Classical Psychoanalytic Tx

Question 1

Freud: definition of mental health

Answer 1

(Freud 1930) In “Civilization and its Discontents”: the compulsion to work and the power of love

Question 2

Topographic Model

Answer 2

(Freud, 1900)
Unconscious: unacceptable ideas and feelings
Preconscious: acceptable ideas and feelings that can become conscious
Conscious: ideas and feelings in awareness

Question 3

Freud’s view of dreams

Answer 3

(Freud 1900) “The royal road to the unconscious” and “the disguised fulfillment of conflictual wishes”

Question 4

4 operations at work in a dream

Answer 4

(Freud 1900)
Condensation - combining different unconscious thoughts into one
Displacement - direction of feelings onto unrelated subject
Representability - an object that is absent is represented by an image
Secondary revision - making the dream coherant

Question 5

Oral Stage

age & pathology

Answer 5

(Freud 1905)
Age: Birth to 18 months
Can manifest as depressed

Question 6

Anal Stage

age & pathology

Answer 6

(Freud 1905)
Age: 18 months to 3 years
Can manifest as obsessional

Question 7

Phallic Stage

age & pathology

Answer 7

(Freud 1905)
Age: 3-6
Can manifest as hysteria
For males: aggression, ambition, vanity
For females: seductiveness or submission
Resolution involves identification with same-sex parent

Question 8

Latency Stage

age & pathology

Answer 8

(Freud 1905)
Age: 6 to puberty
Fixation leads to sexual unfulfillment

Question 9

Genital Stage

age & pathology

Answer 9

(Freud 1905)

Age: puberty to death

Question 10

Psychoanalysis: The Structural Model

Answer 10

(Freud 1923)
Id: operates on the pleasure principle
Ego: mediator, operates on the reality principle
Superego; irrationally moralistic aspect of the mind

Question 11

Drive/Conflict Theory

Answer 11

(Freud 1926)

• A press for the drives creates internal conflict which seeks expression
• The ego engages defenses to repress drives (or fails, causing symptoms); operates on the reality principle
• In a healthy person, compromise formation satisfies all parts of the structural model

Question 12

Psychoanalysis: Techniques

Answer 12

(Auld, Hyman & Rudzinski 2005) WICCA
Association (free)
Confrontation - presenting to the client what has become preconscious
Clarification - description of the perception of something unconscious
Interpretation - makes the unconscious conscious by labeling a wish-defense complex
Working Through - interpretation in areas of life and relationships

Question 13

Psychoanalysis: Events in Treatment

Answer 13

(Auld, Hyman & Rudzinski 2005) RITT

• Resistance in initial stages to prevent discovery
• Interpretation, calling attention to resistance and interprets the purpose it serves
• Transference develops, the patient relates to the therapist as if they are someone from the patient’s life
• Transference Neurosis, when all vital unconscious conflicts are focused on the therapist

Question 14

Psychoanalysis: 3 types of anxiety

Answer 14

(Freud 1926)
Realistic Anxiety: of the physical world
Moral anxiety: threats to the ego
Neurotic anxiety: fear of being overwhelmed by the id

Question 15

Psychoanalysis: Development of neurosis

Answer 15

(Auld, Hyman & Rudzinski 2005)

1) Infantile wish (pregenital sexual wish) is stimulated
2) Wish cannot be gratified, which leads to frustration
3) Defenses develop which also reduce adaptability to the world
4) Verbal (secondary process system) is suppressed and child is stuck in primary process thinking
5) Handicapped by repression, the child repeats mistakes (repetition compulsion)
6) if repression weakens and adult neurosis develops, symptoms emerge which are ego dystonic

Question 16

Freudian Depressive Personality

Answer 16

(Freud 1905)

Over or under-indulgence at oral phase (leads to addiction, dependence, depression)

Question 17

Freudian Obsessional Personality

Answer 17

(Freud 1905)
Over or under-indulgence at anal phase (orderliness, perfectionism, control or cruelty, impulsiveness, rebelliousness, disorganization)

Question 18

Freudian Hysterical Personality

Answer 18

(Freud 1905)

Rejection or seduction at the phallic/oedipal phase

Question 19

Psychoanalysis: Curative Factor

Answer 19

(Freud 1926)

1) Make the unconscious conscious by undoing repression
2) Helping the patient to develop compromise formations (modifying the ego) by deciding to renounce gratification, allowing it, or some combination

Question 20

Psychoanalysis: Goals for Treatment

Answer 20

(Freud 1923) EACH DICE
Ego Strength
Adaptation
Common understanding (patient and therapist)
Hopefulness
Defense
Identification and Internalize
Consciousness
Energy

Question 21

How to explain therapy to a patient psychoanalytically

Answer 21

(Freud 1923)

• Discuss goals of treatment for the first few sessions
• Become curious about the self, explore past to understand present
• Expression of things not fully aware; everything is important

Question 22

A. Freud’s contributions

Answer 22

(A. Freud, 1936)

• Highlighted the impact of environment on child
• Ego develops out of frustration which leads to development of defenses
• When ego development is disturbed, primitive and rigid defenses develop
• Goal is to develop an observing ego

Question 23

Ego Psychology: Curative factor

Answer 23

• Gaining insight (developing an observing ego)

- Developing mature and flexible defenses

Question 24

Ego Psychology: Technique

Answer 24

• Therapist acts as the observing ego (interpreting defenses)
• Interpret superego functioning
• Foster identification with the therapist to facilitate development of ego

Question 25

Core Components to all Analytic Theories

Answer 25

• Psychic determinism (there are no accidents, everything is related to the unconscious)
• Much of mental life is unconscious
• much of who we are is rooted in early life

Question 26

Ego Psychology: Ego functions

Answer 26

Reality testing
Judgement
Sense of reality/self
Affect regulation/Impulse control
Object relations
Thought Processes (primary & secondary)
Adaptive Regression (ARISE)
Defensive Functioning
Autonomous functioning
Synthesizing/Integrating
Mastery & Competence