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 1910. 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 Anxiety (state of tension) motivates us. Reality anxiety is fear caused by external world, and is in proportion with the actual threat. 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 awareness. 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 channels 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 built. 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 Development 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- screen.” 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 transference Transference 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 feelings. Transference is an important part of the therapy, not a “mistake” or “problem.” Countertransference 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 messages. Attend carefully to own reactions, feelings.
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