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Psychoanalytic Theory and Therapy
Transcript of Psychoanalytic Theory and Therapy
the Life Instincts Thantos, the Death Instincts three levels of consciousness: the conscious, the preconscious, and the unconscious Levels of Consciousness unconscious expressions include dreams, slip of tongue and forgetting humor and jokes were an expression of disguised wishes and conflicts Attending to unconscious material was crucial for Freud and is central for all psychoanalysts. Structures of Personality three basic systems that are contained within the structure of personality: the id, the ego, and the superego. Defense Mechanisms strategies the ego employs to prevent the energy of an unfulfilled desire from disrupting its plans Psychosexual Stages of Development the development of personality and the formation of the id, ego, and superego, as well as ego defense mechanisms, depend on the course of psychosexual development in the first 5 years of life Psychoanalytical Approach to Therapy In a Nutshell: Psychoanalytic Therapies stress the value of bringing out what is in the unconscious. Therapeutic Goals As a result of Psychoanalysis, the patient should: become more adept at resolving unconscious conflicts within themselves,
know themselves better and feel more authentic or real,
have improved relationships with family, friends, and coworkers, and
be able to distinguish their own view of reality from real events that have taken place Assessment In Psychoanalysis, assessment is done through:
understanding the family and social history of the client.
projectives such as Rorschach and the Blacky Test
Working Alliance Inventory Free Association The use of free association assumes that unconscious material affects behavior and that it can be brought into meaningful awareness by free expression.
Interpretations can be made from the following:
slips of tongue
difficulty in free -associating Neutrality and Empathy The analyst wants the patient to be able to free-associate to materials that are affected as little as possible by aspects of the analyst that are extraneous to the patient. Resistance patients may resist the analytical process, usually unconsciously, by a number of different means: being late for appointments, forgetting appointments, or losing interest in therapy.
It is the patient’s interpretation of the therapist’s behavior, based on the patient’s early attachment to primary caregivers. Transference Resistance a means of managing the relationship with the therapist so that a wished or feared interaction with the analyst can take place [Patient:] I sensed you were angry with me last time because I didn’t give you what you wanted about the feelings in my dream. I could tell by your voice.
[Therapist:] (Very sure this was a misperception) I don’t know what my voice was like, but what is important is how you interpreted what you perceived.
[Patient:] I was aware of trying to please you, so I tried harder.
[Therapist:] I wonder if these concerns have shaped how you’ve been with me all along.
[Patient:] Sure. I don’t know what to do in this room. I look for messages. Interpretations material that arises from free association, dreams, slips of the tongue, symptoms, or transference must be interpreted to the patient Depending on the content, interpretations may vary from:
sexually repressed material,
unconscious ways the individual is defending against repressed memories of traumatic or disturbing situations
or early childhood disturbances relating to unsatisfactory parenting. Analysts need to attend not only to the content of the interpretation but also to the process of conveying it to the patient Interpretation of Dreams Freud believes that dreams are: “the royal road to a knowledge of the unconscious activities of the mind” some motivations or memories are so unacceptable to the ego that they are expressed in symbolic forms, often in dreams Transference
and Countertransference The relationship between patient and analyst is a crucial aspect of psychoanalytic treatment. Patients work through their early relationships, particularly with parents, by responding to the analyst as they may have with a parent. Three perspectives in countertransference the irrational or neurotic reactions of therapists toward the patient
the therapist’s entire feelings toward the patient, conscious or unconscious
counterpart of the patient’s transference Brief Psychoanalytic Therapy most current short-term psychoanalytic psychotherapies are designed for people who are neurotic, motivated, and focused rather than for those with severe personality disorders BPTherapists ask questions, to restate, to confront, and to deal quickly with transference issues. Three Relationship Episodes in BPT The Wish
Response from the Other
Response from the Self Example of BPT [Patient:] So Beth and I were discussing who should make the presentations. I said that she should.
[Patient:] She had more experience. [Therapist:] So?
[Patient:] She would stand a better chance of getting it through. [Therapist:] If she did the presenting? [Patient:] Yeah. Others would be taken by the way she presents.
[Therapist:] And, if you presented?
[Patient:] What do you mean?
[Therapist:] If you presented, how might others respond (Exploring the Response from the Other)? [Patient:] I don’t think I would do such a good job. [Therapist:] In their eyes?
[Patient:] Yeah. I figure they would think … it was stupid. [Therapist:] Do you see what you are saying?
[Patient:] What? (Perplexed.)
[Therapist:] Isn’t this exactly what we have been talking about? Isn’t it another example of your fear that if you put your best foot forward, that if you attempt to promote yourself and your ideas (her Wish), others will see you and your ideas as stupid and worthless (Response from the Other)? [Patient:] Aha! So I shut up (Response from the Self)? Oh, my goodness. There it is again! I didn’t even realize it!
[Therapist:] Yes. It is interesting how you rule yourself in this way without even realizing it and short change yourself in the process Using Psychoanalysis with Other Theories Psychoanalysis can be helpful in understanding your client
it is a good complement to behavioral, cognitive, person-centered techniques
blending cognitive therapy and psychoanalysis is an increasing trend
the closer the approach to psychoanalysis, where the couch is used, the less likely are psychoanalytic practitioners to use techniques from other theories