Beyond the pleasure principle. New introductory lectures on psychoanalysis. Strachey, Trans. New York: Norton, James, W. Principles of psychology. New York: Holt, CrossRef Google Scholar. Kant, I.
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Chicago: Open Court, Mill, J. A system of logic 8th ed. Thus he hypothesized that anxiety was a consequence of the repressed energy libido attached to sexuality; the repressed energy found expression in various symptoms that served as psychological defense mechanisms. Freud and his followers later extended the concept of anxiety to include feelings of fear, guilt, and shame consequent to fantasies of aggression and hostility and to fear of loneliness caused by separation from a person on whom the sufferer is dependent.
From these investigations he was led to a new conception of the structure of personality: the id , ego , and superego. The id is the unconscious reservoir of drives and impulses derived from the genetic background and concerned with the preservation and propagation of life. The ego, according to Freud, operates in conscious and preconscious levels of awareness. It is the portion of the personality concerned with the tasks of reality: perception , cognition , and executive actions. In the Freudian framework, conflicts among the three structures of the personality are repressed and lead to the arousal of anxiety.
The person is protected from experiencing anxiety directly by the development of defense mechanisms, which are learned through family and cultural influences.
On psychoanalysis | New Scientist
These mechanisms become pathological when they inhibit pursuit of the satisfactions of living in a society. The existence of these patterns of adaptation or mechanisms of defense are quantitatively but not qualitatively different in the psychotic and neurotic states. Early schisms over such issues as the basic role that Freud ascribed to biological instinctual processes caused onetime associates Carl Jung , Otto Rank , and Alfred Adler to establish their own psychological theories. Most later controversies, however, were over details of Freudian theory or technique and did not lead to a complete departure from the parent system.
At one time psychiatrists held a monopoly on psychoanalytic practice, but soon nonmedical therapists also were admitted. There are numerous modifications in technique under the heading of psychoanalysis due to the individualistic nature of personality in both analyst and patient. The most common problems treatable with psychoanalysis include: phobias , conversions , compulsions , obsessions , anxiety attacks , depressions , sexual dysfunctions , a wide variety of relationship problems such as dating and marital strife , and a wide variety of character problems for example, painful shyness, meanness, obnoxiousness, workaholism, hyperseductiveness, hyperemotionality, hyperfastidiousness.
The fact that many of such patients also demonstrate deficits above makes diagnosis and treatment selection difficult. Analytical organizations such as the IPA, APsaA and the European Federation for Psychoanalytic Psychotherapy have established procedures and models for the indication and practice of psychoanalytical therapy for trainees in analysis. The match between the analyst and the patient can be viewed as another contributing factor for the indication and contraindication for psychoanalytic treatment. The analyst decides whether the patient is suitable for psychoanalysis.
This decision made by the analyst, besides made on the usual indications and pathology, is also based to a certain degree by the "fit" between analyst and patient. A person's suitability for analysis at any particular time is based on their desire to know something about where their illness has come from.
Is Psychoanalysis Therapeutic Technique or Scientific Research?
Someone who is not suitable for analysis expresses no desire to know more about the root causes of their illness. An evaluation may include one or more other analysts' independent opinions and will include discussion of the patient's financial situation and insurances. The basic method of psychoanalysis is interpretation of the patient's unconscious conflicts that are interfering with current-day functioning — conflicts that are causing painful symptoms such as phobias, anxiety, depression, and compulsions.
Strachey stressed that figuring out ways the patient distorted perceptions about the analyst led to understanding what may have been forgotten also see Freud's paper "Repeating, Remembering, and Working Through". In particular, unconscious hostile feelings toward the analyst could be found in symbolic, negative reactions to what Robert Langs later called the "frame" of the therapy  — the setup that included times of the sessions, payment of fees, and necessity of talking. In patients who made mistakes, forgot, or showed other peculiarities regarding time, fees, and talking, the analyst can usually find various unconscious "resistances" to the flow of thoughts sometimes called free association.
When the patient reclines on a couch with the analyst out of view, the patient tends to remember more experiences, more resistance and transference, and is able to reorganize thoughts after the development of insight — through the interpretive work of the analyst. Although fantasy life can be understood through the examination of dreams , masturbation fantasies cf. Marcus, I. The analyst is interested in how the patient reacts to and avoids such fantasies cf. There is what is known among psychoanalysts as "classical technique", although Freud throughout his writings deviated from this considerably, depending on the problems of any given patient.
Classical technique was summarized by Allan Compton, MD, as comprising instructions telling the patient to try to say what's on their mind, including interferences ; exploration asking questions ; and clarification rephrasing and summarizing what the patient has been describing.
As well, the analyst can also use confrontation to bringing an aspect of functioning, usually a defense, to the patient's attention. The analyst then uses a variety of interpretation methods, such as dynamic interpretation explaining how being too nice guards against guilt, e. Analysts can also use reconstruction to estimate what may have happened in the past that created some current issue.
These techniques are primarily based on conflict theory see above. As object relations theory evolved, supplemented by the work of John Bowlby and Mary Ainsworth , techniques with patients who had more severe problems with basic trust Erikson , and a history of maternal deprivation see the works of Augusta Alpert led to new techniques with adults. These have sometimes been called interpersonal, intersubjective cf. Stolorow , relational, or corrective object relations techniques. These techniques include expressing an empathic attunement to the patient or warmth; exposing a bit of the analyst's personal life or attitudes to the patient; allowing the patient autonomy in the form of disagreement with the analyst cf.
Paul, Letters to Simon ; and explaining the motivations of others which the patient misperceives. Ego psychological concepts of deficit in functioning led to refinements in supportive therapy.
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These techniques are particularly applicable to psychotic and near-psychotic cf. These supportive therapy techniques include discussions of reality; encouragement to stay alive including hospitalization ; psychotropic medicines to relieve overwhelming depressive affect or overwhelming fantasies hallucinations and delusions ; and advice about the meanings of things to counter abstraction failures.
The notion of the "silent analyst" has been criticized. Actually, the analyst listens using Arlow's approach as set out in "The Genesis of Interpretation", using active intervention to interpret resistances, defenses creating pathology, and fantasies.
Silence is not a technique of psychoanalysis also see the studies and opinion papers of Owen Renik, MD. It refers to the analyst's position of not taking sides in the internal struggles of the patient. For example, if a patient feels guilty, the analyst might explore what the patient has been doing or thinking that causes the guilt, but not reassure the patient not to feel guilty. The analyst might also explore the identifications with parents and others that led to the guilt.
Interpersonal—relational psychoanalysts emphasize the notion that it is impossible to be neutral. Sullivan introduced the term "participant-observer" to indicate the analyst inevitably interacts with the analysand, and suggested the detailed inquiry as an alternative to interpretation. The detailed inquiry involves noting where the analysand is leaving out important elements of an account and noting when the story is obfuscated, and asking careful questions to open up the dialogue.
Although single-client sessions remain the norm, psychoanalytic theory has been used to develop other types of psychological treatment. Schilder, Samuel R. Slavson , Harry Stack Sullivan , and Wolfe. Child-centered counseling for parents was instituted early in analytic history by Freud, and was later further developed by Irwin Marcus, Edith Schulhofer, and Gilbert Kliman.
Psychoanalytically based couples therapy has been promulgated and explicated by Fred Sander, MD. Techniques and tools developed in the first decade of the 21st century have made psychoanalysis available to patients who were not treatable by earlier techniques. This meant that the analytic situation was modified so that it would be more suitable and more likely to be helpful for these patients. Eagle believes that psychoanalysis cannot be a self-contained discipline but instead must be open to influence from and integration with findings and theory from other disciplines.
Psychoanalytic constructs have been adapted for use with children with treatments such as play therapy , art therapy , and storytelling. Throughout her career, from the s through the s, Anna Freud adapted psychoanalysis for children through play. Using toys and games, children are able to demonstrate, symbolically, their fears, fantasies, and defenses; although not identical, this technique, in children, is analogous to the aim of free association in adults.
Psychoanalytic play therapy allows the child and analyst to understand children's conflicts, particularly defenses such as disobedience and withdrawal, that have been guarding against various unpleasant feelings and hostile wishes. In art therapy, the counselor may have a child draw a portrait and then tell a story about the portrait. The counselor watches for recurring themes—regardless of whether it is with art or toys.
Psychoanalysis can be adapted to different cultures , as long as the therapist or counselor understands the client's culture. For example, Tori and Blimes found that defense mechanisms were valid in a normative sample of 2, Thais. The use of certain defense mechanisms was related to cultural values. For example, Thais value calmness and collectiveness because of Buddhist beliefs , so they were low on regressive emotionality.
Psychoanalysis also applies because Freud used techniques that allowed him to get the subjective perceptions of his patients. He takes an objective approach by not facing his clients during his talk therapy sessions. He met with his patients wherever they were, such as when he used free association — where clients would say whatever came to mind without self-censorship. His treatments had little to no structure for most cultures, especially Asian cultures.