Chapter 2: Psychoanalytic, Brief Analytic, Object Relations, and Interpersonal Approaches Flashcards
Birthplace of Freud
Frieberg, Morovia
Family Constellation
Firstborn in a family with three boys and five girls
Father’s Occupation
Wool merchant
Mother’s Occupation
Housewife
Degrees of Freud
Medical Degree from University of Vienna
Freud’s Mentors
Jean Charcot & Josef Breuer
Josef Breuer
Treated hysteria symptoms and discussed treatment in great detail with Freud
Anna O.
Josef Breuer’s patient
Talking Cure
Freud’s interest more than the hypnotic therapy
Classical Freudian Theory
One-person intrapsychic model that treats the client as a separate, individual artifact to be systematically and objectively examined
Modern Analytic Theory
Therapy is a two person field, wherein the therapist’s and client’s intrapsychic and relationship interactions help shed light on patterns that may be troubling the client
Drive Theory or Instict Theory
Freud’s dynamic approach to human psychology; humans are filled with mental or psychic energy; energy comes from the Eros (energy associated with life and sex) and Thanatos (energy associated with death and aggression); Every impulse has an origin, aim, object, and intensity; Impulse originates from some place in the body
Eros
Energy associated with life and sex; libido
Thanatos
Energy associated with destruction
Psychic Energy
Term for a psychological concept, not a physical one
Psychic Determinism
Proposes an underlying psychological explanation for your every emotion, thought, impulse, and behavior
Regions of the Psychoanalytic Mind
Unconscious, Preconscious, & Conscious
Main purpose of Psychoanalytic Therapy
To help us slowly become aware of unconscious impulses; by bringing unconscious impulses to awareness, we’re able to manage them, because even when they are outside awareness, primitive impulses can still act on us in an indirect and destructive manner
Freud’s Developmental Theory
Children go through developmental stages: Oral birth to 1 year old Anal 1 to 3 years old Phallic 3 to 5 years old Latency 5 to 12 years old Genital Adolescence to Adulthood
Biological Maturation
Drives progress through developmental stages; forces the individual to confront demands inherent within each stage
Fixation
Unresolved unconscious conflict
Structural Approach of Freud’s Theory
Involves the interrelationships of the concepts of id, ego, and superego
Id
Seat of biological desires; structural entity within the human personality; functions on the pleasure principle and primary-process thought; “a chaos, a cauldron full of seething excitations.” Outside the awareness or unconscious
Primary Process Thought
Characterized by hallucination-like images of fulfilled sexual or aggressive desires
Ego
Functions include memory, problem-solving ability, and rational or logical thought processes; mediator within the structure of the human personality; Contend with the id’s primitive impulses and the admonitions and expectations of the superego, and the reality of the external world; uses defense mechanisms as a means of dealing with battling forces
Secondary Thought Processes
Directly aid us in coping with or defending against powerful sexual and aggressive drives.
Superego
Two parts of the superego: Conscience & Ego Ideal
Conscience
Develops as a function of parental prohibitions or administers stern punishment; inner source of punishment; uses punishment as a motivator
Ego-Ideal
Positive desire to emulate adult standards of conduct; uses reinforcement as a primary motivator
Primary Characteristics of Defense Mechanisms
They are automatic: Individuals learn to relexively use particular defense mechanisms
They are unconscious
They ward of unacceptable impulses
To a greater or lesser extent (depending on the defense mechanism employed) they distort reality
Superego
Two parts of the superego: Conscience & Ego Ideal
Conscience
Develops as a function of parental prohibitions or administers stern punishment; inner source of punishment; uses punishment as a motivator
Ego-Ideal
Positive desire to emulate adult standards of conduct; uses reinforcement as a primary motivator
Primary Characteristics of Defense Mechanisms
They are automatic: Individuals learn to relexively use particular defense mechanisms
They are unconscious
They ward of unacceptable impulses
To a greater or lesser extent (depending on the defense mechanism employed) they distort reality
Psychopathology According to Freud
Arises from early childhood experiences; existed on a continuum, with even relatively healthy individuals showing occasional signs or symptoms of pathology
Norman-Abnormal Continuum
Everyone shows some symptoms or signs of pathology
Key Issues Pertaining to Psychopathology and Human Change in Psychoanalytic Theory and Therapy
Theory and Therapy remain focused primarily on early childhood experiences as the origin of psychopathology
Early childhood experiences that produce pathology are not completely understood, recalled, or dealt with in a conscious manner
Cornerstone of human change continues to be some form of insight or consciousness raising experience
Human Change is not an instantaneous process, requires working through process where consistent practicing of new ways of understanding inner impulses and contemporary human relationships occurs
Ego Defense Mechanisms
Repression Denial Projection Reaction Formation Displacement Rationalization Regression Sublimation
Repression
Involves forgetting an emotionally painful memory
Denial
Expressed with force
Projection
Occurs when clients push their unacceptable thoughts, feelings, or impulses outward, onto another person
Reaction Formation
When it is too dangerous to directly express aggression toward someone, the individual may behave in an excessively loving way
Implications of Freud’s Theory for Psychotherapy & Counseling
Clients are affected by the traces of unconscious memories left over from childhood
Unconscious memories are acted out and acted on, rather than directly recalled
Clients can project child-parent relationship dynamics onto the therapist (transferrence)
Therapists can also project their childhood relationship patterns onto the client (countertransference)
Transference and countertransference tend to be unconscious, automatic, and repetitive; characterized by inappropriate intensity,
Repetitive quality of inappropriately applying old relationship dynamics is described as repetition-compulsion
Clients often resist therapy because they see it as threatening through defense mechanism
For therapy to succeed, resistances and transference must be understood through some form of interpretation; When this process proceeds smoothly, the client’s ego or self is stengthened and greater insight can be tolerated because of greater ego control
Rationalization
Occurs when clients use excessive explanations to account for their behavior
Regression
Involves going back to an old, less sophisticated method of doing things
Erik Erikson
Proposed an eight-stage epigenetic theory of development; deviated from Freud by emphasizing psychosocial development instead of psychosexual development; emphasized continuous nature of development into old age
Implications of Freud’s Theory for Psychotherapy & Counseling
Clients are affected by the traces of unconscious memories left over from childhood
Unconscious memories are acted out and acted on, rather than directly recalled
Clients can project child-parent relationship dynamics onto the therapist (transferrence)
Therapists can also project their childhood relationship patterns onto the client (countertransference)
Transference and countertransference tend to be unconscious, automatic, and repetitive; characterized by inappropriate intensity,
Repetitive quality of inappropriately applying old relationship dynamics is described as repetition-compulsion
Stages of Development in Psychoanalytical Thinking
Drive
Ego
Object
Self
Goal of Object Relations Therapy
Exorcise the old maladaptive internalized representations and replace them with healthier representations.
Attempts to replace the bad object with a good object
Therapist acts as a good object and through this experience, the client is able to replace the original bad internalized parent object
Object Relations Theory
Focuses on the dynamics and motivation captured within the context of earlier parent-child relationships; referred to as pre-oedipal; humans mentally internalize both a representation of self and a representation of early caretaker figures, internalized self and other representations are carried within theindividual into adulthood
Client’s Relationships
Dominated and affected by early trauma or destructive interpersonal trauma
Goal of Object Relations Therapy
Exorcise the old maladaptive internalized representations and replace them with healthier representations.
Attempts to replace the bad object with a good object
Focus of Object Relations Analysis
Relationship wishes and pre-Oedipal interpersonal dynamics as played out in the regressive analytic situation
Heinz Kohut
Believed that needs for self-cohesiveness and self-esteem are overarching motivations that fuel human behavior; focus is on the development ofhealthy narcissism within individuals
Kohutian Self Psychological Psychotherapy
Due to early childhood developmental defects, client quickly establishes a mirroring and idealizing transference withing the therapy situation
Mirroring and idealizing transference is both regressive and progressive, reengaging a mirroring andideal object in order to repair and build up its psychic structure
Major fear of client is retraumatization by therapist and this fear produces resistance
Therapist interprets resistance
Therapist is imperfect and will fail to provide client’s wish and need for perfect empathy and will not be a perfect figure for idealizing
Client retreat from intimacy with therapist
Therapist’s deficiencies and failures are not of traumatic proportions then this retreat can be interpreted in conjunction with the therapist’s acknowledgement of his or her failures
Failures, if handed well, will be optimal failures and new self structure will be acquired and existing ones will be firmed
Kohutian Therapeutic Unit
Empathic understanding and the repeated working thourhg of optimal failures in empathy constitute the basic therapeutic unit of treatment.
Modifications for Shortening Psychoanalytic Therapy
Use a rigorous initial evaluation and selection process to screen out individuals who are unable to tolerate an internsive short-term psychoanalytic treatment procedure
Fix the time limit or number of sessions from the outset of therapy
Relate surface symptoms to an underlying, core, repeating relationship conflict (core conflictual relationship theme)
Choose, with the client, a mutually agreeable and reasonable focus for therapy
Actively and repeatedly use confrontation, clarification, and interpretation to establish triangles of insight
Two-Person Psychology
Intersubjectivity and relational psychoanalysis; Analyst is viewed as a participant-observer;
Goals of Methods and Techniques of Psychoanalytic Therapy
To make unconscious conscious or to increase client awareness
To help the client develop greater ego-control or self-control over unhealthy or maladaptive impulses
To help the client dispose of maladaptive or unhealthy internalized objects and replace them with more adaptive internalized objects
To repair self-defects through mirroring, presenting a potentially idealized object, and expressing empathy during optimal therapeutic failures
Tips for Timing Interpretations
Watch for when the client is just a step away from becoming aware of something new.
Wait for the client to show positive regard for you.
Wait until you can say the interpretation clearly and articulately; if the interpretation is mddled in your mind, it probably won’t be helpful.
Wait until you have enough data to support your interpretation.
Two-Person Psychology
Intersubjectivity and relational psychoanalysis; Analyst is viewed as a participant-observer;
Countertransferance
The therapist’s tendency to see the client in terms of his or her own previous relationships
Who am I being asked to be in this situation?
Basic Rule in Psychoanalysis
Telling the client, “Say whatever comes to mind.”
Optimal conditions for Psychoanalysis
All external stimuli are minimized
The patient’s internal stimuli are minimized
Cognitive selection or conscious planning is reduced
Steps Needed for Preparation of Clients Prior to analysis
Developing a therapeutic alliance.
Role Induction
Timing
What To Interpret
Tips for Timing Interpretations
Watch for when the client is just a step away from becoming aware of something new.
Wait for the client to show positive regard for you.
Wait until you can say the interpretation clearly and articulately; if the interpretation is mddled in your mind, it probably won’t be helpful.
Wait until you have enough data to support your interpretation.
What to Interpret
The client’s ego defenses
Transference relationship
Client’s underlying wish and inner conflict about the wish
Steps to Prepare for Psychoanalytically Informed Therapy
Strongly consider getter psychoanalytically oriented psychotherapy for yourself
When in doubt, don’t forget the basic rule.
Use noncritical, mutual exploration as a general technique
Pay attention to your client’s childhood baggage and possible transference
Pay attention to your own childhood, interpersonal baggage, and possible countertransference.
Role Induction
A procedure through which therapists tell clients about how therapy works; occurs most formally at the beginning of therapy, but also continues on an intermittent basis throughout therapy.
Conflict-Based Triangle of Insight
The client’s wish, aim, or drive
The threat or imagined threat that makes the direct gratification of the wish impossible
The defensive compromise
Analysis of Resistance
Interpret defense before conflict so that the client will use preexisting defenses to deny your insightful interpretation; When defenses are identified and interpreted repeatedly, clients begin having greater understanding and greater voluntary control over their defenseiveness than before
Transference-Based Triangle of Insight
Observations based on the transference relationship
The client’s reports of his early childhood relationship dynamics
The client’s reports of his contemporary, outside-of-therapy relationships
Psychoanalytic Dream Process
Interactive process, emphasizing the client’s reactions to and impressions of the dream’s meaning; method involves asking clients to free associate to their dreams and then a collaborative exploration of responses ensues
Steps to Prepare for Psychoanalytically Informed Therapy
Strongly consider getter psychoanalytically oriented psychotherapy for yourself
When in doubt, don’t forget the basic rule.
Use noncritical, mutual exploration as a general technique
Pay attention to your client’s childhood baggage and possible transference
Pay attention to your own childhood, interpersonal baggage, and possible countertransference.
Role Induction
A procedure through which therapists tell clients about how therapy works; occurs most formally at the beginning of therapy, but also continues on an intermittent basis throughout therapy.
Assessment Procedures Used by Psychoanalytically Oriented Clinicians
Clinical Interviewing Projective Testing (Rorschach/Thematic Apperception Test), Free Association to Specific Words, & Human Figure Drawings
Analysis of Resistance
Interpret defense before conflict so that the client will use preexisting defenses to deny your insightful interpretation
