Dynamic Psychopathology

Question 1

Who coined the term ‘collective unconscious’?

Select one:
1. Freud
2. Mahler
3. Adler
4. Jung
5. Lacan

Answer 1

Jung

Collective unconscious refers to mental symbols and other mental content outside of our awareness but are perceived cross-culturally. An example of this is the ‘Wise Old Man’ concept

Question 2

After his father’s sudden death, Tom took over his family business, which he used to detest for a long time. The defence mechanism in operation is

Select one:
1. Reaction formation
2. Displacement
3. Repression
4. Altruism
5. Regression

Answer 2

Reaction formation

Reaction Formation occurs when a person feels an urge to do or say something and then actually does or says something that is effectively the opposite of what they really want. A common pattern in Reaction
Formation is where the person uses ‘excessive behavior’, for example using exaggerated friendliness when the person is actually feeling unfriendly. e.g., a person who is angry with a colleague actually ends up being particularly courteous and friendly towards them; or a mother who has a child she does not want becomes very protective of the child.

Question 3

Idealization and denigration are products of which of the following Kleinian processes?

Select one:
1. Regression
2. Splitting
3. Repression
4. Projective identification
5. Projection

Answer 3

Splitting

Splitting refers to splitting of the self into good and bad. Idealization and devaluation (denigration) are the results of splitting and are central in the Kleinian school of thought.

Question 4

Which of the following was employed by Freud as a psychoanalytic technique to uncover the unconscious?

Select one:
1. Free association
2. Empathy
3. Narco-analysis
4. Cognitive restructuring
5. Introspection

Answer 4

Free association

Using the technique of free association, Freud asked patients to relate anything that came into their mind, regardless of how apparently unimportant or potentially embarrassing the memory threatened to be. This technique assumed that all memories are arranged in a single associative network and that sooner or later the subject would stumble across the crucial memory.

Question 5

The predominant defence noted in those with amnesic fugue reactions is

Select one:
1. Dissociation
2. Splitting
3. Somatisation
4. Introjection
5. Acting out

Answer 5

Dissociation

Some dissociation is helpful in keeping one portion of one’s life from interfering with another (e.g., not bringing problems home from the office). However, dissociation is responsible for certain somatoform and dissociative disorders including amnesia and fugue.

Question 6

A young man brings his 19-year-old girl friend who vacantly stares at the wall, not responding to the conversation. He reports that she started behaving in this manner since they had a serious argument. The
most likely defence mechanism operating here is

Select one:
1. Acting out
2. Repression
3. Projection
4. Dissociation
5. Displacement

Answer 6

Dissociation

In general, dissociation includes day dreaming, ‘zoning out,’ or doing things on ‘autopilot.’ For example, staring out during lectures and thinking what to do in the evening, driving a car and not able to describe what you saw on the way are some daily examples of dissociation.

Question 7

Which of the following defence mechanism is classified as a manic defence?

Select one:
1. Repression
2. Sublimation
3. Reparation
4. Humour
5. Denial

Answer 7

Denial

Denial, grandiosity, omnipotence are some of the manic defences described by Klein. Humour and sublimation are mature defences.

Question 8

Superego is formed at which stage of psychosexual development?

Select one:
1. Phallic stage
2. Oral stage
3. Genital stage
4. Anal stage
5. Latency stage

Answer 8

Latency stage

The latency period is the stage of suspension of psycho-sexual development between the age of five and six and puberty. During this period, sexual activity and interest tend to decrease, a consequence of repression, secondary identifications and the establishing of the superego, resulting in the resolution or the
waning of the Oedipus complex. At about five years of age during latency stage, the Superego appears, following the end of the oedipal stage.

Question 9

Which one of the following refers to the contents of the collective unconscious that describes a pancultural representation of human experience expressed through images and symbols?

Select one:
1. Animus
2. Shadow
3. Archetypes
4. Anima
5. Persona

Answer 9

Archetypes

Examples of pancultural representation of human experience (i.e. the Jungian archetypes) include the mother, the child, the hero, the self, the shadow, anima and animus. Anima refers to the unconscious
feminine aspects of the male. Animus refers to the unconscious masculine aspects of the female. Shadow refers to the unacknowledged aspects of oneself that includes both creative impulses and destructive urges. ‘Self’ refers to the main archetype that gives the personality a sense of oneness. Persona refers to the outer concealed aspects of oneself.

Question 10

Klein’s depressive position is related to the process of learning to cope with which of the following conflicts?

Select one:
1. Difficult relationships
2. Ambivalence
3. Sexual needs
4. Depression
5. Hunger

Answer 10

Ambivalence

Melanie Klein described two positions - paranoid-schizoid and depressive position. The paranoid-schizoid position is associated with the use of splitting and projection as a defence mechanism. This position concerns an inability to perceive a whole object and splits all objects into their good and bad parts. But in the depressive position, the infant tolerates the ambiguity or ambivalence and can realise that an individual can have both good and bad qualities. In the paranoid-schizoid position, the anxiety is about the survival of the self but in depressive position the anxiety is about the loss of the object.

Question 11

Carl Gustav Jung is associated with which of the following terms?

Select one:
1. Free association
2. Personal unconscious
3. Neurasthenia
4. Dementia praecox
5. Moral insanity

Answer 11

Personal unconscious

Carl Gustav Jung is associated with the following terms- Personal unconscious, collective unconscious, introvert, extrovert, archetypes, persona, anima and animus.

Question 12

The major source of values in one’s super-ego, according to psychoanalytic theory, is

Select one:
1. Parental ideals
2. Social models such as celebrities
3. Innate values in newborn
4. Knowledge from school education
5. Peer group

Answer 12

Parental ideas

The superego is one of the three agencies making up the psychic apparatus in Freud’s second topography, the structural theory (1923). It results essentially from the internalization of parental authority.

Question 13

Which of the following is correct concerning defence mechanisms employed by the ego?

Select one:
1. Defences operate only in pathological situations
2. All defences lead to complete resolution of anxiety
3. Repression is considered as the primary defence
4. Acting out is a mature defence
5. Immature defences are characteristic of psychosis

Answer 13

Repression is considered as the primary defence

Repression (sometimes called motivated forgetting) is a primary ego defence mechanism since the other ego mechanisms use it in tandem with other methods.

Question 14

A 45-year-old man who has longstanding suspiciousness towards police becomes anxious and acts in a strange manner on seeing 2 policemen at a public event. The police become suspicious of him and arrest
him as a precautionary measure. The underlying psychodynamic mechanism is

Select one:
1. Repression
2. Acting out
3. Projective identification
4. Suppression
5. Projection

Answer 14

Projective identification

Projective identification is used to project the bad object into (not onto) another person, so it becomes a part of that person. The person then identifies with that other person and hence has means to control them. The person projected into may consequently be pressured to behave congruently with the projective phantasy, believing and accepting their role.

Question 15

Which one of the following is true about the Ego?

Select one:
1. Unconsciously motivated
2. It is instinctive
3. Governed by the pleasure principle
4. It is governed by the reality principle
5. It is the most primitive part of the personality

Answer 15

It is governed by the reality principle

The Id is the most primitive part of the personality and it is instinctive, unconsciously motivated and is
governed by the pleasure principle. The Ego is consciously driven, governed by the reality principle and contains reality-oriented parts of the self. The ego is largely conscious. The superego is formed by introjects of parental figures. The superego has both conscious and unconscious aspects, and can be equated to the
conscience of the individual.

Question 16

Which one of the following concepts is not correctly linked to its proponent?

Select one:
1. Splitting - Melanie Klein
2. Malignant Alienation - Morgan and Watts
3. Introversion and Extroversion - Winnicott
4. Sibling Rivalry - Alfred Adler
5. Thanatos - Sigmund Freud.

Answer 16

Introversion and Extroversion - Winnicott

Carl Gustav Jung described the concept of Introversion and extroversion. Jung was the founder of the school of analytical psychology.

Question 17

Following poor feedback from his boss at work, Mark spends all his evening playing tennis with his friend. This is best described as

Select one:
1. Displacement
2. Altruism
3. Turing into self
4. Aggression
5. Sublimation

Answer 17

Sublimination

Sublimation refers to a mature type of defence mechanism where socially unacceptable impulses are transformed into acceptable forms.

Question 18

According to Freud which of the following is true?

Select one:
1. Transference is not seen in the absence of repressed wishes
2. Id obeys the reality principle
3. Phallic phase is the last phase in psychosexual development
4. Id functions through primary process thinking
5. Conscious, subconscious and preconscious form structural model of mind

Answer 18

Id functions through primary process thinking

Id functions by primary process thinking which denies the existence of rational boundaries of thinking, sense of time, space and probability. It does not obey reality principle but instead serves pleasure principle. Transference occurs irrespective of presence or absence of repressed wishes. Id, ego and superego form the structural components while conscious is a part of topographic model. Genital not the phallic stage is the last stage of psychosexual development.

Question 19

The most mature level of anxiety according to psychoanalytic theory is

Select one:
1. Disintegration anxiety
2. Superego anxiety
3. Annihilation anxiety
4. Castration anxiety
5. Separation anxiety

Answer 19

Superego anxiety

At the most mature level of the hierarchy of anxiety, superego anxiety is related to guilt feelings about not living up to internalized standards of moral behaviour derived from the parents. This is seen after resolution
of the oedipal conflict.

Question 20

Which one among the following statements about dream work is true?

Select one:
1. Primary process thinking does not occur in dreaming
2. The mental mechanisms involved in the psychoanalytic therapy of dreams include
primary elaboration
3. The dream work involves a conversion of latent content into manifest content.
4. Dream work converts the manifest content of the dream into its latent content
5. Dreams are always interpreted in psychoanalytic psychotherapy

Answer 20

The dream work involves a conversion of latent content into manifest content.

According to Freud, dreams are the royal road to the unconscious. In dreams, Freud distinguished between latent content (unconscious feelings that include the wishes, anxieties and fantasies) and manifest content ( recalled dream). The dream work involves a conversion of latent content into manifest content.

Question 21

Which of the following defence mechanism is characterised by changing the shape of one’s self-representation to become more like an ideal and admired person?

Select one:
1. Introjection
2. Identification
3. Modelling
4. Projection
5. Displacement

Answer 21

Identification

In identification, a person changes himself to be like someone else who is admired. It is not same as modelling which is a social learning concept. In modelling only behaviour, not self-representation is
modelled.

Question 22

Which of the following is NOT a Kleinian defence?

Select one:
1. Denial
2. Sublimation
3. Grandiosity
4. Introjection
5. Projective identification

Answer 22

Sublimation

Sublimation is believed to be the healthiest and mature defence mechanism: It refers to refocusing of psychic energy away from negative outlets to healthy and creative behaviour.

Question 23

Which one of the following is not considered to be a Neo-Freudian?

Select one:
1. Karen Horney
2. Harry Stack Sullivan.
3. Jean Piaget
4. Erich Fromm
5. Alfred Adler

Answer 23

Jean Piaget

Neo-Freudian psychologists were thinkers who agreed with the basis of Freud’s psychoanalytic theory but changed and adapted the theory to incorporate their own beliefs, ideas and theories. Piaget is not usually considered as a Freudian theorist.

Question 24

Who described the unconscious as composed of both the collective unconscious and personal unconscious?

Select one:
1. Winnicott
2. Carl Gustav Jung
3. Sigmund Freud
4. Alfred Adler
5. Anna Freud

Answer 24

Carl Gustav Jung

Carl Gustav Jung described a holistic theory of psyche that can be applied across varied cultures. According to him, the unconscious mind includes the collective and personal unconscious. He postulated that the personal unconscious is unique to each individual, but the collective unconscious is universal, common to mankind, contains the archetypes that include anima, animus, shadow or self and Hero.

Question 25

The ‘repressive barrier’ to censor unacceptable wishes and desires is maintained by

Select one:
1. Super-ego
2. Preconscious system
3. Unconscious system
4. Id
5. The conscious system

Answer 25

Preconscious system

The preconscious interfaces with both unconscious and conscious - contents of unconscious become conscious by ‘squeezing’ through the preconscious. It maintains the ‘repressive barrier’ to censor
unacceptable wishes and desires (not the repressed contents).

Question 26

The basis of object relations theory is that the primary motivational drive of an individual is to seek

Select one:
1. Self actualisation
2. Money
3. Satisfaction
4. Relationships
5. Pleasure

Answer 26

Relationships

Object relations theory describes with how a growing baby develops relationships with others. Gratification is thought to be obtained through relationships as well as through satisfaction of desires.

Question 27

Which of the defence mechanisms is most often used by people with narcissistic personality?

Select one:
1. Displacement
2. Projective identification
3. Sublimation
4. Reaction formation
5. Projection

Answer 27

Projection

Projection is a narcissistic defence mechanism that refers to the tendency of attributing the origins of the undesirable impulses and feelings to another person, therefore the unacceptable inner impulses are perceived as though they were outside of the self . E.g. A cheating husband blames his wife of being unfaithful.

Question 28

Which of the following is a Kleinian defence?

Select one:
1. Splitting
2. All of the listed
3. Projection
4. Grandiosity
5. Omnipotence

Answer 28

All of the listed
SIPDOG is a mnemonic for Klein’s defences. Splitting, Introjection, Projective Identification, Denial, Omnipotence, Grandiosity.

Question 29

In his lifetime, Freud proposed various theories with many revisions of his former theories being evident in his later works. The terms superego, id and ego are based on

Select one:
1. Dream work model
2. Cathartic model
3. The topographical model
4. The structural model
5. Hysterical Model

Answer 29

The structural model

Freud’s structural model includes the Id, Ego and Superego. The topographical model consists of concepts such as conscious, pre-conscious and the unconscious. The cathartic model posits that hysterical neurosis is mainly due to dammed up repressed feelings, especially sexual feelings. Release of these feelings was described by Freud as opening of the psychic abscess. According to him, through free association or hypnosis these feelings are released leading to a resolution of hysteria.

Question 30

In psychoanalytic terms, condensation refers to
Select one:
Representing abstract concepts by using recognisable images
Combining various unconscious impulses into a single image while dreaming
Avoidance of unconscious impulses
Enacting dreams as they occur
Transfer of energy from an original object to a symbolic representation of the object

Answer 30

Combining various unconscious impulses into a single image while dreaming

Condensation is a term used in dream analysis. It refers to the process of several unconscious impulses
being combined into a single image in the manifest dream content e.g., one’s father and a horrible teacher
may be unified and occur as a single dreadful monster in a child’s dream.

Question 31

In psychoanalytic terms, condensation refers to

Select one:
Representing abstract concepts by using recognisable images
Combining various unconscious impulses into a single image while dreaming
Avoidance of unconscious impulses
Enacting dreams as they occur
Transfer of energy from an original object to a symbolic representation of the object
Condensation is a term used in dream analysis. It refers to the process of several unconscious impulses
being combined into a single image in the manifest dream content e.g., one’s father and a horrible teacher
may be unified and occur as a single dreadful monster in a child’s dream.
The correct answer is: Combining various unconscious impulses into a single image while dreaming
HiY Dynamic Psychopathology 003
In a psychoanalytic group setting, a male group member is noted to make advances towards women both
inside and outside the group whenever his self-esteem was low, but did not show sustained interest when
he started feeling better within himself. This led to many broken relationships. Which of the following
defence mechanism is being used?
Select one:
Reaction formation
Isolation
Sublimation
Displacement
Acting out

Answer 31

Acting out

Acting out refers to a defence mechanism whereby the patient involves in behaviours that relieve tension on a temporary basis through gratification of needs instead of verbalization of emotions.

Question 32

In psychodynamic theory, an active process in which painful thoughts and memories are pushed to the inaccessible corners of the mind is known as

Select one:
1. Repression
2. Retrieval failure
3. Regression
4. False memory syndrome
5. Re-integration

Answer 32

Repression

The concept of repression was described by Sigmund Freud. Here people unconsciously repress painful or disturbing memories and is normally taken to mean motivated forgetting.

Question 33

Oedipus complex and castration anxiety are associated with which stages of psychosexual development?
Select one:
Anal stage
Genital stage
Latency stage
Oral stage
Phallic stage

Answer 33

Phallic stage

Phallic/oedipal stage is seen between 3 and five years of age during which the child increasingly focuses on genitalia and libido is directed towards others. His stage involves castration anxiety and Oedipus complex in males and penis envy and Electra complex in females. The Oedipal complex refers to the intense attachment to the parents of the opposite sex along with a wish to destroy the parents of the same sex. Resolution of the Oedipal complex involves identification with the same sex parent (i.e. the son identifying
with the father).

Question 34

Which one among the following is considered as a mature defence mechanism?

Select one:
1. Projection
2. Sublimation
3. Denial
4. Regression
5. Repression

Answer 34

Sublimation

Primitive/immature defenses include splitting, projection, projective identification, idealization, denigration,
introjection, passive aggression and turning against the self. Neurotic defences include repression, regression, denial, displacement, dissociation, isolation, reaction formation, intellectualisation,
rationalization, externalisation and identification with the aggressor. Humour, anticipation, sublimation, altruism and suppression (SASHA) are all mature defence mechanisms.

Question 35

Defence mechanisms are a function of the

Select one:
1. Ego
2. Id
3. Both Id and Ego
4. Superego
5. Both Ego and superego

Answer 35

Ego

The first systematic account of defence mechanisms was written by Freud’s daughter Anna Freud in the book ‘Ego and the Mechanisms of Defence’ in 1936.

Question 36

A GP, who has an argument with her teenage daughter the previous night, insists with excessive force to her next patient to stop smoking. This is called

Select one:
1. Projection
2. Reaction formation
3. Denial
4. Displacement
5. Acting out

Answer 36

Displacement

Displacement refers to showing emotions at a target different than the one unconsciously intended.

Question 37

One person (A) projects undesirable impulses and feelings onto another person (B), then B unconsciously alters her behaviour in a way as if the projected idea was true. The underlying psychodynamic mechanism is

Select one:
1. Projective identification
2. Acting out
3. Suppression
4. Repression
5. Projection

Answer 37

Projective identification

Projective Identification (PI) is an unconscious interaction that occurs between two persons; this was first
described by Melanie Klein. Person A projects undesirable impulses and feelings to person B, then Person B unconsciously alters the behaviour in a way as if the projected idea was true. Example - a customer unconsciously felt irritable; however, criticized a sales person for being unpleasant; the sales person was annoyed and started to act in a way as if the original criticism was true.