Human Behavioural Science Psychoanalytic theory and illness response

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Human Behavioural Science
Psychoanalytic theory and illness response

• Dr. Ghadah F. AL-Saad.
• M.S.C, Psych. Ph.D.

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PSYCHOANALITIC theory

• Sigmund Freud neurologist was the founder of
  psychoanalysis.
• Psychoanalysis is a comprehensive approach to
  understand the personality, and the emotional
  reactions of patients during stress of physical
  illness.
• Three fundamental aspects of psychoanalytic
  psychology
• A method of investigation of the mind.
• A general theory of human behaviour.
• A method of treatment for certain psychological
  disorders.
• The mind or psyche is perceived as having
  unconscious, active processes taking the form of
  dynamic forces or impulses seeking expression and
  satisfaction.
• The psychological processes are flows of
  psychological energy in the brain, establishing
  "psychodynamics"
• The psychological forces that underlie human
  behavior, emphasizing the interplay between
  unconscious and conscious motivations.

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the Dynamic point view

• The adaptive point of view
• The human organism is born pre-adapted to
  external reality. The ego develops an internal
  regulator of behaviour and becomes the human
  organ of adaptation.
• The developmental hypothesis/genetic point view
• Every behaviour is a product of 2 basic
  interacting factors
• Intrinsic forces which are antecedent to the
  independent of experience.
• Experiential factors which are based on learning
  environmental influences.
• Regression/Fixation
• The human behavioural development is a product of
  a series of progression and regression.
  Regression returning to an earlier immature or
  childlike state of feeling and thinking during
  stress to avoid anxiety it is a self-protective a
  defence mechanism. A person may have become
  fixated in the past, as a failure in the
  psychical behavioural development. Clinically
  important to understand neurosis and psychosis.
• Basic Drives
• Sexual drive
• Aggressive drive
• The Pleasure and Un-Pleasure Principles
• Gratification , Satisfaction, and Pain

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structural concepts

• Unconscious
• Everything in the mind outside of normal
  conscious awareness processes here are
  irrational, and obey primary process logic, and
  may be revealed through dreams, a slip of the
  tongue, and pen or free association. It is source
  of emotional and traumatic conflicts of which
  the person is unaware and which give rise to
  particular symptoms in the form of personal and
  interpersonal problems. It expresses unacceptable
  sexual desires, aggressive, anxiety, shame, guilt
  , impulses.
• Preconscious
• Psychic material (thoughts emotions) not
  occurring as deeply in the mind as conscious or
  unconscious material can be experiences
  consciously through attention.
• Conscious
• Mental processes consisting of the ordinary
  stream of thoughts and emotions which are
  actively experienced as they occurred. These
  processes obey rational secondary processes.
• Dr. Ghadah F. AL-Saad.
• Psychoanalytic Theory
• 17/10/09

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structural concepts

• Id
• Unconscious collection of drives, urges, and
  wishes that continually push for complete and
  immediate gratification despite the constraints
  of reality. The primitive sexual and aggressive
  impulses of the id obey the pleasure principle
  and engage in wish fulfilment through primary
  process through the primary process thinking
  (which is irrational thoughts and demands
  gratification and satisfaction.
• Ego
• Self The agency of the mind that mediates
  between id drives, external reality and the
  prohibitions of the superego, working to
  facilitate maximal gratification while adapting
  to external and internal moral standards it is
  complex set of functions includes reality testing
  trough the rational secondary process thinking.
  Ego regulates thoughts perceptions, logic,
  learning, judgment, intelligence, language, and
  defence mechanisms.
• Superego
• The group of psychic functioning, that represent
  morals standards, prohibitions, and conscious.
  Superego generates affects of shame and guilt .
  It develops through the identification or
  internalisation of one parental figure.

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PSYCHOSEXUAL DEVELOPMENT

• Oral stage (0-18)
• The psychosexual phase during the first 18 months
  during which the mouth, lips, and tongue are the
  major source of sensual pleasure. The baby is
  completely dependent on the mother for
  nourishment, pleasure sensation, and secure
  atmosphere. People fixated at this stage are said
  to have the following tendencies dependency,
  generosity, optimism or pessimism, depression or
  aggression, rejection, mistrust, insecurity, and
  difficulty in making commitments.
• Anal stage (18- 3 years)
• The psychosexual stage occurs during the anal
  sphincter control when the child is aware of
  bowel function, the pleasure is derived from the
  anus. This is being achieved through the
  retention or defecation of faeces. The child
  struggles for control (freedom to produce or
  withhold bowel movements, he/she might be
  stubborn, uses frequently the word no. If the
  family is rigid strict critical, punishing and
  emotionally constricted the child becomes
  obsessive-compulsive person.
• unresolved anger and fear of both
  punishment and loss of the parents love.
• Phallic stage ( 3 6 years)
• The psychosexual stage leads organ of pleasure
  the penis for the boy the clitoris for the girl,
  and the masturbatory stimulation. The child
  becomes interested in genitals. This stage leads
  to Oedipus complex.

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Oedipus complex

• MOTHER
  CHILD FATHER
• Oedipal stage (3-5) This triangular sexual
  relationships is the unconscious desire on the
  part of a child to have sex with the opposite
  sexed parent (love-parent) and at the same time
  the desire to get rid of the same sexed parent.
• Castration anxiety for the boy
• The boy suffers from anxiety because of the fear
  of losing his penis as punishment for the sexual
  desire of the mother, this fear leads him to
  identify with the father to avoid punishment.
• Penis envy for the girl
• The girl feels that she has lost her penis and
  as a result seek an appropriate symbolic
  substitute for the penis. She develops a Genital
  inferiority complex.
• Latency stage (5-12) the sexual drives and
  conflicts are less apparent, this is the period
  of considerable development of the ego.
• The Resolution of Oedipal stage outcome
• love/ hatred of one parent /Ambivalence
• Super Ego/Ego-ideal identification
• Psychopathology
• Homosexuality

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The role of anxiety

• The first danger situation is the loss of the
  parent ( loss of the object) love and dependency.
• The second danger situation is fear of the loss
  of the parents love/ abandonment.
• The third danger situation is fear of the loss of
  the penis by castration in the boy and by the
  genital damage in the girl.
• The fourth danger occurs in conjunction with the
  resolution of the Oedipus complex and the fear of
  disapproval or punishment by the superego

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defense mechanism

• Specific unconscious mental methods used by the
  ego to protect against the danger of conscious
  awareness of repressed drives or wishes
  associated with real or imagined punishments of
  childhood.
• Repression
• Displacement
• Reaction formation
• Intellectualisation
• Suppression
• Sublimation
• Denial ( psychotic)
• Projection
• Passive-aggressive behaviour
• Acting-out
• Dissociation

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the theory of neurosis

• Psychoanalytic theory of neurosis /Freud
• Neurosis a mental disturbance involving
  abnormalities of thoughts and behaviour attitudes
  and emotions. Classical neurosis Hysteria,
  Obsessions, and depression the symptoms are
  ego-dystonic.
• The intrapsychic conflict leads to compromise
  among the agencies id, ego, superego of the mind.
  
• Anytime the ego is confronted with impulses that,
  gratified, would lead to psychic danger, the ego
  signal a conflict. It allows small discharge of
  anxiety to initiate defences against the
  threatening impulse and accommodates to the
  pressure of the drives, superego and the external
  reality.
• If the egos compromise succeeded in terms of
  feelings and behaviour it means the person is
  mentally healthy and stable.
• If the egos compromise failed in terms of
  feelings and behaviour it means neurosis is
  emerged, and the person will be neurotic.

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self theory and development of the self

• Freud
• Ego / Superego idealisation
• Narcissism / mirror stage
• I am perfect look at me
• Ego-centricity, self-importance, grandiosity,
  selfishness, and arrogance in varying degrees

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psychoanalyst- patient relationship

• Transference
• The unconscious displacement of feelings,
  attitudes, and expectations from important
  persons in the patients childhood to current
  relationships.
• Transference Relationship
• Positive transference
• Negative transference
• Counter transference
• Positive counter-transference
• Negative counter-transference
• Resistance
• The automatic opposition to free association that
  is activated to protect against the emergence of
  awareness of inner unconscious conflicts.

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Psychoanalysis Psychotherapy
Psychoanalysis Psychoanalytic Psychotherapy
Purely classical Freudian and others. For patients who suffer chronic symptoms. Long term, intensive. 5-6 years. Intensify the transference relationship. 4-5 times a week 50-minute. Patient on the couch. Psychodynamic schools. For patients who suffer acute symptoms. Short -term, less intense. 3 years. Minimise the transference relationship. 1-3 times a week half an hour-1. Patient and therapist face-to-face.
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Elements of Psychodynamic Therapy

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  Problems will be reduced or
  Use of Transference/Counter
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  resolved through the client
  Transference.
  Interpretation
• 
  
  attaining insight .
  of Resistance
  and Defences.
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  Dream
  Interpretation. Free
  
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  Association .
• Current problems arise
  Structural Id, Libido,
  Ego, Superego
  Interpretations of Dreams, Free
• from unresolved unconscious
  Psychosexual Stages Oral,
  Anal, Phallic,
  Association, Resistance, Defences
• conflicts originating in early
  Latency, Genital . Defence
  Mechanisms.
• childhood (Oedipus Complex)
  Castration Anxiety.
  

Formulation of the Problem
Therapeutic Techniques
Concept of Person
Persons behaviour is determined by unconscious
process








Origins of Problems
Key Concepts
Assessment Techniques
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