Neo-Freudian theorists and theories

Question 1

Drew Western (1990, 1998) as an active proponents of contemp psychoanalysis

Answer 1

“Freud, like Elvis, has been dead for a number of years but continues to be cited with some regularity” (Westen, 1998, p. 333).

Many of Freud’s ideas have not stood the test of time, others have and have been incorporated into a contemporary version of psychoanalysis.

Question 2

what is modern psychoanalysis built on?

Answer 2

ideas inspired by Freud but modified and advanced by others.

Question 3

what do contemporary views focus on?

Answer 3

childhood and adult relationships rather than id, ego and super-ego conflict.

Question 4

how is the cognitive unconscious different from the motivated unconscious described by Freud?

Answer 4

Priming is an example of unconscious influence on behaviour – bounded, rule-governed and specific.

The idea of defence mechanisms has been retained and developed.

Question 5

Freudian Dissenters

Answer 5

Carl Jung (1875-1961)

Alfred Adler (1870-1937)

Erik Erikson (1902-1994)

Karen Horney 91885-1952)

Harry Stack Sullivan (1892-1949)

Erich Fromm (1900-1980)

Behaviour is goal directed – not consciously/biologically directed

Question 6

what 3 issues to the main disagreements revolve around?

Answer 6

The negativity of Freud’s theory - pessimistic and deterministic picture of human nature, people largely controlled by instincts and unconscious forces.
Later theorists emphasised teleological explanations, viewing behaviour as goal directed rather than biologically and unconsciously determined.

Freud believed that most of the adult personality is shaped by early childhood experiences.
Neo-Freudians argue that later experiences in adolescence and adulthood are also important in shaping personality.

Freud over emphasised unconscious, instinctual influences on personality.
Neo-Freudian theorists incorporate social and cultural influences
Cognitive unconscious is quite different from the Freudian motivated unconscious

Question 7

Carl Jung - analytic psych

Answer 7

Jung resigned from Freud’s Psychoanalytic Society in 1914.

Jung - there is more to the unconscious than Freud theorised.
- Individual goals and motivations are just as important in determining life courses as are sexual and aggressive drives.

A teleological view of personality - personality development continues throughout life and is influenced by future goals as well as by the past.
- The endpoint of development is self-realisation which can only occur later in life.

Jung’s thinking was dominated by the principle of opposites - human experience consists of polarities that oppose and balance each other.

Main disagreement around unconscious

Lifelong development theory

Question 8

mind divided into 3 parts

Answer 8

1. The conscious ego –similar in meaning to Freud’s.
2. The personal unconscious
   – grows out of a person’s own unique experiences.
3. The collective unconscious – made up of archetypes
   – more prehistoric. Inherited unconscious content is passed on from previous generations and contains the collected primordial images (archetypes) common across the human species

Question 9

what is the collective unconscious made up of?

Answer 9

archetypes which are emotional symbols or primordial images inherited from our ancestors.

Question 10

why does the collective unconscious influence personality?

Answer 10

because archetypes are inherited tendencies or emotional patterns that predispose us to view the external world in certain ways.

Question 11

examples of archetypes

Answer 11

mother

father

God

death

snakes

animus/anima

persona

the shadow

the self

Question 12

animus

Answer 12

the masculine side of the female

Question 13

anima

Answer 13

the feminine side of the male.

Question 14

persona/mask

Answer 14

represents a compromise between our true self and the expectations of society

Question 15

shadow

Answer 15

unconscious negative or dark side of our personality. - more and less desirable aspects of ourselves

Question 16

self

Answer 16

unifying part of all of us that finds balance in our lives.Works with the ego.

Question 17

Carl Jung’s contribution to personality psych

Answer 17

Jung’s ideas about the collective unconscious and archetypes are not literally accepted as being unconscious representations of our long dead ancestors but more as our naturally born instincts.
- Jung and evolutionary psychology share the view that we are not born as blank slates, but rather that we enter the world with predispositions inherited from our ancestors.
Evolved psychological mechanisms

Jung’s theory of personality traits resulted in the Myers-Briggs Type Indicator, a widely used personality inventory. – used a lot in business

Jung also developed the word association test, the basic idea of which is still being investigated through the Stroop test (emotional reactions to words interfere with cognitive processing of those words).

Question 18

Alfred Adler

Answer 18

1911: Left Freud’s analytic society

Individual Psychology:

• did not accept Freud’s model of personality as comprising of competing structures. Adler perceived an essential unity in the personality.
• Looked at individuals
• Stressed the importance of the social context in personality development.

Inferiority: We all begin life with a sense of inferiority.

Alfred Adler strove throughout his life to overcome a sense of inferiority.

Striving for superiority is the motivating force in life.

If unsuccessful: inferiority complex – born helpless

Well-adjusted people express their striving for superiority through concern for the social interest.

Question 19

AA - birth order

Answer 19

The order in which you are born to a family inherently affects your personality:

• First born children who later have younger siblings have it the worst – put on pedestal – then someone else comes along – dethroned monarch
• Middle born children have it the easiest.
• The youngest child, like the first born, is more likely to experience personality problems during adulthood – they’re the baby in the family – wont be allowed to grow up quickly

Research examining birth order effects does not often support Adler’s predictions. The impact of birth order on personality is far more complex than Adler suggests – impacts how we parent each time

Question 20

AA - parenting styles

Answer 20

Pampering - overprotecting a child. Child will be ill equipped to deal with reality and may doubt own abilities.

Neglect - child is not protected from the world and is forced to face life’s struggles alone. May grow up to fear the world, have a strong sense of mistrust for others and have a difficult time forming intimate relationships.

Question 21

2 main dimensions of parenting behavs

Answer 21

1. support/responsiveness

2. control/demandingness

Question 22

parenting style and devlopment

Answer 22

Authoritative parenting facilitates the development of children’s social, academic and personal competencies.

Neglectful parenting is associated with negative outcomes including low self esteem, delinquency and drug abuse.

Authoritative and permissive parenting styles tend to assume an intermediary position – do what I say

Question 23

ego psych

Answer 23

A major modification to psychoanalysis concerns a change in focus from id to ego.

Freud focused on the id, especially the instincts of sex and aggression.
Later theorists felt that the ego deserved more attention, it performed many constructive functions.

Anna Freud focused on the strengths of the ego as it defended the person against anxiety.

Erik Erikson emphasised the ego as a powerful, independent part of personality. He noted that the ego was involved in mastering the environment, achieving goals, and hence, establishing identity.

Karen Horney was another early proponent of ego psychology – emphasised cultural and social influences on ego development.

Question 24

Erik Erikson

Answer 24

Trained as an analyst in Vienna under Anna Freud.

Two major contributions to psychodynamic thought:

• A reappraisal of the ego – teleological approach, the ego works towards goals.
• The ego’s main job is to establish and maintain a sense of identity.
• Personality development extends across the lifespan.
• Identity crisis is the focal point for each stage of development.

Emphasised social as opposed to sexual development.
A lasting contribution of Erikson’s was the notion of identity as an important developmental achievement in personality development.

Question 25

ego psych and identity crisis

Answer 25

8 stages of psychosocial development.

A crisis/conflict occurs at each stage. How we resolve each conflict determines the direction our personality development will take.

Each stage is characterised by 2 different ways to resolve the identity crisis: one maladaptive and one adaptive.

Question 26

stages of personality development and ego conflict/crisis

Answer 26

Infancy - Trust vs mistrust 
Early childhood - Autonomy vs shame & doubt
Preschool - Initiative vs guilt
School age- Industry vs inferiority
Adolescence- Identity vs role confusion
Young adulthood - Intimacy vs isolation
Adulthood- Generativity vs stagnation
Old age- Ego integrity vs despair

Question 27

Karen Horney

Answer 27

Very ahead of her time

Karen Horney changed the way psychology looked at gender differences.

Disagreed with Freud’s view of women

Countered Freud’s concept of penis envy- the penis was a symbol of social power, rather than an organ women actually desired.

Disagreed with Freud’s belief that males and females were born with inherent differences in their personality - argued for a societal and cultural explanation

Karen Horney was among the first to stress the cultural and social determinants of personality.

She noted that many gender roles were defined by culture.

Made the important distinction that while biology determines sex, culture determines gender.

Developed a major reconceptualisation of psychoanalysis which stressed social influences over biology and gave attention to interpersonal processes in the creation and maintenance of mental disorders.

Question 28

what did Karen emphasise?

Answer 28

importance of parenting and parent-child r’ships

Adult personality and behaviour often represent attempts to deal with basic anxiety.
Basic anxiety results from disturbances in the child’s relationship with their parents.

A consequence of basic anxiety (caused by poor parenting) is to become alienated from the ‘Real Self’.

Question 29

different aspects of ‘self’

Answer 29

Ideal self: ‘the tyranny of the should’, moulded by perceived inadequacies.

Despised self: caused by poor parenting, often based on others’ negative evaluations of us.

Real self: the inner core of personality, healthy personality a result of warm, loving and consistent parenting.

Question 30

Karen and neurosis and r’ships

Answer 30

Defined neurosis as a maladaptive and counterproductive way of dealing with relationships.

Question 31

neurotic personality styles

Answer 31

Passive Personality Type - Moving Toward People
Intense need to be liked and accepted by others

Aggressive Personality Type - Moving Against People
Demanding, selfish, forceful and even cruel.

Withdrawn Personality Type - Moving Away From People
Indifference to others as a way of protection from hurt.

Healthy personality adopts all three styles as appropriate and is adaptable and flexible.

Question 32

object relations theory

Answer 32

A group of theorists (e.g., Anna Freud, Melanie Klein and Donald Winnicott), who expanded on aspects of Freud’s personality theory including:

• The idea that the superego develops from identifications made in childhood with important people.
• The idea that through the mechanism of transference people repeat psychological patterns learnt in childhood in new relationships.

Emphasises the importance of early childhood experiences and interpersonal relations, especially between mother and child, in defining personality.
- The self is socially constructed through interpersonal interactions rather than emerging naturally through biological development.

Object relations theorists move attention away from the individual inner psyche and towards relations with other people.
- The essence of who we are cannot be understood without understanding our relations with significant others.

“Object” actually means person. The term ‘object relations’ is used to refer to the mental representations of significant others.
The child develops an unconscious inner representation of significant “objects” (others) in their environment.

The way the child internalises the parent’s image along with the kind of attachment children feel to their parents, influences their ability to develop meaningful attachments with significant others as adults.

Object relations became the springboard for ‘attachment theory’ (John Bowlby).

Question 33

the scientific status of psychoanalytic theory

Answer 33

Most research does not explicitly test psychoanalytic hypotheses but much research is of relevance. (Westen, 1990).

• Cognitive psychology has provided much evidence showing that most of what the mind does is unconscious.
• The mind consists of ‘mental modules’ (e.g., Stephen Pinker, 1997).

Character traits associated with the anal personality (e.g., stinginess, orderliness, rigidity) and the oral personality (e.g., smoking, biting nails, sucking thumb) are correlated with each other (Westen, 1990).

Defense mechanisms occur (e.g., repression) (Weinberger & Davidson, 1994).
- The use of psychological defense mechanisms is revealed through the way people speak (Feldman-Barrett, Williams, & Fong, 2002).

Attachment Theory (e.g., Bowlby1982) has developed from the Freudian concept of transference. 
- Focuses on repeated patterns in relationships with others.

Question 34

Drew Westen (1998)

Answer 34

1. Much of mental life is unconscious.
2. The mind does many things at once and so it can be in conflict with itself. Behaviour often reflects compromises in conflicts between mental processes, such as emotions, motivations and thoughts.
3. The events of childhood are important in shaping the personality of the adult particularly with respect to attachments/social relationships.
4. Relationships formed with significant others (e.g., parents) form patterns that tend to be repeated throughout life with new people.
5. Psychological development involves not just regulating sexual and aggressive feelings but also moving from an immature, self-centred, socially dependent way of relating to others to a mature, independent relationship style.

Not everybody accepts these conclusions.

Question 35

Shraifin et al. (2018)

Answer 35

This study aimed at constructing a Personality Types Inventory (PTI) based on Jung’s Theory. To achieve this aim, an initial version of the PTI was constructed by the researchers. This version consisted of 118 items, which describe the respondent and cover four subscales, each on a three-point Likert scale. The scale was then administered to 335 students. Factor analysis results indicated that the unidimensionality of the scale had not been achieved with four subscales, indicating that the measure is multidimensional, and the dimensions are not correlated. It was also found that the loading value of 56 items was higher than 0.40. The final version of the scale (56 items), displayed good psychometric properties, where the total internal consistency reliability coefficient of the scale was 0.91. Furthermore, an evidence of the measure’s validity was also found. Results showed that the items possess discriminative ability, where a significant difference was found between the means related to all items of the Personality Types Inventory by category, with the upper category scoring higher, showing the discriminative ability of the PTI items

Question 36

Fosshage and Davies (2000)

Answer 36

JUNG, THROUGH HIS CLOSE COLLABORATION WITH FREUD, WAS ONE OF the founders of psychoanalysis. Subsequently breaking from Freud, he developed his own theories, which he called analytical psychology. In pioneering the development of his particular depth
psychology, Jung cast an influence, albeit by and large outside psychoanalysis, that has been monumental and that has continued long past his death in 1961. Jung was convinced of the importance of prewired givens such as a central unconscious ordering principle of personality, which he called the self, and a fundamental driving force
toward self-realization, a process he termed individuation (Jung, 1953, p. 182). In the clinical arena, Jung, anticipating some of our postmodern sensibilities, emphasized the mutual influence that occurs between patient and analyst and the required deep involvement of the analyst for analysis to work. Today, Jung’s analytical psychology
is experiencing a resurgence in interest and influence within the practice of psychotherapy and our culture at large.

Question 37

Carr (2002)

Answer 37

The psychodynamics described in this paper have many other implications for work organizations and the management of change. However, there is one further issue that should be highlighted. There are certain character types that seem to be able to be coined in a term or phrase and have some resonance, or they seem instantly recognizable. To this point, there has been very little effort in the organization discourse to explore the degree to which such character types are, as was noted earlier, imaginal manifestations (of what Jung originally described as “categories of the imagination”), i.e. archetypes (1935/ 1969 ed., pp. 517-18). The work of Jung, on the notion of the collective unconscious, does demonstrate that myths and tales show a remarkable pattern of similarity irrespective of the culture. The degree to which the archetypal images are manifest in work-related character types might be a useful area of research in a context of understanding and predicting behavior in a period of change. Examining under what conditions certain archetypal images emerge and their relationship to other images will surely help to enhance understanding of behavior in work organizations.

Question 38

Ziff

Answer 38

Analytical psychology is a field supported by training
centers, specially trained analysts, and a growing body of literature. While it receives much recognition, it remains mostly outside the mainstream of counseling and counselor education. This document presents a brief history of analytical psychology and how it has been revisited and renamed archetypal psychology by a group of theorists led by James Hillman. It describes its
main tenets and the process of individuation, which is central to Jungian thought. It reviews the main areas in which analytical psychology comes under critique, including the matter of research and proof; its cult-like aspects; its religious overtones; and the prejudices of Jung himself. It speculates on areas where analytical psychology application may be most fruitful, including its use with personality types; the investigation of symbols and images in various therapies; and the use of expressive therapies to assist in bringing to consciousness material that is unconscious. It discusses the empirical research into Jung’s theory of personality development with regard to the Myers Briggs typology, which has been documented as useful in areas of career counseling and training, staff development, and business and industrial applications.

Question 39

Siedlecki (2013)

Answer 39

Adler characterized the individual by cognition, affect, and behavior; he emphasized the central role of social functioning in his views of optimal health. His developmental views highlighted the role of inferiority and a striving for success as compensation (Overholser, 2010).
Adler’s theory emphasized subjective goals, which motivate and impact how an individual perceives and responds to life. This includes how a person views oneself, others, and the world around them.

Despite having developed a comprehensive model for understanding personality development and guiding psychological treatment, Adler’s influences have gone primarily unnoticed by mainstream psychologist. However, leading theorists are beginning to acknowledge Adler as a major source of their ideas (Watts & Critelli, 1997). It is not surprising that Adler’s theories have been largely overlooked, considering his approach was far ahead of his
time. His cognitive, psychodynamic and systems perspectives, and the benefits of his preventive, holistic, phenomenological, teleological, and socially oriented approach has much to offer psychology and other related fields. Adler’s vision and influence impacted those few, who worked or studied close to him. Adler played a significant role influencing Karen Horney on social factors in her theory of personality, and Gordon Allport on the unity of personality. Adler also had a major impact on Maslow, Rollo May, and Carl Rogers, all of whom studied under Adler (Feist & Feist, 2009). Albert Ellis (1970) stated “Alfred Adler, more than Freud, is
probably the true father of modern psychotherapy” (Watts, 2000, p. 11).

Though Adler’s theories may have been out of step with the prevailing contemporary theorists of his time, the relevance of his achievements are most significant. His preventive and holistic approach, his ethical values, and his social consciousness in fact changed the model of
analytical psychology forever. Most importantly, what gives Dr. Alfred Adler’s Individual Psychology its greatest value is its spiritual congruency with the scriptures of Christianity’s Holy Bible.

Though Adler has not received acclaimed recognition, the influence of his theories is very much alive. “Adler once proclaimed that he was more concerned that his theories survived than that people remembered to associate his theories with his name” (Mosak, 1989, p.69). Apparently, he got what he asked for.

Question 40

Eckstein et al. (2010)

Answer 40

Consistent with Ad[er’s perspective, a recent emphasis in the literature has been the importance of the subjective nature of birtb order. Despite criticism of birth-order findings (Ernst & Angst 1983; Freese et al., 1999;
Johnson, 2000; Spitzer & Lewis-Beck, 1999), researcb overwhelmingly supports general differences in birtb-order characteristics (e.g., Paulhus et al., 1999; Sulloway, 1996). Moreover, these findings regarding specific birtborder characteristics are rarely as confounding as Ernst and Angst argued. Most studies of similar cbaracteristics find comparable results. Some criticism of Sulloway’s major contribution has focused on reports of flawed
research design and manipulation of data (Jobnson; Spitzer & Lewis-Beck); however, successful replication of Sulloway’s research (e.g., Healey & Ellis,
2007; Paulhus et al.) lends support for tbe credibility of his findings. Herrera et al. (2003) emphasized the link between beliefs and behaviors, suggesting
that individuals’ beliefs about typical birtb-order characteristics may affect actual outcomes in career choice. Whatever tbe cause for birtb-order differences, research findings appear to support Adier’s original theory.
Tbe counseling implications of both ordinal and psychological birth order are also important. An anecdotal example of birtb-order consideration is tbat in workshops and media interviews relative to birtb-order implications,
individuals often launch into a discussion of tbeir own family of origin or make similar comparisons to their present work environment. The significant recognition reflexes that families have witb Adierian-oriented therapists and tbe interests tbat interviewers have taken in tbeir own families of origin when interviewing the authors seems to give some credence to the utility of considering birtb order in clinical settings.

A limitation to the findings is that most studies reviewed catalogued ordinal rather than psychological birth order; therefore, some psychological constructs may be lost. As additional findings on psychological positions are
published, it will be helpful to conduct a review of these in comparison to ordinal studies.

This research was also limited by the sources of information gathered. The study did not account for research that found nonsignificant results, thus
limiting its scope. A review of the nonsignificant birth-order findings would provide a nice complement to this study. The emphasis on peer-reviewed journal articles also provides cultural constraints as the research primarily represented European and North American samples. Adler (as cited in Ansbacher & Ansbacher, 1956) emphasized the role of environmental factors, including culture, on birth-order characteristics. Future cross-cultural studies from other cultures may yield different results.

Question 41

Gfroerer et al. (2004)

Answer 41

Existing research on parenting styles is examined in relation to Individual Psychology’s model of parenting, which is characteristically democratic and authoritative. While numerous studies support the efficacy of democratic and authoritative parenting, many of these studies have not been linked previously to Individual Psychology. Most empirical research on parenting styles has not been anchored to any specific theory; rather, individual researchers have Investigated components of parenting style and the positive and negative effects of different styles of parenting. After presenting the Adlerian parenting model, the authors summarize current parenting style research. It is established that Baumrind’s research supports the efficacy of democratic/ authoritative parenting styles. A specific comparison is made between Baumrind’s findings and the Adlerian model. Suggestions for future research are offered. Finally, the implications of this comparison for therapeutic practice are reviewed.

Question 42

Wise (2019)

Answer 42

The etiology of personality disorders is an area of major research in the field of psychology. This study focused on the relationship between parenting styles and early development of personality disorders; specifically Antisocial Personality Disorder, Schizoid Personality Disorder, and Sadistic Personality Disorder. From the perspective of Theodore Millon’s theory of personality
and Adlerian parenting styles, the following study examined the development of personality disorders in adolescents as well as how those adolescents perceive their parents parenting style. The Millon Adolescent Clinical Inventory (MACI) was used to measure adolescent personality. A new measure, the Perceived Parenting Style Index- Adolescent (PPSI-A) was created from a
previous measure and put through initial validity testing. The results yielded good Cronbach’s Alphas for the three specific personality disorders in question. Correlations between personality disorders and parenting styles were shown in moderate amounts. Implications of the study
include moderate correlations between mother’s perceived parenting style and the development of specific personality disorders, the relationship between perceived healthy parenting styles and personality disorders, and the goodness of fit between the MACI and PPSI-A. This study laid the groundwork for future studies to refine the PPSI-A as well as better understand the causes and development of personality disorders. Future studies should focus on perfecting the PPSI-A and its correlation with the MACI in terms of discerning the perceived parenting styles
associated with each personality disorder.

Question 43

Berzoff (2011)

Answer 43

Screenshot

Question 44

Batra (2013)

Answer 44

As a thinker known for his passion for healing and teaching, Erikson offers a hopeful view of humanity and of life in the future. Erikson believes in the ‘goodness of being’, in the roles that human beings can facilitate to look after themselves, their offspring and nature. Helping
children find their place in society is all about helping them build balanced, meaningful relationships with the world around them. Erikson recognises the power of human nature to resolve personal and social conflicts. He believes that a mutuality of relationships can engender this power. He reminds us that this power is not driven by external rewards but is derived from the inner strength of being human. And this inner strength is dependent on the ego synthesis of the stages encountered during childhood, adolescence and young adulthood. It results from the development of an identity that makes choices relevant
for individual evolution and social responsibility. Erikson’s compelling argument is that the development of this identity unfolds through a series of stages and is manifested in the interplay between social actualities and
the balance for which the individual strives. In every human being, and in every community and nation, there is a need to identify with the ethics of social exchange. As long as the equations of social exchange do not promote superiority versus inferiority, winners and losers, achievers and failures, there is hope for human civilisation. If the virtues of every growing child are adequately nurtured, there is hope for the evolution of
constructive social equations. This can be made possible by facilitating dramatic shifts in the way we teach, interact and provide spaces for young people to learn from their own mistakes and from those of previous generations. This means working for the realisation of an authentic, inclusive society that will point the way towards nurturing life for future generations of human kind.

Question 45

Miletic (2013)

Answer 45

Homey developed her work a long time ago, yet in many ways she is the mother of contemporary psychoanalytic feminism and a leader in the integration of cultural theory in psychoanalysis. Most significantly, Horney presented a counterdiscourse to Freudian theory regarding the psychosexual development of women. She wrote about those areas that were not only missing in Freud’s vision of women, but presented the marginalized voice of a woman to challenge Freud in areas that she felt he knew little about, such as motherhood, penis envy, and female libido
and sexuality. She used a startlingly contemporary, postmodern device to challenge him: she illustrated how it was in the service of masculine power to develop such theories regarding women.

Horney not only disclaims many of Freud’s ideas about women, she details how women have accepted them as their own, and in the process accepted their prescriptive practices as well.

Many of Horney’s ideas continue to be prominent in contemporary psychoanalysis, such as womb envy and men’s fear and envy of women and the maternal figure. These conceptions have been further developed in European and American feminist and psychoanalytic literature, particularly in the works of Chodorow (978), Fast (994), and ChasseguetSmirgel (970). Horney’s idea that penis envy in women can be partially attributed to the fear of an oedipal victory and competition with the maternal figure can be located in the work of many contemporary Kleinian authors, such as Marie Torok (1970). In fact, women’s relationship with their mothers, and the prominent place of this relationship in women’s psychic functioning, continue to be essential focuses of psychoanalytic
theory and clinical practice. Homey’s ideas are also prominent in the work of Benjamin, particularly in regard to her theories regarding identification and object love and the psychology of masochism in women

It is fitting, given Horney’s emphasis on the inability to step outside of one’s own culture (Geertz, 1973,1983), that we recognize that she too was limited in this way. Horney took heterosexuality for granted as innate and “natural.” She does not challenge certain essentialist claims and relies heavily on innate anatomical explanations for various psychological positions. In Horney’s world, penises and vaginas matter, but it is most important that they do not matter in the same way they did to Freud. Horney struggled with issues that today are at the forefront of psychoanalysis, feminism, postmodernism, social constructionism, and cultural studies. Although not necessarily articulated fully, these concerns are threads throughout her work. It is this legacy for which I remember her. I believe that she has left a lasting imprint on contemporary thought.

Question 46

Smith (2007)

Answer 46

Born over 100 years ago, Karen Horney was in
many ways a woman ahead of her time. Her ideas
about human behavior and about psychotherapy have
a remarkably contemporary feel. Her appreciation of
the impact of environment and culture on development, long a staple of social work thinking, has acquired more and more currency in analytic circles. Her
optimistic view of the plasticity of development and the
unending human potential for growth is supported by
recent and current brain and infant research. Perhaps
the most impressive aspect of Karen Horney’s work is
that it was conceived and propounded by a woman in a
time and place that were professionally and culturally
steeped in a male-dominated paradigm. To think these
thoughts and then to proclaim them publicly were
extraordinary acts of imagination and courage.

Question 47

Coolidge et al. (2001)

Answer 47

Extant literature reveals that Horney’s neurotic type theory has received little empirical atten-tion. Her theory, nevertheless, appears to provide an excellent framework for a deeper investiga-tion of interpersonal patterns in personality disorders. Because Horney reformulated manymetapsychological psychoanalytic concepts in clinical descriptions and experiences, her theorylends itself well to empirical operationalizations. The present studies lend support to the operationalizationofherneurotictheoryandtotheconstructvalidityofherthreeneurotictypes.Thestrongestevidenceforthissupportcamefromthecon ̄uenceofsimilarrelationshipsbetweenthesame measure of personality disorders and two di€erent measures of Horney’s types. Zero-ordercorrelations revealed a substantial amount of overlap between the two measures of Horney’stypes, although there were some di€erences. The Compliance scale of the CAD produced stron-ger relationships than the HCTI on the paranoid, passive-aggressive, schizoid, and schizotypalscales, while the HCTI Detachment scale produced stronger relationships than Cohen’s samescale for 10 of the 11 personality disorders. The HCTI had better internal scale reliabilities thanCohen’sscales, and the HCTI had excellent test-retest reliabilities.

Horney’s works did not address how gender and age might in ̄uence the expres-sion of her three types. Interestingly, the present study found some signi®cant relationships withregard to both of these variables, although the e€ect sizes were generally small. As might havebeen expected, males scored higher than females on the Aggression and Detachment scales,whereas females scored higher on the Compliance scale. With regard to age, Compliance scoresappeared greater in the oldest age group, perhaps indicating an increased need to rely on helpfromothersinolderpersons.Aggressionscoresbecameprogressivelylowerwithageforfemales,butformales,theoldestgroupwassigni®cantlymoreaggressivethanthemiddle-agedgroup.OntheDetachmentscale,itappearedthatbothgendersexperiencedanincreaseinscoresfromyoungto middle age, but there was no signi®cant change in the oldest age group, providing additionaldata to battle the myth that older people prefer to be alone. Future studies may also wish toinvestigate age in ̄uences on Horney’s types with greater speci®city of age groupings. It alsomight be interesting to determine how age and gender interact, as well as the extent to whichgenetic, culture, and traumatic events in ̄uence Horney’s types. Studies with diverse clinicalsamplesmight also proveuseful

The value of Horney’s tripartite theory of interpersonal styles is multi-fold. First, the presentstudiessupportitsuseinthebetterunderstandinganddescriptionofpersonalitydisorderfeaturesor traits. However, since a majority of the present samples of convenience were well within thenormal range of functioning, her type theory may just as well be used to describe normal per-sonality styles. The latter supposition may be important, because many people who seek therapymaybewell-adjustedindividualsbutcurrentlyexperiencingseverepsychologicalstressors.Totheextent that the therapist understands the patient better, the therapeutic process is aided andadvanced.Second,therewassomesupportfortheDSM-IVconceptofpersonalitydisorderclustersinthepresent studies. Notably, Cluster A (paranoid, schizoid, schizotypal) highly corresponded toHorney’s Detached type, and Cluster B (antisocial, borderline, narcissistic, histrionic) wasstrongly related to the Aggressive type. The relationships between Cluster C (avoidant, depen-dent, obsessive-compulsive) and the Compliant type were weaker. These ®ndings highlight Hor-ney’s clinical conceptual foresight in that her neurotic types relate closely to the empiricalclustering of personality disorders proposednearly 35 years later.Third, Horney’s theory possesses many of the characteristics required of a practical psycholo-gicaltest.Asothershavenoted(e.g.,vandenDaele,1987),hertheoryiscouchedinalanguageofactual clinical experience, and her clinical model is easily operationalized. Horney’s theoryaccounts for normal and abnormal personality features, and it also addresses nonpathological,metaneeds such as self-realization, although the latter aspect of her theory was not examined inthe present studies. Horney’s theory also combines intrapsychic and interpersonal developmentwith parental and cultural issues, and these issues would also be germane to modern clinicalpractice and research. Given recent interest in personality theory with regard to the essentialnumber of personality variables required to describe the normal and abnormal personality (e.g.,Cloninger,Svrakic,&Przybeck,1993;Costa&McCrae,1990;Digman,1990;Goldberg,1993),itseems that Karen Horney’s highly original and yet practical tripartite theory may, and should,join the fray.F.L. Coolidge et al. / Personality and Individual Di€erences 30 (2001) 1387±14001397

Question 48

Cohen and Tourous (2019)

Answer 48

Digital health has much to offer medicine, but theory has much to offer digital health. Object-relations theory offers a simple yet powerful example of how theory can help explain current paradoxes and also a potential path forward to help solve the problem of low engagement. Future research may benefit from the guidance of object-relations theory and subjecting the theory’s application to digital health to empirical scrutiny.

Question 49

Ludlam and Nyberg (2018)

Answer 49

This chapter examines how two different theoretical orientations, object relations and attachment theories, contribute to the understanding of conflict in a couple’s relationship. It explores the source of the insecure couple attachment with reference to two major theoretical frameworks: the level of object relations functioning of the couple and attachment styles in couple relationships. Countertransference feelings of impotence and hopelessness were experienced by the therapist when caught up in the “malignant third” that the couple had created from repeated excessive projective identifications with the other. The chapter suggests that viewing these dynamics from different perspectives is helpful for the therapist and ultimately for the couple, as it helps create a benign third position. It shows how achieving this therapeutic dimension was facilitated in a “sentient” peer group, which expanded the thinking space for the therapist and the couple. The couple was referred by the wife’s analyst, who felt couple therapy was “their last hope”.

Question 50

Fonagy et al. (2018)

Answer 50

The relationship between attachment theory and psychoanalysis, historically, has not been an easy one (Cassidy & Shaver, 2008; Eagle, 2013; Fonagy, 2001). But in recent years, developments in both fields have led to a growing rapprochement (Eagle, 2013; Holmes, 2009). Changes in psychoanalytic thinking have made it more accommodating of attachment thinking; conversely, aspects of the development of attachment findings, applications, and theory have made it more pertinent to psychoanalysis. In this chapter we examine the disagreements between psychoanalysis and attachment theory, and point to some of the two disciplines’ common foundations. We then describe an approach to the role of attachment in human development that considers it in relation to the capacity to mentalize, that is, to understand ourselves and others in terms of intentional mental states, and places both attachment and mentalizing in the context of the development of epistemic trust—the capacity to trust others as a source of knowledge about the world. This approach builds on some of Bowlby’s assumptions drawn from evolutionary biology, placing some of the better founded psychoanalytic criticisms of attachment theory in a different perspective. We suggest that this context allows the ongoing significance of Bowlby and Ainsworth’s thinking for the psychoanalytic project to be appreciated.

Question 51

Westen et al. (2004)

Answer 51

This article provides a critical review of the assumptions and findings of studies used to establish psychotherapies as empirically supported. The attempt to identify empirically supported therapies (ESTs) imposes particular assumptions on the use of randomized controlled trial (RCT) methodology that appear to be valid for some disorders and treatments (notably exposure-based treatments of specific anxiety symptoms) but substantially violated for others. Meta-analytic studies support a more nuanced view of treatment efficacy than implied by a dichotomous judgment of supported versus unsupported. The authors recommend changes in reporting practices to maximize the clinical utility of RCTs, describe alternative methodologies that may be useful when the assumptions underlying EST methodology are violated, and suggest a shift from validating treatment packages to testing intervention strategies and theories of change that clinicians can integrate into empirically informed therapies

Question 52

Westen (1999)

Answer 52

At regular intervals for over half a century, critiques of Freud and psychoanalysis have emerged in the popular media and in intellectual circles, usually declaring that Freud has died some new and agonizing death, and that the enterprise he created should be buried along with him like the artifacts in the tomb of an Egyptian king. Although the critiques take many forms, a central claim has long been that unconscious processes, like other psychoanalytic constructs, lack any basis in scientific research. In recent years, however, a large body of experimental research has emerged in a number of independent literatures. This work documents the most fundamental tenet of psychoanalysis—that much of mental life is unconscious, including cognitive, affective, and motivational processes. This body of research suggests some important revisions in the psychoanalytic understanding of unconscious processes, but it also points to the conclusion that, based on controlled scientific investigations alone (that is, without even considering clinical data), the repeated broadside attacks on psychoanalysis are no longer tenable.

Question 53

Levy et al. (2019)

Answer 53

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