Psychoanalytic Therapy

Founder

Sigmund Freud

Assumptions

• Psychological problems are rooted in the unconscious mind.

• Unconscious thoughts, feelings, desires, and memories influence behavior and symptoms

• Manifest symptoms are caused by latent, hidden disturbances, often unresolved developmental conflicts or repressed trauma

• People have unconscious conflicts, often originating in early developmental stages

• Individuals are ambivalent about change and avoid painful unconscious material

• The therapeutic relationship itself is a key vehicle for exploring and resolving unconscious conflicts

Basic concepts

• The unconscious mind holds repressed conflicts that influence current behavior.

• Bringing unconscious material to consciousness allows insight and resolution.

• Defense mechanisms and resistance are barriers to awareness and change.

• Insight, interpretation, clarification, and confrontation are essential therapeutic techniques

• The therapy explores how unconscious motivations affect thoughts and behaviors

• The therapeutic relationship is used to explore psychological processes and enact change

• Long-term treatment allows for deep personality and characterologic changes

Goals of Therapy

• To make the unconscious conscious.

• To strengthen the ego and improve ego-adaptive capacities.

• To bring out unconscious material to conscious awareness.

• To develop self-understanding and insight into motivations and conflicts.

• To achieve basic characterologic improvement, not just symptom relief

• To help clients achieve greater emotional maturity, meaningful relationships, effective work, and social responsibility

• To resolve repressed conflicts and reduce psychological distress

Role of Therapist

• Facilitate exploration of unconscious material through interpretation and confrontation.

• Maintain a therapeutic relationship characterized by respect, understanding, tact, and belief in the ability to help

• Provide a supportive, consistent emotional environment for working through conflicts

• Use subtle cues, suggestion, persuasion, and corrective emotional experiences to promote change

• Model maturity and provide a "power base" for influence

• Encourage honest self-scrutiny and communication

• Help the client apply insights to daily life

Assessment

• Assessment involves exploring unconscious conflicts, developmental history, defense mechanisms, and symptom functions

• Understanding the patient's resistance and ambivalence toward change is important

• The therapist assesses the capacity and willingness of the patient to engage in the analytic process

Intervention

• Interpretation of unconscious material, including dreams, free associations, and transference phenomena

• Clarification and confrontation of defenses and resistance

• Encouragement of emotional expression and abreaction (release of repressed affect)

• Working through repetitive patterns in the therapeutic relationship

• Use of transference and countertransference as tools for insight and change

• Repeated reality testing and application of insights to real-life situations

Change

• Change is aimed at deep characterologic improvement, not just symptom removal

• Traditionally attributed to insight and emotional release (abreaction), but also involves multiple factors such as therapeutic relationship, suggestion, identification with the therapist, and working through

• Change includes improved ego function, emotional maturity, and better interpersonal relationships

• Change is a gradual process requiring sustained therapeutic work

Termination

• Setting a termination date is part of the therapeutic process and can itself promote change

• Termination involves consolidating gains and preparing the client to maintain changes independently

Evaluation

• Evaluation focuses on the extent of characterologic change, ego strength, and emotional maturity achieved

• Symptom reduction is considered less important than fundamental personality change

• The quality of the therapeutic relationship and the client’s ability to apply insights in daily life are key markers of success