L3 PSYCHOANALYTIC THERAPY

Freud’s View of Human Nature: What does "deterministic" mean in classical psychoanalytic theory?

Human behavior is determined by irrational forces, unconscious motivations, and biological/instinctual drives.

What are Life Instincts vs. Death Instincts according to Freud?

• Life instincts: Powered by libido (sexual energy); serve the purpose of survival of the individual and human race; oriented toward growth, development, creativity, and all pleasurable acts.

• Death instincts: Aggression drives; represent an unconscious wish to die or hurt oneself or others.

The Id: Key characteristics, governing principle, and core drive?

• Nature: Primitive, instinctive component of personality; amoral, illogical, and demanding ("I want it now!!").

• Governing Principle: Pleasure principle — aimed at reducing tension, avoiding pain, and gaining pleasure to satisfy instinctual needs.

The Ego: Role, governing principle, and function among the systems?

• Nature: Relates to the external world; engages in realistic and logical thinking and formulates action plans to satisfy needs.

• Governing Principle: Reality principle.

• Role: Acts as a mediator/compromiser ("What would be a good compromise?") negotiating between the id's impulses, external reality, and the superego.

The Superego: Developmental timeline, role, and internal rules?

• Nature: The moral component of personality and the last part of the mind to develop.

• Role: Internalizes parental and social standards and values ("Good people don't do that"); enforces and stores moral rules.

Conscious vs. Preconscious Level of Awareness?

• Conscious: Contains material (ideas/feelings/thoughts/perceptions) you are currently aware of.

• Preconscious: Contains "acceptable" material (memories, stored knowledge) just beneath the surface of awareness that can be easily retrieved.

The Unconscious Mind: Definition, content, and characteristics?

• Content: Contains "unacceptable" thoughts, violent motives, irrational wishes, fears, shameful experiences, and selfish needs well below conscious awareness.

• Characteristics: Primitive/animalistic, automatic, hard to retrieve, yet exerts great influence on behavior.

• Repression reason: Repressed because it is a source of psychic pain (such as anxiety).

• Access: Manifests in automatic thoughts and dreams ("the royal road to the unconscious"; wish-fulfillment).

Definition and Function of Anxiety in Psychoanalysis?

• Definition: A feeling of dread resulting from repressed feelings, memories, desires, and experiences emerging to the surface of awareness.

• Cause: Develops from conflict among the id, ego, and superego.

• Function: A state of tension that warns of impending danger and motivates action.

The Three Types of Anxiety (Reality, Neurotic, Moral)?

• Reality Anxiety: Fear of danger from the external world; proportionate to the degree of real threat.

• Neurotic Anxiety: Fear that instinctual drives will get out of hand and lead to punishment.

• Moral Anxiety: Fear of one’s own conscience; feeling guilty when acting contrary to one’s moral code.

What are Ego-Defense Mechanisms and their two defining characteristics?

• Definition: Unconscious psychological strategies relied upon when the ego cannot manage anxiety through rational means.

• Two Characteristics: (1) Deny or distort reality; (2) Operate on an unconscious level.

• Adaptiveness: Adaptive short-term to help cope with trauma/pain, but problematic long-term if over-relied upon to avoid reality.

Defense Mechanism: Repression?

Mechanism: Painful, conflicting, or unacceptable thoughts, memories, or impulses that threaten the ego are forcibly buried from consciousness and pushed into the unconscious.

Defense Mechanism: Sublimation?

• Mechanism: Instinctual sexual drives or aggressive energy are repressed and re-channeled into socially acceptable, appropriate, and constructive pursuits.

• Example: Channeling anger or workplace frustration into kickboxing, exercise, sports, music, or art instead of lashing out.

Defense Mechanism: Reaction Formation?

• Mechanism: Recognizing that unacceptable negative emotions (e.g., anger, hostility) should not be expressed, a person unconsciously behaves in the exact opposite manner of their true impulses.

• Example: Transforming an unconscious dislike or hostility toward a parent into exaggerated admiration.

Defense Mechanism: Denial?

• Mechanism: Refusing to accept reality or painful facts by blocking external events and circumstances from awareness to avoid emotional impact.

• Example: Refusing to accept that a loved one has died, or denying clear criticism from others.

Defense Mechanism: Regression?

• Mechanism: Unconsciously "escaping" to an earlier, less mature stage of development with fewer demands, abandoning adult coping strategies.

• Examples: Children wetting the bed or sucking their thumb after trauma; adults sleeping with stuffed animals, overeating comfort foods, or chain-smoking/chewing pens when stressed.

Defense Mechanism: Projection?

• Mechanism: Attributing one’s own unacceptable impulses, desires, or hostile thoughts onto other people to avoid acknowledging them within oneself.

• Examples: Accusing a partner of cheating because of one's own urge to cheat; believing a coworker hates you when you actually dislike them.

Defense Mechanism: Introjection?

• Mechanism: Completely unconscious internalization of the values, ideas, traits, and attitudes of external authority figures (parents, teachers, peers).

• Example: Adopting a parent's worldview, career path, or belief system through deep identification.

Defense Mechanism: Displacement?

• Mechanism: Redirecting intense emotions and frustrations away from the real, threatening target onto a safer, less threatening substitute person or object.

• Example: Getting furious at your spouse or children after an infuriating day at work instead of confronting your boss.

What are Freud's 5 Psychosexual Stages (Ages & Themes)?

• Oral stage (Birth – 1 year): Focus on seeking love and nurturing; developing trust.

• Anal stage (1 – 3 years): Issues of autonomy and self-control; toilet training occurs.

• Phallic stage (3 – 6 years): Foundation of sexual identity.

• Latency stage (6 – 12 years): Strengthening gender identity and socialization.

• Genital stage (12 – adulthood): Maturation of sex drive, personal identity, and mature sexual relationships.

Freud vs. Erikson on Human Development?

• Freud: Emphasizes psychosexual development and stresses the paramount importance of early childhood experiences (especially the first 5–6 years).

• Erikson: Proposes 8 psychosocial stages that emphasize psychosocial tasks across the entire lifespan beyond early childhood.

What are the Ultimate and Primary Goals of Freudian Psychoanalytic Therapy?

• Ultimate Goal: Increase adaptive functioning by reducing symptoms and resolving internal conflicts.

• Two Primary Goals:

  1. Make the unconscious conscious.

  2. Strengthen the ego so behavior is guided more by external reality and less by instinctual cravings (id) or irrational guilt (superego).

• Focus: Deep probing into the past for fundamental character and personality restructuring, rather than brief problem-solving.

What is the "Blank-Screen Approach" and why is it used?

• Definition: Classical psychoanalytic stance where analysts remain anonymous, neutral, and nonjudgmental, strictly avoiding self-disclosure.

• Purpose: Provides a blank screen that fosters a transference relationship, allowing clients to project their past unresolved feelings onto the therapist.

What is the Nature of the Psychoanalytic Client-Therapist Relationship?

• It is inevitably hierarchical.

• The therapist brings specialized training, expertise, personal analysis/growth, and ongoing supervision.

• Defined by the dynamic tension between Neutrality vs. Mutuality.

What are the Client Requirements in Classical Psychoanalysis?

• Commitment to intensive, long-term therapy.

• Lying on a couch facing away from the analyst.

• Engaging in free association (saying everything that comes to mind without self-censorship).

List the 6 Basic Psychoanalytic Techniques.

• Maintaining the analytic framework

• Free association

• Interpretation

• Dream analysis

• Analysis and interpretation of resistance

• Analysis and interpretation of transference

Technique 1: Maintaining the Analytic Framework?

• Elements: Relative anonymity and neutrality, regularity/consistency of meetings, starting and ending on time, fee clarity, and firm boundaries (avoiding advice-giving or imposing personal values).

• Therapeutic Value: The consistent setting/frame itself serves as a therapeutic factor, emotionally comparable to the regular feeding schedule of an infant.

Technique 2: Free Association?

• Client's role: Saying whatever comes to mind without censorship, no matter how trivial, silly, painful, or illogical it seems.

• Therapist's task: Uncover repressed unconscious material by listening for hidden meanings beneath surface content and noting omitted topics.

Technique 3: Interpretation — Purpose and 2 General Rules?

• Purpose: Pointing out, explaining, and teaching meanings of behavior to enable the ego to assimilate new material and accelerate uncovering the unconscious.

• Rule 1: Present interpretations only when the phenomenon is close to conscious awareness.

• Rule 2: Start from the surface and go only as deep as the client is currently able to tolerate.

Technique 4: Dream Analysis (Manifest vs. Latent Content & Dream Work)?

• Latent Content: Hidden, unconscious, symbolic motives, wishes, and fears.

• Manifest Content: The dream as it consciously appears to the dreamer.

• Dream Work: The transformation process where latent content is disguised into manifest content.

• Analyst Task: Decode the symbols in manifest content to uncover the latent meaning.

Technique 5: Analysis of Resistance — Definition & Clinical Rule?

• Definition: Any thought, feeling, or behavior that works against the progress of therapy and prevents producing previously repressed material (serves as a defense against anxiety).

• General Rule: Therapists point out and interpret the most obvious resistances first to minimize client rejection of the interpretation and help them recognize resistive habits.

Technique 6: Transference vs. Countertransference?

• Transference: The client's unconscious shifting onto the analyst of feelings, attitudes, and fantasies from past significant relationships; provides here-and-now insight into past relational schemas.

• Countertransference: The therapist's emotional reactions/feelings toward the client, often stemming from the therapist's own unresolved conflicts; must be managed via supervision/consultation.

What do RCT meta-analyses show regarding the efficacy of psychodynamic therapy?

Randomized controlled trials (RCTs) and meta-analyses (e.g., Steinert et al.) demonstrate that psychodynamic therapy shows equivalent efficacy when compared to other established, empirically supported treatments.