Psychoanalysis

Traditional psychoanalysis stresses the role of unconscious conflict stemming from early childhood relationships
and of psychological defenses against anxiety.
Theoretical Foundation
Freud described mental life as occurring partly at the level of conscious awareness; partly at a preconscious level,
which we can become aware of by shifting our attention; and partly at an unconscious level, which we cannot
experience without the use of special therapy techniques.

Freud’s Personality Theory and View of Psychopathology

Those forces are represented in Freud’s system as the id, ego, and superego.
The id is the part of the mind that generates all the pleasure-seeking, selfish, indulgent, animalistic
impulses.
In contrast, the superego is the part of the mind that establishes rules, restrictions, and prohibitions.
Essentially, the superego is an internalization of the rules and morals taught to each of us, and it
stands in direct opposition to the id (Kernberg, 2004; Moore & Fine, 1990; Skelton, 2006).

Defense Mechanisms
Defense mechanisms are essentially unconscious mental strategies or routines that the ego employs to ward off the
anxiety produced by intrapsychic conflict.
Mechanism Description
1. Denial - Simply refusing to recognize or acknowledge threatening experiences
2. Repression - Pushing anxiety provoking thoughts and memories out of consciousness and into the
unconscious; “motivated forgetting”
3. Regression - Retreating to coping strategies characteristic of earlier stages of development
4. Projection - Attributing one’s unacceptable motives and impulses to others
5. Reaction formation - Adopting thoughts and behaviors that are the opposite of those prompted by one’s
unacceptable, impulses.
6. Displacement - Directing pent-up impulses toward a safer substitute rather than the target that aroused the
feelings
7. Rationalization - Providing socially appropriate, but fundamentally untrue, explanations for one’s
unacceptable behavior
8. Intellectualization - Approaching upsetting experiences in an overly logical manner, without acceptance
of the emotional components
9. Compensation - Coping with feelings of inferiority in one area by working to become superior in another
area
10. Sublimation - Channeling the expression of unacceptable impulses into more socially acceptable activities

Transference
Transference refers to the tendency of clients to form relationships with therapists in which they unconsciously and
unrealistically expect the therapist to behave like important people from the clients’ pasts.
Clients are especially likely to replay their earlier emotional “scripts” in therapy. Psychoanalytic treatment is
designed to reveal, analyze, and ultimately change those scripts.
Of course, clients are not the only ones whose current relationships are colored by those of the past. Therapists are
affected by transference patterns, too.
Countertransference
Countertransference can impair the progress of therapy if the therapist begins to distort the therapeutic interaction
on the basis of his or her own conflicts and defenses. The inevitability of countertransference reactions is one
reason psychoanalytically oriented clinicians believe that therapists themselves should undergo psychoanalysis as
part of training. The more a therapist understands and has worked through his or her own conflicts, the less those
conflicts will interfere with the treatment of clients.

Psychic Determinism
In psychoanalysis, slips of the tongue and other unexpected verbal associations are presumed to be psychologically
meaningful, as are mental images, failures of memory, and a variety of other experiences.
Psychodynamic psychotherapists who witness a client’s slips of the tongue during a session or who hear clients’
stories of such events may be able to glimpse the clients’ underlying intentions.

Resistance
Sometimes, when certain issues come up during the course of therapy, clients make it clear that they “don’t want
to go there.”

Interpretation, Working Through, and Insight

By offering both emotional support and judicious interpretations, the therapist helps the client understand and work
through transference reactions and resistance. In so doing, the client develops a new understanding of his or her
problems, psychological makeup, and ways of relating to others. Interpretation involves the analyst suggesting
connections between patients’ current experiences and their historically based conflicts.

Goals of Psychoanalysis
The main goals of psychoanalytic treatment are:
(a) intellectual and emotional insight into the underlying causes of the client’s problems,
(b) working through or fully exploring the implications of those insights, and
(c) strengthening the ego’s control over the id and the superego.

Free Association
Is a technique in which psychodynamic psychotherapists simply ask clients to say whatever comes to mind
without censoring themselves at all. The client’s task is to verbalize any thought that occurs, no matter how
nonsensical, inappropriate, illogical, or unimportant it may seem.

The Role of the Therapist

During therapy sessions, traditional psychoanalysts maintain an “analytic incognito,” revealing little about
themselves during the course of psychotherapy.
Analysis of Everyday Behavior
 Psychoanalysts are as attentive to clients’ reports of activities outside of treatment as they are to what
happens during treatment sessions.

Analysis of Dreams
Freud theorized that when we sleep, our minds convert
Latent content (the raw thoughts and feelings of the unconscious) to manifest content (the actual plot of
the dream as we remember it).
Dream work, uses symbols to express wishes, which can result in unconscious wishes appearing in a very
distorted or disguised form.

Analysis of Transference
When the patient–therapist relationship creates a miniature version of the causes of the client’s problems, it is
called the transference neurosis and becomes the central focus of analytic work. Transference and transference
neuroses must be handled with care as analysts try to decode the meaning of their clients’ feelings toward them.

Making Analytic Interpretations

Analysts want clients to gain insight into unconscious conflicts, but they don’t want to overwhelm them with
potentially frightening material before they are ready to handle it.
Through questions and comments about the client’s behavior, free associations, dreams, and the like, the analyst
guides the process of self-exploration.
The interpretive process is tentative and continuous, a constant encouragement of clients to consider alternative
views, to reject obvious explanations, to search for deeper meanings.