Psychoanalytic Therapy

1. View of Human Nature

DETERMINISTIC: behavior determined by irrational forces, unconscious motivations, and
biological and instinctual drives.
LIBIDO: sexual energy. This is a source of motivation that goes beyond sexual energy. He later
broadened it to include the energy of all the life instincts (or Eros) which includes all pleasurable
acts. These instincts serve the purpose of the survival of the individual and the human race; they
are oriented toward growth, development, and creativity. He sees the goal of life as gaining
pleasure and avoiding pain.
Death Instincts (Thanatos): aggressive drive – an unconscious wish to die or to hurt themselves
or others.
Eros – procreation, social cooperation, survival
Thanatos – aggression, risky behavior, reliving trauma
2. Structure of Personality
Id – present at birth; ruled by the pleasure principle.
Ego – has contact with reality; reality principle.
Superego – judicial branch of personality; ideal rather than real; strives not for pleasure but for
perfection.
3. Provinces of the Mind
Conscious – a thin slice of the total mind; the larger part of the mind exists below this.
Preconscious – materials not readily in the conscious but can easily be brought out to
consciousness with recall.
Unconscious – stores all experiences, memories, and repressed material; inaccessible needs and
motivations.
Conflict among these three causes anxiety.
4. Anxiety – a feeling of dread that results from repressed feelings, memories, desires, and
experience that emerge to the unconscious. This functions as a warning of impending danger
which then motivates us to do something or our behavior.
Reality Anxiety – fear of danger from external world; level of anxiety is proportionate to the
degree of real threat; the threat is real or present.
Neurotic Anxiety – fear that instincts will get out of hand and cause one to do something for
which one will be punished; fear of punishment.
Moral Anxiety – fear of one’s own conscience.
When the ego cannot control anxiety, it relies on ego-defense behavior.
5. Ego Defense Mechanisms – enables us to not be overwhelmed by, deal with and cope from
anxiety. These can be pathological when it becomes one’s style of life or one is being ruled by
them. They either deny or distort reality, and operate on the unconscious level.
 Repression – threatening or painful thoughts and feelings that are unconsciously
excluded from awareness. Example: A teacher who smokes a pack of cigarette a day
forgets to include nicotine as an addictive substance in his lecture on drug dependence.
  Displacement – directing energy toward another object or person when the original
object or person is inaccessible. Example: Diego got turned down by a lady she asked
out for a date. When he went home, he yelled at his younger brother.
 Projection – attributing to others one’s own unacceptable desires and impulses.
Example: Maria, who hates math class, believes that her math teacher is being unjust to
her.
 Reaction formation – actively expressing the opposite impulse when confronted with
threatening impulse. Example: Shan hates his boss. He talks about a lot of bad things
about her when he is with friends. But when he’s at the office, he treats his boss really
well.
 Sublimation – engaging in work or other activities to distract attention from unpleasant
events or circumstances. Example: Diana failed her midterm exams. She spent the
weekend gardening.
 Regression – acting younger than your age when you’re faced with stress. Example: It’s
the first day of school in Grade 1 for James. He cried so hard and he didn’t want his
mother to leave.
 Rationalization – excuses or rational explanations to justify one’s behavior. Example:
Mina didn’t pass the exam cause it was way more difficult than other years.
 Undoing – the action of “reaction formation”. Acting out the reverse of the
unacceptable behavior. Example: Pyromaniac (one who has an obsessive desire to set
fire to things) putting down fire.
 Denial – avoid becoming aware of painful reality. Example: Eric, a smoker, refuses to
admit that smoking is bad for his health.
 Suppression – conscious forgetting (the only conscious mechanism). Example: Tzuyu
would rather forget that her dog was ran over by a car.
 Day dreaming – the channeling of unacceptable or unattainable desires into
imagination; gratifying frustrated desires by imaginary achievements. Example: Sam
who couldn’t sing imagines herself having a concert and singing in front of thousands of
people.
 Introjection – one internalizes the ideas or voices of other people. Example: A dad telling
his son “boys don’t cry”.
 Identification – modelling of one’s self upon another person’s character and behavior.
Example: An adolescent manifest her behavior similar to her idolized person over time
though she is unaware that her behavior is similar to her idol.
 Compensation – overachieving in one area to compensate for failures in another.
Example: Sana’s siblings are very athletic and she’s not. So she compensates for this lack
by studying hard to become first in her class.
6. Development of Personality

The Therapeutic Process:

1. Therapeutic Goals
 The ultimate goal of the psychoanalytic therapy is to
 increase adaptive functioning – reduction of symptoms and resolution of conflicts.
 make the unconscious conscious and to strengthen the ego – because behaviors are
largely determined by our unconscious processes and because the ego is ruled by the
reality principle and our behavior should be more based here, and not on instinctual
cravings of the id or the irrational guilt caused by our superego.
 achieve insight – insight does not only refer to intellectual understanding of what’s
happening in the person, but it also refers to experiencing feelings and memories
associated with self understanding.
2. Therapist’s Functions and Roles
 Establish relationship with the client
 Listen
 Interpret
 “Blank-screen” Approach – means that analysts typically assume an anonymous stance.
They engage in very little self-disclosure and maintain a sense of neutrality to foster a
transference relationship, in which clients will make projections onto them.
o Transference Relationship – the cornerstone of psychoanalysis. It is the transfer
of feelings originally experienced in an early relationship to other important
people in a person’s present environment.
 To help client acquire freedom to love, work, and play.
 Assisting the client in achieving self-awareness, honesty, ad more effective personal
relationships.
 Dealing with anxiety in realistic way.
 Gaining control over impulsive and irrational behavior.
3. Client’s Experience in Therapy
 Traditional (Classical) Psychoanalysis
o Extensive and long-term therapy process (months to years)
o Client lies on a couch and engage in free association
 Psychoanalytic Therapy
o Typically involves fewer sessions per week
o Sessions are face-to-face
o Therapists are supportive
4. Relationship between Therapists and Clients
 Classical Psychoanalysis
o The therapist stands outside the relationship – s/he remains anonymous
o Therapists are non-participating, detached, and has objective stance
 Contemporary Psychoanalytic Therapy
o Therapists consider relationship as a key factor in bringing about change
o Therapists are attuned to the nature of the therapeutic relationship
o Therapists focus on the here-and-now transference
Transference is the client’s unconscious shifting to the analyst of feelings and fantasies that are
reactions to significant others in the client’s past. It involves the unconscious repetition of the past in the
present.

If the therapy is to produce change, the transference relationship must be worked through. The
working-through process consists of repetitive and elaborate explorations of unconscious material and
defenses, most of which originated in early childhood.

From a traditional psychoanalytic perspective, countertransference is viewed as a phenomenon that

occurs when there is inappropriate affect, when therapists respond in irrational ways, or when they lose
their objectivity in a relationship because their own conflicts are triggered. In a broader perspective,
countertransference involves the therapist’s total emotional response to a client. In today’s
psychoanalytic practice, countertransference is manifested in the form of subtle nonverbal, tonal, and
attitudinal actions that inevitably affect clients, either consciously or unconsciously.

Countertransference is considered as the strongest source of data for the therapist to understand the
client but the therapist must do self-monitoring to make sure that s/he is not being subjective with
his/her relationship with the client.

5. Therapeutic Techniques and Procedures

 Maintaining the analytic framework refers to a whole range of procedural and stylistic factors,
such as the analyst’s relative anonymity, maintaining neutrality and objectivity, the regularity
and consistency of meetings, starting and ending sessions on time, clarity on fees, and basic
boundary issues such as avoidance of advice giving or imposition of therapist’s values.
 Free association – clients are encouraged to say whatever comes to mind, regardless of how
painful, silly, trivial, illogical, or irrelevant it may seem. Clients try to flow with any feelings or
thoughts by reporting them immediately without censorship. This is one of the basic tools used
to open the doors to unconscious wishes, fantasies, conflicts, and motivations.
 Central technique in psychoanalytic therapy; blockings or disruptions may be
experienced. This happens when the client stops talking in the middle of free
association or forgets something, and this indicates or signals that there is a
present anxiety that is provoking materials. Nothing the client says is taken at
face value. Areas that clients do not talk about are as significant as the areas
they do discuss. Now, the therapist must look into the hidden meaning of the
things that the client has been talking about which is called interpretation.
o Catharsis – release of intense feelings that have been blocked.
 Interpretation – consists of the analyst’s pointing out, explaining, and even teaching the client
the meanings of behavior that is manifested in dreams, free association, resistances, and the
therapeutic relationship itself. It functions to enable the ego to assimilate new material and to
speed up the process of uncovering further unconscious material.
 Dream analysis – according to Freud, dreams the “royal road to the unconscious” because it is
important for uncovering unconscious material and giving the client insight into some areas of
unresolved problems. During sleep, defenses are lowered and repressed feelings surface.
 o Latent content – consists of hidden, symbolic, and unconscious motives, wishes, and
fears. Because they are so painful and threatening, the unconscious sexual and
aggressive impulses that make up latent content are transformed into the more
acceptable manifest content.
o Manifest content – the dream as it appears to the dreamer.
 Dream work – the process by which the latent content of a dream is
transformed into the less threatening manifest content.
 Analysis and interpretation of resistance
o Resistance – it is the client’s reluctance to bring to the surface of awareness
unconscious material that has been repressed, which has to be pointed out and
addressed because that means anxiety is present in those materials.
 As a defense against anxiety, it operates in psychoanalytic therapy to work
against the progress of therapy and prevents the client from producing
previously unconscious material. Clients resist to protect themselves from
anxiety or fear of change.
 Resistance also refers to any idea, attitude, feeling, or action (conscious or
unconscious) that fosters the status quo and gets in the way of change. Freud
views resistance as an unconscious dynamic that people use to defend against
the intolerable anxiety and pain that would arise if they were to become aware
of their repressed impulses and feelings.
To deal with resistance, the therapist must create a safe climate that allows clients to
explore their defenses and resistance.
 Analysis and interpretation of transference
o The manifestations of the transference provide clients with the opportunity to
reexperience a variety of feelings that would otherwise be inaccessible.
o Interpreting transference is a route to explaining the client’s intrapsychic life. Through
this, clients can recognize how they are repeating the same dynamic patterns in their
relationships with the therapist, with significant figures from the past, and in present
relationships with significant others. Interpreting and working through of these current
expressions of early feelings, clients are able to become aware of and to gradually
change some of their long-standing patterns of behavior.
o Through this working relationship, clients express feelings, beliefs, and desires that they
have buried in their unconscious.

ASSIGNMENT!!!

IDENTIFY AT LEAST TWO STRENGTHS AND TWO WEAKNESSES OF THE PSYCHOANALYTIC THERAPY.

Strengths

The psychoanalytic approach provides practitioners with a conceptual framework for looking at behavior
and for understanding the origins and functions of symptoms.
It is useful in understanding resistances that take the form of canceling appointments, fleeing from
therapy prematurely, and refusing to look at oneself; understanding that unfinished business can be
worked through, so that clients can provide a new ending to some of the events that have restricted
them emotionally; understanding the value and role of transference; and understanding how the
overuse of ego defenses, both in the counseling relationship and in daily life, can keep clients from
functioning effectively.

Therapists in the developmental perspective are able to see continuity in life and to see certain
directions their clients have taken. This perspective gives a broader picture of an individual’s struggle,
and clients are able to discover some significant connections among the various life stages.

Psychoanalysis practitioners are generally psychiatrists, whose medical degree allows them to prescribe
medications.

Modern Psychoanalytic Approaches contribute to the understanding of how our current behavior in the
world is largely a repetition of patterns set during one of the early phases of development.

Weaknesses

The psychoanalytic approach ignores empirical research. In the eyes of the psychoanalytic practitioners,
the systematic, controlled observations that are required for empirical studies sacrifice the complexity
of what occurs in the therapeutic process.

Another limitation of the traditional psychoanalytic therapy is the long time commitment required to
accomplish analytic goals.

According to Luborsky, O’Reilly-Landry, and Arlow, psychoanalytic therapies are criticized for its
irrelevance to contemporary culture and it being appropriate only to an elite, highly educated clientele.