Clinical psychology chapter 12

Anal stage

The psychosexual stage that extends from about 6 months to 3 years of age, during which the child focuses on urination and defecation as means of satisfaction. Freud's second stage of development, "fixation" at this stage would likely manifest in "obsessive compulsive" symptoms.

Analysis of dreams

A psychoanalytic technique that attempts to shed light on unconscious material. Because dreams are regarded as heavily laden with unconscious wishes in symbolic form, the analysis of dreams is believed to provide important clues to these wishes.

Brief psychotherapy

Psychotherapy of relatively brief duration that has grown in popularity due in large part to the cost-containment measures imposed by health care systems. Many brief therapies have retained a psychodynamic identity.

Catharsis

The release of psychic energy (achieved by reliving traumatic events) believed by psychoanalysts to have important therapeutic benefits.

Death instincts (thanatos)

The innate drives that are responsible for all of the negative or destructive aspects of behavior. Freud invoked this concept to account for man's apparent illogical drive to destroy others and himself.

Defense mechanisms

Strategies used by the ego to stave off threats originating internally, from one's id or superego. (Also referred to as ego defenses.)

Ego

The organized, rational component of the personality. The ego uses perception, learning, planning, and so forth to satisfy the needs of the organism while at the same time preserving its place in the world.

Ego analysis

An alternative to traditional psychoanalysis that is characterized by relative de-emphasis on the role of the unconscious and the exploration of childhood experience and relative emphases on the adaptive functions of the ego (e.g., perception, learning, memory) and the exploration of contemporary problems in living. Anna Freud and the other ego analysts agreed with Freud that the ego invoked defense mechanisms to mediate id - superego conflicts. However, they felt that the ego did not just exist to deal with conflict. It was responsible for functions such as learning, memory, and perception.

Fixation

The defense mechanism that occurs when the frustration and anxiety of the next psychosexual stage cause the individual to be arrested at his or her current level of psychosexual development.

Free association

A cardinal rule of psychoanalysis in which patients are required to say anything and everything that comes to mind. Over time, free association is believed to shed light on unconscious thoughts and urges.

Genital stage

The psychosexual stage that follows the onset of adolescence and ideally culminates in a mature expression of sexuality.

Id

The deep, inaccessible portion of the personality that contains the instinctual urges. The id is without order, logic, or morals and operates solely to gratify the instinctual urges

Insight

In psychoanalytic psychotherapy, a complete understanding of the unconscious determinants of one's irrational and problematic thoughts, feelings, or behaviors. The primary GOAL of orthodox psychoanalysis is to make the unconscious conscious and bring about insight.

Interpersonal psychotherapy

A brief, insight oriented therapy that is psychodynamic in tone. IPT has been applied primarily to the treatment of depression and is considered a "well-established" empirically supported treatment for this disorder. [see box 12 - 3] an active straightforward approach focusing on current relationships. It's three phases include 1. diagnostic evaluation, 2. pursuing specific strategies and goals, and 3, therapist reinforcement of "mastery experiences.

Interpretation

A method in which the psychoanalyst reveals the unconscious meanings of the patient's thoughts and behaviors, thus helping the patient to achieve insight. Interpretation is the cornerstone of nearly every form of dynamic psychotherapy.

latency stage

The psychosexual stage that extends from about 5 to 12 years of age, during which the child is characterized by a lack of overt sexual activity (and perhaps even a negative orientation toward anything sexual).

latent content

The symbolic meaning of a dream's events. It is the true symbolic meaning of a dream which the analyst uncovers [e.g., patient is expressing the Oedipal desire to kill his father if he dreams of being a knight trying to kill the king].

life instincts (eros)

The innate drives that are responsible for all of the positive or constructive aspects of behavior.

Manifest content

What actually happens during a dream. The surface appearance of a dream [e.g., patient is a knight trying to kill the king].

Moral anxiety

Anxiety that arises from the concern that a person will act in a way that conflicts with the standards of his or her conscience. One of three types of anxiety [see neurotic and reality], based on fear that one's actions will conflict with the values of the superego

Neurotic anxiety

Anxiety that stems from the fear that a person's id impulses will be expressed unchecked, thus resulting in trouble. One of three types of anxiety, based on fear that id impulses will be expressed.

Oedipus complex

The phase in which a child feels sexual attraction for the parent of the opposite sex and feelings of hostility toward the parent of the same sex. The superego emerges from the resolution of this complex.

Oral stage

The psychosexual stage spanning about the first year of life, during which the mouth is the chief source of pleasure and satisfaction.

Phallic stage

The psychosexual stage that extends from about 3 to 7 years of age, during which the sexual organs become the primary source of gratification.

Pleasure principle

The rule of conduct by which one seeks pleasure and avoids pain. The id operates according to the pleasure principle.

Primary process

The irrational and impulsive type of thinking that characterizes the id.

Projection

The defense mechanism that occurs when a person attributes his or her unconscious feelings to someone else

Psychic determinism

A major assumption of Freudian theory that holds that everything one does has meaning and is goal directed.

Psychosexual stages

A series of developmental stages posited by Freud, each of which is marked by the involvement of a particular erogenous zone of the body.

Reaction formation

The defense mechanism that occurs when an unconscious impulse is consciously expressed by its behavioral opposite.

Reality anxiety

Anxiety that arises from the presence of a real danger in the outside world. One of three types of anxiety, based on a real threat or danger.

Reality principle

The rule of conduct by which one defers the gratification of instinctual urges until a suitable object and mode of satisfaction are discovered. The ego operates according to the reality principle.

Regression

The defense mechanism that occurs when extensive frustration causes a person to return to a stage that once provided a great deal of gratification.

Resistance

Any attempt by the patient to ward off the therapist's efforts to dissolve his or her neurotic methods for resolving problems. Any client action or behavior that prevents insight or prevents bringing unconscious material into consciousness. An important factor in psychoanalysis. As more relevant and important issues come up, the patient may come up with various ways of avoiding discussion of this sensitive material.

Secondary process

The rational and self-preservative type of thinking that characterizes the ego.

Superego

The component of the personality that represents the ideals and values of society as they are conveyed to the child through the words and deeds of his or her parents. The role of the superego is to block unacceptable id impulses and to pressure the ego to serve the ends of morality rather than those of expediency.

Talking cure

Discovered by Breuer, the use of techniques that encourage patient talking as a way of addressing and alleviating neurotic symptoms. Joseph Breuer discovered the phenomenon that would become known as "catharsis" as he worked with "Anna O," a women with many symptoms of "hysteria."

Therapeutic alliance

The bond between patient and therapist. A strong therapeutic alliance is believed to contribute significantly to a positive therapeutic outcome. Probably the "active ingredient" in psychoanalysis, or any therapy for that matter.

Transference

A key phenomenon in psychoanalytic therapy in which the patient reacts to the therapist as if the therapist represented an important figure from the patient's past. For example, a parent. Early in therapy, transference is usually positive (affection), later on, negative transference (hostility) is likely.

Unconscious

The portion of the mind that is not accessible to awareness.

Unconscious motivation

Motivation that resides outside conscious awareness. Freud posited the existence of unconscious motivation and asserted that it was responsible, in large part, for disturbed behavior.

Working-through process

A careful and repeated examination of how one's conflicts and defenses have operated in many areas of one's life. It is through this process that an insight achieves true, full meaning for the patient.

Studies on hysteria

Josef Breuer and Freud collaborated on this important book
which was published in 1895 (see Box 12 - 1).

Hypnosis

Freud became interested in hypnosis when he studied with Jean Charcot
who had been using it. He later found it unnecessary and focused on other
techniques.

Object relations

Heinz Kohut and others, view relationships with others early in life as primary. Issues of dependence and autonomy are important. Internalized representations of important figures [parents] are the "objects." Unhealthy internalized objects lead to neurosis.

Hans Strupp's Vanderbilt experiment

[see profile 12 - 1] college professors were as
effective as trained therapists in treating moderate anxiety, depression, and social
withdrawal among college students. This supports other research suggesting that
the "curative factor" or active ingredient in psychoanalysis is the "quality and
strength of the therapeutic alliance."

Limited Application

psychoanalysis is definitely NOT for the masses. It requires that the client be 1. reasonably well education, 2. have the potential for insight, and 3. have plenty of money.

Freud's Self analysis

many respected him for this effort. It was motivated by
depression and anxiety following his father's death [see box 12 - 2].