PSYCHOANALYSIS

• Neurological training and expertise

• Scientific thinking of his era

• Fundamental theoretical frame of reference

• Essential for understanding the significant segment of current psychiatric

FREUD thinking
AND HIS THEORY OF PERSONALITY
Diosdado V. Amargo, Jr. MD, MMBM, FPPA • Evolution into a diverse emphases and viewpoints
Faculty, Department of Psychiatry
EVOLUTION OF THE FREUDIAN
FREUD’S THEORY IS COMPLEX
THOUGHT
• Constant modification
Drive
Theory
• No comprehensive summary of final view
Structural
Ego
Theory Object Relations • Multifaceted
Psychology
Theory
• Theory of motivation

• Theory of thinking (dreams, etc)

Self
• Theory of Personality ( Psychosexual Theory)
Psychology

Relational • Theory of mental structures ( faculties of the mind)

Inter subjectivism
Approach
• Theory of psychopathology and symptom formation

• Theory of psychotherapy
 TWO FUNDAMENTAL HYPOTHESES THREE CRUCIAL ASPECTS

1. The Principle of Psychic Determinism

• Therapeutic Technique
• nothing happens by chance
• Body of Scientific and Theoretical Knowledge
2. The Unconscious
• Method of Investigation
• Conscious rationality is the exception rather than rule in psychic
processes
 LIFE OF FREUD
• Born in Freiburg, Moravia (Czech
Republic)
• Family moved to Vienna when he was 4
• Specialized in neurology and studied for
a year in Paris with Jean-Martin
Charcot.
• Studied hypnosis
• Clinical work with hysterical patients
THE CASE OF ANNA O
• Bertha Pappenheim
• Intelligent and strong-minded young
woman
• Paralysis of the limbs, contractures,
anesthesias, visual and speech
disturbances, anorexia, and a distressing
nervous cough.
• “Talking cure” /“Chimney sweeping”
 THE INTERPRETATION OF DREAMS THE INTERPRETATION OF DREAMS
• 1900

• conscious expression of unconscious fantasies or wishes

• Two Layers of Dream Content
• “Censor”
• Manifest = recalled
• working in the service of the ego
• Latent = threatens to awaken the dreamer
• Self-preservative objectives of the ego

• Symbolization
 THE INTERPRETATION OF DREAMS SECONDARY REVISION
Primary Process Thinking Secondary Process Thinking
• Dreamwork
• towards immediate gratification
• amoral
• Condensation/Irradiation • non-temporal • Rational
• non-causal • Moral
• concrete • Logical
• visual
• Cause and Effect
• Displacement •
•
absence of negatives, conditionals or other qualifiers
opposites and contradictions may coexist • Temporal
• representation by allusion, analogy or object parts • Abstract
(pars pro toto) • Ability to delay gratification
• Symbolic Representation • Displacement
• Condensation • Verbal
• Symbolic
 THE INTERPRETATION OF DREAMS THE TOPOGRAPHICAL MODEL OF THE MIND

• Affects in Dreams

• Secondary Emotions

• Anxiety in Dreams = failure in protective function

• Punishment Dreams
 LIMITATIONS
DRIVE THEORY
OF THE TOPOGRAPHICAL MODEL
• Instinct = genetically derived and
independent of learning
• Defense mechanisms that guard against distressing wishes, feelings, or
• 4 Characteristics
thoughts were themselves not initially accessible to consciousness.
• Source

• Freud’s patients frequently demonstrated an unconscious need for • Impetus

punishment. • Aim

• Object
 INSTINCT PLEASURE & REALITY PRINCIPLES

• Libido • Recasting of the Primary and Secondary Process Thinking

• Ego Instinct
• Pleasure Principle = inborn tendency of the organism to avoid pain
• Dual Instinct Theory (Eros and and to seek pleasure through the discharge of tension.
Thanatos)
• Sexual = Narcissistic Investment • Reality principle = modifies the pleasure principle and requires delay
• Self-Preservation or postponement of immediate gratification.
 INFANTILE SEXUALITY SHIFTING OF THE LIBIDINAL ZONES
• Infants are capable of erotic activity
from birth
• Sexuality to include forms of pleasure that transcend genital sexuality
• Earliest manifestations of infantile
sexuality are basically nonsexual and are
• Childhood sexuality that delineated the vicissitudes of erotic activity associated with such bodily functions as
from birth through puberty. feeding and bowel–bladder control.

• As libidinal energy shifts on each stage

• Conceptual linkage between neuroses and perversions of development to build on and to
subsume the accomplishments of the
preceding stage.
THE PSYCHO SEXUAL STAGES
Oral Stage
ORAL PHASE
•

• Anal Stage

• Phallic Stage

• Urethral Stage

• Latency

• Genital Stage
 DEFINITION DESCRIPTION
• ~first 18 months

• Thirst, hunger, pleasurable tactile stimulations evoked by the nipple or

• Earliest stage of development
its substitute, sensations related to swallowing, and satiation.
• needs, perceptions, and modes of expression centered in the mouth,
• Oral drives consist of two separate components: libidinal and aggressive.
lips, tongue, and other organs related to the oral zone
• States of oral tension lead to a seeking for oral gratification, typified by
quiescence at the end of nursing.
 DESCRIPTION OBJECTIVES
• Triad - wish to eat, to sleep, and to reach that relaxation that occurs at the end of
sucking just before the onset of sleep.
• To establish a trusting dependence on nursing and sustaining objects
• Libidinal needs (oral erotism) are thought to predominate in the early parts of the
oral phase, whereas they are mixed with more aggressive components later (oral • To establish comfortable expression and gratification of oral libidinal
sadism).
needs without excessive conflict or ambivalence from oral sadistic
• Oral aggression may express itself in biting, chewing, spitting, or crying. Oral wishes.
aggression is connected with primitive wishes and fantasies of biting, devouring, and
destroying.
 PATHOLOGICAL TRAITS CHARACTER TRAITS
• excessive optimism, narcissism, pessimism (often seen in depressive
states), and demandingness.
• Capacities to give to and receive from others without excessive
• Dependency dependence or envy
• require others to give to them and to look after them
• maintenance of their self-esteem
• Capacity to rely on others with a sense of trust, as well as with a
• may be exceptionally giving to elicit a return sense of self-reliance and self-trust.

• Envy and jealousy

 DEFINITION

ANAL PHASE
• Prompted by maturation of neuromuscular control over sphincters,
particularly the anal sphincters, thus permitting more voluntary
control over retention or expulsion of feces.
 DESCRIPTION DESCRIPTION
• ~1 to 3 years of age

• Recognizable intensification of aggressive drives mixed with libidinal components and in sadistic
• Anal erotism - the sexual pleasure in anal functioning,
impulses. • retaining the precious feces
• presenting them as a precious gift to the parent
• Acquisition of voluntary sphincter control is associated with an increasing shift from passivity to
activity.
• Anal sadism - expression of aggressive wishes
• The conflicts over anal control and the struggle with the parent over retaining or expelling feces
• discharging feces as powerful and destructive weapons
in toilet training
• increased ambivalence,
• children's fantasies as bombing and explosions.
• struggle over separation, individuation, and independence.
 OBJECTIVES
• Period of striving for independence and separation from the
dependence on and control by the parent.
• The objectives of sphincter control without overcontrol (fecal
retention) or loss of control (messing) are matched by the child's
attempts to achieve autonomy and independence without excessive
shame or self-doubt from loss of control.
PATHOLOGICAL TRAITS
• Maladaptive character traits are derived from anal erotism and the
defenses against it.
• Orderliness, obstinacy, stubbornness, willfulness, frugality, and parsimony
• When defenses against anal traits are less effective,
• heightened ambivalence, lack of tidiness, messiness, defiance, rage, and sadomasochistic tendencies.
• Anal characteristics and defenses are most typically seen in obsessive-
compulsive neuroses.
 CHARACTER TRAITS
• Development of personal autonomy URETHRAL PHASE
• Capacity for independence and personal initiative without guilt

• Capacity for self-determining behavior without a sense of shame or

self-doubt, a lack of ambivalence and a capacity for willing
cooperation without either excessive willfulness or sense of self-
diminution or defeat.
 DEFINITION
• Not explicitly treated by Freud but is envisioned as a transitional
stage between the anal and the phallic stages of development.
• It shares some of the characteristics of the preceding anal stage and
some from the subsequent phallic stage
DESCRIPTION
• The characteristics often subsumed under those of the phallic stage.
• Urethral erotism = refer to the pleasure in urination or retention analogous to anal
retention.
• Issues of performance and control are related to urethral functioning.
• May be invested with a sadistic quality, often reflecting the persistence of anal sadistic urges.
• Loss of urethral control (enuresis) may frequently have regressive significance that
reactivates anal conflicts.
 OBJECTIVES PATHOLOGICAL TRAITS

• Competitiveness and ambition, probably related to the compensation

• Issues of control and urethral performance and loss of control. for shame due to loss of urethral control.

• It is not clear whether or to what extent the objectives of urethral • May be the start for the development of penis envy, related to the
functioning differ from those of the anal period. feminine sense of shame and inadequacy in being unable to match
the male urethral performance. .
 CHARACTER TRAITS
• Urethral competence provides a sense of pride and self-competence PHALLIC PHASE
derived from performance.

• Urethral performance is an area in which the small boy can imitate

and match his father's more adult performance.

• The resolution of urethral conflicts sets the stage for budding gender
identity and subsequent identifications.
 DEFINITION DESCRIPTION
• Primary focus of sexual interests, stimulation, and excitement in the genital area.

• Penis becomes the organ of principal interest to children of both sexes

• Sometime during the third year of life and continues until • Lack of a penis in the female being considered evidence of castration.
approximately the end of the fifth year.
• Increase in genital masturbation accompanied by predominantly unconscious
fantasies of sexual involvement with the opposite-sex parent.

• Castration anxiety arise with guilt over masturbation and oedipal wishes.
 OBJECTIVES
• Erotic interest in the genital area and genital functions
• Lays the foundation for gender identity and serves to integrate the
residues of previous stages of psychosexual development into a
predominantly genital-sexual orientation.
• The establishing of the oedipal situation is essential for the furtherance of
subsequent identifications that will serve as the basis for important and
enduring dimensions of character organization.
OEDIPUS COMPLEX
• Oedipus Complex in which the boy wishes to possess his mother
sexually and perceives his father to be a rival in love.
• Child must give up his sexual attraction for his mother in order to
resolve this attraction and move to the next stage of psychosexual
development.
• Electra Complex
 PATHOLOGICAL TRAITS
• The derivation of pathological traits from the phallic-oedipal involvement is
sufficiently complex and subject to such a variety of modifications that it
encompasses nearly the whole of neurotic development.
• The issues, however, focus on castration in males and on penis envy in females.
• The other important focus of developmental distortions in this period derives
from the patterns of identification that are developed out of the resolution of
the oedipal complex.
PATHOLOGICAL TRAITS
• The influence of castration anxiety and penis envy, the defenses against
both, and the patterns of identification that emerge from the phallic
phase are the primary determinants of the development of human
character.
• They also subsume and integrate the residues of previous psychosexual
stages, so that fixations or conflicts that derive from any of the
preceding stages can contaminate and modify the oedipal resolution.
 CHARACTER TRAITS
• Foundations for
• an emerging sense of sexual identity, LATENCY PHASE
• a sense of curiosity without embarrassment,
• initiative without guilt
• a sense of mastery not only over objects and persons in the environment but also over internal processes and impulses

• The resolution of the oedipal conflict at the end of the phallic period gives
rise to powerful internal resources for regulation of drive impulses and their
direction to constructive ends.
• This internal source of regulation is the superego, and it is based on
identifications derived primarily from parental figures.
 DEFINITION DESCRIPTION
• Superego allow considerably greater control of instinctual impulses.

• Sexual interests are quiet.

• Relative quiescence or inactivity of the sexual drive during the period
• Period of primarily homosexual affiliations for both boys and girls
from the resolution of the Oedipus complex until pubescence
• Sublimation of libidinal and aggressive energies into energetic learning and play activities,
• ~5 - 6 years until ~11 - 13 years exploring the environment, and becoming more proficient in dealing with the world of
things and persons around them.

• Period for the development of important skills

 OBJECTIVES PATHOLOGICAL TRAITS
• Further integration of oedipal identifications and a consolidation of sex- • The danger in the latency period can arise from either a lack of
role identity and sex roles. development of inner controls or an excess of them.

• The relative quiescence and control of instinctual impulses allow for the • lack of control can lead to a failure of the child to sufficiently sublimate
development of ego apparatuses and mastery skills. energies in the interests of learning and development of skills;

• Further identificatory components may be added to the oedipal ones on • an excess of inner control, however, can lead to premature closure of
the basis of broadening contacts with other significant figures outside the personality development and the precocious elaboration of obsessive
family, such as teachers, coaches, and other adults. character traits.
 CHARACTER TRAITS
Important consolidations and additions are made to the basic postoedipal identifications.
GENITAL PHASE
•

• It is a period of integrating and consolidating previous attainments in psychosexual

development and establishing decisive patterns of adaptive functioning.

• The child can develop a sense of industry and a capacity for mastery of objects and
concepts that allows autonomous function with a sense of initiative without running the
risk of failure or defeat or a sense of inferiority.

• These important attainments need to be further integrated, ultimately as the essential

basis for a mature adult life of satisfaction in work and love.
 DEFINITION DESCRIPTION
• The physiological maturation of systems of genital (sexual)
• Onset of puberty from ages 11 - 13 until the person reaches young functioning and attendant hormonal systems leads to an
adulthood. intensification of drives, particularly libidinal drives.

• In current thinking, there is a tendency to subdivide this stage into • This produces a regression in personality organization, which reopens
preadolescent, early adolescent, middle adolescent, late adolescent, conflicts of previous stages of psychosexual development and
and even postadolescent periods. provides the opportunity for a re-resolution of these conflicts in the
context of achieving a mature sexual and adult identity.
 OBJECTIVES
• Ultimate separation from dependence on and attachment to the
parents and the establishment of mature, non-incestuous object
relations.
• Related to this are the achievement of a mature sense of personal
identity and acceptance and the integration of a set of adult roles and
functions that permit new adaptive integrations with social
expectations and cultural values.
PATHOLOGICAL TRAITS
• Defects can arise from the whole spectrum of psychosexual residues, since the
developmental task of the adolescent period is in a sense a partial reopening and
reworking and reintegrating of all those aspects of development.
• Previous unsuccessful resolutions and fixations in various phases or aspects of
psychosexual development will produce pathological defects in the emerging adult
personality.
• A more specific defect from a failure to resolve adolescent issues has been
described by Erikson as identity diffusion.
 CHARACTER TRAITS THE STRUCTURAL MODEL OF THE MIND
• Sets the stage normally for a fully mature personality with a capacity
for full and satisfying genital potency and a self-integrated and
consistent sense of identity.

• Such a person has reached a satisfying capacity for self-realization and

meaningful participation in the areas of work and love and in the
creative and productive application to satisfying and meaningful goals
and values.
THE STRUCTURAL MODEL ID

• reservoir of unorganized instinctual drives.

• primary process,

• lacks the capacity to delay or modify the instinctual drives

• should not be viewed as synonymous with the unconscious, because

both the ego and the superego have unconscious components.
 EGO
• Spans the conscious, preconscious, and unconscious.
• Logical and abstract thinking and verbal expression are associated
with conscious and preconscious functions of the ego.
• The executive organ of the psyche, controls motility, perception,
contact with reality, and, through the defense mechanisms available to
it, the delay and modulation of drive expression.
SUPER EGO
• Establishes and maintains an individual’s moral conscience on the basis
of a complex system of ideals and values internalized from parents.
• Ego ideal - prescribes what a person should do according to
internalized standards and values.
• Moral conscience - proscribes—that is, dictates what a person should
not do.
 FUNCTIONS OF THE EGO
• Control and Regulations of Instinctual Drives

• Judgment

• Relation to Reality

• Object Relations

• Synthetic Functions of the Ego

• Primary Autonomous Functions

• Secondary Autonomous Functions

 DEFENSE MECHANISM NARCISSISTIC-PSYCHOTIC DEFENSES
• Specific drive components evoke characteristic ego defenses.

• Grouped hierarchically according to the relative degree of maturity • Projection

associated with them.
• Denial
• Narcissistic defenses are the most primitive
• Distortion
• Neurotic defenses are encountered in obsessive-compulsive and
hysterical patients a
 IMMATURE DEFENSES NEUROTIC DEFENSES
• Intellectualization
• Passive-Aggressive Behavior • Controlling
• Acting Out • Isolation
• Projection • Displacement
• Blocking • Reaction Formation
• Regression • Dissociation
• Hypochondriasis • Rationalization
• Schizoid Fantasy • Externalization
• Introjection • Repression
• Somatization • Inhibition
• Sensualization
 MATURE DEFENSES TREATMENTS
• Freud
embraced many types of therapy. Some of his most
important:
• Altruism
• Relaxed Atmosphere: Therapy can give patients a place
• Anticipation where they feel free to express themselves.

• Free Association: The clients can talk about anything they

• Asceticism
want. This is another way to make the patient feel relaxed.
• Humor • Dream Analysis: When sleeping the patient is more
susceptible to unconscious thoughts, which the therapist
• Sublimation can interpret and find meanings.

• Parapraxes: A “Freudian
• Suppression Slip”, or slip of the tongue, which
Freud thought were clues to unconscious conflicts.