Psychoanalytic

ADVANCED COUNSELING & PSYCHOTHERAPY CLASS

OVERVIEW

Background Sketch of Sigmund Freud

A Review of Freud’s Theory of Personality

Psychosexual Stages

Theory of Psychopatholog y

Therapeutic Processes and Content

15-Item Quiz

BACKGROUND

Sigismund (Sigmund) Freud was born on either March 6 or May 6, 1856, in Freiberg, Moravia (Now part of the Czech Republic).

First born child among the seven children of Jacob and Amalie Nathanson Freud.

He was the favorite child, which contributed to his lifelong self- confidence.

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When he was about one and a half years old, his mother gave birth to his younger brother, Julius, which had a significant impact on his Psychic Development because Sigmund developed hostility and harbored an unconscious wish of Death for Julius.

Julius died less than a year later. Freud suggested that this unexpected and tragic fulfillment of his wish was the

source of some lingering guilt that pursued him throughout his life.

BACKGROUND

Freud went to University of Vienna Medical School because he loved medical practice but intensely curious about human nature.

Freud preferred teaching and doing research in Physiology.

Freud worked for three (3) years in General Hospital of Vienna and practice various branches of psychiatry and nervous diseases

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He spent four months with Jean-Martin Charcot, a French Neurologist from whom he learned the Hypnotic Technique for treating Hysteria.

JEAN-MARTIN CHARCOT

Hysteria - A disorder typically characterized by paralysis or the improper functioning of certain parts of the body.

Came from the Greek word which means Uterus Commonly experienced by Women, the theory that the Uterus travels within the whole body causes

extreme pain

MEETING

A well-known Viennese Physician from whom he learned Catharsis

Freud adapted the use of Catharsis until he discovered the Free Association Technique, which soon replaced Hypnosis as his principal therapeutic technique.

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Freud used Catharsis and revised it into Free Association, which is what he was known for.

Catharsis - The process of removing Hysterical symptoms through “talking them out.”

THE CASE OF

detail

As Freud continued to work with Breuer, he discussed in with Freud the case of Anna O.

Breuer spent several years treating Anna O's Hysteria.

Freud urged Breuer to collaborate with him in publishing an account of Anna O and several cases of Hysteria.

Anna O's real name is Bertha Pappenheim diagnosed with Hysteria as symptoms follow:

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1. Paralysis

2. Involuntary eye movements 3. Lethargy

4. Language

difficulties 5. Hallucinations.

Freud and Breuer used hypnosis to treat Anna O,

which helped her to release her thoughts and described it as

talking therapy.

THE CASE OF

Anna's storytelling habits gave Breuer intriguing insights into her mind. During her meetings with her therapist, Anna also recalled an occasion when she was younger when she had a glass of water. Anna became Hydrophobic (fear of water). The dog approached the glass. Anna was repulsed at the thought of sharing a glass of water with a dog.

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Breuer and Freud believed that by bringing unconscious anxieties, such as hallucinations and traumatic experiences, to conscious attention, Anna could overcome any related symptoms.

Over time, her problems ceased, and she made a gradual recovery and was given a pet dog to look

after

MEETING

Wilhelm Fliess is a Berlin Physician who, through letters, served as a sounding board for Freud’s newly developing ideas. Their friendship ended in 1903, and Freud published his book, ‘Interpretation of Dreams.’

Freud’s Crisis

1. As Freud underwent self-analysis due to professional isolation and personal crises when his father died, he began to analyze his dreams. He regarded himself as his own best patient.

2. Due to his abandonment of his treasured ‘Seduction Theory.’ He believed that repressed memories of Infantile Sexual Abuse cause Hysteria and obsessional neurosis because children unconsciously seduce their parents

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FREUD DEBUNKED

1. This theory had not enabled him to treat even a single patient successfully.

2. A significant number of fathers, including his own, would have to be accused of sexual perversion.

3. Freud believed that the unconscious mind could probably not distinguish reality from fiction

4. He found that unconscious memories of advanced psychotic patients rarely revealed early childhood

sexual experiences.

A REVIEW OF

FREUD’S THEORY

OF PERSONALITY

LEVELS OF MENTAL LIFE

Conscious - Awareness at a given time, directly available to use, our present thoughts.

Preconscious - Elements that are not conscious but can become conscious either quite readily or with some difficulty

For example: I asked you to recall what happened on your birthday last year. The information will be recovered from your preconscious to your awareness.

Unconscious - Drives, urges or instincts that are beyond our awareness but motivates most of our words, feelings and actions

For example: Fears, violent motives, immoral urges,

irrational wishes, selfish needs, unacceptable sexual desires, etc.

CENSORSHIP

These are used to block the passage between the unconscious and preconscious to prevent undesirable anxiety-producing memories from entering awareness. The level of the mind has only two sensors, the Primary and the Final Censors.

PROVINCES

Id (Das es)

Also known as the “it.”

It is based on the pleasure principle, which uses wish fulfillment to satisfy needs

It is concerned with satisfying its personal desires For example, Cutting classes, cheating on a test

Ego (Das ich)

Also known as the “I.”

It starts at the age of 2, the time that a toddler can already understand the concept of right and wrong.

It is based on the reality principle

It mediates between the id and the superego

For example, A person who is dieting but chooses not to give in to hunger cravings.

Superego (Uber ich)

Starts at the age of 5. At this age, a child starts to develop his conscience.

Also known as the “Moral Principle.”

It represents society’s values and parent’s standards.

Drive s

DYNAMICS

Sex (Eros)

The aim of sexual drive is pleasure but is not limited to genital satisfaction.

Libido is not limited to sex; it is a life instinct, an energy that pushes us to make us feel alive, including pleasurable things.

The German stimulus within the

word ‘Trieb’ is a drive or

1. Sex

2. Aggression Freud referred to

it as the two cornerstones of

person Instinct

or Impulse

It operates as a constant motivational force.

Two Major Headings of Drives

Psychoanalysis.

Aggression

Freud constituted the concept of aggression after the World War I when he observed why people kill, why people kill other people.

Also known as Thanatos, powered by an unnamed energy

due to the death of Freud, also referred to as the Death Instinct or Death Energy.

DEFENSE MECHANISMS

According to Freud, these

Repression - The mother of all defense mechanisms and the most common. Threatening

destructive for the body.

memories or feelings are

forced back into the

are used

deal with unwanted thoughts

and

unconscious. Almost similar to forgetting

Sublimation - Substituting Id impulses into socially acceptable actions, converting

desires work

that

negative to positive behavior. For example, if

sexual preoccupation transferred into the art of nude art.

unconsciousl

y. To protect ourselves from anxiety- producing thoughts.

Displacement - Negative impulses are transferred from the original target to another person or object. For example, stress from work is placed into getting mad at your family.

Denial - Stating specific facts do not exist. For example, alcoholics, when asked, say, “I’m already used to it”, yet it’s harmful and

Reaction Formation - Concealing a motive by giving a strong expression of the

opposite. For example, “I hate people, but I love

pursuing Psychology. ”

Projection

Attributing unconscious

impulse to other people instead of oneself. For example, insisting it is other’s fault than oneself.

Rationalization - Making excuses that is more socially acceptable.

Undoing - To make up for a bad act by doing good. For example, when one did something bad, babawi by doing good.

Regression - Turns behavior in early phases of life (safe stage). For example, when dealth wth stress, one turns into their early phases like when crying, hugging a pillow, and in times of difficulties, will look for parents.

PSYCHOSEXUAL DEVELOPMENTAL STAGE

(OAPLG)

To Freud, the first 4 or 5 years of life,

Latency - 6 or 7 year period, time little Genital Stage -

or the infantile stage, are the most crucial for personality formation.

or no sexual growth takes place. of sexual life occurs

Puberty, a renaissance

RAL STAGE

PHALLIC STAGE

LA ENCY

S AGE

REPORTER #2

Xandra is a 2nd year MA Clinical Psychology Student at University of Santo Tomas (UST) Manila.

She is a Registered Psychometrician and is currently working as an a teacher specializing in behavior modification with kids within the ASD.

You can know me better by watching the video that will be played after this slide. :)

Background Sketch of Sigmund Freud

A Review of Freud’s Theory of Personality

Psychosexual Stages

Therapeutic Processes and Content

Theory of Psychopatholog y

15-Item Quiz

Freud's theory of psychopathology is a central component of psychoanalytic theory, which he developed in the late 19th and early 20th centuries.

This theory suggests that psychological disorders and mental distress arise from unresolved unconscious conflicts, often rooted in early childhood experiences.

The UNCONSCIOUS

Psychic Structure and

Defense Mechanisms

Childhood Experience s

GOAL Of PSYCHOANALYTIC THERAPY

THERAPEUTIC

To make unconscious

influences on

current

behavior

conscious, aiming to

enhance

self-

awareness and

correct distortions.

By bringing unconscious drives to

awareness,

psychoanalysis

reduces

reliance on

defense mechanisms,

Psychoanalytic therapy tends to be more long-

term, intensive, and open-ended, with

strengthens the

ego, and balances

the

specific practices like using a couch and

id and superego, leading to more

realistic expression of needs.

maintaining therapist neutrality. Today, many practitioners blend these approaches, valuing flexibility and adapting methods to client needs.

PROCESS

1. EMPATHY

It involves the therapist’s ability to identify with the client's experience and immerse themselves in it, which is crucial for establishing a strong therapeutic alliance.

2. INTERPRETATION

It involves the therapist helping the client become aware of unconscious aspects of their intrapsychic experience and relational

3. CLARIFICATION, SUPPORT AND ADVICE

patterns.

4. TERMINATION

While therapists aim to foster clients’ self-trust, they also acknowledge that reassurance or advice can be crucial, especially in difficult or anxiety- provoking situations.

A well-timed word of advice can be especially important for clients feeling overwhelmed or in crisis.

Termination helps clients integrate insights gained during therapy, provides closure to the therapeutic relationship, and prepares them for continued self- management and independence outside of therapy.

TRADITIONAL INTERVENTION

STRATEGIES

TRANSFERENCE

FREE ASSOCIATION

DREAM

ANALYSIS

POST HYPNOTIC SUGGESTION

RESISTANCE

Definition and Importance:

Transference occurs when the client projects feelings and expectations shaped by past relationships with significant caregivers onto the therapist.

This is common in therapy, where the therapist often takes on a role reminiscent of a parental or authoritative figure.

This process allows the therapist to gain insight into the client's unresolved conflicts and how these influence their current relationships.

Therapeutic Opportunity:

Transference offers the therapist a unique opportunity to help the client relive and re-examine past relationships in the context of the therapeutic relationship.

The insights gained are experiential, leading to deeper change rather than just intellectual understanding.

COUNTER

Definition: Countertransference refers to the therapist's emotional responses to the client, encompassing all reactions, including feelings, fantasies, and associations.

Therapeutic Value and Risks: While countertransference can provide valuable insights into the client's unconscious processes, it carries the risk of interference if the therapist's unresolved issues influence the therapeutic process. It is essential to understand the contributions of

both the client and therapist to fully harness its clinical value.

TRANSFERENCE VS COUNTER-TRANSFERENCE

TYPES of RESISTANCE:

Definiti on:

Repression Resistance

use of defense mechanisms to

suppress painful memories

Transference Resistance

Resistance is the client's instinctual reaction to avoid

projecti on

of unresolved

confronting uncomfortable or repressed emotions and drives, often

manifesting as behaviors that

hinder

feelings onto the therapist

Ego Resistance

therapy, like difficulty expressing thoughts or missing appointments.

maintains dysfunction

unconscious benefits Working Through

for

repeats harmful behaviors

Change in Perspective:

eve n

afte r

other

Once seen as an obstacle, resistance is now viewed as a self-protective mechanism that should be understood and

empathized with, recognizing its role in the client's

psychic functioning.

Definition:

Hypnosis is a mental state induced by a series of instructions and suggestions, leading to a highly focused, absorbed state.

It is used in therapy (hypnotherapy) to make suggestions that unconsciously redirect behavior.

Processes:

INDUCTION SUGGESTION

Technique:

Clients are encouraged to share whatever comes to mind without self-censorship.

The counselor clarifies and confronts to help analyze unconscious content in dreams, fantasies, or enactments.

Goal:

The aim is to explore the client’s thoughts and feelings in a nonjudgmental environment, revealing intuitive links and new personal insights.

It is a journey of co-discovery, enhancing the

client’s integration of thought, feeling, agency, and selfhood.

FREE ASSOCICATION

Freud’s Perspective:

Freud viewed dreams as the "royal road to the unconscious" and encouraged patients to share their dreams.

This approach aims to access deeper, less defended layers of

the individual's personality.

Importance in Therapy:

Dreams are central to understanding the unconscious.

The manifest content is the dream as

Condensation: Understanding how single dream elements may represent multiple associations and ideas.

Displacement: Identifying how emotional significance is shifted from its original source to another object or person in the dream.

Representation: Analyzing how abstract thoughts are converted into visual imagery within dreams.

Symbolism: Interpreting symbols in dreams to uncover hidden conflicts and desires.

BRIEF INTERVENTION STRATEGIES

Brief Psychodynamic

Psychodynamic Interpersonal

Overview: Brief psychodynamic therapy helps clients address unresolved conflicts from past

relationships that manifest in current issues. The therapy focuses on one main problem per session, encouraging exploration of related issues without using free association.

Goals: 1. To help clients understand the connection between their symptoms and interpersonal

relationships by identifying core, unconscious, repetitive patterns.

2. To enhance clients' ability to reflect on their mental states and manage interpersonal difficulties.

Phases:

Duration

1. Initial Phase: The counselor engages the client, providing structure and confronting current difficulties and defenses.

2. Middle Phase: Focuses on a specific problem or pattern, using techniques like dynamic, resistance, transference, and dream interpretation to build awareness of related symptoms.

3. Ending Phase: The counselor and client review progress, discuss the meaning of separation from the counselor, and prepare for the end of treatment.

The therapy generally does not exceed 16 sessions and is designed to initiate lasting change beyond the counseling period. Recent adaptations, such as psychodynamic interpersonal therapy and interpersonal psychotherapy, also align with this brief approach but have distinct techniques.

Overview: It was developed by psychiatrist Robert Hobson in 1983, aiming to make psychoanalytic techniques more

accessible, researchable, and evidence-based.

It integrates psychodynamic, humanistic, and interpersonal concepts to create a comprehensive approach to understanding and treating psychological issues.

Approach: The therapy focuses on collaborative dialogue between counselor and client, using metaphor and present-focused discussions to explore hidden

emotions.

This approach aims to understand and address unconscious content in interpersonal interactions to adjust current behaviors.

Goals:

In up to eight sessions, clients examine negative patterns from childhood to adulthood, identify current symptoms, and develop new communication styles.

The approach emphasizes immediate symptom management and short-term changes for empowerment.

Practice: Studies highlight that language and communication styles play a significant role in client

functionality and symptom management.

The counselor’s neutrality and acceptance are crucial, alongside an awareness of cultural dynamics and potential trauma influences.

Treatment:

Psychodynamic Interpersonal Therapy is used to treat Major Depressive Disorder (MDD) by addressing the interpersonal factors contributing to the client's depression.

It reframes MDD as arising from relational and life circumstances, alleviating self-blame and viewing the condition as treatable.

The therapy’s main goals are to resolve life crises, enhance social skills, improve emotional communication, and strengthen social supports.

This approach helps clients manage their symptoms by addressing the relational dynamics that influence their depression.

Context to Examine:

Counselors frame MDD within four contexts: Grief: Complicated bereavement.

Role Dispute: Ongoing struggle with a significant other.

Role Transition: Life changes such as moving, illness, marriage, or job changes.

Interpersonal Deficits: Social isolation.

Goals: Psychodynamic Interpersonal Therapy (PIT) is effective for treating Major Depressive Disorder

(MDD), as supported by randomized controlled trials. It focuses on interpersonal issues and provides lasting benefits, especially when combined with medication. It's comparable to other therapies like CBT, making it a reliable approach for managing MDD.

Interperson al Psychotehrapy

Interpersonal psychotherapy is a short-term, evidence-based treatment designed to help clients actively manage their mood and functional levels within 12 weeks.

It involves three phases:

a. identifying the diagnosis and its interpersonal context,

b. addressing specific interpersonal problems, and

c. focusing on role transitions and maintaining progress post-therapy.

Narrativ

e Approach

Counselors may use a narrative approach, combining free association with storytelling to help clients process trauma.

As clients narrate their experiences, they transfer their emotions onto the counselor, who aids in reinterpreting these events, leading to

cognitive and emotional change.

Examining Life

Freud's concept of life and death instincts

explores how

and Death Instincts:

traumatic experiences can lead to self-destructive behavior.

Understanding this dynamic helps clients gain insight into

the

interplay between

life, death, and meaning in their

behaviors.

Expressive

Expressive psychotherapy, similar

to psychoanalysis

Psychotherapy

but with a focus on external

problems,

involves more

direct client interaction and less frequent sessions.

While it may

not achieve as profound

results as

psychoanalysis, it can still personality changes.

facilitate significant

Supportiv

Supportive techniques aim to strengthen

clients with

e weakened egos by preventing

regression, reinforcing

Techniques

adaptive defenses,

and

providing emotional and

: practical support through an

interactive therapist-

client relationsh ip.

Overview: In Denmark and other European countries, psychoanalytic psychotherapy is commonly used to

treat eating disorders.

This approach focuses on exploring the underlying psychological issues contributing to disordered eating behaviors.

Evidence:

1. A 2014 randomized controlled trial found that

psychoanalytic psychotherapy was as effective as

cognitive behavior therapy (CBT) in reducing bingeing

and

2. The

purging in eating disorders. therapy's effectiveness was

due

to its ability to

improve

affect

tolerance

and offer

insight into the

psychological functions of these symptoms.

Findings:

The research highlighted psychotherapy helps patients

that psychoanalytic understand and manage

their

emotions

better,

which can lead to

improvements

in eating

disorder

symptoms, making

it a

viable treatment option

alongside other

therapies like CBT.

CLIENTS WITH MENTAL HEALTH ISSUES

Psychoanalytic theory suggests that serious mental illnesses arise from extreme or unbalanced unconscious conflicts.

Symptoms result from hidden drives intruding into voluntary behavior when defense mechanisms fail.

TREATMENT APPROACHES

have emerged for serious mental health disorders, showing positive outcomes.

focusin on insigh transference, and

CLIENTS WITH

INTERVENTION STEPS:

1. Identify attachment-