Psychoanalysis

Question 1

Psychoanalysis : Main Foundations

Answer 1

Less of a unified practice… but still some basic principles that all approaches share…
… like….

1) Searching for relationships between a person’s developmental history and current problems - and how construction of past and present plays a role in perpetuating self defeating patterns.
2) Blockages or dissociations in self-awareness as causes of psycho problems
3) Talking as an approach to treatment
4) Therapeutic relationship as a curative factor / arena for exploring self defeating psycho processes and using it as a vehicle for change

5) Belief in unconscious motivation (all ppl at least partially motivated by wishes/tacit knowledge outside of awareness)
((PA wants to facilitate awareness of these to increase choice))

6) Assumption we are ambivalent about changing and emphasis on exploring ambivalence
7) Exploring how we avoid unpleasant/painful feelings, fantasies, thoughts.

Typical traditional psychotherapy should meet 3-4 times a week, and treatment can last for several years.

Dissect and gradually reconstruct a person’s personality.

Question 2

Topographical Model of the Mind

Answer 2

mental life occurs in three parts:

i) part in the conscious awareness
ii) part in the preconscious (we can become aware of it by shifting our attention)
iii) part in the subconscious (can’t experience without use of therapy techniques)

Topographical Model = continuum of mental life from conscious to preconscious to subconscious

Question 3

Theoretical Foundations: Freud’s Personality Theory

Answer 3

In psychodynamic approach, mental life = interaction between powerful competing forces (some conscious but most unconscious)
–> In Freud’s theory, forces =
1 - ID –> primitive, instinctual; sexual/sensual/agressive drives.
2 - EGO –> mediate the demands of the id and the superego; simultaneously recognize and respond to external realities.
3 - SUPER EGO –> counterbalance id, norms of family, culture; also contains the ego ideal - how the ego would like to be. Super ego seeks to inhibit id and prescribe more socially appropriate behavior.

Conflict between these structures occurs constantly, and most of the time subconsciously.. and most mental life is balancing the competing parts of personality within a changing external reality.

–> Id ego and superego together form a STRUCTURAL MODEL of the mind (the topographical model refers to level of consciousness associated with each structure)

Question 4

Theoretical Foundations: Defense Mechanisms

Answer 4

Unconscious mental strategies (10 of them in the book) or routines that the EGO employs to ward off the anxiety produced by ‘intrapsychic’ conflict to avoid emotional pain.
–> push thoughts/wishes/ feelings/ fantasies out of awareness.

Not always successful or adaptive.
–> may temporarily reduce anxiety, but over time can distort reality, and cause relationship problems.

Question 5

Defense Mechanisms – Denial

Answer 5

Refusing to recognize or acknowledge a threatening experience…

Ex) denying you have a drinking problem even though you lose your job over it.

Question 6

Defense Mechanisms — Repression

Answer 6

‘MOTIVATED FORGETTING’ Pushing anxiety provoking thoughts and memos out of consciousness and into unconscious

Ex) not remembering childhood abuse

Question 7

Defense Mechanisms — Regression

Answer 7

Retreating to coping mechanisms of earlier stages of development

Ex) After a divorce acting like a baby and wanting your mother to baby you.

Question 8

Defense Mechanisms — Projection

Answer 8

Attributing unacceptable motives and impulses to others.

Ex) If your friend forgot your birthday and you see them as hurt and angry

Question 9

Defense Mechanisms — Reaction Formation

Answer 9

Adopting thoughts/behaviors that are opposite of the ones that are prompted by your unacceptable impulses.

Ex) When you hate your boss but go out of your way to defend him when he’s criticized

Question 10

Defense Mechanisms — Displacement

Answer 10

Directing pent up impulses towards safer substitutes rather than the target of the feelings

Ex) When your boss embarrasses you and you come home and yell at your family for no reason.

Question 11

Defense Mechanisms — Rationalization

Answer 11

Providing socially appropriate (but untrue) explanations for your unacceptable behavior

Ex) When you diet and say ice cream has high protein, and the calories won’t matter because you’ll go to the gym tomorrow.

Question 12

Defense Mechanisms — Intellectualization

Answer 12

Approaching upsetting experiences in an overly logical manner - without accepting emotional components

Ex) When you describe your life since a tragic event and methodically recount daily activities or books about coping that you’ve read.

Question 13

Defense Mechanisms — Compensation

Answer 13

Coping with feeling inferior in one area by working to be superior in another.

Ex) When you have a brain injury and can’t hold your job, but start to work hard to be a good friend.

Question 14

Defense Mechanisms — Sublimation

Answer 14

Channeling the expression of unacceptable impulses into more socially accepted activities

Ex) When you channel aggressive impulses through football.

Question 15

Theoretical Foundations:

Transference and Countertransference

Answer 15

Clients tend to repeat patterns of behavior in therapy sessions – (often unconsciously motivated)
- TRANSFERENCE: when client unconsciously brings a maladaptive pattern of relating into therapy;sometimes clients view/relation to therapist is reminiscent of the way they viewed /related to sig figures in their past.. ‘transferring’ a template from past onto present.

Via freud: transference rxns are distortions in the client’s reactions to the therapist that emerge because of the client’s past relationships
–> past relationships create expectations for future ones - and each new relationship is understood by reference to old ones.

• The more similar a relationship to a old one, the more likely transference reactions based on the old one will occur.
• ->emotionally, psychotherapy isn’t dissimilar from childhood (therapist in place of authority as parent); so clients are esp. likely to replay earlier emotional reactions in therapy — psychoanalytic treatment designed to reveal, analyze, and change these ‘scripts’

transference is THERAPEUTIC because reliving past in the analytic relationship can pro die and pop to see how past relations were influencing experience of present

COUNTER-TRANSFERENCE: the same thing can also happen in the opposite direction (therapist to client) – if reactions of therapist to client are based on therapist’s personal history and conflicts
–> this is why many psychoanalysts say you need to go through psychoanalysis as part of training..

Question 16

Theoretical Foundations: Psychic Determinism

Answer 16

The idea that memories, impressions, or experiences that occur together in the clients mind are related and not random

–> this is why psychoanalysts will ask client to elaborate on anything (slip of tongue, unexpected verbal associations, memories, etc) to see what might reveal an unconscious connection.

Question 17

Theoretical Foundations: Resistance

Answer 17

Increasing anxiety that develops as the client gets closer to core unconscious issues – motivate a variety of responses (like ‘forgetting appointments’, panic, detachment from conversation, etc) in therapy that likely reenact earlier patterns of behavior (in the same way transference does)
–> resistance reactions are also analyzed and interpreted

Question 18

Theoretical Foundations: Interpretation, Working Through, and Insight

Answer 18

INTERPRETATION - analyst suggesting connections between patents current experiences and past (how past intrudes on present)
–> optimal = interpretation of transference reactions that can be related to current problems outside of therapy.

• -> if the explanation makes cognitive and emo sense to the client (so its accurate and the client is ready to hear it..) then they might see their behavior pattern in a new light –> called INSIGHT
• –insight = the basic requirement for and the beginning of positive change in psychoanalysis.

Question 19

Goals of Psychoanalysis

Answer 19

Main Goal = Self Understanding

1) To make the unconscious conscious
2) To replace unconscious id processes with conscious ego processes

(when patients see the real (normally unconscious) motives for their maladaptive behaviors they won’t act that way anymore)

To do this you need….

– intellectual and emotional ‘insight’ into the underlying causes of your problems
(recognize them and be emotionally involved in discovering them)

–to ‘work through’ or fully explore the implications of those insights ** esp important because need to understand how pervasive the problem is to prevent it from returning.

–strengthen ego control over the id and the superego

Question 20

Clinical Applications: History and Case Formulation

Answer 20

Begin with assessment and case formulation.

• assessment is an ongoing process for PA’s
• -> more likely to rely on interview data and projective tests than structured assessment instruments.

Information that would be relevant/important:

• Historical data (fam and developmental history)
• Mental status (distress, ego strengths/weaknesses, ‘psychological mindedness’ (aka how well will they engage in PA therapy)
• Defense mechanisms, themes, or patterns of attachment problems (transference patterns?)

Question 21

Clinical Applications: Free Association

Answer 21

Only rule for therapy = client should say everything that comes to mind without editing or censorship

Therapist must try to make sense of these pieces - even if they seem unrelated.. they assume they are related
–> might engage client in a discussion of possible connections, or encourage more free association.

Question 22

Clinical Applications: The Role of the Therapist

Answer 22

Traditionally PA’s maintain ‘ANALYTIC INCOGNITO’
—> aka they reveal little about themselves during therapy.
(even try to remain out of sight or keep neutral expressions/attitude) - remain purposely opaque
…why? so that clients can be free to PROJECT their transference onto the therapist like a neutral blank slate – the attributes/motives they unconsciously associate with the ppl in their lives.

Currently: shift from one person psychologist perspective (as described above) to 2-person psychologist perspective.. where therapist must understand his own contribution to the client’s psyche and change.

Question 23

Clinical Applications: Analysis of Everyday Behavior

Answer 23

Maintain ‘evenly divided’ attention to trivial as well as momentous events inside and outside of therapy…

• see mistakes in speaking (‘freudian slips’), accidents, memory loss, and humor as sources of unconscious material.

Question 24

Clinical Applications: Dream Analysis

Answer 24

Believe unconscious material is closer to the surface while dreaming than while awake. Believed they had to be interpreted separately because each person’s unconscious is different..

Ideas for further Q’s.. not answers…

Contain:

• MANIFEST content - features associated with recent activities (‘daily residue’) – most = viewed as being symbolic of something else (b/c of dream work)
• LATENT content - unconscious impulses that appear in disguise

—> DREAM WORK = process of transforming unacceptable material into acceptable manifest content.

Question 25

Clinical Applications: Analysis of Transference / Resistance

Answer 25

Transference Neurosis: when patient-therepest relationship creates version of the causes of client’s problems..
–> allows to deal with problems in the past as they happen in the present.

Resistance = behaviors that interfere with therapeutic process of achieving insight.
–> obstructing free association, missing appointments, changing subject, etc.

Question 26

Clinical Applications: Making Analytic Interpretations

Answer 26

Analyst should guide the process of self-exploration – but don’t push it if client can’t handle it…
–> ex) resistance - point it out and offer interpretation about whats happening..

Basically always offer alternative view and search for deeper meanings in behavior
– will help clients to see how defenses and unconscious conflicts have caused problems, and then learn to deal with them differently.

Question 27

The Unconscious

Answer 27

Part of the mind where some impulses/wishes and some memories are split from awareness.

Basically:

1) experience and action are influenced by psycho processes that aren’t part of psychological awareness

2) these unconscious processes are kept out of awareness to avoid psycho pain.
… because the content is too threatening or is learned to be unacceptable by cultural conditioning.

Question 28

Fantasy

Answer 28

Believed to play an important role in psychological functioning and how we relate to the enviornment/ppl.

Viewed as motivating behavior and shaping experience so important to interpret and explore client fantasies.

– range in degree of conscious awareness
Freud originally said they were linked to instal wishes (sexual/aggressive) and served as a type of imaginary wish fulfillment…

Question 29

Primary vs. Secondary Processes

Answer 29

Primary Process = unconscious thought, raw, primitive, no distinction between past, present and future. Can see it in dreams and fantasy, and in those with acute psychosis

Secondary Process = associated with consciousness, logical, sequential, rational, reflexive thinking

Question 30

Defense Mechanisms: Splitting

Answer 30

Avoid tainting perception of another as good with negative feelings by splitting the representation of the other into two different images.

Commonly used by infants with mom but you have to grow out of it to be able to have functional relationships.