality, and the influence that childhood experiences have on later life.

Freud believed that the unconscious mind determines most of our behavior and that we are motivated by unconscious emotional drives.

Psychodynamic Psychotherapy 102: Questions to Guide Case Conceptualization and Intervention

by Thomas Lindquist, PsyD, ATR | May 5, 2022 | Clinical Corner

Each year I sit down with trainees to review our goals for supervision and collaborate around areas of growth. For many, learning about psychodynamic psychotherapy is often at the top of the list. 

This post discusses different dimensions of psychodynamic therapy that present-day practitioners think about when they work with their patients and provides practical questions to aid in addressing these dimensions in practice. 

What’s notable is what isn’t on this list. Psychodynamic psychotherapy is built upon a lengthy history with plenty of room for myths and misunderstandings. Frequent misgivings often result from negative cultural stereotypes and a lack of knowledge regarding current research and practice. Ultimately, the ways psychodynamic clinicians practice today are often far different from the early days of psychoanalysis.

For example, the pronounced shift toward relational psychoanalysis and intersubjectivity in the early 1980s sometimes seems to go unnoticed. Moreover, assumptions about the therapist as a blank slate, extended silences, and lofty interpretations as the standard elements of practice remain a common misperception amongst some students and practitioners.    

One of the challenges in educating and training involves translating theory into practice. In my experience, this can be particularly difficult when teaching psychodynamic therapy. In contrast to more structured approaches — where explicit training can be provided through the use of thought records, cognitive restructuring exercises, and skill-based strategies — psychodynamic interventions are sometimes less tangible.

Likewise, approaches aimed at reducing observable symptoms are typically easier to measure. Although identifying and reducing symptoms is a common goal for most approaches, psychodynamic therapy adds emphasis on understanding the origin and function of symptoms. I wrote about this in a previous blog post .

Furthermore, goals such as developing greater autonomy, expanding capacities for affect tolerance and regulation, deepening self-understanding, exploring inner conflicts, and promoting realistic and reliable self-esteem are common goals that may not always translate well to concrete interventions or manualized protocols.        

The following dimensions and questions were assembled in an attempt to help make psychodynamic psychotherapy more accessible by providing concrete starting points within key areas important to understanding and working with clients in therapy. Thinking about therapy through these domains – and through these questions – can facilitate case conceptualization and lead to useful considerations in planning interventions or responding to the here-and-now in the therapy process. Generally, these questions should be thought of as useful starting points and not manualized instructions.

Adaptive Functioning

Psychological symptoms often have multiple causes and can serve multiple purposes or have multiple functions [1]. Psychodynamic therapists generally view symptoms as related to previously adaptive attempts to manage or deal with distress, provide some form of a solution, and fulfill more than one unconscious function. Understanding the role symptoms and behaviors play in adaptation and how they came to have a negative impact on current functioning is an important component of psychodynamic psychotherapy as this helps elucidate the underlying factors that sustain or perpetuate symptoms.  

The following questions allow for thinking more deeply about adaptive functioning:

What are the functions of the current systems?

How can the client’s underlying core issues be brought into conscious awareness?

How can you help the client loosen the grip of past experiences to create new perspective and opportunities?

Freud first wrote about psychological defenses in Studies on Hysteria [2] where he described defenses as “warding off” or “fending off.” Since inception, defenses have been seen as unconscious attempts to avoid or fend off powerful, threatening emotions and distress.  According to McWilliams (2011) defenses are unconsciously used for the “(1) avoidance or management of some powerful, threatening feeling, usually anxiety, but sometimes overwhelming grief, shame, envy, and other disorganizing emotional experiences; and (2) the maintenance of self-esteem” [3].

Understanding and illuminating defenses is an important step in working to address underlying issues or painful feelings that have been avoided so that the client can work through and make more deliberate and thoughtful choices while making room for more adaptive defenses.

When considering defenses, it is also important to examine how groups of defenses function together or what is are referred to as “characteristic defenses.” Suggestions for further reading about defenses include George Vaillant’s 1992 book Ego Mechanisms of Defense and Nancy McWilliam’s 2011 book Psychoanalytic Diagnosis: Understanding Personality Structure in the Clinical Process.

The following questions allow for thinking more deeply about defenses:

How does the client avoid or disavow what is distressing?

What aspects of the client’s experience are disavowed? 

How are attempts to avoid reinforced and perpetuated in the life of the client?

How are the client’s attempts to avoid what is painful reflected in their personality or characteristic ways of thinking, feeling, acting, coping, and relating?

How does the client (knowingly or unknowingly) engage in activities that hinder the progress of therapy?

What does a client’s resistance tell us about their personality or character structure? 

Relationship templates, patterns, schemas

According to object relations theory, human beings are shaped in relation to the significant others surrounding them, particularly in childhood. Subsequently, internal representations or templates of self and other relationships acquired in childhood are later played out in adulthood. Bowlby (1988) highlights the importance of exploring representational models and attachment figures so that these models can be reappraised and restructured based on insights that occur within the therapeutic relationship [4].

Exploring and understanding these templates and patterns of relationships can lead to greater flexibility and new ways of relating to others as a client comes to understand their attachment patterns and the impact of these patterns on their overall functioning. Suggestions for further reading on object relations and attachment include Steven Wallin’s 2015 book Attachment in Psychotherapy , and David E. Scharff’s 1996 book Object Relations Theory and Practice , which provides a broad introduction covering many of the major figures in psychoanalytic theory. 

The following questions allow for thinking more deeply about relationships:

How does the client view the present through the lens of past experiences?

How do past childhood experiences, past unresolved conflicts, and historical relationships significantly affect a person’s present life situation?

How are patterns in the client’s interpersonal functioning repeated over time, settings, and with various people?

How do the client’s relationships promote or interfere with their ability to fulfill their basic needs and wishes?

Inner conflict, contradiction, and ambivalence

Inner conflict is generally seen as a primary cause of psychological distress. Exploring inner conflict with the goal of working through and processing ambivalence to achieve a new level of insight and awareness often leads to a reduction of symptoms and more adaptive solutions to problems. The goal is generally not to eliminate conflicts, but to work towards more effective and adaptive solutions [5].

The following questions allow for thinking more deeply about conflict:

What inner conflicts do you find with this client?

What seems irreconcilable or contradictory about the client’s inner experiences? 

What two or more opposing views, values, or options is the client attempting to reconcile? 

How does the client experience or manage inner conflict or ambivalence?

How does inner conflict or ambivalence contribute to psychological distress and maladaptive behaviors?

Transference

We all carry our attachment history or expectations into new relationships. For this reason, a client is likely to reenact or engage with the therapist in ways that repeat as they bring previous templates and scripts into the therapy situation. Therefore, the therapy relationship becomes a useful tool for understanding the ways a client relates to others and the problems that might arise in relationships.

The following questions allow for thinking more deeply about transference:

How is the client relating to you?

How are old patterns, expectations, desires, and schemas activated or enacted in the therapy sessions? 

How can we help the client examine, understand, and rework them?

What role(s) does your client assign to you and how do they play it out?

Countertransference  

As a therapist, we likewise carry a history of attachment patterns and object relationships as well as unique inner conflicts and beliefs about ourselves, others, and the world. We also have reactions to our clients in a way that is similar to a client’s transference. Knowing ourselves and the role of our psychology in the therapy room is helpful, as it allows for us to better understand how our reactions are typical for us or related to our past object relationships versus unique to the presentation and interpersonal dynamics of a client.

This knowledge can help us to further understand a client’s inner world as well as the ways a client impacts others and how their patterns of relating unfold in ways that are either helpful or harmful. This is also a primary reason why therapy for the therapist is an important element of personal and professional development.

The following questions allow for thinking more deeply about countertransference:

How are you relating to the client?

How are your own conflicts and relationship templates being activated or enacted in the therapy session and with the therapy relationship? 

What is going on in the relational dynamics of therapy ?

Self-esteem, Self-regulation, Self-efficacy

Heinz Kohut (1978) identified the maturation of a cohesive nuclear self and core of the personality as central to development and includes a person’s perception of their experience of self, as well as the presence or lack of a sense of self-esteem, as important [6]. A coherent sense of self has been defined as one that is stable, adaptive, flexible and energized [7].

Self-esteem is understood as rooted in childhood experiences related to the responsiveness of early caregivers in promoting a secure attachment [8]. Therefore, supporting a therapy client in both solidifying and living more and more from within a coherent self with a realistic and reliable sense of self-esteem is common goal in psychotherapy.

Likewise, assisting a client in developing a realistic and reliable sense of self-esteem means supporting one that is based on a reasonable set of criteria for self-evaluation and consistently protects a person from becoming devastated by criticism or easily manipulated by excessive praise [9]. 

The following questions allow for thinking more deeply about sense of self:

How does the client experience themselves? 

How does the client tolerate and manage ambiguity and uncertainty?

Does the client experience internal restraints and rigidities that are problematic?

How are the client’s thoughts, feelings, and actions part of larger, more general patterns and themes? 

Emotion and Affect

Focusing on affect and the expression of emotion has long been a key component of psychodynamic therapy [10]. Emotional awareness or emotional intelligence is also recognized as a significant component of healthy psychological functioning [11]. Furthermore, a number of approaches, most notably Dialectical Behavior Therapy, have focused on expanding the capacity and skills necessary to improve emotion regulation [12]. Understanding how a client experiences, expresses, and manages emotion is therefore an important part of therapy, as are the goals around expanding the capacity to identify emotion and regulate affect with increasingly adaptive defenses [9]. Regulating or tolerating painful affect instead of taking self-destructive actions to manage them is particularly relevant to therapy and an important area to address as defenses are lowered and focus on expressing emotion is encouraged. 

The following questions allow for thinking more deeply about emotion and affect:

What does the client feel?

How does the client experience and manage affect?

What does the client communicate implicitly and nonverbally?

Is the client able to access and enjoy a full range of emotion?

What are the client’s beliefs and historical templates for emotions and emotional expression?

How can you help the client find a way to express, understand, and be comfortable with their intense feelings?

The questions outlined above aim to make psychodynamic psychotherapy more accessible by providing questions or prompts as entry points. Asking these questions can help illuminate several core constructs of psychodynamic theory and assist in better understanding how these concepts appear in practice. Ultimately, the answers to these questions can facilitate case conceptualization and lead to useful considerations in planning interventions or responding to the here-and-now in the therapy process.

Readers interested in learning more about psychodynamic theory and practice as described in this article might consider reading Nancy McWilliam’s 2004 book Psychoanalytic Psychotherapy: A Practitioner’s Guide and well as her 2011 book Psychoanalytic Diagnosis: Understanding Personality Structure in the Clinical Process, 2nd Edition .

Teri Quatman’s 2015 book Essential Psychodynamic Psychotherapy: An Acquired Art and Karen J. Maroda’s 2009 book Psychodynamic Techniques: Working with Emotion in the Therapy Relationship are also accessible and useful for learning more about psychodynamic theory and practice.

Glen O. Gabbard’s 2010 book Long-term Psychodynamic Psychotherapy: A Basic Text 2nd Edition is a useful basic introduction. Jonathan Shedler’s 2010 article The Efficacy of Psychodynamic Psychotherapy is an excellent summary of empirical evidence supporting the efficacy of psychodynamic therapy.   

[1] Waelder, R. (2007). The principle of multiple function: Observations on over-determination. The Psychoanalytic Quarterly LXXVI (1), 75-92.

[2] Freud, S. (1895). Studies on Hysteria, SE, 2. With Josef Breuer. In J. Strachey (Ed.), The standard edition of the complete psychological works of Sigmund Freud (pp. 1953-1974). Hogarth Press.

[3] McWilliams, Nancy (2011). Psychoanalytic Diagnosis: Understanding Personality Structure in the Clinical Process (2nd ed.). New York: Guilford Press.

[4] Bowlby, J. (1988). A secure base: Parent-child attachment and healthy human development . Basic Books.

[5] Gabbard, G. O. (2010). Long-term psychodynamic psychotherapy: A basic text (2nd ed.)

[6] Kohut, H., & Wolf, E.S. (1978). The Disorders of the Self and their Treatment: An Outline. The International Journal of Psychoanalysis, 59 (4), 413-425.

[7] Wallin, D. J. (2007). Attachment in psychotherapy . New York: Guilford Press.

[8] Ainsworth, M. D. S., Blehar, M. C., Waters, E., & Wall, S. (1978). Patterns of attachment: A psychological study of the strange situation . Hillsdale, NJ: Erlbaum.

[9] McWilliams, Nancy (2021). Psychanalytic supervision . The Guilford Press.

[10] Blagys, M.D. & Hilsenroth, M.J. (2000). Distinctive of short-term psychodynamic-interpersonal psychotherapy: A review of the comparative psychotherapy process literature. Clinical Psychology: Science and Practice, 7 (2), 167-189.

[11] Goleman, D. P. (1995). Emotional intelligence: Why it can matter more than IQ for character, health and lifelong achievement . New York: Bantam Books. [12] Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder . New York, NY: Guilford Press.

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FOCUSED REVIEW article

Clinical case studies in psychoanalytic and psychodynamic treatment.

This article mentions parts of:

Theoretical pluralism in psychoanalytic case studies

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• Centre for Psychoanalytic Studies, University of Essex, Colchester, UK

This manuscript provides a review of the clinical case study within the field of psychoanalytic and psychodynamic treatment. The method has been contested for methodological reasons and because it would contribute to theoretical pluralism in the field. We summarize how the case study method is being applied in different schools of psychoanalysis, and we clarify the unique strengths of this method and areas for improvement. Finally, based on the literature and on our own experience with case study research, we come to formulate nine guidelines for future case study authors: (1) basic information to include, (2) clarification of the motivation to select a particular patient, (3) information about informed consent and disguise, (4) patient background and context of referral or self-referral, (5) patient's narrative, therapist's observations and interpretations, (6) interpretative heuristics, (7) reflexivity and counter-transference, (8) leaving room for interpretation, and (9) answering the research question, and comparison with other cases.

Introduction

Psychoanalysis has always been, according to its inventor, both a research endeavor and a therapeutic endeavor. Furthermore it is clear from Freud's autobiography that he prioritized the research aspect; he did not become a doctor because he wished to cure people in ill health ( Freud, 2001 [1925] ). His invention of the psychoanalytic approach to therapy, involving the patient lying down and associating freely, served a research purpose as much as a therapeutic purpose. Through free association, he would be able to gain unique insight in the human mind. Next, he had to find a format to report on his findings, and this would be the case study. The case study method already existed in medicine ( Forrester, 2016 ), but Freud adjusted it considerably. Case studies in medical settings were more like case files, in which the patient was described or reduced to a number of medical categories: the patient became a case of some particular ailment ( Forrester, 2016 ). In Freud's hands, the case study developed into Kranken Geschichten in which the current pathology of the patient is related to the whole of his life, sometimes even over generations.

Although Freud's case studies have demonstrably provided data for generations of research by analysts ( Midgley, 2006a ) and various scholars ( Pletsch, 1982 ; Sealey, 2011 ; Damousi et al., 2015 ), the method of the case study has become very controversial. According to Midgley (2006b) , objections against the case study method can be grouped into three arguments. First there is the data problem: case studies provide no objective clinical data ( Widlöcher, 1994 ), they only report on what went right and disregard any confusion or mistakes ( Spence, 2001 ). Second, there is the data analysis problem: the way in which the observations of the case study are analyzed lack validity; case studies confirm what we already know ( Spence, 2001 ). Some go even so far to say that they are purely subjective: Michels calls case studies the “crystallization of the analyst's countertransference” ( Michels, 2000 , p. 373). Thirdly, there is the generalizability problem: it is not possible to gain generalizable insight from case studies. Reading, writing and presenting case studies has been described as being a group ritual to affirm analysts in their professional identity, rather than a research method ( Widlöcher, 1994 ).

These criticisms stand in contrast to the respect gained by the case study method in the last two decades. Since the 1990s there has been an increasing number of psychoanalytic and psychodynamic clinical case study and empirical case studies being published in scientific journals ( Desmet et al., 2013 ; Cornelis et al., in press ). It has also been signaled that the case study method is being revived more broadly in the social sciences. In the most recent, fifth edition of his seminal book on case study research, Yinn (2014) includes a figure showing the steady increase of the frequency with which the term “case study research” appears in published books in the period from 1980 to 2008.

KEY CONCEPT 1. Clinical case study A clinical case study is a narrative report by the therapist of what happened during a therapy together with the therapist's interpretations of what happened. It is possible that certain (semi)-structured assessment instruments, such as a questionnaire or a diagnostic interview are included in clinical case studies, yet it is still the therapist that uses these, interprets and discusses them.

KEY CONCEPT 2. Empirical case studies In an empirical case study data are gathered from different sources (e.g., self-report, observation,…) and there is a research team involved in the analyses of the data. This study can take place either in a naturalistic setting (systematic case study) or in a controlled experimental environment (single-case experiment).

In addition to the controversy about the case study method, psychoanalysis has developed into a fragmented discipline. The different psychoanalytic schools share Freud's idea of the unconscious mind, but they focus on different aspects in his theoretical work. Some of the schools still operate under the wings of the International Psychoanalytic Association, while others have established their own global association. Each school is linked to one or several key psychoanalysts who have developed their own version of psychoanalysis. Each psychoanalytic school has a different set of theories but there are also differences in the training of new psychoanalysts and in the therapeutic techniques that are applied by its proponents.

Based on this heterogeneity of perspectives in psychoanalysis, a research group around the Single Case Archive investigated the current status of case study research in psychoanalysis ( Willemsen et al., 2015a ). They were particularly interested to know more about the output and methodology of case studies within the different psychoanalytic schools.

KEY CONCEPT 3. Single case archive The Single Case Archive is an online archive of published clinical and empirical case studies in the field of psychotherapy ( http://www.singlecasearchive.com ). The objective of this archive is to facilitate the study of case studies for research, clinical, and teaching purposes. The online search engine allows the identification of sets of cases in function of specific clinical or research questions.

Our Survey Among Case Study Authors About their Psychoanalytic School

In order to investigate and compare case studies from different psychoanalytic schools, we first had to find a way of identifying to which school the case studies belonged. This is very difficult to judge straightforwardly on the basis of the published case study: the fact that someone cites Winnicott or makes transference interpretations doesn't place him or her firmly within a particular psychoanalytic school. The best approach was to ask the authors themselves. Therefore, we contacted all case study authors included in the Single Case Archive (since the time of our original study in 2013, the archive has expanded). We sent emails and letters in different languages to 445 authors and received 200 replies (45% response rate). We asked them the following question: “ At the time you were working on this specific case, to which psychoanalytic school(s) did you feel most attached? ” Each author was given 10 options: (1) Self Psychology (1.a Theory of Heinz Kohut, 1.b Post-Kohutian Theories, 1.c Intersubjective psychoanalysis), (2) Relational psychoanalysis, (3) Interpersonal psychoanalysis, (4) Object relational psychoanalysis (4.a Theory of Melanie Klein, 4.b Theory of Donald W. Winnicott, 4.c Theory of Wilfred R. Bion, 4.d Theory of Otto F. Kernberg), (5) Ego psychology (or) “Classic psychoanalysis” (5.a Theories of Sigmund Freud, 5.b Ego psychology, 5.c Post-Ego psychology), (6) Lacanian psychoanalysis, (7) Jungian psychoanalysis, (8) National Psychological Association for Psychoanalysis (NPAP) related theory, (9) Modern psychoanalysis related to the Boston or New York Graduate School of Psychoanalysis (BGSP/NYGSP), (10) Other. Respondents could indicate one or more options.

Analysis of the responses indicated that the two oldest schools in psychoanalysis, Object-relations psychoanalysis and Ego psychology, dominate the field in relation to case studies that are published in scientific journals. More than three quarters of all case study authors (77%) reported these schools of thought to be the ones with which they considered themselves most affiliated. Three more recent schools were also well-represented among case studies: Self Psychology, Relational Psychoanalysis, and Interpersonal Psychoanalysis. Lacanian Psychoanalysis, Jungian Psychoanalysis, NPAP related Theory and Modern Psychoanalysis related to the BGSP/NYGSP were only rarely mentioned by case study authors as their school of thought. This does not mean that clinicians or researchers within these latter schools do not write any case studies. It only means that they publish few case studies in the scientific journals included in ISI-ranked journals indexed in Web of Science. But they might have their own journals in which they publish clinical material.

Our survey demonstrated that the majority of case study authors (59%) feel attached to more than one psychoanalytic school. This was in fact one of the surprising findings in our study. It seems that theoretical pluralism is more rule than exception among case study authors. There were some differences between the psychoanalytic schools though in terms of pluralism. Case study authors who feel attached to Self Psychology and Interpersonal Psychoanalysis are the most pluralistic: 92 and 86%, respectively also affiliate with one or more other psychoanalytic schools. Case study authors who feel attached to Object Relations Psychoanalysis are the “purest” group: only 69% of them affiliate with one or more other psychoanalytic schools.

KEY CONCEPT 4. Theoretical pluralism A situation in which several, potentially contradicting, theories coexist. It is sometimes interpreted as a sign of the immaturity of a science, under the assumption that a mature science should arrive at one single coherent truth. Others see theoretical pluralism as unavoidable for any applied discipline, as each theory can highlight only part of reality.

Psychoanalytic Pluralism and the Case Study Method

We were not really surprised to find that Object Relations psychoanalysis and Ego psychology were the most dominant schools in the field of psychoanalytic case studies, as they are very present in European, Latin-American and North-American psychoanalytic institutes. We were more surprised to find such a high degree of pluralism among these case study authors, given the fact that disputes between analysts from different schools can be quite ardent ( Green, 2005 ; Summers, 2008 ). Others have compared the situation of psychoanalytic schools with the Tower of Babel ( Steiner, 1994 ).

It has been argued that the case study method contributes to the degree of theoretical pluralism within psychoanalysis. The reason for this is situated in the reasoning style at the basis of case study research ( Chiesa, 2010 ; Fonagy, 2015 ). The author of a psychoanalytic case study makes a number of observations about the patient within the context of the treatment, and then moves to a conclusion about the patient's psychodynamics in general. The conclusion he or she arrives at inductively gains its “truth value” from the number and quality of observations it is based on. This style of reasoning in case study research is very similar to how clinicians reason in general. Clinicians look for patterns within patients and across patients. If they make similar observations in different patients, or if other psychoanalysts make similar observations in their patients, the weight of the conclusion becomes greater and greater. The problem with this reasoning style is that one can never arrive at definite conclusions: even if a conclusion is based on a large number of observations, it is always possible that the next observation disconfirms the conclusion. Therefore, it could be said, it is impossible to attain “true” knowledge.

The above argument is basically similar to objections against any kind of qualitative research. To this, we argue with Rustin (2003) that there is not one science and no hierarchy of research methods. Each method comes with strengths and weaknesses, and what one gains in terms of control and certainty in a conventional experimental setup is lost in terms of external validity and clinical applicability. Numerous researchers have pleaded for the case study approach as one method among a whole range of research methods in the field of psychoanalysis ( Rustin, 2003 ; Luyten et al., 2006 ; Midgley, 2006b ; Colombo and Michels, 2007 ; Vanheule, 2009 ; Hinshelwood, 2013 ). Leuzinger-Bohleber makes a distinction between clinical research and extra-clinical research ( Leuzinger-Bohleber, 2015 ). Clinical research is the idiographic type of research conducted by a psychoanalyst who is working with a patient. Unconscious phantasies and conflicts are symbolized and put into words at different levels of abstraction. This understanding then molds the perception of the analyst in subsequent clinical situations; even though the basic psychoanalytic attitude of “not knowing” is maintained. The clinical case study is clinical research par excellence . Extra-clinical research consists in the application of different methodologies developed in the natural and human sciences, to the study of the unconscious mind. Leuzinger-Bohleber refers to empirical psychotherapy research, experimental research, literature, cultural studies, etc. We believe that the clinical case study method should step up and claim its place in psychoanalytic research, although we agree that the method should be developed further. This paper and a number of others such as Midgley (2006b) should facilitate this methodological improvement. The clinical research method is very well-suited to address any research question related to the description of phenomena and sequences in psychotherapy (e.g., manifestation and evolution of symptoms and therapeutic relationship over time). It is not suitable for questions related to causality and outcome.

We also want to point out that there is a new evolution in the field of psychotherapy case study research, which consists in the development of methodologies for meta-studies of clinical case studies ( Iwakabe and Gazzola, 2009 ). The evolution builds on the broader tendency in the field of qualitative research to work toward integration or synthesis of qualitative findings ( Finfgeld, 2003 ; Zimmer, 2006 ). The first studies which use this methodology have been published recently: Widdowson (2016) developed a treatment manual for depression, Rabinovich (2016) studied the integration of behavioral and psychoanalytic treatment interventions, and Willemsen et al. (2015b) investigated patterns of transference in perversion. The rich variety of research aims demonstrates the potential of these meta-studies of case studies.

KEY CONCEPT 5. Meta-studies of clinical case studies A meta-study of clinical case studies is a research approach in which findings from cases are aggregated and more general patterns in psychotherapeutic processes are described. Several methodologies for meta-studies have been described, including cross-case analysis of raw data, meta-analysis, meta-synthesis, case comparisons, and review studies in general.

Lack of Basic Information in Psychoanalytic Case Studies

The second research question of our study ( Willemsen et al., 2015a ) concerned the methodological, patient, therapist, and treatment characteristics of published psychoanalytic case studies. All studies included in the Single Case Archive are screened by means of a coding sheet for basic information, the Inventory of Basic Information in Single Cases (IBISC). The IBISC was designed to assess the presence of basic information on patient (e.g., age, gender, reasons to consult), therapist (e.g., age, gender, level of experience), treatment (e.g., duration, frequency, outcome), and the methodology (e.g., therapy notes or audio recoding of sessions). The IBISC coding revealed that a lot of basic information is simply missing in psychoanalytic case studies ( Desmet et al., 2013 ). Patient information is fairly well-reported, but information about therapist, treatment and methodology are often totally absent. Training and years of experience are not mentioned in 84 and 94% of the cases, respectively. The setting of the treatment is not mentioned in 61% of the case studies. In 80% of the cases, it was not mentioned whether the writing of the case studies was on the basis of therapy notes, or audiotapes. In 91% of the cases, it was not mentioned whether informed consent was obtained.

Using variables on which we had more comprehensive information, we compared basic information of case studies from different psychoanalytic schools. This gave us a more detailed insight in the type of case studies that have been generated within each psychoanalytic school, and into the difference between these schools in terms of the kind of case study they generate. We found only minimal differences. Case studies in Relational Psychoanalysis stand out because they involve older patients and longer treatments. Case studies in Interpersonal Psychoanalysis tend to involve young, female patients and male therapists. Case study authors from both these schools tend to report on intensive psychoanalysis in terms of session frequency. But for the rest, it seems that the publication of case studies throughout the different psychoanalytic schools has intensified quite recently.

Guidelines for Writing Clinical Case Studies

One of the main problems in using psychoanalytic case studies for research purposes is the enormous variability in quality of reporting and inconsistency in the provision of basic information about the case. This prevents the reader from contextualizing the case study and it obstructs the comparison of one case study with another. There have been attempts to provide guidelines for the writing of case studies, especially in the context of analytic training within the American Psychoanalytic Association ( Klumpner and Frank, 1991 ; Bernstein, 2008 ). However, these guidelines were never enforced for case study authors by the editors from the main psychoanalytic journals. Therefore, the impact of these guidelines on the field of case study research has remained limited.

Here at the end of our focused review, we would like to provide guidelines for future case study authors. Our guidelines are based on the literature and on our experience with reading, writing, and doing research with clinical case studies. We will include fragments of existing case studies to clarify our guidelines. These guidelines do not provide a structure or framework for the case study; they set out basic principles about what should be included in a case study.

Basic Information

First of all, we think that a clinical case study needs to contain basic information about the patient, the therapist, the treatment, and the research method. In relation to the patient , it is relevant to report on gender, age (or an age range in which to situate the patient), and ethnicity or cultural background. The reader needs to know these characteristics in order to orientate themselves as to who the patient is and what brings them to therapy. In relation to the therapist , it is important to provide information about professional training, level of professional experience, and theoretical orientation. Tuckett (2008) emphasizes the importance for clinicians to be explicit about the theory they are using and about their way of practicing. It is not sufficient to state membership of a particular group or school, because most groups have a wide range of different ways of practicing. In relation to the treatment itself, it is important to be explicit about the kind of setting, the duration of treatment, the frequency of sessions, and details about separate sequences in the treatment (diagnostic phase, follow-up etc.). These are essential features to share, especially at a time when public sector mental health treatment is being subjected to tight time restrictions and particular ways of practising are favored over others. For example short-term psychotherapies are being implemented in public services for social and economic reasons. While case studies carried out in the public sector can give us information on those short-term therapies, private practice can offer details about the patient's progress on a long-term basis. Moreover, it is important to report whether the treatment is completed. To our astonishment, there are a considerable number of published case studies on therapies that were not finished ( Desmet et al., 2013 ). As Freud (2001 [1909] , p. 132) already advised, it is best to wait till completion of the treatment before one starts to work on a case study. Finally, in relation to the research method , it is crucial to mention which type of data were collected (therapy notes taken after each session, audio-recordings, questionnaires, etc.), whether informed consent was given, and in what way the treatment was supervised. Clinicians who would like to have help with checking whether they included all necessary basic information case use the Inventory for Basic Information in Single Cases (IBISC), which is freely available on http://www.singlecasearchive.com/resources .

Motivation to Select a Particular Patient

First of all, it is crucial to know what the motivation for writing about a particular case comes from. Some of the following questions should be kept in mind and made explicit from the beginning of the case presentation. Why is it interesting to look at this case? What is it about this case or the psychotherapist's work that can contribute to the already existing knowledge or technique?

“This treatment resulted in the amelioration of his [obsessive-compulsive] symptoms, which remained stable eight years after treatment ended. Because the standard of care in such cases has become largely behavioral and pharmacological, I will discuss some questions about our current understanding of obsessive-compulsive phenomena that are raised by this case, and some of the factors that likely contributed to the success of psychoanalytic treatment for this child ( McGehee, 2005 , p. 213–214).”

This quotation refers to a case that has been selected on the basis of its successful outcome. The author is then interested to find out what made this case successful.

Informed Consent and Disguise

As regulations on privacy and ethics are becoming tighter, psychotherapists find themselves with a real problem in deciding what is publishable and what is not. Winship (2007) points out that there is a potential negative effect of research overregulation as clinicians may be discouraged from reporting ordinary and everyday findings from their clinical practice. But he also offers very good guidelines for approaching the issue of informed consent. A good practice is asking for consent either at the start of the treatment or after completion of the treatment: preferably not during treatment. It is inadvisable to complete the case study before the treatment has ended. It is also advisable that the process of negotiating consent with the patient is reported in the case study.

“To be sure that Belle's anonymity was preserved, I contacted her while writing this book and told her it would not be published without her complete approval. To do this, I asked if she would review every word of every draft. She has ( Stoller, 1986 , p. 217).”

In relation to disguise, one has to strike a balance between thin and thick disguise. Gabbard (2000) suggests different useful approaches to disguising the identity of the patient.

Patient Background and Context of Referral or Self-Referral

It is important to include relevant facts about the patient's childhood, family history, siblings, any trauma or losses and relationship history (social and romantic) and the current context of the patient's life (family, working, financial). The context of referral is also key to understanding how and why the patient has come to therapy. Was the patient encouraged to come or had wanted to come? Has there been a recent crisis which prompted the intervention or an on-going problem which the patient had wanted to address for some time?

“Michael was one of the youngest children in his family of origin. He had older brothers and sisters who had been received into care before his birth. His parents separated before he was born. There had been some history of violence between them and Michael was received into care on a place of safety order when he was an infant because his mother had been unable to show consistent care toward him ( Lykins Trevatt, 1999 , p. 267).”

Patient's Narrative, Therapist's Observations, and Interpretations

A case study should contain detailed accounts of key moments or central topics, such as a literal transcription of an interaction between patient and therapist, the narration of a dream, a detailed account of associations, etc. This will increase the fidelity of the case studied, especially when both patient's and therapist's speech are reported as carefully as possible.

“Martha spoke in a high-pitched voice which sounded even more tense than usual. She explained that her best friend's mum had shouted at her for being so withdrawn; this made her angry and left her feeling that she wanted to leave their home for good. I told Martha that she often tried to undo her bad feelings by acting quickly on her instincts, as she did not feel able to hold her feelings in her mind and bring them to her therapy to think about with me. Martha nodded but it was not clear whether she could really think about what I just said to her. She then said that she was being held in the hospital until a new foster placement could be found. “In the meantime,” she said in a pleased tone, “I have to be under constant supervision” ( Della Rosa, 2015 , p. 168).”

In this example, observations of nonverbal behavior and tonality are also included, which helps to render a lively picture of the interaction.

Interpretative Heuristics

In which frame of reference is the writer operating? It is important to know what theories are guiding the therapist's thinking and what strategies he employs in order to deal with the clinical situation he is encountering. Tuckett (1993) writes about the importance of knowing what “explanatory model” is used by the therapist in order to make sense of the patient and to relate his own thinking to a wider public for the purpose of research. This idea is also supported by Colombo and Michels (2007) who believe that making theoretical orientations as explicit as possible would make the case studies intelligible and more easily employed by the research community. This can be done by the therapists explaining why they have interpreted a particular situation in the way they have. For example, Kegerreis in her paper on time and lateness (2013) stresses throughout how she is working within the object-relations framework and looking out for the patient's use of projective mechanisms.

“She was 10 minutes late. Smiling rather smugly to herself she told me that the wood supplied for her new floor had been wrongly cut. The suppliers were supposed to come and collect it and hadn't done so, so she had told them she was going to sell it to a friend, and they are now all anxious and in a hurry to get it.

I said she now feels as if she has become more powerful, able to get a response. She agrees, grinning more, telling me she does have friends who would want it, that it was not just a ploy.

She said she had found it easier to get up today but was still late. I wondered if she had a sense of what the lateness was about. She said it was trying to fit too much in. She had been held up by discussing the disposal of rubble with her neighbors.

I said I thought there was a link here with the story about the wood. In that she had turned the situation around. She had something that just didn't work, had a need for something, but it was turned around into something that was the suppliers' problem. They were made to feel the urgency and the need. Maybe when she is late here she is turning it around, so it is me who is to be uncertain and waiting, not her waiting for her time to come.

We maybe learn here something of her early object relationships, in which being in need is felt to be unbearable, might lead to an awful awareness of lack and therefore has to be exported into someone else. One could go further and surmise that in her early experience she felt teased and exploited by the person who has the power to withhold what you need ( Kegerreis, 2013 , p. 458).”

There can be no doubt reading this extract about the theoretical framework which is being used by the therapist.

Reflexivity and Counter-Transference

A good case study contains a high degree of reflexivity, whereby the therapist is able to show his feelings and reactions to the patient's communication in the session and an ability to think about it later with hindsight, by himself or in supervision. This reflexivity needs to show the pattern of the therapist's thinking and how this is related to his school of thought and to his counter-transferential experiences. How has the counter-transference been dealt with in a professional context? One can also consider whether the treatment has been influenced by supervision or discussion with colleagues.

“Recently for a period of a few days I found I was doing bad work. I made mistakes in respect of each one of my patients. The difficulty was in myself and it was partly personal but chiefly associated with a climax that I had reached in my relation to one particular psychotic (research) patient. The difficulty cleared up when I had what is sometimes called a ‘healing’ dream. […] Whatever other interpretations might be made in respect of this dream the result of my having dreamed it and remembered it was that I was able to take up this analysis again and even to heal the harm done to it by my irritability which had its origin in a reactive anxiety of a quality that was appropriate to my contact with a patient with no body ( Winnicott, 1949 , p. 70).”

Leaving Room for Interpretation

A case study is the therapist's perspective on what happened. A case study becomes richer if the author can acknowledge aspects of the story that remain unclear to him. This means that not every bit of reported clinical material should be interpreted and fitted within the framework of the research. There should be some loose ends. Britton and Steiner (1994) refer to the use of interpretations where there is no room for doubt as “soul murder.” A level of uncertainty and confusion make a case study scientifically fruitful ( Colombo and Michels, 2007 ). The writer can include with hindsight what he thinks he has not considered during the treatment and what he thinks could have changed the course for the treatment if he had been aware or included other aspects. This can be seen as an encouragement to continue to be curious and maintain an open research mind.

Answering the Research Question, and Comparison with Other Cases

As in any research report, the author has to answer the research question and relate the findings to the existing literature. Of particular interest is the comparison with other similar cases. Through comparing, aggregating, and contrasting case studies, one can discover to what degree and under what conditions, the findings are valid. In other words, the comparison of cases is the start of a process of generalization of knowledge.

“Although based on a single case study, the results of my research appear to concur with the few case studies already in the field. In reviewing the literature on adolescent bereavement, it was the case studies that had particular resonance with my own work, and offered some of the most illuminating accounts of adolescent bereavement. Of special significance was Laufer's (1966) case study that described the narcissistic identifications of ‘Michael’, a patient whose mother had died in adolescence. Both Laufer's research and my own were conducted using the clinical setting as a basis and so are reflective of day-to-day psychotherapy practice ( Keenan, 2014 , p. 33).”

As Yinn (2014) has argued for the social sciences, the case study method is the method of choice when one wants to study a phenomenon in context, especially when the boundaries between the phenomenon and the context are fussy. We are convinced that the same is true for case study methodology in the fields of psychoanalysis and psychotherapy. The current focused review has positioned the research method within these fields, and has given a number of guidelines for future case study researchers. The authors are fully aware that giving guidelines is a very tricky business, because while it can channel and stimulate research efforts it can as well-limit creativity and originality in research. Moreover, guidelines for good research change over time and have to be negotiated over and over again in the literature. A similar dilemma is often pondered when it comes to qualitative research ( Tracy, 2010 ). However, our first impetus for providing these guidelines is pedagogical. The three authors of this piece are experienced psychotherapists who also work in academia. A lot of our students are interested in doing case study research with their own patients, but they struggle with the methodology. Our second impetus is to improve the scientific credibility of the case study method. Our guidelines for what to include in the written account of a case study, should contribute to the improvement of the quality of the case study literature. The next step in the field of case study research is to increase the accessibility of case studies for researchers, students and practitioners, and to develop methods for comparing or synthesizing case studies. As we have described above, efforts in that direction are being undertaken within the context of the Single Case Archive.

Author Contributions

JW has written paragraphs 1–4; ER and JW have written paragraph 5 together; SK has contributed to paragraph 5 and revised the whole manuscript.

Conflict of Interest Statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Author Biography

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Keywords: clinical case study, methodology, psychotherapy research, psychoanalysis, psychoanalytic schools, theoretical pluralism, review

Citation: Willemsen J, Della Rosa E and Kegerreis S (2017) Clinical Case Studies in Psychoanalytic and Psychodynamic Treatment. Front. Psychol . 8:108. doi: 10.3389/fpsyg.2017.00108

Received: 29 November 2016; Accepted: 16 January 2017; Published: 02 February 2017.

Reviewed by:

Copyright © 2017 Willemsen, Della Rosa and Kegerreis. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: [email protected]

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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10 The Process of Questioning

• Published: February 2019
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Therapist questions are meant to generate patient information that is unknown to the therapist but needed for treatment. They are used to (a) facilitate free association/foster patient exploration and (b) to gain specific information about the patient, their problems, and the unique ways that they think, feel, behave, and respond to the therapy process. Suggestions are provided for the proper wording of questions as well as determining an appropriate frequency for their use. This is because an overuse of questions, or even the inclusion of irrelevant questions, can derail the therapy process and lead to alliance ruptures. However, questions can be used to meet a number of important clinical aims and are a necessary part of any treatment. The chapter ends with a consideration of how therapists can effectively handle patient questions.

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11.2 Freud and the Psychodynamic Perspective

Learning objectives.

By the end of this section, you will be able to:

• Describe the assumptions of the psychodynamic perspective on personality development
• Define and describe the nature and function of the id, ego, and superego
• Define and describe the defense mechanisms
• Define and describe the psychosexual stages of personality development

Sigmund Freud (1856–1939) is probably the most controversial and misunderstood psychological theorist. When reading Freud’s theories, it is important to remember that he was a medical doctor, not a psychologist. There was no such thing as a degree in psychology at the time that he received his education, which can help us understand some of the controversy over his theories today. However, Freud was the first to systematically study and theorize the workings of the unconscious mind in the manner that we associate with modern psychology.

In the early years of his career, Freud worked with Josef Breuer, a Viennese physician. During this time, Freud became intrigued by the story of one of Breuer’s patients, Bertha Pappenheim, who was referred to by the pseudonym Anna O. (Launer, 2005). Anna O. had been caring for her dying father when she began to experience symptoms such as partial paralysis, headaches, blurred vision, amnesia, and hallucinations (Launer, 2005). In Freud’s day, these symptoms were commonly referred to as hysteria. Anna O. turned to Breuer for help. He spent 2 years (1880–1882) treating Anna O. and discovered that allowing her to talk about her experiences seemed to bring some relief of her symptoms. Anna O. called his treatment the “talking cure” (Launer, 2005). Despite the fact that Freud never met Anna O., her story served as the basis for the 1895 book, Studies on Hysteria , which he co-authored with Breuer. Based on Breuer’s description of Anna O.’s treatment, Freud concluded that hysteria was the result of sexual abuse in childhood and that these traumatic experiences had been hidden from consciousness. Breuer disagreed with Freud, which soon ended their work together. However, Freud continued to work to refine talk therapy and build his theory on personality.

Levels of Consciousness

To explain the concept of conscious versus unconscious experience, Freud compared the mind to an iceberg ( Figure 11.5 ). He said that only about one-tenth of our mind is conscious , and the rest of our mind is unconscious . Our unconscious refers to that mental activity of which we are unaware and are unable to access (Freud, 1923). According to Freud, unacceptable urges and desires are kept in our unconscious through a process called repression. For example, we sometimes say things that we don’t intend to say by unintentionally substituting another word for the one we meant. You’ve probably heard of a Freudian slip, the term used to describe this. Freud suggested that slips of the tongue are actually sexual or aggressive urges, accidentally slipping out of our unconscious. Speech errors such as this are quite common. Seeing them as a reflection of unconscious desires, linguists today have found that slips of the tongue tend to occur when we are tired, nervous, or not at our optimal level of cognitive functioning (Motley, 2002).

According to Freud, our personality develops from a conflict between two forces: our biological aggressive and pleasure-seeking drives versus our internal (socialized) control over these drives. Our personality is the result of our efforts to balance these two competing forces. Freud suggested that we can understand this by imagining three interacting systems within our minds. He called them the id, ego, and superego ( Figure 11.6 ).

The unconscious id contains our most primitive drives or urges, and is present from birth. It directs impulses for hunger, thirst, and sex. Freud believed that the id operates on what he called the “pleasure principle,” in which the id seeks immediate gratification. Through social interactions with parents and others in a child’s environment, the ego and superego develop to help control the id. The superego develops as a child interacts with others, learning the social rules for right and wrong. The superego acts as our conscience; it is our moral compass that tells us how we should behave. It strives for perfection and judges our behavior, leading to feelings of pride or—when we fall short of the ideal—feelings of guilt. In contrast to the instinctual id and the rule-based superego, the ego is the rational part of our personality. It’s what Freud considered to be the self, and it is the part of our personality that is seen by others. Its job is to balance the demands of the id and superego in the context of reality; thus, it operates on what Freud called the “reality principle.” The ego helps the id satisfy its desires in a realistic way.

The id and superego are in constant conflict, because the id wants instant gratification regardless of the consequences, but the superego tells us that we must behave in socially acceptable ways. Thus, the ego’s job is to find the middle ground. It helps satisfy the id’s desires in a rational way that will not lead us to feelings of guilt. According to Freud, a person who has a strong ego, which can balance the demands of the id and the superego, has a healthy personality. Freud maintained that imbalances in the system can lead to neurosis (a tendency to experience negative emotions), anxiety disorders, or unhealthy behaviors. For example, a person who is dominated by their id might be narcissistic and impulsive. A person with a dominant superego might be controlled by feelings of guilt and deny themselves even socially acceptable pleasures; conversely, if the superego is weak or absent, a person might become a psychopath. An overly dominant superego might be seen in an over-controlled individual whose rational grasp on reality is so strong that they are unaware of their emotional needs, or, in a neurotic who is overly defensive (overusing ego defense mechanisms).

Defense Mechanisms

Freud believed that feelings of anxiety result from the ego’s inability to mediate the conflict between the id and superego. When this happens, Freud believed that the ego seeks to restore balance through various protective measures known as defense mechanisms ( Figure 11.7 ). When certain events, feelings, or yearnings cause an individual anxiety, the individual wishes to reduce that anxiety. To do that, the individual’s unconscious mind uses ego defense mechanisms , unconscious protective behaviors that aim to reduce anxiety. The ego, usually conscious, resorts to unconscious strivings to protect the ego from being overwhelmed by anxiety. When we use defense mechanisms, we are unaware that we are using them. Further, they operate in various ways that distort reality. According to Freud, we all use ego defense mechanisms.

While everyone uses defense mechanisms, Freud believed that overuse of them may be problematic. For example, let’s say Joe is a high school football player. Deep down, Joe feels sexually attracted to males. His conscious belief is that being gay is immoral and that if he were gay, his family would disown him and he would be ostracized by his peers. Therefore, there is a conflict between his conscious beliefs (being gay is wrong and will result in being ostracized) and his unconscious urges (attraction to males). The idea that he might be gay causes Joe to have feelings of anxiety. How can he decrease his anxiety? Joe may find himself acting very “macho,” making gay jokes, and picking on a school peer who is gay. This way, Joe’s unconscious impulses are further submerged.

There are several different types of defense mechanisms. For instance, in repression, anxiety-causing memories from consciousness are blocked. As an analogy, let’s say your car is making a strange noise, but because you do not have the money to get it fixed, you just turn up the radio so that you no longer hear the strange noise. Eventually you forget about it. Similarly, in the human psyche, if a memory is too overwhelming to deal with, it might be repressed and thus removed from conscious awareness (Freud, 1920). This repressed memory might cause symptoms in other areas.

Another defense mechanism is reaction formation , in which someone expresses feelings, thoughts, and behaviors opposite to their inclinations. In the above example, Joe made fun of a gay peer while himself being attracted to males. In regression , an individual acts much younger than their age. For example, a four-year-old child who resents the arrival of a newborn sibling may act like a baby and revert to drinking out of a bottle. In projection , a person refuses to acknowledge her own unconscious feelings and instead sees those feelings in someone else. Other defense mechanisms include rationalization , displacement , and sublimation .

Link to Learning

Watch this video of Freud's defense mechanisms to review.

Stages of Psychosexual Development

Freud believed that personality develops during early childhood: Childhood experiences shape our personalities as well as our behavior as adults. He asserted that we develop via a series of stages during childhood. Each of us must pass through these childhood stages, and if we do not have the proper nurturing and parenting during a stage, we will be stuck, or fixated, in that stage, even as adults.

In each psychosexual stage of development , the child’s pleasure-seeking urges, coming from the id, are focused on a different area of the body, called an erogenous zone. The stages are oral, anal, phallic, latency, and genital ( Table 11.1 ).

Freud’s psychosexual development theory is quite controversial. To understand the origins of the theory, it is helpful to be familiar with the political, social, and cultural influences of Freud’s day in Vienna at the turn of the 20th century. During this era, a climate of sexual repression, combined with limited understanding and education surrounding human sexuality, heavily influenced Freud’s perspective. Given that sex was a taboo topic, Freud assumed that negative emotional states (neuroses) stemmed from suppression of unconscious sexual and aggressive urges. For Freud, his own recollections and interpretations of patients’ experiences and dreams were sufficient proof that psychosexual stages were universal events in early childhood.

In the oral stage (birth to 1 year), pleasure is focused on the mouth. Eating and the pleasure derived from sucking (nipples, pacifiers, and thumbs) play a large part in a baby’s first year of life. At around 1 year of age, babies are weaned from the bottle or breast, and this process can create conflict if not handled properly by caregivers. According to Freud, an adult who smokes, drinks, overeats, or bites her nails is fixated in the oral stage of her psychosexual development; she may have been weaned too early or too late, resulting in these fixation tendencies, all of which seek to ease anxiety.

After passing through the oral stage, children enter what Freud termed the anal stage (1–3 years). In this stage, children experience pleasure in their bowel and bladder movements, so it makes sense that the conflict in this stage is over toilet training. During this stage of development, children work to master control of themselves. Freud suggested that success at the anal stage depended on how parents handled toilet training. Parents who offer praise and rewards encourage positive results and can help children feel competent. Parents who are harsh in toilet training can cause a child to become so fearful of soiling that they over-control and become fixated at the anal stage, leading to the development of an anal-retentive personality. The anal-retentive personality is stingy and stubborn, has a compulsive need for order and neatness, and might be considered a perfectionist. If parents are too lenient in toilet training, the child may fail to develop sufficient self-control, become fixated at this stage, and develop an anal-expulsive personality. The anal-expulsive personality is messy, careless, disorganized, and prone to emotional outbursts.

Phallic Stage

Freud’s third stage of psychosexual development is the phallic stage (3–6 years), corresponding to the age when children become aware of their bodies and recognize the differences between boys and girls. The erogenous zone in this stage is the genitals. Conflict arises when the child feels a desire for the opposite-sex parent, and jealousy and hatred toward the same-sex parent. For boys, this is called the Oedipus complex, involving a boy's desire for his mother and his urge to replace his father who is seen as a rival for the mother’s attention. The Oedipus complex is named for the Greek myth of Oedipus, who unwittingly kills his biological father and marries his biological mother. According to Freud, the boy is afraid his father will punish him for his feelings, so he experiences castration anxiety . The Oedipus complex is successfully resolved when the boy begins to identify with his father as an indirect way to have the mother. Failure to resolve the Oedipus complex may result in fixation and development of a personality that might be described as vain and overly ambitious.

Freud described penis envy , which he alleged girls experience because they do not have a penis. Girls also experience the Electra complex. The Electra complex, while often attributed to Freud, was actually proposed by Freud’s protégé, Carl Jung (Jung & Kerenyi, 1963). A girl desires the attention of her father and wishes to take her mother’s place. While Freud initially embraced the Electra complex as a parallel to the Oedipus complex, he later rejected it, yet it remains as a cornerstone of Freudian theory, thanks in part to academics in the field (Freud, 1931/1968; Scott, 2005).

Latency Period

Following the phallic stage of psychosexual development is a period known as the latency period (6 years to puberty). This period is not considered a stage, because sexual feelings are dormant as children focus on other pursuits, such as school, friendships, hobbies, and sports. Children generally engage in activities with peers of the same sex, which serves to consolidate a child’s gender-role identity.

Genital Stage

The final stage is the genital stage (from puberty on). In this stage, there is a sexual reawakening as the incestuous urges resurface. The young person redirects these urges to other, more socially acceptable partners (who often resemble the other-sex parent). People in this stage have mature sexual interests, which for Freud meant a strong desire for the opposite sex. Individuals who successfully completed the previous stages, reaching the genital stage with no fixations, are said to be well-balanced, healthy adults.

While most of Freud’s ideas have not found support in modern research, and several contemporary researchers rejected his premises, we cannot discount the contributions that Freud has made to the field of psychology. It was Freud who pointed out that a large part of our mental life is influenced by the experiences of early childhood and takes place outside of our conscious awareness; his theories paved the way for others.

While Freud's focus on biological drives led him to emphasize the impact of sociocultural factors on personality development, his followers quickly realized that biology alone could not account for the diversity they encountered as the practice of psychoanalysis spread during the time of the Nazi Holocaust. The antisemitism which was prevalent during this period of time may have led mainstream psychoanalysts to focus primarily on the universality of the psychological structures of the mind.

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Major Perspectives in Modern Psychology

Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

Amy Morin, LCSW, is a psychotherapist and international bestselling author. Her books, including "13 Things Mentally Strong People Don't Do," have been translated into more than 40 languages. Her TEDx talk,  "The Secret of Becoming Mentally Strong," is one of the most viewed talks of all time.

Verywell / Emily Roberts

• Psychodynamic Perspective
• Behavioral Perspective
• Cognitive Perspective
• Biological Perspective
• Cross-Cultural Perspective
• Evolutionary Perspective
• Humanistic Perspective

Psychological perspectives are different ways of thinking about and explaining human behavior. Psychologists utilize a variety of perspectives when studying how people think, feel, and behave.

Some researchers focus more on one specific school of thought, such as the biological perspective, while others take a more eclectic approach that incorporates multiple points of view.

No single perspective is "better" than another. Instead, each simply emphasizes different aspects of human behavior.

This article explores seven of the major perspectives in psychology, where these perspectives originated, and how they attempt to explain psychological issues. It also provides examples of key ideas from each psychological perspective.

Major Perspectives

The early years of psychology were dominated by a succession of these different schools of thought. If you have taken a psychology course, you might remember learning about structuralism, functionalism , psychoanalysis, behaviorism, and humanism—all of which are different schools of psychological thought.

As psychology has grown, the number and variety of topics psychologists investigate have also expanded. Since the early 1960s, the field of psychology has flourished. It continues to grow rapidly, as has the depth and breadth of subjects studied by psychologists.

Psychological Perspectives Today

Few psychologists identify their outlook according to a particular school of thought. While there are still some pure behaviorists or psychoanalysts, the majority of psychologists today categorize their work according to their specialty area and perspective.

Purpose of Psychological Perspectives

Why are there so many different perspectives in psychology? It is important to remember that every topic in psychology can be looked at in many ways. For example, let's consider the subject of aggression.

• A professional who emphasizes a biological perspective would look at how the brain and nervous system impact aggressive behavior.
• A professional who stresses a behavioral perspective would look at how environmental variables reinforce aggressive actions.
• A professional who utilizes a cross-cultural approach might consider how cultural and social influences contribute to aggressive or violent behavior.

Here are seven of the major perspectives in modern psychology .

1. The Psychodynamic Perspective

The psychodynamic perspective originated with the work of Sigmund Freud . This view of psychology and human behavior emphasizes the role of the unconscious mind , early childhood experiences, and interpersonal relationships to explain human behavior, as well as to treat mental illnesses.

Much thanks to Freud's work and influence, psychoanalysis became one of the earliest major forces within psychology. Freud conceived of the mind as being composed of three key elements: the id, the ego, and the superego .

• The id is the part of the psyche that includes all the primal and unconscious desires.
• The ego is the aspect of the psyche that must deal with the demands of the real world.
• The superego is the last part of the psyche to develop and is tasked with managing all of our internalized morals, standards, and ideals.

While the psychodynamic perspective is not as dominant today, it continues to be a useful psychotherapeutic tool.  

2. The Behavioral Perspective

Behavioral psychology focuses on learned behaviors. It was founded on the work of psychologists such as Edward Thorndike and John B. Watson.   Behaviorism dominated psychology in the early twentieth century but began to lose its hold during the 1950s.

Behaviorism differs from other perspectives because it focuses solely on observable behaviors rather than on emphasizing internal states.

Today, the behavioral perspective is still concerned with how behaviors are learned and reinforced. Behavioral principles are often applied in mental health settings, where therapists and counselors use these techniques to explain and treat a variety of illnesses.

3. The Cognitive Perspective

During the 1960s, a new perspective known as cognitive psychology emerged. This area of psychology focuses on mental processes like memory, thinking, problem-solving, language, and decision-making.  

Influenced by psychologists such as Jean Piaget and Albert Bandura , the cognitive perspective has grown tremendously in recent decades.

Cognitive psychologists often utilize an information-processing model (comparing the human mind to a computer) to conceptualize how information is acquired, processed, stored, and utilized.

4. The Biological Perspective

The study of physiology played a major role in the development of psychology as a separate science. Today, the perspective is known as biological psychology (also called biopsychology or physiological psychology). The point of view emphasizes the physical and biological bases of behavior.

Researchers with a biological perspective on psychology might look at how genetics influence behavior or how damage to specific areas of the brain affect personality.

The nervous system, genetics, the brain, the immune system, and the endocrine system are just a few subjects of interest to biological psychologists. Over the last few decades, the perspective has grown significantly with advances in our ability to explore and understand the human brain and nervous system.

Magnetic resonance imaging (MRI) and positron emission tomography (PET) scans give researchers tools to observe the brain under a variety of conditions. Scientists can now look at the effects of brain damage, drugs, and disease in ways that were not possible in the past.

5. The Cross-Cultural Perspective

Cross-cultural psychology is a fairly new perspective that has grown significantly in the last twenty years. Psychologists and researchers in this school of thought look at human behavior across different cultures.

By looking at these differences, we can learn more about how culture influences our thinking and behavior.   For example, researchers have looked at how social behaviors differ in individualistic and collectivistic cultures .

• In individualistic cultures (such as the United States) people tend to exert less effort when they are part of a group—a phenomenon known as social loafing .
• In collectivistic cultures (such as China), people tend to work harder when they are part of a group.

6. The Evolutionary Perspective

Evolutionary psychology focuses on the study of how the theory of evolution can explain physiological processes.   Psychologists who take this perspective apply the basic principles of evolution (like natural selection) to psychological phenomena.

The evolutionary perspective suggests that these mental processes exist because they serve an evolutionary purpose—meaning that they aid in human survival and reproduction.​​​

7. The Humanistic Perspective

In the 1950s, a school of thought known as humanistic psychology arrived. It was greatly influenced by the work of prominent humanists such as Carl Rogers and Abraham Maslow .

The humanistic perspective emphasizes the role of motivation in thought and behavior. Concepts such as self-actualization are essential. Psychologists with a humanist perspective focus on what drives humans to grow, change, and develop their personal potential.

Positive psychology (which focuses on helping people live happier, healthier lives) is a recent movement in psychology with roots in the humanist perspective.  

A Word From Verywell

There are many ways to think about human thought and behavior. The different perspectives in modern psychology give researchers and students tools to approach problems and answer questions. They also guide psychologists in finding new ways to explain and predict human behavior. This exploration and deeper understanding can even lead to the development of new treatment approaches.

Fonagy P. The effectiveness of psychodynamic psychotherapies: An update .  World Psychiatry . 2015;14(2):137–150. doi:10.1002/wps.20235

Malone JC. Did John B. Watson really "found" behaviorism? .  Behav Anal . 2014;37(1):1–12. doi:10.1007/s40614-014-0004-3

Glenberg AM, Witt JK, Metcalfe, J. From the revolution to embodiment: 25 years of cognitive psychology . Perspectives on Psychological Science . 2013;8(5):573-585. doi:10.1177/1745691613498098

American Psychological Association. Biological psychology . 

Lonner WJ. Half a century of cross-cultural psychology: a grateful coda . Am Psychol . 2015;70(8):804-14. doi: 10.1037/a0039454

Cosmides L, Tooby, J. Evolutionary psychology: a new perspective on cognition and motivation . Annu Rev Psychol . 2013;64:201-229. doi:10.1146/annurev.psych.121208.131628

Waterman AS. The humanistic psychology-positive psychology divide: contrasts in philosophical foundations . Am Psychol . 2013;68(3):124-33. doi:10.1037/a0032168

By Kendra Cherry, MSEd Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

80 fascinating psychology research questions for your next project

Last updated

15 February 2024

Reviewed by

Brittany Ferri, PhD, OTR/L

Psychology research is essential for furthering our understanding of human behavior and improving the diagnosis and treatment of psychological conditions.

When psychologists know more about how different social and cultural factors influence how humans act, think, and feel, they can recommend improvements to practices in areas such as education, sport, healthcare, and law enforcement.

Below, you will find 80 research question examples across 16 branches of psychology. First, though, let’s look at some tips to help you select a suitable research topic.

• How to choose a good psychology research topic

Psychology has many branches that break down further into topics. Choosing a topic for your psychology research paper can be daunting because there are so many to choose from. It’s an important choice, as the topic you select will open up a range of questions to explore.

The tips below can help you find a psychology research topic that suits your skills and interests.

Tip #1: Select a topic that interests you

Passion and interest should fuel every research project. A topic that fascinates you will most likely interest others as well. Think about the questions you and others might have and decide on the issues that matter most. Draw on your own interests, but also keep your research topical and relevant to others.

Don’t limit yourself to a topic that you already know about. Instead, choose one that will make you want to know more and dig deeper. This will keep you motivated and excited about your research.

Tip #2: Choose a topic with a manageable scope

If your topic is too broad, you can get overwhelmed by the amount of information available and have trouble maintaining focus. On the other hand, you may find it difficult to find enough information if you choose a topic that is too narrow.

To determine if the topic is too broad or too narrow, start researching as early as possible. If you find there’s an overwhelming amount of research material, you’ll probably need to narrow the topic down. For example, instead of researching the general population, it might be easier to focus on a specific age group. Ask yourself what area of the general topic interests you most and focus on that.

If your scope is too narrow, try to generalize or focus on a larger related topic. Expand your search criteria or select additional databases for information. Consider if the topic is too new to have much information published on it as well.

Tip #3: Select a topic that will produce useful and relevant insights

Doing some preliminary research will reveal any existing research on the topic. If there is existing research, will you be able to produce new insights? You might need to focus on a different area or see if the existing research has limitations that you can overcome.

Bear in mind that finding new information from which to draw fresh insights may be impossible if your topic has been over-researched.

You’ll also need to consider whether your topic is relevant to current trends and needs. For example, researching psychology topics related to social media use may be highly relevant today.

• 80 psychology research topics and questions

Psychology is a broad subject with many branches and potential areas of study. Here are some of them:

Developmental

Personality

Experimental

Organizational

Educational

Neuropsychology

Controversial topics

Below we offer some suggestions on research topics and questions that can get you started. Keep in mind that these are not all-inclusive but should be personalized to fit the theme of your paper.

Social psychology research topics and questions

Social psychology has roots as far back as the 18th century. In simple terms, it’s the study of how behavior is influenced by the presence and behavior of others. It is the science of finding out who we are, who we think we are, and how our perceptions affect ourselves and others. It looks at personalities, relationships, and group behavior.

Here are some potential research questions and paper titles for this topic:

How does social media use impact perceptions of body image in male adolescents?

2. Is childhood bullying a risk factor for social anxiety in adults?

Is homophobia in individuals caused by genetic or environmental factors?

What is the most important psychological predictor of a person’s willingness to donate to charity?

Does a person’s height impact how other people perceive them? If so, how?

Cognitive psychology research questions

Cognitive psychology is the branch that focuses on the interactions of thinking, emotion, creativity, and problem-solving. It also explores the reasons humans think the way they do.

This topic involves exploring how people think by measuring intelligence, thoughts, and cognition. 

Here are some research question ideas:

6. Is there a link between chronic stress and memory function?

7. Can certain kinds of music trigger memories in people with memory loss?

8. Do remote meetings impact the efficacy of team decision-making?

9. Do word games and puzzles slow cognitive decline in adults over the age of 80?

10. Does watching television impact a child’s reading ability?

Developmental psychology research questions

Developmental psychology is the study of how humans grow and change over their lifespan. It usually focuses on the social, emotional, and physical development of babies and children, though it can apply to people of all ages. Developmental psychology is important for understanding how we learn, mature, and adapt to changes.

Here are some questions that might inspire your research:

11. Does grief accelerate the aging process?

12. How do parent–child attachment patterns influence the development of emotion regulation in teenagers?

13. Does bilingualism affect cognitive decline in adults over the age of 70?

14. How does the transition to adulthood impact decision-making abilities

15. How does early exposure to music impact mental health and well-being in school-aged children?

Personality psychology research questions

Personality psychology studies personalities, how they develop, their structures, and the processes that define them. It looks at intelligence, disposition, moral beliefs, thoughts, and reactions.

The goal of this branch of psychology is to scientifically interpret the way personality patterns manifest into an individual’s behaviors. Here are some example research questions:

16. Nature vs. nurture: Which impacts personality development the most?

17. The role of genetics on personality: Does an adopted child take on their biological parents’ personality traits?

18. How do personality traits influence leadership styles and effectiveness in organizational settings?

19. Is there a relationship between an individual’s personality and mental health?

20. Can a chronic illness affect your personality?

Abnormal psychology research questions

As the name suggests, abnormal psychology is a branch that focuses on abnormal behavior and psychopathology (the scientific study of mental illness or disorders).

Abnormal behavior can be challenging to define. Who decides what is “normal”? As such, psychologists in this area focus on the level of distress that certain behaviors may cause, although this typically involves studying mental health conditions such as depression, obsessive-compulsive disorder (OCD), and phobias.

Here are some questions to consider:

21. How does technology impact the development of social anxiety disorder?

22. What are the factors behind the rising incidence of eating disorders in adolescents?

23. Are mindfulness-based interventions effective in the treatment of PTSD?

24. Is there a connection between depression and gambling addiction?

25. Can physical trauma cause psychopathy?

Clinical psychology research questions

Clinical psychology deals with assessing and treating mental illness or abnormal or psychiatric behaviors. It differs from abnormal psychology in that it focuses more on treatments and clinical aspects, while abnormal psychology is more behavioral focused.

This is a specialty area that provides care and treatment for complex mental health conditions. This can include treatment, not only for individuals but for couples, families, and other groups. Clinical psychology also supports communities, conducts research, and offers training to promote mental health. This category is very broad, so there are lots of topics to explore.

Below are some example research questions to consider:

26. Do criminals require more specific therapies or interventions?

27. How effective are selective serotonin reuptake inhibitors in treating mental health disorders?

28. Are there any disadvantages to humanistic therapy?

29. Can group therapy be more beneficial than one-on-one therapy sessions?

30. What are the factors to consider when selecting the right treatment plan for patients with anxiety?

Experimental psychology research questions

Experimental psychology deals with studies that can prove or disprove a hypothesis. Psychologists in this field use scientific methods to collect data on basic psychological processes such as memory, cognition, and learning. They use this data to test the whys and hows of behavior and how outside factors influence its creation.

Areas of interest in this branch relate to perception, memory, emotion, and sensation. The below are example questions that could inspire your own research:

31. Do male or female parents/carers have a more calming influence on children?

32. Will your preference for a genre of music increase the more you listen to it?

33. What are the psychological effects of posting on social media vs. not posting?

34. How is productivity affected by social connection?

35. Is cheating contagious?

Organizational psychology research questions

Organizational psychology studies human behavior in the workplace. It is most frequently used to evaluate an employee, group, or a company’s organizational dynamics. Researchers aim to isolate issues and identify solutions.

This area of study can be beneficial to both employees and employers since the goal is to improve the overall work environment and experience. Researchers apply psychological principles and findings to recommend improvements in performance, communication, job satisfaction, and safety. 

Some potential research questions include the following:

36. How do different leadership styles affect employee morale?

37. Do longer lunch breaks boost employee productivity?

38. Is gender an antecedent to workplace stress?

39. What is the most effective way to promote work–life balance among employees?

40. How do different organizational structures impact the effectiveness of communication, decision-making, and productivity?

Forensic psychology research questions

Some questions to consider exploring in this branch of psychology are:

41. How does incarceration affect mental health?

42. Is childhood trauma a driver for criminal behavior during adulthood?

43. Are people with mental health conditions more likely to be victims of crimes?

44. What are the drivers of false memories, and how do they impact the justice system?

45. Is the media responsible for copycat crimes?

Educational psychology research questions

Educational psychology studies children in an educational setting. It covers topics like teaching methods, aptitude assessment, self-motivation, technology, and parental involvement.

Research in this field of psychology is vital for understanding and optimizing learning processes. It informs educators about cognitive development, learning styles, and effective teaching strategies.

Here are some example research questions:

46. Are different teaching styles more beneficial for children at different times of the day?

47. Can listening to classical music regularly increase a student’s test scores?

48. Is there a connection between sugar consumption and knowledge retention in students?

49. Does sleep duration and quality impact academic performance?

50. Does daily meditation at school influence students’ academic performance and mental health?

Sports psychology research question examples

Sport psychology aims to optimize physical performance and well-being in athletes by using cognitive and behavioral practices and interventions. Some methods include counseling, training, and clinical interventions.

Research in this area is important because it can improve team and individual performance, resilience, motivation, confidence, and overall well-being

Here are some research question ideas for you to consider:

51. How can a famous coach affect a team’s performance?

52. How can athletes control negative emotions in violent or high-contact sports?

53. How does using social media impact an athlete’s performance and well-being?

54. Can psychological interventions help with injury rehabilitation?

55. How can mindfulness practices boost sports performance?

Cultural psychology research question examples

The premise of this branch of psychology is that mind and culture are inseparable. In other words, people are shaped by their cultures, and their cultures are shaped by them. This can be a complex interaction.

Cultural psychology is vital as it explores how cultural context shapes individuals’ thoughts, behaviors, and perceptions. It provides insights into diverse perspectives, promoting cross-cultural understanding and reducing biases.

Here are some ideas that you might consider researching:

56. Are there cultural differences in how people perceive and deal with pain?

57. Are different cultures at increased risk of developing mental health conditions?

58. Are there cultural differences in coping strategies for stress?

59. Do our different cultures shape our personalities?

60. How does multi-generational culture influence family values and structure?

Health psychology research question examples

Health psychology is a crucial field of study. Understanding how psychological factors influence health behaviors, adherence to medical treatments, and overall wellness enables health experts to develop effective interventions and preventive measures, ultimately improving health outcomes.

Health psychology also aids in managing stress, promoting healthy behaviors, and optimizing mental health, fostering a holistic approach to well-being.

Here are five ideas to inspire research in this field:

61. How can health psychology interventions improve lifestyle behaviors to prevent cardiovascular diseases?

62. What role do social norms play in vaping among adolescents?

63. What role do personality traits play in the development and management of chronic pain conditions?

64. How do cultural beliefs and attitudes influence health-seeking behaviors in diverse populations?

65. What are the psychological factors influencing the adherence to preventive health behaviors, such as vaccination and regular screenings?

Neuropsychology research paper question examples

Neuropsychology research explores how a person’s cognition and behavior are related to their brain and nervous system. Researchers aim to advance the diagnosis and treatment of behavioral and cognitive effects of neurological disorders.

Researchers may work with children facing learning or developmental challenges, or with adults with declining cognitive abilities. They may also focus on injuries or illnesses of the brain, such as traumatic brain injuries, to determine the effect on cognitive and behavioral functions.

Neuropsychology informs diagnosis and treatment strategies for conditions such as dementia, traumatic brain injuries, and psychiatric disorders. Understanding the neural basis of behavior enhances our ability to optimize cognitive functioning, rehabilitate people with brain injuries, and improve patient care.

Here are some example research questions to consider:

66. How do neurotransmitter imbalances in specific brain regions contribute to mood disorders such as depression?

67. How can a traumatic brain injury affect memory?

68. What neural processes underlie attention deficits in people with ADHD?

69. Do medications affect the brain differently after a traumatic brain injury?

70. What are the behavioral effects of prolonged brain swelling?

Psychology of religion research question examples

The psychology of religion is a field that studies the interplay between belief systems, spirituality, and mental well-being. It explores the application of the psychological methods and interpretive frameworks of religious traditions and how they relate to both religious and non-religious people.

Psychology of religion research contributes to a holistic understanding of human experiences. It fosters cultural competence and guides therapeutic approaches that respect diverse spiritual beliefs.

Here are some example research questions in this field:

71. What impact does a religious upbringing have on a child’s self-esteem?

72. How do religious beliefs shape decision-making and perceptions of morality?

73. What is the impact of religious indoctrination?

74. Is there correlation between religious and mindfulness practices?

75. How does religious affiliation impact attitudes towards mental health treatment and help-seeking behaviors?

Controversial topics in psychology research question examples

Some psychology topics don’t fit into any of the subcategories above, but they may still be worthwhile topics to consider. These topics are the ones that spark interest, conversation, debate, and disagreement. They are often inspired by current issues and assess the validity of older research.

Consider some of these research question examples:

76. How does the rise in on-screen violence impact behavior in adolescents.

77. Should access to social media platforms be restricted in children under the age of 12 to improve mental health?

78. Are prescription mental health medications over-prescribed in older adults? If so, what are the effects of this?

79. Cognitive biases in AI: what are the implications for decision-making?

80. What are the psychological and ethical implications of using virtual reality in exposure therapy for treating trauma-related conditions?

• Inspiration for your next psychology research project

You can choose from a diverse range of research questions that intersect and overlap across various specialties.

From cognitive psychology to clinical studies, each inquiry contributes to a deeper understanding of the human mind and behavior. Importantly, the relevance of these questions transcends individual disciplines, as many findings offer insights applicable across multiple areas of study.

As health trends evolve and societal needs shift, new topics emerge, fueling continual exploration and discovery. Diving into this ever-changing and expanding area of study enables you to navigate the complexities of the human experience and pave the way for innovative solutions to the challenges of tomorrow.

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