Chapter Two: Psychoanalytic, Brief Analytic, Object Relations, and Interpersonal Approaches

Biographical Information: Sigmund Freud Freud was born in Freiberg, Moravia, in 1856. His intellectual potential was obvious from early

on and Freud felt like a favored child. He obtained his medical degree from the

University of Vienna with the goal of being a research scientist

He went into private practice because of financial needs.

He initially used hypnosis, but later became more enamored with the “talking cure.”

Historical Context

The Seduction Hypothesis Recanting the Seduction Hypothesis

Psychoanalytic Theoretical Principles The Dynamic Approach The Topographic Approach The Developmental Stage Approach The Structural approach Psychopathology and Human Change Freud’s Theory in Action: Implications for

Psychotherapy

Evolution and Development in Psychoanalytic Theory and Practice Anna and the Ego Psychoanalytic Ego Psychology Object Relations Self Psychology Continuing Theoretical Developments Karen Horney versus Freudian Orthodoxy:

The Battle of the Sexes

Evolution and Development (continued) Practical Modifications: Short-Term and

Time-Limited Psychoanalytic Psychotherapy

Selection Criteria for Brief Analytic Psychotherapy

The Intersubjectivity, Two-Person Psychology, or Relational Psychoanalytic Movement

The Practice of Psychoanalytic Therapy Psychoanalytic Principles and Therapy Methods The Basic Rule Maintaining a Safe Container Interpretation Transference Countertransference Triangles of Insight Dream Interpretation

The Practice of Psychoanalytic Therapy (continued) Preparing Yourself to Do

Psychoanalytically Informed Therapy Preparing Your Client to Engage in

Psychoanalytically Informed Therapy Assessment Issues and Procedures

Extended Case Examples

Initial analysis of resistance Analysis leading to transference material Exploration and interpretation of

transference Additional techniques

Therapy Outcomes Research

Research is limited Existing research is mostly positive Some specific treatment approaches (such

as IPT) show promise

Boxes

Interpersonal Psychotherapy for Depression Why I Am a Psychoanalyst

Concluding Comments

Freud was an incredibly productive individual

He probably had many psychological issues of his own that fueled his productivity, including oedipal or phallic issues

He remained bitter toward Janet until the very end

Student Review Assignments

Critical corner Reviewing key terms Review questions

Critical Corner Traditional psychoanalysis is based on the

interpretation of unconscious conflicts and unconscious maladaptive relationship patterns. This approach is inherently defective because it relies on another completely fallible human being with his own unconscious conflicts and problems to make accurate interpretations. Comment on how this approach can ever have any legitimacy. Does the contemporary psychoanalytic “two-person psychology” model offer any improvement in this regard?

Critical Corner (continued)

Presently, many would agree that psychoanalytic theory is an overly intellectual and impractical approach to helping clients. As Gedo has suggested, it has become a piecemeal patchwork of different theories and approaches. Isn’t it time to throw out Freud’s psychoanalytic theory and to begin again with a more practical, contemporary approach? Isn’t that why interpersonal psychotherapy of depression is gaining popularity?

Critical Corner (continued)

Some critics might argue that psychoanalytic drive theory and even more contemporary object relations and self psychology reformulations of psychoanalytic theory are blatantly sexist. Consider Karen Horney’s criticisms. What do you think of the possibility of men having pregnancy, childbirth, breast, and motherhood envy? How would acknowledgement of these important social and cultural influences affect traditional psychoanalytic theory?

Critical Corner (continued)

Traditional psychoanalytic forms of therapy have “making the unconscious conscious” or “insight” as their primary therapy goal. Some critics claim there is no scientific evidence of the unconscious. Where do you stand on this issue? Are there unconscious processes that affect interpersonal relationships?

Critical Corner (continued)

After over 100 years of psychoanalysis, there is still little or no hard scientific evidence attesting to its efficacy. How can an approach to therapy rationalize its existence without any scientific data to support its practice?

Critical Corner (continued)

Traditional psychoanalytic theory is strongly deterministic. Similar to behavioral approaches, psychoanalytic therapies minimize client choice and personal responsibility. After all, if behavior is psychologically determined, then is there any possibility of human choice as a method of change? For psychoanalysts, to achieve significant personal change, psychoanalysis is required. What do you think of this criticism?

Reviewing Key Terms

·        The seduction hypothesis ·        The Oedipal conflict ·        Unconscious ·        Preconscious ·        Conscious ·        Id ·        Ego ·        Superego

Key Terms (continued)

·        Repression ·        Denial ·        Projection ·        Reaction Formation ·        Displacement ·        Rationalization ·        Regression ·        Sublimation

Key Terms (continued)

·        Repetition compulsion ·        Ego psychology ·        Objection relations theory ·        Self psychology ·        Corrective emotional experience ·        Focal psychotherapy ·        Selection criteria ·        The basic rule

Key Terms (continued) ·        Role induction ·        Transference ·        Countertransference ·        Interpretation ·        Triangles of insight ·        Two-person psychology or intersubjectivity ·        Projective assessment ·        Dream interpretation ·        Interpersonal psychotherapy of depression

Review Question

Describe Freud’s seduction hypothesis as outlined in his famous paper “The Aetiology of Hysteria.” According to Anna Freud, why did Freud have to recant the seduction hypothesis ?

Review Question

What are the four primary characteristics of ego defense mechanisms?

Review Question

Both corrective emotional experience and seeding the transference were suggested as methods for speeding up psychoanalytic therapy. What is the difference between these two concepts or approaches?

Review Question

How might the requirement of reporting client information to insurance companies interfere with the basic rule in psychoanalytic therapy?

Review Questions

What is a triangle of insight? Draw two triangles, one with a conflict-based triangle of insight and the other with a transference-based triangle of insight.

What are the main differences between one-person and two-person psychology as it applies to psychoanalytic theory and practice?

Review Questions

What are the main differences between interpersonal psychotherapy for depression and psychodynamic therapy?