PSY2205 Personality and Individual Differences > The Psychoanalytic Approach - Freudian Theory > Flashcards
The Psychoanalytic Approach - Freudian Theory Flashcards
Sigmund Freud born
1856
Jewish family in Moravia
1873-1881
attended medical school at Uni of Vienna
specialised in treatment of nervous disorders
1885-1886
Studied hypnosis under the French psychiatrist Jean-Martin Charcot in
Studied the “talking cure” under Viennese physician Joseph Breuer and adopted this approach in his own work.
1900
published ‘The Interpretation of Dreams’ which introduced the concept of the unconscious.
For over 40 years Freud explored the unconscious using the method of free association and also dream interpretation.
Developed the first comprehensive theory of personality.
key assumptions underlying Psychoanalytic Theory
psychic determinism
unconscious instinctual urges
structure of mind
psychic conflict
psychic energy is needed to make the mind go and this energy cannot be destroyed, it must be expressed
psychoanalytic therapy
psychic determinism
Everything that happens in a person’s mind and everything a person does has a specific cause in their unconscious
unconscious instinctual urges
people are driven by unconscious, animalistic, instinctual urges.
structure of mind
the mind has an internal structure.
It is divided into three parts (Id, Ego, Superego).
psychic conflict
Personality characteristics are determined by the way in which a person learns to resolve unconscious conflicts between the Id, Ego and Superego.
Psychic energy is needed to make the mind go and this energy cannot be destroyed, it must be expressed:
The psychic energy comes from two drives:
- Eros/libido (life and sexual instincts)
- Thanatos (death instinct)
closed system
maintains at a constant rate
psychoanalytic therapy
aims to relieve psychic conflicts and thereby free up psychic energy by providing insight into the Unconscious.
the topographic model
Three levels of awareness:
- Conscious
- Preconscious
- Unconscious
only provided a limited description of personality so Freud developed the Structural Model of the mind.
conscious
current awareness
preconscious
just below the surface of consciousness, can be accessed if required - can be recalled
unconscious
cannot be voluntarily accessed
the structural model of the mind
id
ego
superego
id
Primitive “irrational” mind
“pleasure principle”
I want it and I want it now
Baby up to 18 months
ego
Rational part of the mind
Reality principle – you can’t always get what you want
Negotiates compromise between the Id and Superego
conscience
superego
The moral part of the mind, the conscience
Embodiment of parental and societal values
Develop at about age of 6
intra-psychic conflict
Interactions between the three structures of personality create intra-psychic conflict which can be observed as symptoms of mental disturbance.
The basic symptom is anxiety.
Personality characteristics are determined by the way in which a person learns to resolve unconscious conflicts between the Id, Ego and Superego.
example of intra-psychic conflict
You want to go to a friend’s party but it’s a long journey and will mean missing a practical class (the second one in a row) - Id - “pleasure principle” - Go to the party and have a good time Ego - Rational part of the mind - Negotiates compromise between the Id and Superego - Perhaps we can find a way around this by downloading the notes and getting a friend to record it. - Superego - The moral part of the mind, the conscience - This is wrong, you can’t go, you already skipped a class and you need to do well in this course.
These competing demands cause anxiety and make it difficult to decide - whatever you decide you will feel guilty.
how do we deal with intra-psychic conflict?
defence mechanisms
what are the main motivators of human behaviour?
sexual and aggressive drives
Freud ignores the social world in which individuals operate.
Life and death drives
Libido – life/sexual instinct or drive
Thanatos – death/aggressive instinct or drive
Finite amount of psychic energy
psych development - psychosexual stages of development
Oral (0-18 months)
Anal (18 months - 3 1/2 years)
Phallic (3 1/2 years - 6 years)
Latency (6 years - puberty)
Genital (puberty - adulthood)
parts to psychosexual stages
- a physical focus,
- a psychological theme,
- an adult character type
Fixation can occur during any of the psychosexual stages of development
Doctrine of opposites
oral stage physical focus
mouth
anal stage focus
anus
phallic stage focus
penis
latency stage
period of relative calm
genital stage focus
genitals
oral stage psych theme
dependency
oral stage adult char
extremely dependent or highly independent
Extremely stress situ – might oscillate between the 2
anal stage theme
self control/obedience
anal stage char
highly self-controlled, overly organised, subservient to authority (anally retentive) – rigid
little self-control, disorganised, hostile (anally expulsive)
E.g. police (retentive),
phallic stage theme
sexual identification
- Oedipus Complex – “Little Hans”, the “Analysis of a Phobia in a Five-Year-Old Boy” (1909). - Castration anxiety
- Electra Complex
phallic stage char
Promiscuous, amoral or asexual, puritanical
genital stage theme
sexual reproduction, intellectual and artistic creativity
genital stage char
well adjusted and balanced
ego defence mechanisms
denial
regression
regression
reaction formation
projection
rationalisation
intellectualisation
displacement
sublimation
denial
stating an anxiety provoking stimuli doesn’t exist – limit to how long it can protect you
repression
pushing anxiety into the unconscious – takes a large amount of energy
regression
returning to a previous stage of development
reaction formation
taking the opposite belief because the true belief causes anxiety
projection
placing unacceptable impulses in yourself onto someone else
rationalisation
supplying a logical or rational reason as opposed to the real reason
intellectualisation
avoiding unacceptable emotions by focusing on the intellectual aspects
displacement
taking out impulses on a less threatening target
sublimation
acting out unacceptable impulses in a socially acceptable way – best one to have/do – positive
evidence of the unconscious
parapraxes
humour
dreams
parapraxes
(Freudian slips): random/uncontrolled
forgetting
- slips of the tongue
- Accidents – accidents deliberate according to Freud
humour
a controlled “leak”
- an essential from of sublimation
dreams
“the royal road to the unconscious”
through providing id impulses with a stage for expression they reveal the unconscious
manifest content
(what we see and remember) – ‘the dream’ on the surface
latent content
(what is really being said) – symbolic nature of the dream
- Desires are expressed in a disguised form, they are represented symbolically
- Unconscious threatening impulses are expressed and the conscious mind is not threatened
- Majority of Freudian dream symbols are sexual
aim of psychoanalysis
to uncover repressed, unconscious material and thereby release pent-up, anxiety inducing emotions
main psychoanalysis techniques
dream analysis
free association
transference and counter-transference - big issues in psychoanalysis
measuring unconscious material
Projective tests
- Rorschach inkblot test
- Thematic perception Test (TAT)
- human figure drawing test
Rorschach inkblot test
Ten inkblot cards
Describe what you see in an inkblot
Evidence is very poor
TAT
Series of ambiguous pictures
Tell a story about each picture
human figure drawing test
draw pic for therapist
strength’s of Freud’s theory
The first comprehensive theory of behaviour and personality.
Emphasizes the role of the unconscious mind and early childhood experiences.
Emphasizes dynamic nature of behaviour.
Stimulated much research and theorising and has influenced the subject matter of personality research today.
Developed the first system of psychotherapy
Research evidence - old (support)
The unconscious part of mind can perceive things without conscious awareness (Erdelyi, 1974).
Defense mechanisms, in particular, repression appears to occur (Weinberger & Davidson, (1994).
Anal characteristics are intercorrelated.
Oral characteristics are intercorrelated (Weston, 1990)
Catharsis is helpful to physical/psychological health (Erdelyi, 1994).
Laboratory studies have demonstrated transference (Andersen & Baum, 1994).
criticisms of Freud’s theory
Concepts are poorly designed - What is “psychic energy”?
Difficult to test empirically
Role of the environment is overlooked
Over-emphasis on sexual drive, early experiences and destructive inner urges.
Case-study method - data from neurotic, wealthy, European females – did form initial basis
Pessimistic - psychic determinism - is there no free will?
Assumes any deviation from heterosexual relations is pathological.
Focuses on heterosexual male behaviour as the norm
Eysenck (1972) - Qs efficacy of psychotherapy
Survey of 19 studies covering over 7000 cases
Compared patients who received psychotherapy (experimental group) with patients who had been hospitalized for neurosis or treated only by their GPs (control groups).
Control groups provided a baseline of spontaneous recovery (66%).
- Of patients treated by psychoanalysis, 44% recovered.
- Of patients treated eclectically 64% recovered.
- Patients treated only by GPs show 72% recovery.
Findings suggest an inverse correlation between recovery and psychotherapy: more psychotherapy = smaller recovery rate – worse than no treatment
Sletvold (2013)
Freud’s statement in The Ego and the Id (1923) that the ego is first and foremost a bodily ego is well known. This paper tempts to clarify the premises underlying Freud’s thesis. Particular attention is paid to Freud’s investigation of internal perceptions. Freud argued that internal perceptions are more primordial than perceptions arising externally. In Freud’s opinion the roots of the ego, the id, are to be found in body sensations and feelings, but he had to admit that very little was known about these sensations and feelings. Only much later was neuroscience in a position to offer evidence that feelings can be the direct perception of the internal state of the body. Damasio (2010) has recently suggested that the core of the self might be found in what he, like Freud, terms primordial feelings. Not only was Freud able to conceive of the ego as the perception and feeling of our own body but also to conceive of knowing the mental life of another by means of recreating the bodily state of another through imitation.
Lepoutre (2019)
Method. - Besides considering Freud’s work, this article weaves together three threads by reappraising the writings of Melanie Klein, Donald Winnicott and Jacques Lacan. While Freud raises a number of crucial points relating to the boundaries of the ego, a comparative reading of these three authors highlights how their work reconsiders, elaborates on or goes beyond Freud’s views.
Results. - From a reading of the Freudian corpus emerges a three-fold definition of the boundaries of the ego: 1) Intra-subjective: the ego opens onto the id, but is strictly separate from the repressed 2) Extra-subjective: the ego is established through opposition to external reality. 3) Inter-subjective: the ego, as it relates to the other, is experienced both as separated from the object while at the same time being the object of a series of identifications. Each in their own way, Klein, Winnicott and Lacan shed new light on these questions according to their particular readings of different aspects of Freud’s work.
Discussion. - The aim of this paper is to underline the originality of these four authors by pointing out what they have in common and what differentiates them. It also sheds light on a whole set of questions (the separation between the ego as agency and the subject of the unconscious, between the ego and reality, between the outside and the inside, between the subject and the object, between the ego and the alter ego) that pervade psychoanalytical theory.
Conclusions. - Ultimately it is the shattered state of the Freudian Ich - as revealed by its diverse readings by the post-Freudians according to their respective clinical paradigms-that is the key to understanding the extent of the problem of the ego in psychoanalysis. (C) 2018 Published by Elsevier Masson SAS.
Blass (2012)
This paper explores fundamental dimensions of Melanie Kleins concept of the ego through a detailed study of the writings of Klein and her early colleagues (Paula Heimann, Susan Isaacs and Joan Riviere). The study examines three central issues: (a) the basic theoretical framework for Kleins conceptualization of the ego, and specifically how her conceptualization builds on Freuds structural and dual instinct models; (b) the processes involved in the development of the ego and its capacities (including the development from id to ego and from ego to superego); and (c) the view of the ego as an object of phantasy. Through this examination, the study demonstrates that Kleins conceptualization of the ego is firmly grounded both in Freuds formulations about the ego and in his theoretical and metapsychological approach to thinking about the ego. This counters the prevalent view that Klein was only focused on clinical understandings, unconcerned with theory and fuzzy in her abstract thinking. More specifically, it counters the view that Klein did not really have a concept of the ego in any well-structured sense of the term (Britton, 2003; Hinshelwood, 1994; Segal, 2001). The study considers the sources of these misconceived views. Finally, it argues that discarding such views allows us to appreciate better the richness of Kleins thinking, her theoretical affinities to Freud, and the role of theory in the development and justification of psychoanalysis.
Frank (1999)
Because of conceptual problems, the recommendation is made to no longer use the term the superego and refer rather to the processes involved
Dunn (1993)
Freud’s theory of the instinctual drives is examined in the light of his adherence to Darwinian thought. In this scheme, the drives arise from the interaction between biological and environmental stimuli and are dialectically constructed from both pressures: internal and external phenomena reciprocally organise each other and attempts to conceptualise them as separate entities restrict the degree to which we can understand the nature of mental life. Inhibition that became built-in to biological stimuli redirected and ‘elevated’ these bodily urges to representational functioning, a phylogenetic process which developed from environmental demands in the species’ struggle to survive. These ideas bear upon Freud’s notion that ubiquitous mental conflict, environmental sensitivities, and primitive id and ego (including defence) organisations are inherent components of instinctual activity. This construction is compared to Freud’s other models of the instinctual drives. The attitude conveyed by the metapsychological suppositions put forward is related to the clinical situation.
Kupfersmid (2019)
In Freud’s day, his case studies, coupled with the findings of others (e.g., Breuer, Charcot), provided evidence that the Oedipus complex and his dynamic theory of repression (i.e., the unconscious interactions between id, ego, and superego) as causal agents in neurotic symptoms was suspect. With the aid of over 75 years of research since Freud’s death, today’s psychodynamic-orientated clinicians have discarded many of Freud’s tenets related to the Oedipus complex. Modern psychoanalysts have focused their attention instead on a patient’s personal relationships in their early life, their current life, and in their interactions with their therapist (transference).
Michael (2019)
Despite its profound influence on modern thought, psychoanalysis remains peripheral to the concerns of most analytic philosophers. I suggest that one of the main reasons for this is intellectual reservation, and explore some philosophical arguments against psychoanalysis that may be contributing to such reservation. Specifically, I address the objections that psychoanalytic theories are unfalsifiable, that the purported findings of psychoanalysis are readily explained as due to suggestion, that there is a troubling lack of consensus in psychoanalytic interpretation, and that there is a lack of support for psychoanalysis within mainstream science. I also consider a major obstacle to the acceptance of contemporary defenses of psychoanalysis: the “bad lot” argument against Inference to the Best Explanation. My conclusion is that, though these objections have some merit, they are not sufficient reasons for not taking psychoanalytic ideas seriously.
Lo Dico (2018)
Although Freud and contemporary cognitive/social psychologists differ with regards to various traditions, vocabularies, methods, and areas of application, they agree in their criticism of the use of introspection as a means of inquiring about the mind. They share not only a strong outlook against introspection but both go so far as to make some outright arguments against introspection. Very briefly, it seems that both of these approaches conceive of introspection and the data stemming from it as hindrances to the construction of a science of mind. After presenting the theoretical assumptions and methodological underpinnings of contemporary cognitive/social psychology and Freud’s psychoanalysis, this article will compare them so as to highlight their differences and commonalities. The paper will conclude by arguing that both approaches appear to reject introspection as a method of inquiry because each understands psychology to be a natural science that is free from subjectivity.
Cynthia and Darling-Fisher (2018)
The Modified Erikson Psychosocial Stage Inventory (MEPSI) is an 80-item, comprehensive measure of psychosocial development based on Erikson’s theory with published reliability and validity data. Although designed as a comprehensive measure, some researchers have used individual subscales for specific developmental stages as a measure; however, these subscale reliability scores have not been generally shared. This article reviewed the literature to evaluate the use of the MEPSI: the major research questions, samples/populations studied, and individual subscale and total reliability and validity data. In total, 16 research articles (1990-2011) and 28 Dissertations/Theses (1991-2016) from nursing, social work, psychology, criminal justice, and religious studies met criteria. Results support the MEPSI’s global reliability (aggregate scores ranged .89-.99) and validity in terms of consistent patterns of changes observed in the predicted direction. Reliability and validity data for individual subscales were more variable. Limitations of the tool and recommendations for possible revision and future research are addressed.
Riley (2019)
The aim of this study is to investigate defence mechanisms, emotional regulation and personality, across 120 secondary school students. Assessing help seeking behaviour, perceptions of mental health and knowledge of services available, using a mixed method approach. Students in 1st, 2nd and 5th year within the age range of 12-17 years old, 62 males and 58 females took part in the study. The 5th year students use mature and immature defences suppression and devaluation. There was a relationship with emotional regulation, mature, neurotic and immature defences, and personality. First year students are more reliant on family support than friends, while 2nd and 5th year students rely more on friends and less on family.
Lysgaard (2019)
This chapter will engage denial as a term and a mechanism that harbours both negative and positive aspects. The negative being; denying uncomfortable facts and suffering the consequences of failing to acknowledge them. The positive aspect: the ability to limit the impact of uncomfortable facts, as not to be paralyzed in horror and/or existential angst—e.g. even though we are faced with plausible “doomsday prophecies”, we are still able to cook dinner for our family and “kick back” once and a while. This chapter examines Denial in relation to education, and how denial of specific scientific, historical, medicinal facts has been applied as societal strategies, through education, in order to implement certain attitudes and values. Finally, we argue that denial offers a great potential when linked with the emerging thoughts related to Speculative Realism and Object Oriented Ontology (henceforth OOO) and how we could, perhaps, enter a more critical and productive relationship with Denial on a societal, individual and educational level.
Boag (2018)
Possibly no other psychoanalytic concept has caused as much ongoing controversy, and attracted so much criticism, as that of ‘repression’. Repression involves denying knowledge to oneself about the content of one’s own mind and is most commonly implicated in disputes concerning the possibility of repressed memories of trauma (and their subsequent recovery). While fundamental in Freudian psychoanalysis, recent developments in psychoanalytic thinking (e.g., ‘mentalization’) have downplayed the importance of repression, in part due to less emphasis being placed on the importance of memory within therapy
Rizzolo et al. (2018)
The Critique of Regression presents the most in-depth critique of regression available in the psychoanalytic literature, whilst presenting the first psychoanalytic theory of irreversible lifespan development. The clinical implications are amply demonstrated in three chapter-length psychoanalytic cases. The most important implication is that when we revisit the past, in a private memory or in an analytic session, we remake it afresh in light of the present. The analysis of the past is always, in this sense, an exploration of the present.
Gregory S. Rizzolo demonstrates that where we think we see returns, or regressions, to past stages of the lifespan, we in fact find the emergence of novel structures in subjective experience. Rizzolo considers the work of human development to be a work of mourning in which we lose, internalize and keep re-working the residue of a past to which we never return. The traditional notion of regression, which supports the fantasy of a literal return, operates as an intellectual defense against the mourning process. To critique the concept is to address the defense and to confront the loss of past relationships and of past versions of selfhood inherent in development. From the work of mourning emerge ever-new configurations of desire, defense and subjective meaning. The task of analysis is to cultivate, amidst the repetition of familiar patterns, the potential for novelty at play in each moment.
This thought-provoking work will interest new and experienced psychoanalytic clinicians alike, who want to go beyond traditional theories of development to a contemporary look at how we develop inexorably across the lifespan.
Meissner (2018)
Sigmund Freud’s discussion of the Schreber case focuses on Schreber’s paranoid delusions and the role of projection in his symptom formation. Freud put considerable emphasis on projection in trying to illumine the psychodynamics of paranoid delusions. The mechanism of projection can be considered meaningfully only in the context of its correlated intrapsychic process—introjection. Melanie Klein introduces the term projective identification: Much of the hatred against parts of the self is now directed toward the mother. This leads to a particular form of identification which establishes the prototype of an aggressive object-relation. In considering post-Kleinian developments, it seems clear that most Kleinian thinkers recognize to some degree the basically psychotic character of projective identification and acknowledge the aspects of self-fragmentation, diffusion of identity, and loss of self-object differentiation that it implies. Projective identification is exemplified as a basic mechanism in the schizophrenic process and reflects the regressive reconstitution of the paranoid-schizoid position.
Civitarese (2017)
Although it encapsulates the Freudian theory of art, the theory of sublimation has become outmoded. What is more, since its inception there has always been something ill‐defined about it. Does it use sexualized or de‐sexualized drive energy? Is it a defence or an alternative to defence? Does it serve Eros or Thanatos? Is it useful in clinical work or is it unusable? The only, albeit uncertain, aid to a definition relies on the extrinsic criterion of concrete artistic realization. My aim here to revisit and possibly ‘reinvent’ sublimation in the light of certain principles of the pre‐Romantic aesthetics of the sublime. Both are theories of spiritual elevation, in other words, elevation that moves towards abstract thinking, and of man’s ‘moral’ achievement; and both attempt to explain the mystery of aesthetic experience. On the one hand, the aesthetics of the sublime offers a modern myth that helps us articulate a series of factors occasionally referred to by various authors as constitutive of sublimation but which have not been incorporated into a single organic framework: loss and early mourning work; the earlier existence of a catastrophic factor – to be regarded, depending on the situation, as either traumatic or simply ‘negative’; the correspondence with a process of somatopsychic categorization which coincides with subjectivity. On the other hand, it also helps us grasp the experience of negative pleasure empathically, living it ‘from the inside’.
Cariola (2017)
Although intellectualization can represent an
adaptive function to accumulate knowledge and
enrich intelligence in everyday life, from a psychodynamic perspective, intellectualization can
also be used as a defense mechanism by isolating
uncomfortable emotions and impulses from conscious awareness.
Wagas et al. (2015)
Methods: This cross-sectional study was done at CMH Lahore Medical College and Fatima Memorial Hospital Medical and Dental College, both in Lahore, Pakistan, from December 1, 2014 to January 15, 2015. Convenience sampling was used and only students who agreed to take part in this study were included. The questionnaire consisted of three sections: 1) Demographics, documenting demographic data and academic scores on participants’ most recent exams; 2) Hospital Anxiety and Depression Scale (HADS); and 3) Defense Style Questionnaire-40 (DSQ-40). The data were analyzed with SPSS v. 20. Mean scores and frequencies were calculated for demographic variables and ego defense mechanisms. Bivariate correlations, one-way ANOVA, and multiple linear regression were used to identify associations between academic scores, demographics, ego defense mechanisms, anxiety, and depression.
Results: A total of 409 medical students participated, of whom 286 (70%) were females and 123 (30%) were males. Mean percentage score on the most recent exams was 75.6% in medical students. Bivariate correlation revealed a direct association between mature and neurotic ego defense mechanisms and academic performance, and an indirect association between immature mechanisms and academic performance. One-way ANOVA showed that moderate levels of anxiety (P < .05) and low levels of depression (P < .05) were associated with higher academic performance.
Conclusion: There was a significant association between academic performance and ego defense mechanisms, anxiety, and depression levels in our sample of Pakistani medical students.
Cunliffe (2019)
In this thesis, I argue that a deconstructive approach to Freudian dream-work gives new perspective on how meaning is generated in the mind. Using that perspective I develop a new metaphor for mind, and an accompanying theory of meaning. I argue that The Interpretation of Dreams suffered from assumptions about the nature of consciousness issuing from attachment to a ‘metaphysics of presence’. This inhibited the development of metapsychology, putting concepts such as the unconscious, phantasy and repression on an unstable basis and contributing to the subsequent development of psychoanalysis in a fragmented manner. It also prevented Freud from reaching valuable philosophical conclusions about the relationship of the unconscious to consciousness. Existing literature has examined Derrida’s approach to Freud but this has found application primarily in fields such as literary and critical theory: far less attention has been paid to the potential clinical implications of a deconstructive reading of Freud, or the possibilities for a revised theory of mind. Extending Derrida’s delineation of Freud’s metaphors for mind, I suggest a new metaphor, based on the method of Fractal Image Compression used to store images digitally. I claim this updated version of Freud’s ‘mystic writing pad’ enables us to conceptualize how the mind processes experience to produce meaning based on structures of difference, thereby providing a challenge to traditional representational theories of mind. This model of the mind provides a conceptual frame within which psychoanalytic theories can be evaluated and brought into conversation with each other. I use it as a tool to test different theories of dream interpretation, analysing a dream of my own. I then demonstrate how we can employ it to critically evaluate different psychoanalytic schools of thought by showing how my account supports and extends Bion’s notion of ‘dream-work-alpha’, and challenges Lacan’s ideas about language and the unconscious.
Cohler (2015)
Sigmund Freud’s The Interpretation of Dreams (1900b) remains the cornerstone of psychoanalytic inquiry. In a carefully argued and complex text that was revised eight times during the course of Freud’s career (Grubrich-Simitis, 2000; Marinelli and Mayer, 2003), the dream book portrays a model of mental life that is founded on conflict between a nuclear wish, arising in the preschool years and always seeking satisfaction, that is opposed by personal morality founded on values learned in childhood. This wish must necessarily remain out of awareness and is able to realize at least partial satisfaction only in a disguised manner, evading censorship, such as in dreams or symptoms. the problem of the dream book is that Freud must convince the reader that our mental life is governed by this wish that by definition can never attain awareness (Kohut and Seitz, 1963). This essay discusses how Freud resolved the rhetorical dilemma he confronted by using his own biography in supporting his theory of dream interpretation, while struggling not to reveal aspects of his life that might prove embarrassing.
An additional problem posed by the argument of the dream book is that in his effort to convince the reader of his model of the mind through the analysis of dreams, Freud is unable to use the dreams of his analysands. the scientific community and lay readers would be likely to disregard these dreams as products of an abnormal mental state. of equal importance, working in a milieu in which his analysands were often family friends or neighbors and easily recognizable (Anzieu, 1986; Gay, 1988), Freud would have found it difficult to maintain confidentiality if he were to recount his analysands’ dreams. There was only one alternative, that of using his own dreams. Because Freud was a physician and a University of Vienna Medical School faculty member, he believed that his own accounts of the interpretation of dreams would gain credibility.
Glucksman and Kramer (2017)
A number of behavioral, social, biological, and cultural factors are associated with suicide. However, the ability to predict an imminent suicide attempt remains problematic. Prior studies indicate that the manifest dream content of depressed, non-suicidal patients differs from that of depressed, suicidal patients. The dream imagery of depressed, suicidal patients contains themes of death, dying, violence, and departure. The dream imagery of depressed, non-suicidal patients contains themes of rejection, helplessness, hopelessness, humiliation, failure, and loss. In the present study, the dream reports of 52 depressed patients were collected and rated for various themes. Patients were divided into three groups: Depressed and non-suicidal; Depressed, with suicidal ideation; Depressed, with suicidal ideation and/or attempt(s). Themes of death and/or dying, and to a lesser extent, themes of violence, injury, and/or murder occurred with greater frequency in the dream reports of depressed patients with suicidal ideation and/or attempts, than in the dream reports of depressed patients without suicidal ideation or behavior. These observations correspond with the prevailing psychodynamic explanation of suicide; namely, that it is a murderous attack on the self that is identified with hated internalized objects.
Leuzinger-Bohleber (2018)
Methods:
A total of 252 adults met the inclusion criteria (aged 21-60 years, major depression, dysthymia, double depression for at least 24 months, Quick Inventory of Depressive Symptoms [QIDS] >9, Beck Depression Inventory II [BDI] >17, informed consent, not meeting exclusion criteria). Main outcome measures were depression self-rating (BDI) and rating (clinician-rated QIDS [QIDS-C]) by independent, treatment-blinded clinicians. Full remission rates (BDI ≤12, QIDS-C ≤5) were calculated. An independent center for data management and biostatistics analyzed the treatment effects and differences using linear mixed models (multilevel models and hierarchical models).
Results:
The average BDI declined from 32.1 points by 12.1 points over the first year and 17.2 points over 3 years. BDI overall mean effect sizes increased from d = 1.17 after 1 year to d = 1.83 after 3 years. BDI remission rates increased from 34% after 1 year to 45% after 3 years. QIDS-C overall effect sizes increased from d = 1.56 to d = 2.08, and remission rates rose from 39% after 1 year to 61% after 3 years. We found no significant differences between PAT and CBT or between preferential and randomized allocation.
Conclusions:
Psychoanalytic as well as cognitive-behavioural long-term treatments lead to significant and sustained improvements of depressive symptoms of chronically depressed patients exceeding effect sizes of other international outcome studies.
Neal (2019)
Methods. Twenty-eight participants meeting inclusion criteria were selected from amongst participants in the Austen Riggs Center’s (ARC) 11-year Follow-Along Study (FAS). For each participant, two archived transcripts of Dynamic Interviews administered at least six months apart were rated using the abbreviated Metacognitive Assessment Scale (MAS-a), which provides scores for metacognitive functioning across four separate but interdependent domains of functioning. Raters had experience and training on the MAS-a and were blinded to personality disorder group assignment of the FAS participants. Group differences and change over time were assessed using a general linear model regression with metacognitive scores for occasion one as a covariate and scores for occasion two as the dependent variable.
Results. Metacognitive scores improved over time in response to treatment for the sample as a whole. Treatment effect sizes were medium to large. However, group differences were negligible. Effect sizes for individual groups indicate possible differences in the way that groups change over time. NPD group exhibited no change in Awareness of Others, but had a large effect size in the category of Mastery. Large effect sizes in the category of Self-Reflectivity were found for SPD and BPD groups. BPD demonstrated lower Mastery scores than NPD or SPD.
Conclusions. Evidence for metacognitive improvement over time for the sample as a whole suggests treatment at ARC is effective. Differences in effect sizes in change over time between groups may suggest that personality disorder diagnosis influences treatment outcomes, a hypothesis that may be more readily testable with a larger sample. Generalizability of results is limited by the relatively small size of sample subgroups and by the unique patient population and unique treatment setting of ARC
schacter (2018)
ABSTRACT
Freud’s development of free association
Lothane’s conception of reciprocal free association
Free association: Theoretical and actual
Ethical issues in free association
Why discuss training analysis in an article about free association?
Changes in attitude toward analytic theory and practice
The influence of psychoanalytic education on the use of free association
Proposed modifications of psychoanalytic education
Conclusion
References
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ABSTRACT
Freud probably created free association to minimize the possibility that the psychoanalyst’s suggestion might play any role in psychoanalytic treatment, thus assuring the scientific status of such treatment. Freud admittedly developed a personal psychoanalytic technique to suit himself as an individual. Candidates are instructed to utilize free association and also learn about it by identifying with its use by their training analyst. This identification with the training analyst probably plays the most significant role in the candidate’s learning to utilize free association, and therefore requires a discussion of training analysis in this article about free association. Mounting criticisms of recognized vulnerabilities of training analysis have led to numerous recommendations to terminate the training analyst system. Hopefully, doing so may provide candidates with a wider choice of analysts and changed educational emphases that might facilitate their selecting techniques to initiate and conduct analytic treatment best suited to them individually, as Freud advised, rather than acquiring standard analytic techniques.
Abend (2017)
The author traces the development of Freud’s conception of the nature and significance of transference in the psychoanalytic process. He notes that from 1910 onward, Freud was convinced that the analysis of the transference is the sole factor involved in the therapeutic action of psychoanalytic treatment, despite the fact that, late in his career, he observed and described the power of reconstruction to be effective as well. The author agrees with those analysts who contend that, while the analysis of the transference is essential to proper analytic technique, it is not the only agent of therapeutic impact.
Olga (2016)
Our study was intended to test whether there are any differences in the way defense mechanisms are used by patients suffering from pure anxiety and those with pure depressive disorders. The sample size was as follows: depressive disorders without psychotic symptoms 30, anxiety disorders 30, and the healthy control group 30. The assessment of defense mechanisms was made using the DSQ-40 questionnaire. Our findings show that “pure” anxiety disorders differ from “pure” depressive disorders only in the use of immature defense mechanisms. The group with depressive disorders was significantly more prone to use immature defense mechanisms than the group with anxiety disorders (p = 0.005), primarily projection (p = 0.001) and devaluation (p = 0.003). These defense mechanisms may therefore be used both to differentiate between anxiety and depressive disorders and also to determine which symptoms (anxiety or depressive disorders) are dominant at any given stage of treatment.
Perry et al. (2011)
Defense mechanisms are one of the most durable constructs in psychoanalysis and dynamic psychiatry/psychology, spanning theoretical, clinical, and research approaches. While the construct originated with Freud’s 1894 [1] publication, The Neuro-Psychoses of Defence, the first seven decades of psychoanalytic writing largely advanced the theoretical understanding and clinical approaches to defense mechanisms, while the research did not begin in earnest until about the last 40 years, accelerating somewhat more recently. Much of this research has understandably concentrated first on issues of how to assess defenses [2, 3], second, on the relationship of defenses to clinical disorders, such as depression [4] and personality disorders [5, 6], and, third, on change in defenses over time and long-term development [7]. In recent years, this latter avenue has expanded to include treatment outcome studies indicating that defenses and defensive functioning improve with treatment [4, 8–10]. To date, these have been naturalistic observational studies of patients in treatment and follow-up, but they have also begun to examine the role of defenses in the processes of change with psychotherapy. Kramer et al. [11] found that change in distress was mediated by prior improvement during psychotherapy of defensive functioning, but not of conscious coping. Perry and Bond [12] reported that change in defense mechanisms at 2.5 years of long-term dynamic psychotherapy predicted change in multiple measures of symptoms and functioning at 5 years. While we await additional research to establish that change in defenses mediates improvement in symptoms and functioning, it is important to explore and delineate therapeutic processes that lead to change in defenses. This chapter, then, is an effort to examine some early hypotheses and approaches to determining how therapeutic interventions lead to change in defensive functioning within and across psychotherapy sessions.
