Week 4 Flashcards
Entirely unconscious, its existence and power can however be inferred from derivatives, such as thoughts acts and emotions
The Id
Unconscious aspects
Include defensive processes like repressions, displacements, sublimation & rationalization
Observing ego
The part of the patients self that is conscious and rational and can comment on emotional experience, allies with therapist to see total self
The superego is similar to the ego
From which it arises partly conscious and partly unconscious
Anxious reactions are caused by
Defenses
Defenses were reconceptualized
As existing not only to protect a person from anxiety about id, ego and superego dangers but also to sustain a consistent, positively valued sense of self
How were neurotic people viewed with psychological infrastructure?
Viewed as suffering because their ego defenses were too automatic and inflexible, cutting them off from Id energies that could be put to creative use
How were psychotic people viewed with psychological infrastructure?
Suffered because their ego defenses were too weak, leaving them helplessly overwhelmed by primitive material from the id
Therapy with a neurotic person
Should involve weakening the defenses and getting access to the id so that it energies may be released for more constructive activity
Therapy with a psychotic person
Should aim at strengthening defenses, covering over primitive preoccupations, influencing realistically stressful circumstances so that they are less upsetting
If someone has neurosis (neurotic)
strong transference and counter transference reactions might appear
If a character neurosis is present
Then the therapeutic task would be more complicated, demanding and time consuming and the prognosis more guarded
A lot of the time Freud called neurotic were actually
Considered “borderline” or even psychotic features
Neurotic range show
Early in therapy a capacity for the therapeutic split between observing and the experiencing parts of the self
Defense mechanisms
they protect one against a nameless dread, even the frightening distortions that the defenses themselves may create are a lesser evil than the state of terror
People whose personalities are organized at an essentially psychotic level
Have grave difficulties with identity, so much so that they may not be fully sure that they exist
Psychotic personalities are usually confused
About reality & may be estranged from it
Who lacks reflective functioning?
People with psychotic tendencies
Primary conflict in people with a potential for psychosis is literally existentialist
Life versus death, existence versus obliteration, safety versus terror, their dreams are full of death and destruction
Borderline patients can be hard to distinguish from
Psychotic patients because they use primitive defenses and both suffer a basic defect in the sense of self
Difference between borderline and psychotic
Borderline is more inclined to speak about certain things whereas psychotics may get agitated
How to make a differential diagnosis between borderline and psychotic levels of organization?
Investigate the persons appreciation of conventional notions of reality by picking out some unusual feature of his or her self presentation
Transferences in borderline clients tend to be
Strong, um ambivalent and resistant to ordinary kinds of intervention
Countertransference reactions with borderline clients
Tend to be strong and upsetting
CBT
How well the person learns from consequences including rewards, punishments and an absence of stimuli
Four broad psychoanalytic theories
Ego psychology, objects relations theory, self psychology and attachment theory
Ego psychology (unconscious and conscious)
Hysterical symptoms were seen as the result of repressed memories or events or ideas, hypothesized that psychotherapeutic intervention could lift repression, decision maker
The id is only interested in discharging
Tension, it is controlled by the ego and super ego
When the id, the ego and the super ego are battling
It causes anxiety, which alerts the ego that a defense mechanism is required
When a defense happens what happens to id & ego
A compromise forms between them
What do all defenses have in common?
The protection of the ego against instinctual demands from the id
Freuds topography of mind
Preconscious, unconscious & conscious
Preconscious
Mental contents can be brought into conscious awareness by shifting attention
Unconscious
Mental contents that are censored because they are unacceptable and repressed (driving our behavior)
Evidence of the unconscious
Dreams, parapraxes, posthypnotic suggestions, material derived from free association & projective techniques & symbolic content of psychotic symptoms
Tripartite structure theory of the mind
Ego, id & super ego
Ego
Keeps these thoughts in the unconscious by using defense mechanisms, if it’s not able to, these thought will come out and be preconscious or conscious
Id
Completely unconscious and only interested in discharging tension, impulsive thoughts want to come out
Superego
Mostly unconscious, protects us from allowing these thoughts of shame, impulsive thoughts live there
Experiencing ego
Holds more deep down sense of therapeutic process (can feel what it feels like without knowing why)
Ego alien/ego dystonic
This is easier to treat as observing ego vs ego syntonic
With conflict what happens with unconscious forces and the ego
Unconscious forces seek expression and the ego attempts to prevent their expression
Conflict in action
Conflict leads to a signal of anxiety which leads to a defense and leads to a compromise between id and superego and leads to the symptom or outcome
Ego defense mechanisms
Are normal behaviors which operate on an unconscious level, help individual to cope with anxiety
Primitive defense mechanisms
There are here at our early points of development, all unconscious
Projective identification (primitive)
that involves splitting off parts of the self and projecting them onto another person
Projection (primitive)
unwanted feelings are displaced onto another person, where they then appear as a threat from the external world
Denial (primitive)
“Closing one’s eyes” to the existence of a threatening aspect of reality
Dissociation (primitive)
involves a person disconnecting from their sense of self, surroundings, or a traumatic event
Regression (primitive)
Returning to an earlier phase of development or functioning to avoid the conflicts and tensions associated with one’s present level of development
Higher level neurotic defenses
Also still unconscious but more in the interactive conscious directive
Introjection (higher)
a person unconsciously adopts the characteristics, attitudes, or ideas of others
Displacement (higher)
Shifting feelings from one situation to another (angry at work and angry at home)
Rationalization (higher)
Justification of unacceptable attitudes, beliefs or behaviors to make them tolerable to oneself
Reaction formation (higher)
someone expresses the opposite of their true feelings or impulses to mask an unwanted thought or desire
Repression (higher)
involves pushing unacceptable thoughts, feelings, or memories out of conscious awareness to avoid anxiety or threat to one’s self-image
Undoing (higher)
trying to cancel out or remove an unwanted thought or action by engaging in an opposite behavior
Mature defenses
Means a person is doing good
Humor (mature)
helps people deal with emotional conflicts and stressors
Suppression (mature defenses)
a person consciously pushes away unwanted thoughts, feelings, or behaviors to avoid distress
Asceticism (mature)
Denying yourself, finding a higher purpose than our earthly desires
Altruism (higher)
Your ego is being diminished, they want to become something better
Anticipation (mature)
it’s a healthy way to cope with stress by proactively planning for potential problems and preparing to manage them before they arise
Sublimation (mature)
redirecting unacceptable impulses or feelings into socially acceptable behaviors or actions (I’m angry I want to be a boxer)
What is anxiety in conflict in action?
A signal and a symptom
Levels of character development (1st dimension)
Included a persons degree of healthy psychological growth or pathology (psychotic, borderline, neurotic (normal))
Level of character development (2nd dimension)
Identifies his or her type of character (paranoid, depressive, schizoid, etc)
Psychotic (undifferentiated) (McWilliams)
Psychotic: At this level, individuals often struggle with reality testing, showing significant disconnection from reality.
Borderline (separation-individuation) (McWilliams)
Individuals in this category experience instability in their self-image and relationships. They may oscillate between idealization and devaluation of others, struggle with emotional regulation, and often exhibit impulsive behaviors. Their sense of self can feel fragmented or fluctuating.
Neurotic (oedipal) (McWilliams)
This level reflects a more integrated sense of self, though individuals still experience internal conflicts and anxiety.
When does the ego develop?
Throughout childhood but over the lifespan
How would a psychotic person respond to a break up?
Would pretend it’s not happening
How would a neurotic person respond to a breakup?
They would say it’s not you, it’s me
How would a borderline person respond to a breakup?
Would look like psychotic personality
