Chapter 4

Psychoanalytic Therapy
Barlam, Dela Cruz, Olivares, Saludes
Sigmund Freud’s Background
Early Life:
Born as the oldest in a Viennese household
of three boys and five girls, they grew up
under a very authoritarian dad and a caring
mother.
Education:
Settling on medicine due to restricted
choices (being of Jewish background), he
earned his degree in medicine at the age of
26, from the University of Vienna; Later
attaining a position as a Lecturer there.
Theory Culmination:
All started happening or at least peaked
during his 40s, severe experiences of
emotional distress, psychosomatic
disorders, and irrational fears of dying
contributed to him even delving more into
the hard task of self-analysis. His analysis
of his dreams and childhood memories gave
clarity on his perception of his parents; his
Father being intense and hostile, and his
mother whom he’d had sexual feelings for
during his childhood, is attractive, loving,
and protective. Through this, he formulated
his own theory alongside observing his
patients working to analyze their own
problems.
Relationship with colleagues:
He has little to no tolerance to theories
diverging from his own. Notable colleagues
of Freud are Alfred Adler, and Carl Jung
who both created their own school of
thought due to repeated disagreements with
Freud.
Lasting Influence on Psychology:
Pioneered psychoanalysis, it became a
blueprint to subsequent psychologists to
further his theories, or disagree with
psychoanalysis as the baseline.
Development of theory of personality and
psychotherapy of the modern era is
attributed to him.

Being the baseline of psychotherapy and therapeutic procedures involving psychodynamic

structures, Freud gave a new perspective on the effects of the unconscious, and how it affects a
person’s behavior and basic character making it a benchmark of theories to come.

View of Human Nature

Mainly deterministic, Freud views human behavior as something heavily influenced by
instinctual drives that develop through psychosexual stages from the first six years of life.
Freud’s theories centers heavily on instincts: Libido → Life instincts
Libido is initially the center of Freud’s theories but it was later broadened to include life instincts.
In light of this, Libido could be understood as motivation mainly exuding sexual energy but goes
beyond it.
Instincts serve the main purpose of survival.
Death Instincts explains the aggressive drive.
People may manifest to die, hurt themselves, or others; which Freud believes is a challenge to
humans. These drives are the factors to why people act the way they do.

Structure of Personality
Three systems of Personality according to Freudian psychoanalytic view: id, ego, super ego
 Id Ego Superego

Instincts, derivative / mainly
focused on pleasure. It is
illogical as it is only driven to
satisfy the “wants“. Pleasure
principle
Regulates the personality,
connecting the desires of the
id while connecting it to the
possibilities with the external
world, governed by logical
thinking. Reality principle
Upholds the moral compass
of the personality modeled
from the ideals of society and
the primary caregiver.
Rewards: pride and self-love
Punishment: guilt and
inferiority

Consciousness and the Unconscious

Freud’s most notable contribution: concept of the unconscious, and the levels of consciousness
Clinical evidence for postulating the unconscious:
- dreams (symbolic representations of - Information incurred from projective
unconscious needs) techniques
- slip of the tongue and forgetting - Symbolic content of psychotic
- posthypnotic suggestions symptom
- information collected from
free-association techniques
Compared to the unconscious that makes up the majority of the total mind, consciousness is
only a thin slice of it.
The unconscious stores experiences, memories and repressed materials that are initially
inaccessible where an individual has no control over. Psychoanalytic therapy focuses on making
the unconscious motivations conscious, so that an individual can gain control and exercise the
ability of choice.
Neurotic symptoms are said to stem from the unconscious.

Anxiety
Repressed emotions can emerge to the surface of awareness, warning an individual to
perceived danger.
Three Kinds of Anxiety

Reality anxiety Neurotic Anxiety Moral Anxiety

Fear evoked by the outside Fear of having uncontrolled Fearing own conscience
world that matches the instincts (doing something against
severity of the real threat personal moral code)

Ego - Defense Mechanisms

Activated to help prevent the ego from being overwhelmed. It is not pathological but rather, an
adaptive system.
Two common characteristics: Deny or distort reality, and operate on an unconscious level

Most common ego defense

Repression Threatening or painful thoughts and feelings are excluded from awareness.
 Denial “Closing one’s eyes” to the existence of a threatening aspect of reality.

Reaction Actively expressing the opposite impulse when confronted with a threatening
formation impulse.

Projection Attributing to others one’s own unacceptable desires and impulses.

DIsplacement Directing energy toward another object or person when the original object or
person is inaccessible.

Rationalization Manufacturing “good” reasons to explain away a bruised ego.

Sublimation Diverting sexual or aggressive energy into other channels.

Regression Going back to an earlier phase of development when there were fewer
demands.

Introjection Taking in and “swallowing” the values and standards of others.

Identification Identifying with successful causes, organizations, or people in the hope that
you will be perceived as worthwhile.

Compensation Masking perceived weaknesses or developing certain positive traits to make

up for limitations.

Development of Personality
Comparison of Freud’s Psychosexual stages and Erikson’s Psychosocial Stages

Period of Life Freud Erikson

First year of life Oral stage Infancy: Trust versus mistrust

Sucking at mother’s breasts satisfies
need for food and pleasure. Infant
needs to get basic nurturing, or later
feelings of greediness and
acquisitiveness may develop. Oral
fixations result from deprivation of oral
gratification in infancy. Later
personality problems can include
mistrust of others, rejecting others;
love, and fear of or inability to form
intimate relationships.
If significant others provide for basic
physical and emotional needs, infant
develops a sense of trust. If basic
needs are not met, an attitude of
mistrust toward the world,especially
toward interpersonal relationships, is
the result.

Ages 1-3 Anal stage Early childhood: Autonomy versus

Anal zone becomes of major shame and doubt A time for
significance in formation of developing autonomy. Basic struggle
personality. Main developmental tasks is between a sense of self-reliance
include learning independence, and a sense of self-doubt. Child
accepting personal power, and needs to explore and experiment, to
 learning to express negative feelings
such as rage and aggression.
Parental discipline patterns and
attitudes have significant
consequences for child’s later
personality development.
Ages 3-6 Phallic stage
Basic conflict centers on unconscious
incestuous desires that child develops
for parent of opposite sex and that,
because of their threatening nature,
are repressed. Male phallic stage,
known as Oedipus complex, involves
mother as love object for boy. Female
phallic stage, known as Electra
complex, involves girl’s striving for
father’s love and approval. How
parents respond, verbally and
nonverbally, to child’s emerging
sexuality has an impact on sexual
attitudes and feelings that child
develops.
Ages 6-12 Latency stage
After the torment of sexual impulses
of preceding years, this period is
relatively quiescent. Sexual interests
are replaced by interests in school,
playmates, sports, and a range of new
activities. This is a time of
socialization as child turns outward
and forms relationships with others.
Ages 12-18 Genital stage
Old themes of phallic stage are
revived. This stage begins with
puberty and lasts until senility sets in.
Even though there are societal
restrictions and taboos, adolescents
can deal with sexual energy by
investing it in various socially
acceptable activities such as forming
friendships, engaging in art or in
sports, and preparing for a career.
make mistakes, and to test limits. If
parents promote dependency, child’s
autonomy is inhibited and capacity to
deal with world successfully is
hampered.
Preschool age: Initiative versus guilt
Basic task is to achieve a sense of
competence and initiative. If children
are given freedom to select
personally meaningful activities, they
tend to develop a positive view of self
and follow through with their projects.
If they are not allowed to make their
own decisions, they tend to develop
guilt over taking initiative. They ey
then refrain from taking an active
stance and allow others to choose for
them.
School age: Industry versus inferiority
Child needs to expand understanding
of world, continue to develop
appropriate gender-role identity, and
learn the basic skills required for
school success. Basic task is to
achieve a sense of industry, which
refers to setting and attaining
personal goals. Failure to do so
results in a sense of inadequacy.
Adolescence: Identity versus role
confusion A time of transition
between childhood and adulthood. A
time for testing limits, for breaking
dependent ties, and for establishing a
new identity. Major conflicts center on
clarification of self-identity, life goals,
and life’s meaning. Failure to achieve
a sense of identity results in role
confusion.
 Ages 18-35 Genital stage continues
Core characteristic of mature adult is
the freedom “to love and to work.”
This move toward adulthood involves
freedom from parental influence and
capacity to care for others.
Young adulthood: Intimacy versus
isolation. Developmental task at this
time is to form intimate relationships.
Failure to achieve intimacy can lead
to alienation and isolation.

Ages 35-60 Genital stage continues Middle age: Generativity versus

stagnation. There is a need to go
beyond self and family and be
involved in helping the next
generation. This is is a time of
adjusting to the discrepancy between
one’s dream and one’s actual
accomplishments. Failure to achieve
a sense of productivity often leads to
psychological stagnation.

Ages 60+ Genital stage continues Later life: Integrity versus despair
If one looks back on life with few
regrets and feels personally
worthwhile, ego integrity results.
Failure to achieve ego integrity can
lead to feelings of despair,
hopelessness, guilt, resentment, and
self-rejection.

Counseling Implications
Combined understanding of both the psychosexual and psychosocial stages of developments
could be helpful in creation of frameworks and the clients the clients would like to explore. The
following questions can give direction to the therapeutic process:
- What are some major developmental tasks at each stage in life, and how are these tasks
related to counseling?
- What themes give continuity to this individual’s life?
- What are some universal concerns of people at various points in life? How can people
be challenged to make life-affirming choices at these points?
- What is the relationship between an individual’s current problems and significant events
from earlier years?
- What choices were made at critical periods, and how did the person deal with these
various crises?
- What are the sociocultural factors influencing development that need to be understood if
therapy is to be comprehensive?
- Highlighting childhood experiences while tackling current craisins can give a recurring
theme within the client’s life.
 positive or negative
(originally experienced with
significant figures from the
past or in an early
Therapeutic Process relationship).
I. Therapeutic Goals ■ In a therapeutic
● Based on 3 premises: setting, clients will
1. A significant part of the problems make projections
clients present with originated in the towards therapists.
past, particularly early childhood. ■ By enabling a
2. These problems are mostly related blank-screen
to relationships with other people. approach, therapists
3. Feelings, behaviors, ways of thinking can assume that what
are influenced by the unconscious the client shows them
part that the client is unaware of or feels toward them
(may be causing their problems). are projections.
● Increase adaptive functioning by ■ Have clients elicit
reducing symptoms and resolving negative/positive
conflicts. reactions towards the
○ Make the unconscious therapist, then help
material → conscious. them evaluate.
■ The client replicates
○ Strengthen ego.
in the therapeutic
● Dive into the past to establish
session the problems
self-understanding that will result in
they had in the past.
the modification of character and
They react to the
personality.
therapist in ways that
● Foster the capacity of clients to
they react to these
solve their own problems.
significant people in
their life in the past.
II. Therapist’s Role and Function
○ Projections: analyzed as
● In classical psychoanalysis, analysts
they originate in unfinished,
must consider the following:
unresolved, and repressed
○ Blank-screen approach:
situations.
non-judgmental, neutral,
● Therapists assist/help clients into:
avoid self-disclosure to foster
○ Acquiring freedom to love,
transference relationship.
work, play.
■ Therapists say little
○ Achieving self-awareness,
about themselves and
honesty
rarely share personal
○ Establishing/maintaining
reactions.
effective personal
○ Transference: the client’s
relationships.
unconscious transfer to the
○ Dealing with anxiety in a
analyst of feelings, attitudes,
realistic way.
and fantasies, whether
 ○ Gaining control over
impulsive/irrational behavior.
● Therapeutic alliance
○ The analyst is receptive,
respectful, open-minded, and
empathic towards the client’s
intrapsychic world.
○ They develop trust so that
the client feels free to talk
openly.
○ Feedback loop: the therapist
listens, is sensitive to, and
pays attention to what the
client says and does not say,
what feelings they show, how
the client reacts or responds,
and gauges the readiness of
the client.
■ Helps the therapist to
decide real-time how
to react or make
interpretations
accordingly and
appropriately.
● Interpretations
○ Why: To accelerate the
process of uncovering
unconscious material.
○ What: Therapists use what is
spoken and unspoken, gaps
and inconsistencies in the
client’s story, meanings from
reported dreams and free
associations, feelings toward
the therapist
○ How: Done by teaching
clients the meanings to (1)
achieve insight into their
problems, (2) increase
awareness of ways to
change, and (3) gain more
control over their lives.
○ When: Interpretations are
offered when clients are
ready to change, for therapy
to be effective.
III. Client’s Experience In Therapy
● Classical psychoanalysis
○ Long-term, intensive
process.
○ Free association: say
whatever comes to mind
without self-censorship.
■ Feelings,
experiences,
associations,
memories, fantasies.
○ Lying on the couch
○ Client: free to express any
idea or feeling (whether
considered as
correct/incorrect,
moral/immoral, good/bad,
etc)
○ Analyst: nonjudgmental,
neutral, consistent, listens
carefully, asks questions,
makes interpretations.
○ Clients are discouraged to
make any major changes in
lifestyle during the period of
analysis.
■ Results may be
confused to either
have been caused by
these changes or by
the intervention.
● Psychodynamic therapy
○ Simplified and shortened
version of classical
psychoanalysis.
○ Does not use all techniques
related to classical
psychoanalysis.
○ Still considers transference,
dreams, the past and the
 present, defenses/resistance,
unconscious material.
○ Fewer sessions per week
○ The therapist is supportive
● Talk therapy
○ Clients have to be committed
to the intensive process.
○ Clients agree to talk and
engage in verbal
productions.
● When are clients ready to end
therapy?
○ When the client and therapist
have a mutual agreement
that symptoms and core
conflicts are resolved.
○ When remaining emotional
problems are clarified and
accepted.
○ When clients understand the
roots of the difficulty and how
these can manifest into
themes in their life.
○ When they can make use of
connecting past problems to
help with their present
relationships.
○ When clients gain insight into
how their environment affects
them, and how they affect
their environment.
○ When they have reduced
defensiveness.
○ When the client has answers
to the “why” questions
regarding their life.
IV. Relationship Between Therapist
and Client
● Contemporary relational analysis
○ Does not strive for an
objective stance.
○ Focuses on a new
understanding of the past (by
bringing the past into the
present).
○ Uses emotional
communication to gain
information and create
connections.
● Therapeutic relationship increases
self-awareness, self-understanding,
and exploration.
● Transference
○ Involves the unconscious
repetition of the past in the
present.
○ Patterns that originate from
old experiences emerge in
current life.
○ In a therapeutic setting, a
mixture of positive and
negative feelings are
transferred to the therapist.
■ Can pave the way to
understanding and
resolving past
conflicts or
“unfinished business”.
○ The therapist becomes a
substitute or dummy for
significant others in a client’s
life.
○ Not all the time is a client’s
reaction towards a therapist
a projection or manifestation
of transference.
● Countertransference
○ Occurs when the therapist
responds to clients in
irrational ways, when they
lose objectivity when their
own personal conflicts are
triggered.
■ Emotional responses
(anger, love,
avoidance,
overidentification,
 etc.) or subtle ○ It is vital to have the ability to
nonverbal, tonal, and recognize how we project our
attitudinal actions feelings, expectations and
○ The therapist has demands onto people in our
unconscious emotional present life.
responses to a client based ● Clients gain insight into their own
on their own past. This leads unconscious processes and
to a distorted perception of repressed material.
the client which may affect ● Clients understand the connection
clients. between their past experiences and
○ With the risk of current behavior, which can then
countertransference, lead to personality change or
therapists are encouraged to resolution of current problems.
seek their own professional
consultation, clinical
supervision, or therapy Application: Therapeutic Techniques and
■ Enable therapists to Procedures
work out their
personal issues and
Approaches
become as efficient
as possible. Psychoanalytic/psyc Classical/traditional
○ Some countertransference hodynamic therapy psychoanalysis
reactions may be used to
● More ● Focus on
better understand the client.
objectives restructuring
■ apart from personality.
● Working-through process modifying ● More likely to
○ Explores the unconscious personality use ‘the couch’
material and defenses ● Less likely to during sessions
repetitively. use ‘the ● More sessions;
○ Through exploration, clients couch’ longer intensive
● Fewer process
start to accept their defensive
sessions each ● Focus on
structures and understand week neutrality and
how these played a role in ● Frequent use objectivity;
their life. of blank-screen
○ As they accept and resolve reassurance, approach
these old patterns, clients empathy, ● Explores
support, and fantasies,
can now learn how to make
suggestions repressed
new choices to produce ● Emphasis on desires or
change. the material
● It is important to note that traces of ‘here-and-now’
childhood traumas or experiences relationship
will never be completely erased or ● More freedom
resolved. for
self-disclosure

from therapist
● Focus on
mutual
transference
● Focused on
pressing
practical
concerns
(social
environment)
● Aims:
○ Increase awareness
○ Foster insights into behavior
○ Understand meanings of
symptoms
● Process:
○ Talk → catharsis
(expression of emotion) →
insight → working through
unconscious material
● 6 basic techniques of
psychoanalytic therapy
1. Maintaining the Analytic
Framework
- Consistent framework
- Analyst’s anonymity,
neutrality/objectivity
- Regular and consistent
meetings
- Designated time for starting
and ending sessions
- Clarity on fees
- Boundary issues
2. Free Association
- Clients are encouraged to
say whatever comes to mind,
without censorship.
- Opens doors to unconscious
wishes, fantasies, conflicts,
motivations.
- Enables the recollection of
past experiences or catharsis
(release of feelings)
- Therapist: identifies
repressed material that is
unlocked in the unconscious;
gives meaning to this
material; guides clients
toward insight.
3. Interpretation
- The therapist points out,
explains, and teaches the
client the meanings of
behavior manifested in their
inner world (dreams, free
associations, resistances,
defenses, etc)
- Collaboration between client
and therapist to expand
consciousness and
awareness.
- Therapists should gauge
readiness and tolerance of
clients before giving out
interpretations.
4. Dream Analysis
● Procedure used to uncover
unconscious material that give
insight to areas of unresolved
conflicts
● Sleep = defenses lowered,
repressed/unconscious feelings and
desires surface
● “royal road to the unconscious”
Dreams
❖ Dream have two levels of
content
 ➢ Latent content - ●
hidden, symbolic,
unconscious motives,
wishes, and fears
➢ Manifest content -
more acceptable
meaning; the dreams
as it is
❖ The process of the
transformation of latent
content into less threatening
manifest content is called
dream work
❖ Therapist's aim - uncover the
hidden meaning through
studying symbols and
symbolic interpretations in
dream's manifest content
○ Dream gives an important
message to client’s lives
which is ought to be looked
into as it could be
problematic when left ignored
(Curtis & Hirsch, 2011)
5. Analysis and Interpretation of
Resistance
● Resistance is a fundamental practice
of psychoanalysis that could oppose
the progress of the therapy,
preventing the production of the
unconscious material
○ It refers to the client’s
reluctance in bringing out into
awareness the repressed
unconscious material
● Freud defined it 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.
Therapist should build a safe space
and environment in order for the
client to recognize resistance (Curtis
& Hirsch, 2011; McWilliams, 2014;
Wolitzky, 2011a)
● Resistance is considered to be
representative of defensive
approaches in daily life which could
be recognized as devices that
defend against anxiety
6. Analysis and Interpretation of
Transference
● Earlier relationships of clients
contribute to the distortion of the
present connection with the therapist
as transference could be manifested
in the therapeutic process
● Transference situation is considered
valuable - allowing the opportunity to
re-experience feelings that would be
inaccessible
● Interpreting transference is a route
to elucidating the client’s
intrapsychic life (Wolitzky, 2011b)
● Exploring and interpreting the
process of transference feelings is
considered as the core of the
therapeutic possess by the
analytically oriented therapists
● Analysis of transference is a central
technique in both classical
psychoanalysis and
psychoanalytically oriented therapy
● It enables clients to work through old
conflicts in which the effects of early
relationships are counteracted
through similar emotional conflict on
the present therapeutic relationship.
7. Application to Group Counseling
Transference
 ○ Group works reenact early
life situations that continue to
affect the client
○ Transference feelings may
resemble to the feelings
experienced by some
members towards their
significant people in their
past
■ Finding symbolic
parents and siblings
within the group
■ Competing for the
attention of the group
leader
● A basic tenet of psychodynamic
therapy groups is the notion that
group participants re-create their
social situation, implying that the
group becomes a microcosm of their
everyday lives (Rutan et al., 2014).
● Projections onto the leader and onto
other members are valuable clues to
unresolved conflicts within the
person
Countertransference
● The group therapist has
reactions to members and is
affected by member’s
reactions
● This is also one of the
valuable tool for the group
therapist to understand the
dynamics in the group
○ Group leaders need
to be alert for signs of
unresolved internal
conflicts which could
lead to members
being used to satisfy
the leader’s own
unfulfilled needs
Jung’s Perspective on the Development
of Personality
● Jung developed a theory of
personality that was different from
Freudian psychoanalysis
○ Analytical psychology is an
elaborate explanation of
human nature that combines
ideas from history,
mythology, anthropology, and
religion (Schultz & Schultz,
2013)
○ It centralized the importance
of psychological changes
associated with midlife
■ It concerns the need
to confront
unconsciousness by
being aware of the
messages of our
dreams and involving
ourselves in creative
activities
■ The main aim is to be
less influenced by
rational thought and
instead give
expression to these
unconscious forces
and integrate them
into our conscious life
(Schultz & Schultz,
2013)
● Carl Jung
○ At the age of 81, he wrote his
autobiography, Memories,
Dreams, Reflections (1961)
○ He focused on the
unconscious realm in his
personal life that influenced
his development of his theory
“Analytical Psychology”
 ○ Jung developed a spiritual thoughts, feelings,
approach that placed and actions
emphasis in finding the
meaning of life * In a dream, all of these can
be a manifestation of what
● Jung contradicts Freudian and who we really are
determinism in which he states that ● Jung wrote that dreams have 2
we are influenced by our future and purpose:
past. ○ Prospective; prepare people
○ His theory is based on the for the events they
assumption that humans anticipated in the future
tend to move toward the ○ Compensatory function;
fulfillment of all of their bringing the balance between
capabilities the opposites within the
● Achieving individuation - harmonious person
integration of conscious and ● He viewed dreams more as an
unconscious elements of personality attempt to express than as an
○ Innate and a primary goal attempt to repress
○ Humans have constructive
and destructive forces which Contemporary Trends: Object-Relations
is essential to accept in order Theory, Self Psychology, and Relational
for them to be integrated Psychoanalysis
● According to Jung, dreams - source ● Psychoanalytic theory has evolved
of creativity which undergone reformulations and
○ Collective unconscious - is comprised of variety of schools
deepest and least accessible (classical perspective, ego
level of psyche psychology, object relations and
■ He found a interpersonal psychoanalysis, self
connection between psychology, and relational
person’s personality psychoanalysis)
and the past ● Commonalities between
specifically the history perspectives - “All presuppose a
of species supportive, warm, but neutral and
○ Archetypes - universal fairly unobtrusive therapist who
experiences contained in the strives to create a safe, supportive,
collective unconscious. The and therapeutic relationship” (p. 73).
main archetypes are: ● Object-relations theory
■ The persona - a encompasses the work of
mask, or public face, psychoanalytic theorists concerning
■ The anima and attachment and separation
animus - masculinity ○ Emphasizing how
and femininity relationships with other
■ The shadow - our people are affected by the
dark side, the way we internalized
 experiences and set up ○ She also noted that the
representations of others caregiver’s qualities reflect
○ Object relations - the particular culture in which
interpersonal relationships the person lives.
which are represented ■ Different cultures
intrapsychically, influencing maintain different
our interactions with people values - no objective
■ Object psychic truth
■ Other ■ Internal structures are
● Self psychology - came from the all relational and
work of Heinz Kohut (1971) which relative.
emphasizes the use of interpersonal
relationships (self objects) to Summary of Stages of Development
develop the sense of self. ● Psychoanalytic theories have
○ Nonjudgmental acceptance, experienced shifts to expand
empathy, and authenticity awareness of others.
■ Empathy - forefront of ○ These patterns established
psychoanalytic can influence interpersonal
healing relationships as well as can
● The relational model is based on the provide insight on how an
assumption that therapy is an individual's inner world can
interactive process between cause difficulties in living in
therapist and client the everyday world of people
○ The relational movement and relationships (St. Clair,
gives new emphasis on more 2004)
egalitarian therapeutic ● Margaret Mahler (1968) had a
approach (McWilliams, 2016) central influence on contemporary
■ Relational analysts object-relations theory.
put values in ○ A pediatrician who
approaching the client emphasized that the
with genuine curiosity resolution of the Oedipus
● Due to the unequal power between complex during Freud’s
analyst and patient during the earlier proposed phallic stage is less
times, contemporary relational critical than the child’s
theorists replaced it to more progression from a symbiotic
egalitarian model relationship with a maternal
● Mitchell (1988, 2000) integrates new figure toward separation and
theories of analytic relationship, individuation.
specifically developmental theory, ■ She believed that the
attachment theory, systems theory, individual begins in a
and interpersonal theory to state of psychological
demonstrate the ways in which we fusion with the mother
seek attachments with others. and gradually
progress to
 separation - different organization
from Freudian and sense of
psychosexual stages self would
● Unresolved lead to return
crises in the to this infantile
earlier state stage
and in the ■ Daniel Stern (1985)
process of challenged her theory
separation in which he believed
influence later that infants are
relationships innately interested in
● Object others
relations of ● Symbiosis, the next phase,
later life build noticeable by 3rd month extending
on the child’s through 8th month
search for a ○ Infant has pronounced
reconnection dependency on mother
with the ● The separation–individuation
mother (St. process begins in the 4th or 5th
Clair, 2004). month
● Mahler calls the first three or four ○ Child being torn enjoying
weeks of life normal infantile autism separate states of
○ Infant is presumed to be independence and
responding more to states of dependence
physiological tension than
psychological processes
■ She believes that ○ Children who do not
infants is unable to experience the opportunity to
differentiate itself from differentiate as well as to
its mother idealize others while taking
● There is no pride in themselves may
whole self as eventually suffer from
infants narcissistic character
perceives disorders and problems of
parts rather self-esteem
than unified ■ Narcissistic
self (according personality -
to theory of grandiose and
Melanie Klein) exaggerated sense of
● Adults self-importance and
showing exploitive attitude
extreme lack towards others
of ■ Perceiving threats to
psychological their self-esteem and
 having feelings of
emptiness and
deadness.
○ “Borderline” conditions are
rooted in the stage of
separation-individuation
■ People suffering from
this have moved into
the separation
process however
have been foiled due
to parental rejection
■ Borderline people are
usually characterized
by instability,
irritability,
self-destructive acts,
impulsive anger, and
extreme mood shifts.
Kernberg (1975) describes them as
having a lack of clear identity, a lack of
deep understanding of other people, poor
impulse control, and the inability to
tolerate anxiety.
● The final subphase in the
separation-individuation involves a
move toward constancy of self and
object.
○ This developed by the 36th
month where others are
more fully seen as separate
from the self
Treating Borderline and Narcissistic
Disorders
● Kohut (1984) stated that people are
their healthiest and best when they
can feel both independence and
attachment, taking joy in themselves
and also being able to idealize
others
○ Mature adults are grounded
in a sense of freedom,
self-esteem, and
self-sufficiency
Some Directions of Contemporary
Psychodynamic Therapy
● According to Strupp (1992), the
diverse modern adaptations of
psychoanalysis have given
psychodynamic psychotherapy with
renewed vitality and vigor.
○ Disturbing behaviors that
occur during childhood and
adolescence are getting
greater attention.
○ The emphasis on treatment
has shifted therapeutically
with chronic personality
disorders, borderline
conditions, and narcissistic
personality disorders.
○ A good therapeutic bond
being formed early on in
therapy is receiving more
focus.
○ Renewed interest in the
development of briefer forms
of psychodynamic therapy,
The Trend Toward Brief, Time-Limited
Psychodynamic Therapy
● Psychoanalytically oriented
therapists adapt their work to a
time-limited framework as they
support briefer therapy when it is
indicated by the client’s need rather
than the limits set by the managed
care system.
● Prochaska and Norcross (2014)
have noted these characteristics
○ Work within the framework of
time-limited therapy.
 ○ Target a specific ○ Client’s present life or the
interpersonal problem and “the here and now” rather
goals during the initial than exploring the past or
session. “the there and then of
○ Assume a less neutral childhood”
therapeutic stance than is ● BPT is considered to be an
true of traditional analytic opportunity to begin the process of
approaches. change
○ Establish a strong working ○ Practitioners ask directive
alliance early in the therapy. and confrontive questions
○ Use interpretation relatively which deal quickly with
early in the therapy transference issues
relationship.
● Brief psychodynamic therapy (BPT) Not suitable for:
applies principles of psychodynamic
With severe
theory as well as treatment for characterological disorder
selective disorders within
pre-established time limit of 10-25 With severe depression
session
● Therapist assumes a direct and ● BPT is more
active role formulating a therapeutic suitable for
focus people who
○ It includes possible goals of are neurotic,
this approach: it might be motivated,
conflict resolution, greater and focused
access to feelings, increasing ● Clients tend to have a richer range
choice possibilities, of interactions with others and have
improving interpersonal opportunity to practice functional
relationships, and symptom behaviors by the end of the therapy
remission
● Levenson emphasizes that Psychoanalytic Therapy From a
time-limited dynamic therapy is not Multicultural Perspective - BARLAM
to bring cure but to stimulate
changes in behavior, thinking, and
Psychoanalytic Therapy From a Multicultural
feeling.
Perspective
○ Accomplished using
client-therapist relationship - Strengths From a Shortcomings From a
understand how the person Diversity Diversity Perspective
interacts in the world Perspective
● Brief dynamic therapy tends to
● appropriate for ● Traditional
emphasize a client’s strengths,
culturally psychoanalytic
competencies, and resources in diverse approaches are
dealing with real-life issues. populations. costly.
● review ● the ambiguity
 ● The opportunity to develop a
environmental inherent in most
situations at psychoanalytic transference relationship and work
the various approaches. through it is the core of the therapy
critical turning ● criticized for process.
points in their failing to ● The analytic process stresses an
lives. adequately intensive exploration of Stan’s past.
● intensive address the ● the goal is for him to have a more
psychotherapy social, cultural,
as part of the and political integrated self, where feelings split
training of factors off as foreign (the id) become more
therapists. ● by unexamined a part of what he is comfortable with
classist attitudes (the ego).
and that these ● As he comes to understand how he
attitudes has been shaped by these past
constitute a
experiences, Stan is increasingly
significant
obstacle for able to exert control over his present
practitioners’ functioning
success in
working with the
poor. Summary and Evaluation
● Some of the major concepts of
Psychoanalytic Therapy Applied to the Case psychoanalytic theory includes:
of Stan ○ dynamics of the unconscious
● The psychoanalytic approach and its influence on behavior,
focuses on the unconscious ○ the role of anxiety,
psychodynamics of Stan’s behavior. ○ an understanding of
● Stan demonstrated a transference and
self-destructive tendency countertransference,
● Stan’s preoccupation with drinking ○ and the development of
could be hypothesized as evidence personality at various stages
of an oral fixation in the life cycle.
● he never received love and ● Each of the eight stages of human
acceptance during his early development of Ericson is
childhood = suffering from this characterized by a crisis, or turning
deprivation and continues to point.
desperately search for approval and ○ Either master or fail
acceptance. ● It focuses primarily on childhood
● his mother was the strong, experiences, which are discussed,
domineering force who could and did reconstructed, interpreted, and
hurt men = Stan generalized his fear analyzed.
of his mother to all women. ● the transference relationship with the
● But then the woman he married was therapist, is necessary for character
similar to his mother. change
 ● In Jungian analytical therapy, the
therapist assists the client in tapping
his or her inner wisdom.
● The contemporary trends in
psychoanalytic theory are reflected
in these general areas: ego
psychology, object-relations
interpersonal approaches, self
psychology, and relational
approaches
Contributions of the Classical
Psychoanalytic Approach
● Appreciating Freud’s many
significant contributions.
● . Applying the psychoanalytic point
of view to therapy practice is
particularly useful in
○ (1) understanding
resistances that take the
form of canceling
appointments, fleeing from
therapy prematurely, and
refusing to look at oneself;
○ (2) 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;
○ (3) understanding the value
and role of transference; and
○ (4) understanding how the
overuse of ego defenses,
both in the counseling
relationship and in daily life,
can keep clients from
functioning effectively
Contributions of ● Erikson’s emphasis on
Contemporary psychosocial factors
gives a more complete
Psychoanalytic picture of the critical
Approaches turning points at each
stage of development.
● 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.
● Object-relations theory
helps us see the ways
in which clients
interacted with
significant others in the
past and how they are
superimposing these
early experiences on
present relationships
Limitations and Considering factors such as
Criticisms of ● time,
Psychoanalytic ● expense, and
Appoaches ● availability of trained
psychoanalytic
therapists, the practical
applications of many
psychoanalytic
techniques are limited.
● From a feminist
perspective there are
distinct limitations to a
number of Freudian
concepts, especially the
Oedipus and Electra
complexes.
● object-relations
approach has been
criticized for its
emphasis on the role of
the mother–child
relationship in
determining later
 interpersonal
functioning
○ Fathers are
conspicuously absent
from the hypothesis
about patterns of early
development
● psychoanalytic
therapies have been
criticized for being
irrelevant to
contemporary culture
and being appropriate
only to an elite, highly
educated clientele.