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Theory and Design in Counseling and Psychotherapy
Susan X Day , Iowa State University and University of Houston
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CHAPTER 4: Psychoanalytical and Psychodynamic
Approaches
Key Terms and Essential Concepts
Psychoanalytic:
Sigmund Freud attempted to explain psychological symptoms through a pioneering theory. Psychoanalytic concepts describe the inner world of human beings and how unconscious strivings influence personality and behavior. Freud perceived that biological drives required complex controls if people were to maintain civilized and moral behavior. An elaborate system of unconscious subparts (id, ego, superego) played out the struggle between instinctual drives and societal restraints while also trying to cope with life demands. The closed energy system distributed psychic energy between the personality subparts. Freud also perceived that sexual drives originated in childhood and were hidden from awareness as societal propriety required. He proposed a sequence of psychosexual developmental stages where the unconscious kept the desires out of awareness and redirected energy into appropriate adult roles. Deviations from normal development caused internal struggles and mental symptoms. Finally, he proposed a treatment method called psychoanalysis to bring the unconscious conflicts into awareness and to free the patient from internal pain and psychological neurosis.
Drives:
Innate energy to satisfy biological determinants, such as sex and aggression.
Unconscious:
A part of the psychoanalytic and psychodynamic psychological structure that remains out of awareness but still influences all a person is and does. It contains memories of experiences, wishes, and impulses.
Id:
The home for biological drives contained within the structure of the unconscious and operating by the pleasure principle of satisfying all urges.
Superego:
The seat for societal messages limiting the expression of innate urges and acting according to moral restraints and perfectionistic standards.
Ego:
The third space within the psychoanalytic personality structure that observes and takes into account realistic considerations, while negotiating the clashes between the id and the superego.
Reality principle:
Problem-solving utilized by the ego to manage internal conflicts and external demands.
Pleasure principle:
A biological standard of reacting impulsively to satisfy appetites without consideration of others or future oriented consequences.
Anxiety:
Generalized fear that, if severe, can impair one's ability to function. Freud proposed that neurotic anxiety was caused by a fear that id forces would overpower the ego's ability to contain impulsivity.
Oedipal stage:
A psychosexual period of development (age 3-6) where a boy desires a proprietary relationship with his mother without interference from his father. In fear of retaliation from the father, the boy resolves his urges by identifying with the father and establishing the appropriate male sex role for future heterosexual relationships.
Electra complex:
A psychosexual syndrome for girls paralleling the Oedipal experience of boys during the same age period of 3-6 years. A girl wants to take her mother's place with her father but fears mother would punish her for such thoughts. To manage the anxiety created by her desires, the girl identifies with her mother and takes on the feminine sex role.
Penis envy:
A Freudian term describing the disappointment of girls when they discover they do not have a male appendage and resulting in the limitations of women's superego development. Horney countered the sexist concept by suggesting womb envy for men.
Ego theory:
Sigmond Freud believed that the ego managed the conflict between the id and the superego. Anna Freud and Erik Erikson added to psychoanalytic thought by expanding the functions of the ego. This became a school of thought known as ego psychology. Kohut extended ego theory even further in self psychology.
Ego psychology:
Anna Freud expanded her father's concept of the unconscious by introducing the influence of social factors on psychological development, and by emphasizing the ego and its defense mechanisms. Therapeutic interpretations focused on the patient's defenses to encourage greater choices for perceptions and flexibility for behavior. Eric Erikson extended ego psychology further by describing psychosocial developmental stages throughout life and adding healthy ego functions such as mastery and competency
Ego strength:
The ability of the ego to manage internal conflicts so the person can cope with life demands and pursue healthy goals.
Interpretation:
Psychoanalytic and psychodynamic therapists interpret for clients the meaning of internal dynamics revealed in counseling session. Interpretations come from theoretical concepts endorsed by the therapists.
Defense mechanisms:
Unconscious methods used by the ego to adapt to realistic considerations while also reducing internal anxiety. Many defense mechanisms provide healthy functions when not rigidly applied. Defensive patterns can also redefine reality in unhealthy ways or pathological ways.
Sublimation:
A defense mechanism that transforms socially unacceptable desires into socially useful behaviors.
Repression:
A defense mechanism that unconsciously stifles a painful experience so the memory is kept out of awareness.
Denial:
Disregarding negative realities to such a degree that the conditions avoided do not exist in the person's awareness at all.
Regression:
When a person who typically behaves at one maturity level performs actions characteristic of an earlier stage of development. Such behavior defends against the requirement of coping at the appropriate level of responsibility.
Fantasy:
Creating a vision of pleasant circumstances to escape mundane realities.
Rationalization:
Creating logical explanations that make the cause of an event sound acceptable. One way of rationalizing is to point to external causes and, therefore, protect one's self from blame.
Reaction formation:
To avoid recognizing unacceptable impulses, the person subscribes to the exact opposite inclination.
Projection:
A person attributes his own characteristic onto other people, defending himself by believing others are the same way, or by negating the characteristic for himself thereby displacing the trait.
Suppression:
Consciously forgetting as a defensive maneuver to manage the feelings related to a difficult situation or incident.
Emotional insulation:
A person unconsciously protects herself against unwanted feelings by creating an attitudinal shield of not caring.
Displacement:
A person has feelings aimed at one person but directs those feelings to someone or something else. In this way, direct confrontation is avoided.
Identification:
A person admires characteristics of another person, and so she aligns with the admirable figure to overcome her own limitations and to take on new traits.
Psychodynamic:
Psychodynamic theories retained basic Freudian ideas such as the unconscious and childhood development as critically influential. However, the description of how the unconscious works changed. Instead of maintaining the hydraulic principle of energy transferred between subparts of the unconscious, dynamic theories describe social introjects and emphasize an internal process revolving around the ego or the self.
Object relations theory:
This post-Freudian theory proposes relational constructs or objects in the unconscious as the structure that affects human development. The child retains an imprint of the relationship with the primary caretaker and projects the representation onto all future relationships. When parenting is deficient, the object relations embedded in the unconscious is problematic and the person exhibits psychological difficulties. Relational objects can be inconstant, or not dependable, when based on neglectful parenting. An adult with a problematic childhood history will forever project inappropriate prototypes onto others. When parenting is sufficient, the child develops through a sequence of stages where the child gradually grows from dependence on parents to personal independence.
Object relations psychology:
Therapists using object relations theory provide reparenting experiences for clients so that positive objects can be internalized by clients.
Objects:
A term used in object relations theory to denote internal images of other people. When we are infants, other people are merely objects that provide food and other necessities. Childhood reactions to others are distilled into mental constructs and these mental images become a permanent part of a person's internal world .
Self-theory/psychology:
Extending the concepts of object relations, self psychology focuses on the unconscious self object which is emphasized more than relationships with others. The healthy self develops from early parenting that results in feelings of self-worth, an ego ideal of what the self can become, and a conscience that limits self-expression to societal standards.
Self:
A continuing inner sense of our personhood that organizes our perceptions of our experience. Includes feelings of worth, individuality, our relationship to others and the world, and our basic comfort or anxiety level.
Mirroring:
Self psychology describes the mirroring process typical of good parenting where the child's behavior is reflected back to the child with praise and empathy. Such reflective interactions help the child build a positive self-image.
Grandiose self:
Through mirroring the child by age 3 develops an object called the grandiose self, denoting the self as perfect and the center of attention. The grandiose self object becomes the source of ambition, energy, and self-esteem.
Ego ideal:
The internal object from self-psychology that represent the perfect self if it were achievable. The ego ideal is developed through the process of idealizing parents.
Idealization:
A second basic need for the developing child in self psychology is a view of parents as powerful and flawless. The idealization provides an internalized object representing that part of the self striving for perfection and acting in good conscience. Idealizing the parent results in an ego ideal that subconsciously serves as a motivator for worthy goals, and competency and it acts as a conscience.
Splitting:
One reason for reenacting inappropriate relational patterns as an adult is that immature object development prevents realistic assessments of how others react. Immature object relations may cause a person to interpret interactions and other people as all good or all bad. The object relations are said to be splitting, categorizing others as either positive or negative without an ability to hold constant the memory of the good in a relationship when disagreements or bad things happen. Splitting may also occur with the self-image that is judged with black or white evaluations. The person himself is seen as all good or all bad. Such a lack of integration causes disruptions in relationships and an unstable identity.
Object constancy:
The psychological ability to remember the good in a person or the self even when disappointed or frustrated. Objects are integrated with both good and bad qualities and can then be held as a constant. If parenting is inadequate, according to self psychology, the underlying dynamic of seeking a protector or an admirer who could meet the need for a grandiose self or an ego ideal is reenacted in adulthood.
Therapy stages:
The process of therapy follows a pattern where the client gradually gains more trust in the therapist and the counseling activity. Psychoanalytic and dynamic therapies describe the beginning stage as the period where the transference relationship is established and initial interpretations occur. Interpretations would entail therapist's inferences about the client's unconscious patterns as shown in the counseling interactions and in the material shared by the client. Psychoanalysts might also use the technique of free association where the client tells whatever enters his mind, revealing a pattern of associated thoughts. Psychoanalysts might also interpret dreams, said by Freud to be the "royal road to the unconscious." In the middle stage of therapy, the client becomes accepting of the interpretations, willingly brings in confirming material, and is said to work through psychological difficulties. Dynamic therapists would act as positive parental objects providing the client with a corrective life experience, meaning the new interaction would correct misperceptions about the self and others. Object relations therapy could include controlled regression where a child would return to an earlier stage of development in order to experience positive parenting. The ending stage is titled termination, the time when the client reviews the progress made and says farewell to the therapist.
Transference and countertransference:
Both analytic and psychodynamic therapies presume the client will project unconscious relational material onto the counselor. In analyzing the projections, clients work through the accompanying feelings and begin to develop new ways of seeing themselves and others. The counselor also relates to the client with unconscious reactions. Since the focus of therapy is on the client, the counselor is careful to prevent his own material from interfering with the client's counseling experience. Hence, analytic therapists try to maintain a nonresponsive stance to limit countertransference and promote transference. Dynamic therapists, however, come from an empathic posture and use their own reactions to understand the client's impact on others for interpretations of transference and countertransference.
Insight:
When a client becomes aware of unconscious material, thus bringing the unconscious into the consciousness, then the client has gained insight. This is the primary goal of psychoanalysis since understanding previously buried patterns changes the interplay between the id, superego and ego. The ego can then manage internal presses and have more energy for dealing with external realities.
Resistance:
Insights gained in therapy challenge clients to face frightful issues and to make difficult changes. Clients may use a variety of avoidance behaviors to protect themselves from dealing with tough interpretations and the implications of needed change.
Working-through process:
When the client accepts the therapy process and no longer resists, the counseling interaction flows smoothly, the client shares willingly, insights are gained, and the psychological effort to change proceeds. Clients resolve some issues, gain new perspectives, and practice new behaviors.
Neutrality:
A term used to describe the therapist's ability to maintain an objective viewpoint in analyzing the client's issues according to psychoanalytic principles.
Abstinence:
Psychoanalysts refrain from psychologically participating in clients' expressions of feelings, wishes, and fantasies.
Anonymity:
Psychoanalysts present an anonymous front for the client, revealing nothing personal about themselves. With the therapist maintaining a blank slate, the client is free to project feelings from past relationships.
Free association:
A psychoanalytic technique whereby the client speaks whatever comes to mind. The sequencing of topics implies underlying meanings and reveals unconscious material.
Empathy:
Self psychologists reject the neutral and anonymous stance of psychoanalytic therapists by deliberately entering the client's inner world and gaining an understanding of life experiences from the client's perspective.
Corrective emotional experiences:
A life event that allows a person to gain a new perspective on a past experience. The term is used by self psychology therapists to describe the process of reparenting clients. The term is also used to describe experiences outside of therapy that change perceptions so that the person feels differently about similar situations.
Analytical psychology:
Jung's theory of psychodynamics that adds to the unconscious another layer of a collective knowledge shared by all human beings and representing historically universal experiences for people across all cultures.
Archetypes and collective unconscious:
Jungian psychoanalytic theory conceives the unconscious as containing both a personal level and a level of communal knowledge passed on from previous generations. Artistic creations and spiritual traditions transmit values and dramatic roles that are embedded in unconscious memories. Archetypes represent universal roles that play out in common interactions that appear in different cultures.
Persona:
A Jungian term for the public mask individuals show to the world which censors personal attributes and desires that may be socially unacceptable.
Shadow:
The term from Jung that represents the dark side of the self with unacceptable desires that a person tries to hide from others.
Anima and animus:
According to Jung, each woman's unconscious contains a male archetype, the animus. The female archetype for men is the anima.
Self-actualization:
The process of a person becoming all she can be, living up to her true potential and contributing to society. A basic tenet of Jung's theory and other humanistic philosophies.
Introspection:
A person examining her own internal world.
Confession, Elucidation, Education, Transformation:
The stages of Jungian psychoanalytic therapy. Stage one involves the client sharing life experiences and telling secrets not typically told to others. The second stage includes the therapist analyzing the transference and countertransference relationship with the client gaining insight into unconscious material. In the third stage, the therapist helps the client translate insights into his current life and in the fourth stage, the client seeks self-actualization interacting with the therapist on an equal level where both are affected.
Dream analysis:
A major technique in Jungian therapy where interpretations reveal the client's unconscious dilemmas, archetypal enactments, and solutions to current issues. The progress of therapy is evaluated by the changing themes of dreams.
Termination:
The process of ending and completing therapy. Typically, termination includes a review of the gains accomplished by the client, some reminiscing of the progression of the relationship, and a sense of loss experienced by both the client and the counselor.
Developmental stages:
Different theories describe a sequence of childhood learning that requires progressively more complex skills and cognitive functions. Each level of learning is typically seen as a stage of development that must be completed before the next stage can be approached. For psychoanalytic thought, stages follow biological functions; for ego psychology, stages follow psychosocial influences; for object relations, stages follow the increasingly sophisticated interactions between the child and caretaker.
Humanism:
A philosophy maintaining that human nature is basically growth-oriented and that all people possess the growth potential to express their worth in positive, constructive ways. When human beings do bad things, it is because their basic nature has been thwarted in some way.
Deterministic:
A belief system proposing that human life is programmed by antecedent occurrences such as pre-birth destiny or early childhood. Lives unfold according to preset patterns and are not open to influence once the pattern is set.
Narcissistic personality disorder:
An adult self-absorbed personality pattern where narcissists overestimate their own needs and lack empathy for others. Results from impoverished mirroring and lack of parental idealization so the self is the primary object of the person's inner world.
Borderline personality disorder:
A personality disorder characterized by instability in both self-concept and interpersonal relationships, featuring dramatic moods swings and impulsivity. This is said to be caused by neglectful parenting and continual childhood frustration whereby the child becomes angry and projects anger onto parents. The child internalizes a world view of danger, and as an adult continually acts out in defense against the imagined hostility of others.
Schizoid personality disorder:
A group of disorders where people experience a limited range of emotions, lack interest in relating to others, and show hardly any emotional expression. Theoretically caused by blocked ego development when a child received little love and was prevented from giving love.
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