Psychoanalytic Therapy

Russell Resti L. de VillaMA Psychology

Part IIntroduction and Key Concepts

Introduction Among other theories on Human Behavior developed by well known pillars in the field of Psychology, Sigmund Freud’s Psychoanalytic Theory, stands up even until today, as one of the most controversial, as it included terms and concept on sex, the unconscious and the interpretation of dreams. The theory nonetheless, had provided a wide breeding ground for developing other kinds of theories that aim to understand human behavior. Such as Carl Jung’s own mix of Analytical Psychology, and Erik Erikson’s Psychosocial Stages of Development, a more ‘toned down’ and a greater supplement to Freud’s Psychosexual Stages of Development

Introduction In terms of contemporary psychotherapy, the practice of Psychoanalysis had radically changed and properly organized into a more ‘less sensitive’ method to treat psychological disorders. By making use of different techniques to conquer the incongruence of the personality from the unconscious. Psychoanalysis proves to be one of the more useful techniques when it comes to handling internal psychological conflicts that can alter the person’s perception of reality.

Sigmund FreudThe proprietor and the original

initiator of the Psychoanalytic approach on Human Behavior. Eldest among 8 children, Freud was well known for his utter devotion to devoting and expanding the borders of his theory.

With the stresses, psychosomatic occurrences, and paranoia about dying that he experienced in his early 40’s led him to discover new ways to understanding how and why people behave the way they do. He had eventually overcome his stresses and then began devoting the remaining years of his life developing the Psychoanalytic approach to discover the unconscious that affects a person’s behavior

Sigmund FreudFreud was known to be very creative and productive on his work. He was very dedicated to his theory, and had very little tolerance to persons who had thought otherwise or critiqued his school of thought. Because of this, had had dismissed two of his closest colleagues, Carl Jung and Alfred Adler, who had disagreed on Freud’s views, and created their own theories stemming from Freud’s Work.

Sigmund Freud died in September 1939 due to an inoperable cancer of the jaw.

Key ConceptsIt’s General Psychology all over again.

The View of Human Nature

In most cases on his work on Psychoanalysis, Freud has drawn a clear line on two things

concerning Human Nature.

Human nature is “Purely Deterministic”

Simply put, Human Nature “Happens because it happens”, there is no point in time in where we “call the shots” (or having control over our behavior) because according to Freud, our behavior is determined by Irrational forces, unconscious motivations and biological & instinctual drives that are stemmed from repressed childhood memories or experiences that hold a certain degree of impact to our lives.

“Instincts” are essential to the Psychoanalytic Approach

Instincts are actively displayed in times of survival. Leaning towards growth, development and creativity. Freud originally termed this as “Libido”, comprising of sexual energy, but then broadened the term to “Life Instincts”, where all ‘pleasurable’ acts serves as a person’s goal in life to simply gain pleasure and avoid pain.

“Instincts” cont. Freud also came up with another type of instinct called the “Death Instinct”, mostly responsible for the aggressive drive where at times some persons manifest through their behavior, an unconscious wish to die, or to hurt themselves or to hurt others.

All in all, both Life and Death instincts are powerful determinants to why people act the way they do.

The Structure of PersonalityWell known and commonly taught in the annals of the theory of Psychoanalysis. The theory illustrates the personality consists of three specific and distinct systems: the Id, the Ego, and the Superego.

Bear in mind that the three systems don’t function as three separate entities, but as one whole inter-dependent system.

The IdThe Id is considered as the primary and original system of personality, the source of psychic energy, and the seat of instincts. It lacks organization, is blind, and very insistent. It cannot tolerate tension, and once it does feel tension, it functions to immediately discharge it. Having ruled by the Pleasure Principle, it always aims to avoid pain and gain pleasure.

The EgoKnown as the “Traffic Cop”, it has it’s touch with reality, controls consciousness and exercises censorship.

It formulates rational and logical decisions and plans for satisfying needs.

Another duty of the Ego is to keep in check, and balance the demands of the pleasure-seeking and unorganized Id, and of the perfectionist-centered and radical moral objectives of the Superego

The SuperegoThe Judicial Branch of the three. Comprised of an individual’s moral conduct and the concept of right and what’s wrong given from earlier life experiences and the cultural mores given from the environment. The Superego holds the Moralistic Principle. It strives to inhibit the Id and seeking to be “Perfect” by persuading the ego to replace it’s realistic goals for the more “perfectionist” ones.

Consciousness & The Unconscious

The unconscious can be compared to an Iceberg. The conscious can be on the tip of it, but underneath sea level is a massive body of the unconscious, where, according to Freud, is where psychological functioning exists. Experience, memories, repressed material, as well as needs or motivations that are out of awareness and control. Considered as one of the primary concepts to understand Human behavior. It cannot be normally studied under ordinary means, but it can mostly be inferred from a person’s behavior. From Freud’s work and clinical evidences, there are six concepts that are believed to be part of the unconscious

6 Things:1.Dreams – Symbolic representations of

Unconscious needs, wishes, and conflicts.2.Slips of the tongue and forgetting3.Post hypnotic suggestions4.Material derived from free-association5.Material derived from projective

techniques6.Symbolic content of psychotic symptoms

What does the Unconscious relate to Psychoanalytic Therapy? Internal psychological conflicts are not easily tackled as it is repressed deep within the bowels of the unconscious. Because of this, one of the main goals of the Psychoanalytic Therapy is to make the unconscious motives conscious, as this will be the only time where the individual can understand the role of the unconscious, as well as exercise choice. The unconscious is at the root of all forms of neurotic symptoms and behavior. The “cure” is based on how one uncovers the meaning of symptoms, causes of behavior and repressed materials that interfere with healthy functioning

AnxietyAlso known as the feeling of “Dread” that results from repressed feelings,

memories, desires, and experience that emerge to the surface of awareness.

Anxiety usually develops out of a conflict among the Id, Ego, and

Superego over control of the available psychic energy.

There are 3 kinds of Anxiety1.Reality Anxiety. Simply put- it is the fear of

danger from the external world

2.Neurotic Anxiety. The fear that the impulses may cause someone to do something where the person will be punished.

3.Moral Anxiety. The fear of one’s own conscience. If a person does something contrary to their moral code, they usually feel bad and guilt-ridden of what they have done

Ego Defense Mechanisms

For the individual to cope with anxiety and prevent the ego from being overwhelmed, self-defense mechanisms are used. These mechanisms that are employed depends on how well the individual is develop, and the level of anxiety. Defenses have 2 things in common: (1) They either deny or distort reality and (2) They operate on the preconscious/unconscious level.

Defense Mechanisms1.Repression – A process of removing

something from awareness and consciousness. Burying it deep within unconsciousness.

2.Denial – “Closing one’s eyes” to the existence of a threatening stimuli. It is where the individual “distorts” what the individual thinks, feels, or perceives in a traumatic situation.

3.Reaction Formation – Actively expressing the opposite impulse when confronted with a threatening impulse.

4.Projection - Attributing to others one’s own unacceptable desires and impulses.

Defense Mechanisms5. Displacement - Directing energy toward another object or person when the original object or person is inaccessible.

6. Rationalization - Manufacturing “good” reasons to explain away a bruised ego.

7. Sublimation - Diverting sexual or aggressive energy into other channels.

8. Regression - Going back to an earlier phase of development when there were fewer demands.

Defense Mechanisms 9. Introjection - Taking in and “swallowing” the values and standards of others. 10. Identification - Identifying with successful causes, organizations, or people in the hope that you will be perceived as worthwhile. 11. Compensation - Masking perceived weaknesses or developing certain positive traits to make up for limitations.

The Development of Personality: The Importance of Early Development

A significant contribution of the psychoanalytic model is delineation of the stages of psychosexual and psychosocial stages of development from birth through adulthood. This stage perspective provides the counselor with the conceptual tools for understanding key developmental tasks characteristic of the various stages of life.

The Psychosexual Stages of Development Freud had come up with three stages of development which deals with three areas of personal and social development—love and trust, dealing with negative feelings, and developing a positive acceptance of sexuality, and believed that all three are grounded within the first six years of life. When a child’s needs are not adequately met during these stages of development, an individual may become fixated at that stage and behave in psychologically immature ways later on in life.

The Psychosexual Stages of Development The Oral Stage which deals with the inability to trust oneself and others, resulting in the fear of loving and forming close relationships and low self-esteem

The Anal Stage which deals with the inability to recognize and express anger

The Phallic Stage which deals with the inability to fully accept one’s sexuality and sexual feelings, and also to difficulty in accepting oneself as a man or woman.

The Psychosocial Stages of Development Erik Erikson’s theory of development holds that psychosexual growth and psychosocial growth take place together, each stage of life we face the task of establishing equilibrium between ourselves and our social world. He describes development in terms of the entire life span, divided by specific crises to be resolved. According to Erikson, a crisis is equivalent to a turning point in life when we have the potential to move forward or to regress. At these turning points, we can either resolve our conflicts or fail to master the developmental task.

Counseling Implications When applied in psychotherapy, Freud’s Psychosexual Stages of development alone may cause difficulty to the client to actually recall repressed memories, more so on the person’s childhood, Erikson’s Psychosocial Stages can prove useful on later stages, but may require a more deeper approach to explain fixation and behaviors expressed by the unconscious, but by combining both theories can help counselors tackle both issues. While the theory gives implications on the client’s childhood and adolescent stages that can affect later development, counselors can also help the client realize that later development have their own crises as well. Two birds with one stone.

Part IIThe Therapeutic

Process

Overview Psychoanalytic therapy typically uses methods to bring unconscious material out in the open. It’s main focus is leaned toward the development of the individual in the earlier years, where experiences are discussed, reconstructed, interpreted, and analyzed. With the help of transference relationship with the therapist, both client and therapist explores the past of the client, which will then, lead to character change. The primary tools of the trade of the Psychoanalytic Therapy is the analytic framework, free association, interpretation, dream analysis, analysis of resistance, and analysis of transference.

Therapeutic Goals There are two basic goals when applying Psychoanalytic Therapy. These are: 1) To make unconscious motives conscious, and;

2) To strengthen the Ego to be more aligned with reality and lessen dependence on the instinctual cravings of the Id or the irrational guilt provided by the Superego.

The Therapist’s Function and Role

Therapists usually assume an anonymous kind of role, also known as the “Blank-Screen Approach”, where they limit self-disclosure that will then promote a ‘transference relationship’ with the client, where the client will pour projections, where, according to Luborsky, et.al (2008) “refers to the transfer of feelings originally experienced in an early relationship to other important people in a person’s present environment”.

In terms of functions, one of the central functions of the therapist is to assist the client acquire the freedom to love, work, and play, achieving self-awareness, honesty, dealing with anxiety realistically. In order to do this, the therapist must first create a working relationship and do the task of listening and interpreting.

The Therapist’s Function and Role

Particular attention is given to the client’s resistances. The analyst listens, learns, and decides when to make appropriate interpretations of the gathered unconscious material from the client through listening, and inferred reports from Free Association and other techniques.With the gathered unconscious material, it is then, the therapist’s role to properly organize the material to properly formulate the nature of the client’s problem, and then have it interpreted to them, so as to give proper insight, increase their awareness to change, and thus leading them to having better control’s over their lives.

Summary The process of psychoanalytic therapy is somewhat like putting the pieces of a puzzle together. Whether clients change depends considerably more on their readiness to change than on the accuracy of the therapist’s interpretations. If the therapist pushes the client too rapidly or offers ill-timed interpretations, therapy will not be effective. Change occurs through the process of reworking old patterns so that clients might become freer to act in new ways. (Luborsky et al., 2008).

The Client’s ExperienceIn the classical approach to Psychoanalysis, Clients must commit themselves to long and intensive psychotherapy. Face-to-Face sessions with the therapist will be the starting point in initiating a relationship with the client, and from there, clients will be then be instructed to lie down on a couch and actively engage Free Association, that is, to say your inward thoughts without censorship.Clients must also be in a commitment with the therapist and that they must stick with the procedures of the therapy.Clients are not recommended to make any ‘radical’ changes in lifestyle while undergoing therapy.

SummaryA successful analysis answers a client’s “why” questions regarding his or her life. Clients who emerge successfully from analytic therapy report that they have achieved such things as an understanding of their symptoms and the functions they serve, an insight into how their environment affects them and how they affect the environment, and reduced defensiveness (Saretsky, 1978).

The Relationship between the Client and Therapist

There can be two kinds of therapists that can be seen in a typical psychoanalytic therapy session: The Classic Analyst, and the Current Relational AnalystThe Classic Analyst mostly stands outside the relationship, sometimes gives comments, and provides interpretation to the client. The Current Relational Analyst is not ‘detached’ from clients, rather, they are more focused on the here-and-now interaction with the client, and they find it more useful in creating rapport and gathering background information from the client.

The Relationship between the Client and Therapist

Therapists and clients mostly hold a transference relationship. Transference, again, is the resurfacing of old experiences that were reactions from significant people from repressed memory and having them shifted to the therapist.Clients and therapists go through a working-through process, where they both tackle unconscious material and defenses.Therapists must be well aware of Countertransference where in the therapist’s own unconscious conflict comes out and projects them into the client. Not call countertransference feelings are bad, but other cases may seem beneficial to both client and therapist.

Summary The client–therapist relationship is of vital importance in psychoanalytic therapy. As a result of this relationship, particularly in working through the transference situation, clients acquire insights into the workings of their unconscious process. Awareness of and insights into repressed material are the bases of the analytic growth process. Clients come to understand the association between their past experiences and their current behavior. The psychoanalytic approach assumes that without this dynamic self-understanding there can be no substantial personality change or resolution of present conflicts.

The Therapeutic ProcessApplication:

Therapeutic Techniques and Procedures

Overview The techniques of psychoanalytic therapy are aimed at increasing awareness, providing insight to the client’s behavior, and understanding the meanings of symptoms. The therapy proceeds from the client’s talk to catharsis (or expression of emotion) to insight to working through unconscious material. This work is done to attain the goals of intellectual and emotional understanding and reeducation, which then leads to personality change.

Psychoanalysis - Psychodynamics

As opposed from the classic Psychoanalysis, psychoanalytically oriented therapists mostly adapt with the Psychodynamic therapy which includes these features:

• The therapy is geared more to limited objectives than to restructuring one’s personality.

• The therapist is less likely to use the couch.

• There are fewer sessions each week.

• There is more frequent use of supportive interventions—such as reassurance, expressions of empathy and support, and suggestions—and more self-disclosure by the therapist.

• The focus is more on pressing practical concerns than on working with fantasy material.

Maintaining the Analytic Framework

Like a systematic process on how students follow their class schedules, Analysts must keep in mind in maintaining the framework as it will provide proper guidance and a planned course for achieving the goals of the therapy. The framework includes a wide variety of procedures and styles on clients, ranging from the amount of disclosure and anonymity of the therapist to the consistency of meetings, etc.

Free Association A central technique used in psychoanalysis. This is where the client, without censorship, will be encouraged to say whatever is on their mind. The therapist will sit by and listen well on what the client says, listening for significant resistances which may mean that there are anxiety-arousing material or surfaced unconscious material which will lead to discovering the ‘root’ problem.

Interpretation A technique where therapists use to explain, point out, and even teach the meaning of gathered unconscious material, free association themes, manifests of dreams, and even the relationship of the client and therapists. Interpretation is the main line of communication for the clients to understand their unconscious and help their ego assimilate the material to help them further progress into uncovering more unconscious material.

Dream Analysis Freud describes dreams as “The Royal Road To Unconsciousness”. While asleep, the person’s defenses are lowered, and repressed feelings and emotions arise in dreams. Material in dreams may show a person’s unconscious needs, wishes and fears. Clients are asked to ‘describe’ the Manifest Content of their dreams, and then through Free Association, the therapist then helps and finds the client’s associations with the manifest content to uncover the latent content.

Analysis and Interpretation of Resistance

This technique identifies the client’s restriction, refusal, and reluctance to bring surface of awareness any unconscious material that is repressed. Resistance of any kind coming from Free Association gets into the way of the progress, and through interpretation, the therapist should make it clear to the client that he/she is to unbar any restrictions, as he/she has to confront the problem in reality than keeping it repressed.

Analysis and Interpretation of Transference

Being one of the major cornerstones in Psychoanalytic therapy, it is important that the therapist analyze and properly interpret the transference relationship they hold. This holds one of the crucial solutions for the client to understand what exactly made them fixated and deep-rooted on such anxiety. Transference, again, is where the client will re-experience the emotions felt back at the repressed experience, and will put the therapist as the person who would be there experiencing and reacting to the client’s re-enactment.

The Therapeutic ProcessLast Leg: The Modern

Psychoanalytic Therapy, Limits and Critiques on the

Therapy

The Modern Psychoanalytic Therapy

With the world changing in an ever-rapid pace, people with psychological problems also trend in areas such as separation and individuation, intimacy, dependence versus independence, and identity have cause many present-day therapists to make alterations to the psychoanalytic approach and are more on the development of the ego, are paying attention to the social and cultural factors that influence the differentiation of an individual from others, and are giving new meaning to the relational dimensions of therapy.

Marmor (1997), a therapist, demonstrates an openness toward integrating various methods: “I try to avoid putting every patient on a Procrustean bed of a singular therapeutic method but rather adapt my approach to the patient’s own unique needs”

The Modern Psychoanalytic Therapy

Although contemporary psychodynamic forms diverge considerably in many respects from the original Freudian emphasis on drives, the basic Freudian concepts of unconscious motivation, the influence of early development, transference, countertransference, and resistance are still central to the newer modifications. These concepts are of major importance in therapy and can be incorporated into therapeutic practices based on various theoretical approaches.

The Limitations and Critique of the Psychoanalytic

TherapyIn general, considering factors such as time, expense, and availability of trained psychoanalytic therapists, the practical applications of many psychoanalytic techniques are limitedCommitments to such therapy takes a long time to accomplish an analytic goal.The anonymous role of the Therapist while applying therapy.Clashes and issues with feminist psychologyPsychoanalysis and it’s therapy is now recently criticized over it’s irrelevance to contemporary culture.

Thanks for listening!