Psychoanalytic Therapy by 6cTNTL

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									Psychoanalytic Therapy

         Chapter Four
The Importance of Freud

 Psychoanalytic theory is more than a theory
  of psychotherapy; it is a theory of personality
  development, a philosophy of human nature,
  a worldview!
 Freud was the first person to formalize a
  method of “talk therapy.” All other theories of
  psychotherapy can be viewed as building
  upon or reacting against Freud’s theories.
A Little History. . .

 Freud earned a medical degree and, by 1885,
  was working with a psychiatrist named
  Charcot, who was using hypnotherapy to
  treat hysteria.
 Freud developed many of the important
  concepts of psychoanalysis between 1895
  and 1900. He found that free association
  could be as effective as hypnosis in unlocking
  the secrets of the unconscious.
A Little History. . . (continued)

 Freud attracted many followers, and the
  Psychoanalytic Society was founded in
 Freud was forced to leave Vienna as
  the Nazis gained power in Austria, and
  he died in London in 1939. World War I
  and the rise of Nazism profoundly
  influenced Freud’s view of humanity.
The Freudian Worldview

 Freud believed that human nature is
  largely deterministic, meaning that our
  behavior is determined by our biological
  and instinctual drives, as well as by our
  powerful unconscious motivations.
 Insight and awareness can increase the
  level of choice and control that one has
  over these drives and motivations.
The Role of Instincts

 Freud believed that instincts are central to
  understanding the behavior of humans.
 Libido or Eros originally referred to sexual
  energy, but was later revised to mean the life
  instinct and the drive toward pleasure and
  away from pain.
 Thanatos refers to the death instinct, which is
  the aggressive drive.
The Structure of Personality
 Id—ruled by the pleasure principle; driven to
  satisfy basic needs, the id remains immature,
  illogical, largely unconscious. It is the earliest
  part of our personality, present at birth.
 Ego—ruled by the reality principle; serves as
  a mediator between the id and the external
  world. Also works to mediate between the id
  and the superego.
 Superego—ruled by the perfection principle;
  represents the ideal, a moral code.
The Unconscious

 Freud postulated that the unconscious
  forms the largest part of the mind; the
  conscious portion is much smaller.
 The unconscious cannot be seen or
  proven, but must be inferred from
  certain mental processes.
Evidence for the Unconscious

 Dreams—symbolic          Material from free
  of needs, wishes,         association—why
  anxieties, conflicts.     would I think of that?
                           Material from
 Slips of the
                            projective tests—
  tongue—Freudian           making meaning.
  slips, what you
                           Symbolic content of
  really wanted to say.     psychotic
 Posthypnotic              processes—often
  suggestions.              wish fulfillment.
 Anxiety (state of tension) motivates us.
 Reality anxiety is fear caused by external
  world, and is in proportion with the actual
 Neurotic anxiety is the tension between an
  unconscious wish and the prohibition against
  that wish; fear of being overcome by instincts.
 Moral anxiety is the fear of one’s own super-
  ego; guilt reaction.
Anxiety (continued)

 The ego works to control anxiety, and will
  resort to defense mechanisms if necessary.
 Defense mechanisms serve to deny or distort
  reality, and operate out of the conscious
 Defense mechanisms are normal and
  adaptive as long as they are not a constant
  way of life.
Ego-Defense Mechanisms
   Repression—excluded           Rationalization—justify
    from awareness                 behaviors
   Denial—not                    Sublimation—divert
    acknowledged                   sexual energy to other
   Reaction formation—           Regression—revert to
    opposite of what is true       earlier stage of
   Projection—attribute           development
    your feelings to others       Introjection—take on
   Displacement—shift to          values of others
    safer target                  Undoing—taking it back
Personality Development

 Freud believed that the first six years of life
  laid the foundation upon which personality is
 There are key developmental “tasks” at the
  various stages of development.
 In discussing psychosexual development in
  children, remember that we aren’t talking
  about adult sexuality. It’s more about the
  drive toward pleasure!
Stages of Psychosexual
 Oral stage (first year)—feeding satisfies need
  for food and pleasure; basic nurturing.
 Anal stage (ages 1-3)—toilet-training leads to
  independence, fosters sense of control; learn
  to accept angry feelings.
 Phallic stage (ages 3-6)—desire to join with
  opposite-sex parent and remove competition
  of same-sex parent; castration anxiety (boys)
  and penis envy (girls) are part of this stage.
Stages of Psychosexual
Development (continued)
 Latency stage (ages 6-12)—time of
  socialization and forming relationships
  with others outside family, developing
  interests, etc.
 Genital stage (ages 12-adult)—sexual
  energy re-emerges, interest in sexual
  relationships begins and must be
  appropriately expressed.
Goals of Psychoanalytic Therapy

 To make the unconscious conscious.
 To strengthen the ego so that it is better
  able to “keep a lid on” the id, and also
  able to keep the superego from totally
  taking over.
Therapist’s Role

 Classical analytic stance is “blank-
 Therapist takes a neutral stance, says
  very little, cautiously makes
  interpretations as relationship develops.
 This allows for projection.
Process of Therapy

 Therapy is often long (can be 3-5
  years), and often takes place more than
  once a week.
 Client is first assessed to see if they are
  appropriate for psychoanalytic therapy;
  must have some level of ego strength,
  not floridly psychotic, etc.
Process of Therapy (continued)

 Maintaining the        Interpretation—
  frame                   listening for
 Free association        patterns, themes
 Dream analysis—        Analysis and
  clients must agree      interpretation of
  to remember and         resistance
  report their dreams    Analysis and
                          interpretation of

 Much of the work of analysis is looking at
  transference. Transference is the process of
  transferring unresolved feelings or issues
  onto the therapist and the therapeutic
  relationship; the client reacts not to the
  therapist, but to their own unresolved
 Transference is an important part of the
  therapy, not a “mistake” or “problem.”

 Therapists can also be guilty of
  transference, but then it is called
  countertransference—a reaction to the
  client based on therapist’s own issues.
 Countertransference can damage the
  therapist’s objectivity, so therapist must
  have an awareness of when it occurs so
  that it can be dealt with, minimized.
Criticisms and Limitations
 Not appropriate for every client or every type
  of problem.
 Feminist perspective argues that
  psychoanalytic therapy places too much
  emphasis on penis envy, mother’s
  responsibility for patient’s problems.
 Closed system—Freud could always prove
  himself right.
 Long term and lots of commitment, cost.
Psychodynamic Therapists
   Believe in the unconscious, that people do
    things for reasons that are not always
    available to them.
   Attend closely to client’s language, the words
    they choose—important.
   “There would be a reason why. . .”
   Respond to latent meaning in client’s
   Attend carefully to own reactions, feelings.

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