Psychoanalysis

ADDRESSING RESISTANCE

1. What is the concept of this technique? Taking many forms, resistance represents the ego's attempt at interfering with the uncovering of the unconscious. Resistance is a normal function and should be expected at some point in psychoanalysis. 2. How does it relate to the theory? Resistance is another defense mechanism employed by the ego to protect itself from dealing with undesirable and painful conflicts. Resolution of resistance is necessary to continue insightful work and interpretation. When interpretation is the object of resistance, interpretation must be temporarily suspended while the counselor waits for an opportunity when the client is more receptive. 3. Counselor statements using this technique and theory: • I can see by your actions that you are resisting our work. Would you like to tell me more about this? • I believe that your resistance is due to a need to protect yourself from dealing with a painful subject. (Interpretation)

FREE ASSOCIATION

1. What is the concept of this technique? Free association is a primary technique of psychoanalysis. It consists of spontaneous and uncensored verbalizations by the client, which gives clues to the nature of the client's unconscious conflicts 2. How does it relate to the theory? Repressed material in the unconscious is always seeking release. In psychoanalysis, the client is encouraged to relax and freely recall early childhood memories or emotional experiences. During free association, the client abandons the normal way of censoring thoughts by consciously repressing them and instead saying whatever comes to mind, even if the thought seem silly, irrational, suggestive or painful. In this way the id is required to speak and the ego remains silent. Unconscious material enters the conscious mind, and the counselor interprets it. 3. Counselor statements using this technique and theory: • I would like you to speak freely without censoring yourself even if you feel concerned that I won't know what you are talking about. Allow yourself to speak freely without judgment. • I noticed when you are talking about your childhood you skip the years you lived in Sacramento. • When you were talking about your mother, you said "I loathe her. She is my life." What do you suppose that means?

ANALYSIS OF TRANSFERENCE

1. What is the concept of this technique? The client's unconscious shifting to the therapist of feelings and fantasies, positive, negative and mixed, which are displacements from reactions to significant others from the client's past. 2. How does it relate to the theory? Understanding and insight grow with each analysis of the transference experience. The analyst encourages this transference and interprets the positive or negative feelings expressed. The release of feelings is an emotional catharsis. The real value of these experience lie in the client's increased self-knowledge, which comes through the counselor's analysis of the transference. 3. Counselor statements using this technique and theory: • When you look at me and say, "You men, don't have any idea about what it is to be a woman", specifically who are you talking about? • Do I remind you of your mother? In what ways, do you think we are similar?

BIG IDEA

BIG IDEA A psychoanalysist, employing this method of therapy, presupposes clandestine content (called latent content) can be made conscious (manifest content) through a relational exploration between the analyst and the client/patient. Through the therapeutic process, neurotic impulses (sexual [life affirming] & destructive), as bits of psychic content, are interpreted by the psychoanalyst under the supposition that if the client/patient experiences insight that she/he can be released from the neurosis.

DREAMWORK

DREAMWORK 1. What is the concept of this technique? Dreams work to symbolize unconscious, primitive wishes and thereby create content that is manifest- or a remembered account of the dream that hides the true meaning. Uncovering the latent content of the dream and discovering its true meaning through a process of decoding and interpreting the symbols will hopefully lead the client to the realization of the dream's relationship to unresolved childhood conflicts. 2. How does it relate to the theory? Dreamwork can provide further insight into the unconscious mind as dreams represent an interaction between the id and ego, with the ego creating a fantasy to simulate an attainment of some unconscious wish that originates within the id. Dreams are then a defense mechanism that the ego uses to protect itself from the pressure of the job. As defense mechanisms always end up with some sort of innate anxiety, the resolution of conflicts through uncovering the latent content in dreams can lead to relief. 3. Counselor statements using this technique and theory: • I would like you to speak freely about a particular object in your dream without censoring yourself? (Free association) • Might this object represent your feelings of inadequacy that originate in a childhood experience? (Offering interpretation)

Defense mechanisms

Denial fending off awareness of an unpleasant truth or of a reality that is a threat to the ego Reaction formation takes place when a person takes the opposite approach consciously compared to what that person wants unconsciously Displacement takes place when someone redirects emotion from a "dangerous" object to a "safe" one Repression occurs when an experience is so painful (such as war trauma) that it is unconsciously forced from consciousness, while Suppression is a conscious effort to do the same Projection occurs when a person "projects" his or her own undesirable thoughts, motivations, desires, feelings — basically parts of oneself — onto someone or something else

Derivative forms of psychoanalytic theory:

Ego Psychology, Interpersonal Psychoanalysis, Object Relations (& other relational perspectives), & self-psychology

Structural Theory

Id - unconscious, basic drives, amoral & self-centric (pleasure principle), primary process Ego - balance primitive drives, morals & external world (reality principle & secondary process) Superego - judges ego, authority (superlatives)

Foundational Constructs for Psychoanalytic Theory

Latent versus manifest content Influence of biological drives (intrapersonal psychic energy, innate compulsion to repress) Structural Theory Dynamic psychic forces Stages of Development Neuroses (defense mechanisms) Analysis

Biological Drives

Libido (life affirming; "eros") vs. thanatos (destructive) Building off the work of Karl Abraham The libido is instinct energy or force (contained in the id; i.e., largely unconscious) that is confounded by conflicts experienced at certain biologically bound developmental phases in which said libido fixates on related erogenous zones Libidinal drives can conflict with the conventions of civilized behavior, represented in the superego The ego attempts to conform to society and control the libido that leads to tension and turbulence in the individual, activating ego defenses to dissipate the psychic energy (which in excess result in neurosis) that are largely unconscious needs

Analytic theory of Change

Making the unconscious conscious Interpreting patterns & themes as defenses Stronger ego Psychoanalytic techniques of change? Transference is the transfer of mind-state from a prior psychic event/experience to present phenomena (and affect the manner in which present phenomena are experienced and responded to) [Countertransference refers to the therapist's reaction to the client] Free association unedited expression of thoughts Interpretation therapist expresses understanding (translation) of central themes (especially from "latent content") Hypnosis is placing the individual in a trance state to uncover suppressed cognitive structures Symptoms and Symptom-Context Methods is the usage of in-the-moment (during session) manifest of symptoms Transformation is the gradual increase of self-understanding

Related Psychodynamic theories

Object Relations Theory describes the process of developing a mind as one grows in relation to others in the environment. The "objects" of the theory are both real others in one's world, and one's internalized image of others. (Otto Rank, Ronald Fairbairn, Melanie Klein, et al.) Jungian theory: The self is composed of the ego, the personal unconscious, the collective unconscious (containing archetypes - i.e., tensions between individual and collective psyche, organize conceptions) The Transcendent Function: The emergence of the third resolves the split between dynamic polar tensions within the archetypal structure. Positive Psychology Ego Therapy (Anna Freud) - positive ego Self Psychology -

Thinking and Consciousness

Primary process thinking, assumed by Freud to be present in babies and in the unconscious part of the adult mind, is unconscious thought characterized by displacement, symbolism, and an irrational drive toward immediate gratification. Secondary process thinking, which develops as the child moves toward adulthood, is ordinary, rational, conscious thought. The three layers of consciousness are the conscious mind, the preconscious, and the unconscious. Freud thought the conscious mind was by far the smallest of the three.

Biological Drives (Con't)

Sex Oedipal - metaphor describing son-father psychosexual competition for possession of mother A boy's psychosexual son-father competition for possession of mother (generally in third stage of psychosexual development [ages 3-6]). Electra complexe (Jung, 1913) A girl's daughter-mother competition for psychosexual possession of father

Biological Drives (con't)

Stages of Development - primordial development (latent) of the libido expressed as manifest Each developmental stage has a physical focus (manifest), a psychological theme (latent), and an adult character type that results if that stage of development does not go well.

Personality

There exist the conscious (manifest content) and unconscious (latent content) & develops from interaction between biological factors and experience (especially early childhood) a. Most all psychic activity is experienced and witnessed on the conscious level b. Most all psychic activity -- in reality - develops & exists at the unconscious level

Human nature

a. Impulses drive behaviors i. Negative impulses drive behavior - humans have destructive, aggressive impulses ii. Positive, life-affirming impulses - sexual instinct is innate, source of energy b. Innate compulsion to repress impulses that are in conflict with social mores & expectations c. Hence, the individual is constantly at odds, conflicted - between destructive and affirming instincts and between instincts and society, conscious and unconscious forces i. Impetus of neurosis ii. Manifests in problematic symptoms and behaviors (i.e., neurotic symptoms)

As a brand of therapy:

a. Insight therapy (i.e., investigation of inner experience as channel to remedy problems) b. Investigation into the realm of the unconscious with the intent to make the indefinite manifest c. Exploration of the inner conflicts between understanding, repression, meaning, etc. of unconscious psychic material

Defenses (mechanisms)

are methods that the Ego deals with conflict between the Id & Super-ego; while defenses may assuage the conflict, overuse or misuse may lead to anxiety, neurosis, pathology (typically diverts troubling impulse into other forms/manifests) • Denial fending off awareness of an unpleasant truth or of a reality that is a threat to the ego • Reaction formation takes place when a person takes the opposite approach consciously compared to what that person wants unconsciously • Displacement takes place when someone redirects emotion from a "dangerous" object to a "safe" one • Repression occurs when an experience is so painful (such as war trauma) that it is unconsciously forced from consciousness, while Suppression is a conscious effort to do the same • Projection occurs when a person "projects" his or her own undesirable thoughts, motivations, desires, feelings — basically parts of oneself — onto someone or something else • Intellectualization involves removing one's self, emotionally, from a stressful event, by focusing on rational and factual components of the situation • Rationalization involves constructing a logical justification for a decision that was originally arrived at through a different mental process • Compensation occurs when someone takes up one behavior because one cannot accomplish another behavior • Sublimation is the channeling of impulses to socially accepted behaviors • Regression occurs when a client reverts back to a previous state or to a more immature or less advanced way of acting

The Unconscious

are states of mind exclusive of personal awareness of self (including thoughts, feelings, & memories that each contribute to behavior). • Largely made up of instructs & primordial drives (therefore, we are often unaware of their influence & motivations for behavior)

Stages of Development

fixed process that is genetically determined; grounded in the development of the libido (i.e., psychic sexual desire) through sublimation (i.e., the various forms of coping mechanisms) • Oral (0 to 18 months) - source of pleasure is mouth (sucking) o Consequences of fixation: Orally Aggressive (excessive chewing/biting) & Orally Passive (smoking, eating, kissing, fellatio/cunnilingus) • Anal (18 to 36 months) - anal area, expelling feces o Consequences of fixation: Anal-retentive (obsession w/ organization/neatness) or Anal-expulsive (reckless, defiant, disorderly) • Phallic (3 to 6 years old) - source of pleasure is the genitals, interest in other-sex parent o Consequences of fixation: Oedipus Complex (in boys) & Electra Complex (in girls, according to Jung not Freud) • Latent (6 to puberty) - social development, sexual urges underground & solidify prior stages within the psyche o People do not tend to fixate at this stage, but if they do, they tend to be extremely sexually unfulfilled.) • Genital (puberty to adulthood) - sexual impulses integrated with reproductive functions o Consequences of fixation: Frigidity, impotence, unsatisfactory relationships

manifest vs. latent T

hree types of experiences: Conscious (manifest) Unconscious (latent) Preconscious - latent psychic energy that is readily available to conscious mind, although not currently in use. This division makes clear, for Freud, that repressed memories are a part of the unconscious, although not all of the unconscious Although we generally experience the manifest, it's the latent that perpetuates most all psychic experience Dynamic theory of personality - internal operations that navigate through the various human experiences and expressions

Psychodynamics

is the interplay between psychic forces in the mind (e.g., b/t the conscious and unconscious). • Intra-psychic conflict is that which is b/t 2 opposing mind-states (e.g., w/n emotions, b/t thoughts & emotions) & one or more of these states are outside of awareness • Symptoms, thus, are the expression of the inner conflict • Because of fixations, we may repeat relationship patterns

Defense mechanisms (con't) I

ntellectualization involves removing one's self, emotionally, from a stressful event, by focusing on rational and factual components of the situation Rationalization involves constructing a logical justification for a decision that was originally arrived at through a different mental process Compensation occurs when someone takes up one behavior because one cannot accomplish another behavior Sublimation is the channeling of impulses to socially accepted behaviors Regression occurs when a client reverts back to a previous state or to a more immature or less advanced way of acting

• Psychoanalytic techniques of change?

o Therapeutic alliance o Transference is the transfer of mind-state from a prior psychic event/experience to present phenomena (and affect the manner in which present phenomena are experienced and responded to) [Countertransference refers to the therapist's reaction to the client] • In therapy, analysis of the meanings of transference are vital to treatment, as it offers a portrait of the inner operating forces of the client; exploration of relationship dynamics as indicative of past patterns o Free association unedited expression of thoughts o Interpretation therapist expresses understanding (translation) of central themes (especially from "latent content") o Hypnosis is placing the individual in a trance state to uncover suppressed cognitive structures o Symptoms and Symptom-Context Methods is the usage of in-the-moment (during session) manifest of symptoms o Transformation is the gradual increase of self-understanding o Therapist as "nonperson," mirror, or blank screen for the patient to express cognitive structures in therapy

Structure of the mind (i.e., Structural Theory)

• Id - unconscious, responsible for our basic drives (e.g., food, sex and aggressive impulses); amoral & self-centric o operates from the "pleasure principle" (the desire for immediate gratification versus the deferral of that gratification; seek pleasure & avoid pain); "primary process" (nonlogical thinking) • Ego - task is to balance & mitigate between primitive drives, morals, & reality while satisfying the id & superego o Operates from "reality principle" (Id impulses are not appropriate for civilized society, so society presses us to modify the pleasure principle in favor of the reality principle); "secondary processes" (logical/verbal thinking) • Superego - conscience, judges Ego, authority figure, repository of "shoulds"/superlatives o Forms as the child grows and internalizes parental and societal standards o two structures: 1) Conscience, which stores information about what is "bad" & what has been punished and 2) Ego ideal, which stores information about what is "good" & what one "should" do or be.

From the Psychoanalytic perspective, how do people change?

• Making the unconscious conscious - use adult thinking skills to resolve them in a better fashion e.g., resolving Oedipal complex • Discovering patterns and themes within self as defense mechanisms & disruptions to mental health • See how current difficulties are related to past relationship conflicts and handle current problems in new, more mature, ways • Able to keep energy focused on current, conscious efforts, rather than tying it up in the past • Stronger ego • Processes of therapy (usually long-term, multiple sessions per week): o Opening phase (prior to first session through several sessions) - Why seeking treatment at this time? What are the current triggers to the problem? Levels of disturbance? o The supportive relationship o Expressive work - i.e., the gradual process of making sense of the patient's problems, symptoms, etc. o Deepening Exploration o Termination Phase

From the psychoanalytic perspective, what is mental health?

• Minimal levels of repression needed/expressed by the individual • Use of healthy defense mechanisms • Resolved the Oedipal Complex • Have ability to love and work • Ego is able to balance demands of id and superego • Less fixations and less unconscious material • Absence of symptoms

From the Psychoanalytic perspective, what are the sources of people's problems?

• Repression is the process of removing a painful cognitive structure from consciousness by means of a defense mechanism • Fixation (stuck) in one or more development stages (typically associated with memory of a traumatic event or unresolved conflict) • Regression reversion to earlier forms of behavior to avoid stress & enactment where troublesome memories are reacted to behaviorally • Parents overindulged or were harsh/punitive • Sources of problems are in early childhood (by age of 6) • Unable to identify and resolve unconscious conflicts • If ego can't contain urges (b/c defense mechanisms fail, etc.), then anxiety is felt • Symptoms develop as way of draining off energy associated with urges, symptoms can't be explained physiologically, are symbolic of underlying conflict • Symptoms have primary gains & secondary gains o Primary - unconscious urges & conflicts stay unconscious o Secondary - attention, reduction in responsibilities, etc. • Over-demanding superego • Current conflicts trigger earlier unresolved conflicts

Selected criticisms, limitations, and evaluation of psychoanalytic theory:

• Traditional modality was oppressively sexist - i.e., view of women as inferior morally • Dismissed reports of abuse and trauma as fantasy or forms of repression • Very negative view of the poor and of marginalized populations • Negative view of homosexuality • Assumes everyone has same experience (i.e., biological basis of personality) • Western, upper-class, European world view • Ignores or undervalues the broader context of person's life - e.g., class, gender, race, ethnicity, etc. • Hypothesizing about childhood development without studying children • Lack of structure and connection with therapist may be problematic for clients from different cultures o i.e., certain cultural groups prefer (or respond to) methodologies that are more structured, direct, & less exploratory o analysis and interpretation could be viewed as intrusive or esoteric (impractical) • Assumes everyone is a sexual being - what about asexual people? o Even if definition of sexuality is extended in the classical Freudian sense (and replaced with other inertia mechanisms), it does not account for universal human phenomena such as asceticism, etc. • Treatment extends over many months or years, frequent (e.g., multiple sessions a week) and therefore limited to those patients who have the resources • Reductionistic philosophy • Little to no empirical evidence for either the constructs behind the philosophy/theory or the outcomes of treatment • Need verbal, psychologically minded clients who want insight