**5. Psychodynamic Interventions**

The quality of life of a human being is related to his psychological maturity, according to the previous pages. So an intervention in a person's QoL could be an intervention to improve their psychological maturity. In other words, quality-of-life intervention can be psychological maturity intervention.

How to improve psychological maturity?

There must be several answers to this question, and the concept of psychodynamics is undoubtedly one of them.

Let us see what each author says about this issue.

### **5.1 Sigmund Freud**

For this author, the relationship between the analyst and his patient is fundamental to promoting psychological development.

This premise can be helpful when thinking about improving a person's quality of life through psychodynamics.

Initially, we need to think of a quality of life manager, a professional that will conduct the intervention on the quality of life of a target person or a group of people.

Let us draw a parallel between the analyst-patient relationship and the relationship of this professional with the target group of his intervention.

For Freud, the analytic relationship occurs within a technical framework in which the patient and the analyst have specific roles.

While the patient freely speaks what comes to mind, the analyst listens, trying to understand what is happening inside the patient.

The framework is the relationship space that allows deep listening by the clinician, relevant sharing by the patient, and therapeutic use of the relationship to foster psychological healing. In Freudian theories, the frame is essential for discerning and using the unconscious to heal psychological conflicts that cause suffering or symptoms [33].

In the same way, the quality of life manager must know how to listen to his target audience to understand their personal needs. Thus, a quality-of-life intervention must offer conditions to reduce psychological conflict and promote the development of the human being.

#### **5.2 Melanie Klein**

This author's contribution focuses on the analyst's ability to contain the patient's emotional oscillations. She described as fundamental to the human experience a change between opposing states. She noted how infants swing between frenzied protestation and comfortable calm.

She also noted that the mother figure holds the extremes of feeling as the infant oscillates between anxiety and bliss. This holding, which allows the expression and metabolism of intense vicissitudes, is critical for finding a manageable way forward.

Here, we have a new model for thinking about the quality-of-life interventions.

The target group expects the quality of life manager to contain their emotional swings the same way a mother holds the extreme feelings of her baby's anxiety and bliss. This holding can allow adjustment and eventual settling into a sound decision [33].

The quality-of-life intervention process can be held and help metabolize feelings allowing them to live with and use those feelings.

The holding process enables the integration of opposing mental states, thus reducing the fear of separation.

The reduction of this fear promotes independence and maturation of the human being.

The quality of life manager should be able to contribute to the integration of opposing emotions, promoting independence and personal growth of the target audience.

#### **5.3 Wilfred Bion**

According to this author, feeling that it is normal and acceptable to have these swings, as described above, helps with thinking and talking about new realities.

It entails facilitating ways to think and feel about matters that were likely to be inchoate or suppressed to articulate.

From this point of view, the quality of life manager should be able to consider these swings as usual and hold people to deal with them as acceptable. This tolerance will help them to recognize their human nature which will be crucial for their personal development.

Wilfred Bion postulated psychological processes to describe how a child puts out raw feelings that are emphatically processed by the carer, resulting in nondisruptive understanding that can be verbalized or, in some way, symbolized.

The linkage between feelings and symbolizable (usually verbalized) thoughts is critical and depends on human interaction. This author considered this interaction between the two people essential for psychic existence. The absence of or trouble with this interaction is a devastating psychic loss or lack that can feel worse than tangible loss or death. Bion called the feeling of that failed interaction "nameless dread" [33].

Thinking about one's feelings is fundamental for the individual to know his truth. Thus, the quality of life manager must be able to do this exercise with himself before starting the quality-of-life intervention program.

Only then will he be able to help others identify and name their feelings, which will be essential to make meaning of themselves.

As we saw above, Freud, Klein, and Bion present their theoretical contributions to the psychological development of human beings.

One common element of these three authors is the concept of holding.

Let us now look at Winnicott's point of vision, who was the author who most worked on this concept.
