Psychodynamics I & II

Question 1

Topographic Model

Answer 1

1) Conscious–>currently aware
2) Pre-conscious–>easily recalled
3) Unconscious (drives)–>repressed thoughts and feelings

Question 2

Name the 5 stages of Psychosexual Development and the ages in which they occur

Answer 2

1) Oral phase –> birth-1.5yrs
2) Anal phase–>1.5-3yrs
3) Phallic phase–>3-5/6yrs
4) Latency phase–>6yrs-adolescent
5) Genital phase –>adolescent/adult onward…

Question 3

Oral Phase

Answer 3

sucking, dependency, paradise because there is someone 24/7 available to take care of me;

in adults: enjoy food, chew gum, smoke, drink; develop behaviors that are passive and dependent

Question 4

Anal Phase

Answer 4

crawling, exploring, learning how to say “no!”, potty training (holding on, letting go); terrible twos (paradise lost!)

in adults: neat, on time, correct, organized, careful with money, controlled

fixation (carry a phase w/us b/c we enjoyed that phase) and regression (common when parents have second child)

Question 5

Phallic Phase

Answer 5

Oedipal (boys); Electra (girls); curious about sex differences and close to parent of opposite sex

Question 6

Latency Phase

Answer 6

Girl scouts/boyscouts; learn the usual social traditions of being a boy or girl

Question 7

Genital Phase

Answer 7

Capacity for true intimacy

Question 8

Structural Model contains what 3 parts?

Answer 8

Id, Ego/Ego Defense Mechanisms, and Superego

Question 9

Id “Child”

Answer 9

from birth; wants fun, gratification; instinctive sexual and aggressive drives; “I want now!”

Question 10

Superego “Parent”

Answer 10

from age 5 onward; the conscience–>rules, morals, values w/input from parents, teachers, religious authorities, political authorities, societal norms, legal system; “Thou shalt not!”

Question 11

Ego “Adult”

Answer 11

Ego begins developing at birth but isn’t fully formed. controls expression of id and adapts to requirements of external world through defense mech; Ego is aware of both Superego and Id

Question 12

Ego Normal vs Under Stress

Answer 12

normal: helps form personality/satisfy relationships/sense of reality about world; stress: id threatens control of ego/superego causing anxiety and defense mechanisms

Question 13

Level I Psychotic Mechanisms - Name them, describe them

Answer 13

1) Delusional Projection
2) Psychotic Denial
3) Distortion

-common in “healthy” individuals before age five, in adult dreams/fantasy. For user, mechanisms alter reality. For beholder, appear “crazy”.

Question 14

Delusional Projection

Answer 14

Frank delusions about external reality, usually of a persecutory type. Perception of one’s feelings in another person and then acting on it (paranoid delusions). Perception of other people or their feelings literally inside oneself (“the devil is devouring my heart”)

Question 15

Psychotic Denial

Answer 15

denial of external reality; “I am Jesus Christ” denies the fact that he is John Williams

Question 16

Distortion

Answer 16

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.

Question 17

Level II Immature Defense Mechanisms - Name them, describe them

Answer 17

1) Projection
2) Somatization
3) Acting Out
4) Splitting

-common in healthy individuals ages 3-15; seen in personality disorders; for user–> alter distress due to thread of interpersonal intimacy or its loss; to the beholder–>socially undesirable

Question 18

Projection

Answer 18

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”

Question 19

Somatization

Answer 19

Turning an unacceptable impulse or feeling into physical symptom (pain/illness/neurasthenia)

Permits individual to belabor others with his own pain or discomfort in lieu of making direct demands upon them or in lieu of complaining that others have ignored his wishes to be dependent (cry for help)

Question 20

Acting Out

Answer 20

Delinquent or impulsive act to avoid being aware of one’s feelings; direct expression of an unconscious wish or impulse in order to avoid being conscious of the affect that accompanies it

Drug use, failure, perversion, self-inflicted injury to relieve tension (doing instead of thinking or feeling)

“antisocial personality disorder”

Question 21

Splitting

Answer 21

Seeing people and events as ALL good or ALL bad and quickly switch between these extreme positions

“borderline personality disorder”

Question 22

Level III “Neurotic” Defense Mechanisms – Name them, describe them

Answer 22

1) Denial
2) Displacement
3) Dissociation
4) Identification
5) Intellectualization
6) Isolation of Affect
7) Rationalization
8) Reaction Formation
9) Regression
10) Undoing

common in “healthy: individuals age 3-90; also in neurotic disorders and acute stress. For user: alter private feelings or instinctual expression; for beholder: quirks or hangups!

Question 23

Denial

Answer 23

Unable to accept intolerable facts about reality; most common defense seen in medical practice

Question 24

Displacement

Answer 24

Redirection of feelings toward a relatively less cared for object than the person or situation arousing the feelings

Ex: if angry at your boss, replace w/a thing (kick a chair) or stranger (road rage)

**most phobias, many hysterical conversion reactions, and some prejudice involve displacement

Question 25

Dissociation

Answer 25

Temporary but drastic modification of one’s character or of one’s sense of personal identity to avoid emotional stress (separation of mental processes)–>acute rxn to trauma

“multiple personality disorder”

Question 26

Identification

Answer 26

unconscious patterning of one’s behavior after a powerful, influential person (adopting habits of parent or coach, behaviors/parenting style “runs in families, Stockholm syndrome)

Question 27

Intellectualization

Answer 27

Thinking about instinctual wishes in formal, affectively bland terms and NOT acting on them. The idea is in the consciousness but the feeling is missing (isolation, rationalization, ritual, un-doing, restitution, magical thinking, “busywork”)

“Obsessive Compulsive Disorder”

Question 28

Isolation of Affect

Answer 28

Intellectual knowledge and understanding of a negative event WITHOUT experiencing the feelings

Question 29

Rationalization

Answer 29

Providing superficially reasonable accounts to explain away negative events, feelings, actions

Question 30

Reaction Formation

Answer 30

Behavior in a fashion diametrically opposed to an unacceptable instinctual impulse (overtly caring for someone else when one wishes to be cared for oneself, “hating” someone or something that one really likes; “loving” a hated rival or unpleasant duty)

Question 31

Regression

Answer 31

Appearance of child-like behavior during periods of stress (seen in medical crises, when a sibling is born)

Question 32

Undoing

Answer 32

Protecting against a negative past event by acceptable “corrective” behavior eg superstitious rituals or formal atonement or confession

Question 33

Level IV: Mature Mechanisms - Name and Describe

Answer 33

1) Altruism
2) Sublimation
3) Anticipation
4) Suppression
5) Humor

common in “healthy” adults 12-90yrs; for “user”: integrate reality, interpersonal relationships and private feelings; to beholder they appear as convenient virtues

Question 34

Altruism

Answer 34

Vicarious but constructive and instinctually gratifying service to others; constructive reaction formation, philanthropy, repaid service to others. Differs from projection/acting out in that it provides REAL, not imaginary, benefit to others and from reaction formation in that it leaves person using defense as partly gratified

Question 35

Sublimation

Answer 35

Indirect/attenuated expression of instincts w/out either adverse consequences or marked loss of pleasure. (expressing aggression through pleasurable games, sports, hobbies; romantic attenuation of instinctual expression during real courtship; instincts are channeled rather than damned/diverted); feelings acknowledged, modified and directed toward people/goals

Question 36

Anticipation

Answer 36

realistic anticipation of or planning for future inner discomfort (goal-directed; premature but realistic affective anticipation of death or surgery or separation)

Question 37

Suppression

Answer 37

Conscious or semiconscious decision to postpone paying attention to a conscious impulse or conflict (seeing silver linings, minimizing discomfort, employing a stiff upper lip); postponing but NOT avoiding

Question 38

Humor

Answer 38

Over expression of ideas and feelings w/out individual discomfort or immobilization and w/out unpleasant effect on others; permits one to bear and focus upon what is too terrible to be borne

Question 39

Transference

Answer 39

patient’s unconscious “transfer” and replay of relationship with influential figures from the past. More likely with physicians; Positive transference = patient has unrealistic expectations of the doctor; Negative transference = patient develops mistrust, missed appointments, non-adherence, poor outcomes if patient’s desires aren’t realized

Question 40

Countertransference

Answer 40

The MD’s transference to the patient (positive and negative)