Psychodynamics Flashcards
what is the difference between the conscious, pre-conscious, and unconscious?
make up the topographic model
- conscious: currently aware
- pre-conscious: easily recalled from the past
- REPRESSION BARRIER
- unconscious: repressed thoughts and feelings (drives)
what is the fundamental hypothesis of psychoanalytic theory?
- psychic determinism: every event/symptom has a meaning
- consciousness is an exceptional psychic process
what are the psychosexual stages of development?
the libido (life force that may be sexual and/or aggressive)
- oral
- anal
- phallic
- latent
- genital
what is the oral libido phase?
from birth to 1.5 years
- sucking
- dependent (paradise b/c everything is being catered to)
- as an adult: enjoy food, chew gum, smoke, drink
- -become passive and dependent
what is the anal libido phase?
from 1.5 to 3 years
- crawling, exploring
- potty training (holding on, letting go)
- terrible twos (paradise is lost, and both mother and parent say “NO”
- as an adult: neat, on time, correct, organized, careful with money, controlled
what is fixation?
extra investment of libido in one phase
what is regression?
reversion to an earlier phase under stress
what is the phallic libido phase?
3 to 5-6 years
- curious about sex differences (what makes one a boy or a girl)
- close to parent of opposite sex
- -Oedipal complex in boys, Electra complex in girls
what is the latency libido phase?
6 years to adolescents
-practice being a boy or a girl (scouts)
what is the genital libido phase?
adolescence to adulthood
-capacity for true indimacy
what is the structural model of the mind?
id, ego (and defense mech), superego
what is the “id”?
the “child” part
- have it from birth
- cause fun and gratification (I want now; selfish)
what is the “superego”?
the “parent” part that tries to control the id
- have it from age 5 on
- conscience, rules, morals, and values
- develops based on input from
- -parents, teachers, religious authorities
- -political authorities, societal norms, legal system
- “Thou shalt not”
- -although guilt dissolves in alcohol, thus id takes over
what is the “ego”?
the “adult” part that is dependent on id and superego
- growing and evolving “I” which is constantly changing
- deals with internal and external reality
- combines id, superego, and reality (consequences) to create ego and personality
- “I will do”
what happens to the ego under stress?
if the normal response doesn’t work, the ego is unable to combine everything well, leading to anxiety and ego defense mechanisms
what are level I “psychotic” ego defense mechanisms?
- delusional projection
- psychotic denial
- distortion
common in “healthy” individuals before age 5, and in adult dreams and fantasy
- for the user, these mechanisms alter reality
- for the beholder, they appear crazy
what is delusional projection?
a level 1 “psychotic” ego defense mechanism
- frank delusions about external reality, usually of a persecutory type
- perception of one’s feelings in another person, and then acting on it (florid paranoid delusions)
- perception of other people or their feelings literally inside oneself (agitated person has devil eating heart)
what is psychotic denial?
a level 1 “psychotic” ego defense mechanism
-denial of external reality (person pretends that he is someone else, while denying his true persona)
what is distortion?
a level 1 “psychotic” ego defense mechanism
- grossly reshaping external reality to suit inner needs
- unrealistic megalomaniacal beliefs
- hallucinations, wish-fulfilling delusions of delusional superiority or entitlement
- denial of personal responsibility for one’s own behavior
what are level II “immature” ego defense mechanisms?
- projection (w/o psychosis)
- somatization
- acting out
- splitting
common in “healthy” individuals ages 3 to 15
- seen in personality disorders
- for the user, alter distress due to threat of interpersonal intimacy or its loss
- to the beholder, they appear socially desirable
what is projection (w/o psychosis)?
a level 2 “immature” ego defense mechanism
- attributing one’s own unacknowledged feelings to others
- includes severe prejudice, rejections of intimacy through unwarranted suspicion, marked hypervigilance to external danger, and injustice-collecting
- behavior may be eccentric and abrasive, but within the “letter of the law”
- -paranoid personality
what is somatization?
a level 2 “immature” ego defense mechanism
- turning an unacceptable impulse or feeling into complaints of pain or somatic illness
- permits individual to belabor others with own pain or discomfort in lieu of making direct demands upon them, or in lieu of complaining that others have ignored his (often unexpressed) wishes to be dependent
- -hypochondriac, psychosomatic disorders
what is acting out?
a level 2 “immature” ego defense mechanism
- direct expression of an unconscious wish or impulse in order to avoid being conscious of affect that accompanies it
- delinquent or impulsive act to avoid being aware of one’s feelings
- includes chronic use of drugs, failure, perversion, or self-inflicted injury to relieve tension
- antisocial personality disorder
what is splitting?
a level 2 “immature” ego defense mechanism
- seeing people and events as ALL good or ALL bad
- will quickly switch between these extreme positions
- borderline personality disorder
what are level III “neurotic” ego defense mechanisms?
- denial
- displacement
- dissociation
- identification
- intellectualization (isolation of affect, rationalization)
- reaction formation
- regression
- undoing
common in “healthy” individuals aged 3-90
- occurs in neurotic disorder and acute stress
- for the user, these alter private feelings or instinctual expression
- to the beholder, they are quirks or “hang ups”
what is denial?
a level 3 “neurotic” ego defense mechanism
- unable to accept (and therefore seems to ignore/be unaware of/deny) intolerable facts about reality
- commonest defense seen in medical practice
what is displacement?
a level 3 “neurotic” ego defense mechanism
- redirection of feelings toward a relatively less cared for (cathected) object than the person or situation arousing the feelings
- most phobias, many hysterical conversion reactions, and some prejudice involve this
what is dissociation
a level 3 “neurotic” ego defense mechanism
- temporary but drastic modification of one’s character or of one’s sense of personal identity to avoid emotional distress
- acute reaction to trauma (short term)
- multiple personality disorder
what is identification?
a level 3 “neurotic” ego defense mechanism
- unconscious patterning of one’s behavior after a powerful, influential person
- -adopting habits of a parent or coach (runs in families)
- -Stockholm syndrome
what is intellectualization?
a level 3 “neurotic” ego defense mechanism
- thinking about instinctual wishes in formal, affectively bland terms, and NOT acting on them
- idea is in consciousness, but the feeling is missing
- isolation of affect, rationalization
- ritual, un-doing restitution, magical thinker, and “busywork”
- usually occurs as a cluster (OCD)
what is isolation of affect?
part of intellectualization (a level 3 “neurotic” ego defense mechanism)
-intellectual knowledge and understanding of a negative event WITHOUT experiencing the feelings (numb)
what is rationalization?
part of intellectualization (a level 3 “neurotic” ego defense mechanism)
- providing superficially reasonable accounts to explain away negative events, feelings, and actions
- try to dodge the blame, explain away an awkward situation
what is reaction formation?
a level 3 “neurotic” ego defense mechanism
- behavior in a fashion diametrically opposed to an unacceptable instintual impulse
- overtly caring for someone else when one wishes to be cared for oneself
- “hating” or “loving” someone when you mean the opposite
what is regression?
a level 3 “neurotic” ego defense mechanism
- appearance of child-like behavior during periods of stress
- seen in medical crises or when a sibling is born
what is undoing?
a level 3 “neurotic” ego defense mechanism
-protecting against a negative past event by acceptable “corrective” behavior (superstitious rituals or formal atonement or confession)
what are level IV “mature” mechanisms?
- altruism
- sublimation
- anticipation
- suppression
- humor
commonly in “healthy” individuals aged 12-90
- for the user, they integrate reality, interpersonal relationships, and private feelings
- to the beholder, they appear as convenient virtues
what is altruism?
a level IV “mature” ego defense mechanism
- vicarious but constructive and instinctually gratifying service to others
- includes benign and constructive reaction formation, philanthropy, and well-repaid service to other
- differs from projecting and acting out b/c provides real, not imaginary, benefit to others
- differs from reaction formation b/c leaves uer partly gratified
what is sublimation?
a level IV “mature” ego defense mechanism
- indirect or attenuated expression of instincts w/o adverse consequences or marked loss of pleasure
- -aggression through games or sports
- -romantic attenuation during courtship
- channeled, rather than damned or diverted
- feelings are acknowledged, modified, and directed toward a relatively significant person or goal so that modest instinctual satisfaction results
what is anticipation?
a level IV “mature” ego defense mechanism
- realistic anticipation of or planning for future inner discomfort
- includes goal-directed but overly careful planning or worrying
- premature but realistic affective anticipation of death or surgery or separation
what is suppression?
a level IV “mature” ego defense mechanism
- conscious or semiconscious decision to postpone paying attention to a conscious impulse or conflict
- includes looking for silver linings, minimizing acknowledged discomfort, and employing a stiff upper lip
- deliberately postponing, but not avoiding
what is humor
a level IV “mature” ego defense mechanism
- overt expression of ideas and feelings without individual discomfort or immobilization and without unpleasant effect on others
- some games and playful regression may be included
- permits one to bear yet focus on what is too terrible
what is transference VS counter-transference
transference: patient’s unconscious “transfer” and replay of relationship with influential figures from the past
- more likely with physicians, but cannot be helped b/c patient’s past
- positive, unrealistic expectations
- negative mistrust, missed appointments, non-adherence, poor outcomes
