Psychoanalytic Therapy

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Psychoanalytic Therapy

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Levels of Consciousness

• Conscious
• Sensations and experiences that the person is
  aware of any point in time
• Preconscious
• Memories of events and experiences that can
  easily be recalled with little effort
• Unconscious
• The container for memories and emotions that are
  threatening to the conscious mind and must be
  pushed away (Sharf, 2004)

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The Structure of Personality

• Id (biological and unconscious component)
• the pleasure principle
• Ego (psychological component)
• the reality principle
• Superego (social component)
• the moral principle

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Ego-Defense Mechanisms

• Are normal behaviors
• Help the individual cope with anxiety
• Deny or distort reality while operating on an
  unconscious level
• Have adaptive value

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The Development of Personality

• 1. Oral Stage (0-1 year) learning to trust
  others
• 2. Anal Stage (1-3) learning independence or
  accepting personal power.
• 3. Phallic Stage (3-6) how parents respond to
  childs sexuality has impacted on later sexual
  attitudes.
• 4. Latency Stage (6-12) investing their sexual
  energy to social acceptable activities.
• 5. Genital Stage (12-60) the focus of sexual
  energy is toward members of the other sex.

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View of human nature

• Deterministic
• Behavior is determined by unconscious motivation
  and biological instinctual drives.
• The first 6 years of life determined your
  personality
• Libido a source of motivation and energy

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Therapeutic Goals

• Make the unconscious conscious
• Strengthen the ego, so that behavior can apply to
  reality
• Explore the past to increase self-understanding
  and gain insight about oneself
• Conduct a successful analysis in order to change
  a persons personality

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Therapists function and role

• Foster a transference relationship
• Help clients gain insight and understand why
  for their symptoms
• make unconscious conscious
• Build relationship, listen, interpret, and pay
  attention on resistances
• Assess the clients readiness to change

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Therapeutic Relationship

• Understanding the old pattern, connecting to
  current issues, and making new choices
• Working through the transference relationship
• Therapists reaction is not equal to
  transferences
• Counter-transference reaction as a therapeutic
  tool to understand the world of the clients

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Psychoanalytic Techniques

• Free Association
• Dream Analysis
• Interpretation
• Transference
• Counter-transference
• Resistance

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Free Association

• Client reports whatever comes to mind
• It opens doors to unconscious wishes, fantasies,
  conflicts, and motivation.
• Content may be bodily sensations, feelings,
  fantasies, thoughts, memories, recent events, and
  the therapist.

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Dream Analysis

• Dreams provide insights for unresolved issues
• Wishes and fears can be revealed in dreams
• Unacceptable wishes or memories are often
  expressed in dreams
• Dream is a compromise between repressed id and
  the ego defenses

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Interpretation

• Therapist points out, explains, and teaches the
  meanings of whatever is revealed
• Guidelines
• Close to conscious awareness
• Consider clients readiness
• Go only as deep as the client is able to go
• Point out resistance or defense before
  interpreting the emotion or conflict that lies
  beneath it

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Transference

• The client reacts to the therapist as he did to
  an earlier significant other
• This allows the client to experience feelings
  that would otherwise be inaccessible
• Analysis of transference allows the client to
  achieve insight from the influence of the past

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Counter-transference

• The reaction of the therapist toward the client
  that may interfere with objectivity
• Different kinds of counter-transference
• The irrational reactions of therapists toward the
  patients
• Therapists reactions

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Resistance

• Anything that works against the progress of
  therapy and prevents the production of
  unconscious material
• Working alliance increased when resistance
  decreased (Patton, Kivlighan, Multon, 1997)
• Examples?

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Analysis of resistance

• Helps client become aware of the reasons for the
  resistance (e.g., avoiding pain or anxiety)
• Helps the client see that resistance (e.g.,
  canceling appointments) is a way of defending
  against anxiety
• Resistance interferes with the ability to accept
  changes

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Contribution to multicultural counseling

• Help clients to build ego and cultural identity
• Help therapists become aware of their own source
  of counter-transference, bias, prejudices, and
  stereotypes.

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Limitations for multicultural counseling

• Cost, Upper- and middle-class values
• Ambiguity (vs. Asian prefers structured and
  concrete solution)
• Blame clients vs. blame external factors (social,
  cultural, or political factors)