This is called group analysis. This form of therapy brings together psychoanalytic techniques with interpersonal functions. You may not know what type of therapy is best for you. It takes time and research, and what works for one person, may not work for someone else. You can learn more about the different types of therapy through reading, sharing experiences with others, or by talking to your doctor or counsellor. When searching for a counsellor , be sure to ask questions. If they work to a certain therapeutic technique, they can explain this to you, including the process behind the therapy and its benefits.
You may have an initial consultation, where after you have discussed your concerns and why you are seeking therapy, the therapy may suggest a different approach. Remember that it takes time. What would you say to someone being bullied right now? Find out more at happiful. Are you a counsellor? Log in Join us Find a counsellor. Home What's worrying you? Getting help What is counselling? Not sure where to start? Log in Join us. On this page The history of psychoanalysis How does psychoanalytic therapy work?
By , Freud had theorised that dreams had symbolic significance, and generally were specific to the dreamer. Freud formulated his second psychological theory— which hypothesises that the unconscious has or is a "primary process" consisting of symbolic and condensed thoughts, and a "secondary process" of logical, conscious thoughts.
This theory was published in his book, The Interpretation of Dreams. In this theory, which was mostly later supplanted by the Structural Theory, unacceptable sexual wishes were repressed into the "System Unconscious", unconscious due to society's condemnation of premarital sexual activity, and this repression created anxiety. This "topographic theory" is still popular in much of Europe, although it has fallen out of favour in much of North America.
Psychodynamic Approach | Simply Psychology
In , Freud published Three Essays on the Theory of Sexuality [27] in which he laid out his discovery of so-called psychosexual phases: His early formulation included the idea that because of societal restrictions, sexual wishes were repressed into an unconscious state, and that the energy of these unconscious wishes could be turned into anxiety or physical symptoms. Therefore, the early treatment techniques, including hypnotism and abreaction, were designed to make the unconscious conscious in order to relieve the pressure and the apparently resulting symptoms.
This method would later on be left aside by Freud, giving free association a bigger role. In On Narcissism [28] Freud turned his attention to the subject of narcissism. Still using an energic system, Freud characterized the difference between energy directed at the self versus energy directed at others, called cathexis.
Psychodynamic Summary
By , in "Mourning and Melancholia", he suggested that certain depressions were caused by turning guilt-ridden anger on the self. By , Freud addressed the power of identification with the leader and with other members in groups as a motivation for behavior Group Psychology and the Analysis of the Ego. Also, it was the first appearance of his "structural theory" consisting three new concepts id, ego, and superego.
Three years later, he summarised the ideas of id, ego, and superego in The Ego and the Id. Hence, Freud characterised repression as both a cause and a result of anxiety. In , in Inhibitions, Symptoms and Anxiety, Freud characterised how intrapsychic conflict among drive and superego wishes and guilt caused anxiety , and how that anxiety could lead to an inhibition of mental functions, such as intellect and speech. According to Freud, the Oedipus complex, was at the centre of neurosis, and was the foundational source of all art, myth, religion, philosophy, therapy—indeed of all human culture and civilization.
It was the first time that anyone in the inner circle had characterised something other than the Oedipus complex as contributing to intrapsychic development, a notion that was rejected by Freud and his followers at the time. Also in , Anna Freud , Sigmund's daughter, published her seminal book, The Ego and the Mechanisms of Defense , outlining numerous ways the mind could shut upsetting things out of consciousness.
When Hitler 's power grew, the Freud family and many of their colleagues fled to London. Within a year, Sigmund Freud died. Led by Heinz Hartmann , Kris, Rappaport and Lowenstein, the group built upon understandings of the synthetic function of the ego as a mediator in psychic functioning [ jargon ]. Hartmann in particular distinguished between autonomous ego functions such as memory and intellect which could be secondarily affected by conflict and synthetic functions which were a result of compromise formation [ jargon ].
These "Ego Psychologists" of the s paved a way to focus analytic work by attending to the defenses mediated by the ego before exploring the deeper roots to the unconscious conflicts. In addition there was burgeoning interest in child psychoanalysis. Although criticized since its inception, psychoanalysis has been used as a research tool into childhood development, [39] and is still used to treat certain mental disturbances.
Several researchers [41] followed Karen Horney 's studies of societal pressures that influence the development of women. In the first decade of the 21st century, there were approximately 35 training institutes for psychoanalysis in the United States accredited by the American Psychoanalytic Association APsaA , which is a component organization of the International Psychoanalytical Association IPA , and there are over graduated psychoanalysts practicing in the United States.
The IPA accredits psychoanalytic training centers through such "component organisations" throughout the rest of the world, including countries such as Serbia, France, Germany, Austria, Italy, Switzerland, [42] and many others, as well as about six institutes directly in the United States. The predominant psychoanalytic theories can be organised into several theoretical schools. Although these theoretical schools differ, most of them emphasize the influence of unconscious elements on the conscious.
There has also been considerable work done on consolidating elements of conflicting theories cf. In the 21st century, psychoanalytic ideas are embedded in Western culture, [ vague ] especially in fields such as childcare , education , literary criticism , cultural studies , mental health , and particularly psychotherapy. Though there is a mainstream of evolved analytic ideas , there are groups who follow the precepts of one or more of the later theoreticians. Psychoanalytic ideas also play roles in some types of literary analysis such as Archetypal literary criticism.
Topographic theory was named and first described by Sigmund Freud in The Interpretation of Dreams These systems are not anatomical structures of the brain but, rather, mental processes. Although Freud retained this theory throughout his life he largely replaced it with the Structural theory. Structural theory divides the psyche into the id , the ego , and the super-ego. The id is present at birth as the repository of basic instincts, which Freud called " Triebe " "drives": The ego develops slowly and gradually, being concerned with mediating between the urging of the id and the realities of the external world; it thus operates on the 'reality principle'.
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The super-ego is held to be the part of the ego in which self-observation, self-criticism and other reflective and judgmental faculties develop. The ego and the super-ego are both partly conscious and partly unconscious. During the twentieth century, many different clinical and theoretical models of psychoanalysis emerged.
Ego psychology was initially suggested by Freud in Inhibitions, Symptoms and Anxiety A major step forward was Anna Freud 's work on defense mechanisms , first published in her book The Ego and the Mechanisms of Defence [46]. The theory was refined by Hartmann , Loewenstein, and Kris in a series of papers and books from through the late s. Leo Bellak was a later contributor. This series of constructs, paralleling some of the later developments of cognitive theory, includes the notions of autonomous ego functions: Freud noted that inhibition is one method that the mind may utilize to interfere with any of these functions in order to avoid painful emotions.
Hartmann s pointed out that there may be delays or deficits in such functions. Frosch described differences in those people who demonstrated damage to their relationship to reality, but who seemed able to test it. According to ego psychology, ego strengths, later described by Otto F. Kernberg , include the capacities to control oral, sexual, and destructive impulses; to tolerate painful affects without falling apart; and to prevent the eruption into consciousness of bizarre symbolic fantasy. Synthetic functions, in contrast to autonomous functions, arise from the development of the ego and serve the purpose of managing conflict processes.
Defenses are synthetic functions that protect the conscious mind from awareness of forbidden impulses and thoughts. One purpose of ego psychology has been to emphasize that some mental functions can be considered to be basic, rather than derivatives of wishes, affects, or defenses. However, autonomous ego functions can be secondarily affected because of unconscious conflict. For example, a patient may have an hysterical amnesia memory being an autonomous function because of intrapsychic conflict wishing not to remember because it is too painful.
Taken together, the above theories present a group of metapsychological assumptions. Therefore, the inclusive group of the different classical theories provides a cross-sectional view of human mentation. There are six "points of view", five described by Freud and a sixth added by Hartmann. Unconscious processes can therefore be evaluated from each of these six points of view.
The "points of view" are: Dynamic the theory of conflict 3. Economic the theory of energy flow 4. Genetic propositions concerning origin and development of psychological functions and 6. Adaptational psychological phenomena as it relates to the external world. Modern conflict theory, a variation of ego psychology, is a revised version of structural theory, most notably different by altering concepts related to where repressed thoughts were stored Freud, , Modern conflict theory addresses emotional symptoms and character traits as complex solutions to mental conflict.
Moreover, healthy functioning adaptive is also determined, to a great extent, by resolutions of conflict.
Theories of counseling and psychotherapy : a multicultural perspective
A major objective of modern conflict-theory psychoanalysis is to change the balance of conflict in a patient by making aspects of the less adaptive solutions also called "compromise formations" conscious so that they can be rethought, and more adaptive solutions found.
How the Mind Shields Itself. Object relations theory attempts to explain the ups and downs of human relationships through a study of how internal representations of the self and others are organized. The clinical symptoms that suggest object relations problems typically developmental delays throughout life include disturbances in an individual's capacity to feel warmth, empathy, trust, sense of security, identity stability, consistent emotional closeness, and stability in relationships with significant others.
It is not suggested that one should trust everyone, for example. Concepts regarding internal representations also sometimes termed, "introspects", "self and object representations", or "internalization of self and other" although often attributed to Melanie Klein , were actually first mentioned by Sigmund Freud in his early concepts of drive theory Three Essays on the Theory of Sexuality , Freud's paper "Mourning and Melancholia", for example, hypothesized that unresolved grief was caused by the survivor's internalized image of the deceased becoming fused with that of the survivor, and then the survivor shifting unacceptable anger toward the deceased onto the now complex self-image.
Vamik Volkan , in "Linking Objects and Linking Phenomena", expanded on Freud's thoughts on this, describing the syndromes of "Established pathological mourning" vs. Margaret Mahler Mahler, Fine, and Bergman, The Psychological Birth of the Human Infant , and her group, first in New York, then in Philadelphia, described distinct phases and subphases of child development leading to "separation-individuation" during the first three years of life, stressing the importance of constancy of parental figures, in the face of the child's destructive aggression, to the child's internalizations, stability of affect management, and ability to develop healthy autonomy.
John Frosch, Otto Kernberg , Salman Akhtar and Sheldon Bach have developed the theory of self and object constancy as it affects adult psychiatric problems such as psychosis and borderline states. Peter Blos described in a book called On Adolescence , how similar separation-individuation struggles occur during adolescence, of course with a different outcome from the first three years of life: During adolescence, Erik Erikson —s described the "identity crisis", that involves identity-diffusion anxiety.
In order for an adult to be able to experience "Warm-ETHICS" warmth, empathy, trust, holding environment Winnicott , identity, closeness, and stability in relationships see Blackman, Defenses: How the Mind Shields Itself , , the teenager must resolve the problems with identity and redevelop self and object constancy. Self psychology emphasizes the development of a stable and integrated sense of self through empathic contacts with other humans, primary significant others conceived of as "selfobjects".
Selfobjects meet the developing self's needs for mirroring, idealization, and twinship, and thereby strengthen the developing self. The process of treatment proceeds through "transmuting internalizations" in which the patient gradually internalizes the selfobject functions provided by the therapist. Lacanian psychoanalysis , which integrates psychoanalysis with structural linguistics and Hegelian philosophy, is especially popular in France and parts of Latin America.
Lacanian psychoanalysis is a departure from the traditional British and American psychoanalysis, which is predominantly Ego psychology. Lacan's concepts concern the " mirror stage ", the "Real" , the "Imaginary" , and the "Symbolic" , and the claim that "the unconscious is structured as a language". Though a major influence on psychoanalysis in France and parts of Latin America, Lacan and his ideas have taken longer to be translated into English and he has thus had a lesser impact on psychoanalysis and psychotherapy in the English-speaking world.
In the United Kingdom and the United States, his ideas are most widely used to analyze texts in literary theory. Interpersonal psychoanalysis accents the nuances of interpersonal interactions, particularly how individuals protect themselves from anxiety by establishing collusive interactions with others, and the relevance of actual experiences with other persons developmentally e. This is contrasted with the primacy of intrapsychic forces, as in classical psychoanalysis.
Some psychoanalysts have been labeled culturalist , because of the prominence they attributed culture in the genesis of behavior. Feminist theories of psychoanalysis emerged towards the second half of the 20th century, in an effort to articulate the feminine, the maternal and sexual difference and development from the point of view of female subjects. For Freud, male is subject and female is object.
For Freud , Winnicott and the object relations theories, the mother is structured as the object of the infant's rejection Freud and destruction Winnicott. For Lacan , the "woman" can either accept the phallic symbolic as an object or incarnate a lack in the symbolic dimension that informs the structure of the human subject. Feminist psychoanalysis is mainly post-Freudian and post-Lacanian with theorists like Toril Moi , Joan Copjec , Juliet Mitchell , [55] Teresa Brennan [56] and Griselda Pollock that rethinks Art and Mythology [57] following French feminist psychoanalysis, [58] the gaze and sexual difference in, of and from the feminine.
The "adaptive paradigm of psychotherapy" develops out of the work of Robert Langs. The adaptive paradigm interprets psychic conflict primarily in terms of conscious and unconscious adaptation to reality. Relational psychoanalysis combines interpersonal psychoanalysis with object-relations theory and with inter-subjective theory as critical for mental health. It was introduced by Stephen Mitchell.
Fonagy and Target, in London, have propounded their view of the necessity of helping certain detached, isolated patients, develop the capacity for "mentalization" associated with thinking about relationships and themselves. Arietta Slade, Susan Coates , and Daniel Schechter in New York have additionally contributed to the application of relational psychoanalysis to treatment of the adult patient-as-parent, the clinical study of mentalization in parent-infant relationships, and the intergenerational transmission of attachment and trauma.
The term interpersonal-relational psychoanalysis is often used as a professional identification. Psychoanalysts under this broader umbrella debate about what precisely are the differences between the two schools, without any current clear consensus. The term " intersubjectivity " was introduced in psychoanalysis by George E.
Atwood and Robert Stolorow Intersubjective approaches emphasize how both personality development and the therapeutic process are influenced by the interrelationship between the patient's subjective perspective and that of others. The authors of the interpersonal-relational and intersubjective approaches: Levenson, Jay Greenberg , Edward R. Ritvo, Beatrice Beebe, Frank M. Lachmann, Herbert Rosenfeld and Daniel Stern.
Interventions based on this approach are primarily intended to provide an emotional-maturational communication to the patient, rather than to promote intellectual insight. These interventions, beyond insight directed aims, are used to resolve resistances that are presented in the clinical setting.
This school of psychoanalysis has fostered training opportunities for students in the United States and from countries worldwide. Its journal Modern Psychoanalysis has been published since The various psychoses involve deficits in the autonomous ego functions see above of integration organization of thought, in abstraction ability, in relationship to reality and in reality testing. In depressions with psychotic features, the self-preservation function may also be damaged sometimes by overwhelming depressive affect.
Because of the integrative deficits often causing what general psychiatrists call "loose associations", "blocking", " flight of ideas ", "verbigeration", and "thought withdrawal" , the development of self and object representations is also impaired. In patients whose autonomous ego functions are more intact, but who still show problems with object relations, the diagnosis often falls into the category known as "borderline". Borderline patients also show deficits, often in controlling impulses, affects, or fantasies — but their ability to test reality remains more or less intact.
Adults who do not experience guilt and shame, and who indulge in criminal behavior, are usually diagnosed as psychopaths, or, using DSM-IV-TR , antisocial personality disorder. Panic, phobias, conversions, obsessions, compulsions and depressions analysts call these " neurotic symptoms " are not usually caused by deficits in functions. Instead, they are caused by intrapsychic conflicts. The conflicts are generally among sexual and hostile-aggressive wishes, guilt and shame, and reality factors.
The conflicts may be conscious or unconscious, but create anxiety, depressive affect, and anger. Finally, the various elements are managed by defensive operations — essentially shut-off brain mechanisms that make people unaware of that element of conflict. Neurotic symptoms may occur with or without deficits in ego functions, object relations, and ego strengths. Therefore, it is not uncommon to encounter obsessive-compulsive schizophrenics, panic patients who also suffer with borderline personality disorder , etc.
This section above is partial to ego psychoanalytic theory "autonomous ego functions". As the "autonomous ego functions" theory is only a theory, it may yet be proven incorrect. Freudian theories hold that adult problems can be traced to unresolved conflicts from certain phases of childhood and adolescence , caused by fantasy, stemming from their own drives.
Freud, based on the data gathered from his patients early in his career, suspected that neurotic disturbances occurred when children were sexually abused in childhood the so-called seduction theory. Later, Freud came to believe that, although child abuse occurs, neurotic symptoms were not associated with this. He believed that neurotic people often had unconscious conflicts that involved incestuous fantasies deriving from different stages of development. He found the stage from about three to six years of age preschool years, today called the "first genital stage" to be filled with fantasies of having romantic relationships with both parents.
Arguments were quickly generated in early 20th-century Vienna about whether adult seduction of children, i. There still is no complete agreement, although nowadays professionals recognize the negative effects of child sexual abuse on mental health. Many psychoanalysts who work with children have studied the actual effects of child abuse, which include ego and object relations deficits and severe neurotic conflicts. Much research has been done on these types of trauma in childhood, and the adult sequelae of those.
In studying the childhood factors that start neurotic symptom development, Freud found a constellation of factors that, for literary reasons, he termed the Oedipus complex based on the play by Sophocles , Oedipus Rex , where the protagonist unwittingly kills his father Laius and marries his mother Jocasta.
The validity of the Oedipus complex is now widely disputed and rejected. Sandler in "On the Concept Superego" and modified by Charles Brenner in The Mind in Conflict — refers to the powerful attachments that children make to their parents in the preschool years. These attachments involve fantasies of sexual relationships with either or both parent, and, therefore, competitive fantasies toward either or both parents.
Humberto Nagera has been particularly helpful in clarifying many of the complexities of the child through these years. Both seem to occur in development of most children. Eventually, the developing child's concessions to reality that they will neither marry one parent nor eliminate the other lead to identifications with parental values. These identifications generally create a new set of mental operations regarding values and guilt, subsumed under the term "superego".
Besides superego development, children "resolve" their preschool oedipal conflicts through channeling wishes into something their parents approve of "sublimation" and the development, during the school-age years "latency" of age-appropriate obsessive-compulsive defensive maneuvers rules, repetitive games. Using the various analytic and psychological techniques to assess mental problems, some believe that there are particular constellations of problems that are especially suited for analytic treatment see below whereas other problems might respond better to medicines and other interpersonal interventions.
To be treated with psychoanalysis, whatever the presenting problem, the person requesting help must demonstrate a desire to start an analysis. The person wishing to start an analysis must have some capacity for speech and communication. As well, they need to be able to have or develop trust and insight within the psychoanalytic session. Potential patients must undergo a preliminary stage of treatment to assess their amenability to psychoanalysis at that time, and also to enable the analyst to form a working psychological model, which the analyst will use to direct the treatment.
For example, how is it possible to scientifically study concepts like the unconscious mind or the tripartite personality? In this respect, it could be argued that the psychodynamic perspective is unfalsifiable as its theories cannot be empirically investigated. Such empirical findings have demonstrated the role of unconscious processes in human behavior. Kline argues that psychodynamic theory comprises a series of hypotheses, some of which are more easily tested than others, and some with more supporting evidence than others.
Also, while the theories of the psychodynamic approach may not be easily tested, this does not mean that it does not have strong explanatory power. Nevertheless, most of the evidence for psychodynamic theories is taken from Freud's case studies e. The main problem here is that the case studies are based on studying one person in detail, and with reference to Freud, the individuals in question are most often middle-aged women from Vienna i. This makes generalizations to the wider population e. Another problem with the case study method is that it is susceptible to researcher bias.
Reexamination of Freud's own clinical work suggests that he sometimes distorted his patients' case histories to 'fit' with his theory Sulloway, The humanistic approach makes the criticism that the psychodynamic perspective is too deterministic. Freud suggests that all thoughts, behaviors and emotions are determined by our childhood experiences and unconscious mental processes. This is a weakness because it suggests we have no conscious free will over our behavior, leaving little room for the idea of personal agency i.
Finally, the psychodynamic approach can be criticized for being sexist against women. For example, Freud believed that females' penis envy made them inferior to males. He also thought that females tended to develop weaker superegos and to be more prone to anxiety than males. The unbearable automaticity of being. American psychologist, 54 7 , In Standard edition Vol. Heredity and the etiology of the neuroses. The interpretation of dreams.
In Standard edition Vols. Notes upon a case of obsessional neurosis.