Freud: definition of mental health
(Freud 1930) In “Civilization and its Discontents”: the compulsion to work and the power of love
Topographic Model
(Freud, 1900)
Unconscious: unacceptable ideas and feelings
Preconscious: acceptable ideas and feelings that can become conscious
Conscious: ideas and feelings in awareness
Freud’s view of dreams
(Freud 1900) “The royal road to the unconscious” and “the disguised fulfillment of conflictual wishes”
4 operations at work in a dream
(Freud 1900)
Condensation - combining different unconscious thoughts into one
Displacement - direction of feelings onto unrelated subject
Representability - an object that is absent is represented by an image
Secondary revision - making the dream coherant
Oral Stage
age & pathology
(Freud 1905)
Age: Birth to 18 months
Can manifest as depressed
Anal Stage
age & pathology
(Freud 1905)
Age: 18 months to 3 years
Can manifest as obsessional
Phallic Stage
age & pathology
(Freud 1905) Age: 3-6 Can manifest as hysteria For males: aggression, ambition, vanity For females: seductiveness or submission Resolution involves identification with same-sex parent
Latency Stage
age & pathology
(Freud 1905)
Age: 6 to puberty
Fixation leads to sexual unfulfillment
Genital Stage
age & pathology
(Freud 1905)
Age: puberty to death
Psychoanalysis: The Structural Model
(Freud 1923)
Id: operates on the pleasure principle
Ego: mediator, operates on the reality principle
Superego; irrationally moralistic aspect of the mind
Drive/Conflict Theory
(Freud 1926)
- A press for the drives creates internal conflict which seeks expression
- The ego engages defenses to repress drives (or fails, causing symptoms); operates on the reality principle
- In a healthy person, compromise formation satisfies all parts of the structural model
Psychoanalysis: Techniques
(Auld, Hyman & Rudzinski 2005) WICCA
Association (free)
Confrontation - presenting to the client what has become preconscious
Clarification - description of the perception of something unconscious
Interpretation - makes the unconscious conscious by labeling a wish-defense complex
Working Through - interpretation in areas of life and relationships
Psychoanalysis: Events in Treatment
(Auld, Hyman & Rudzinski 2005) RITT
- Resistance in initial stages to prevent discovery
- Interpretation, calling attention to resistance and interprets the purpose it serves
- Transference develops, the patient relates to the therapist as if they are someone from the patient’s life
- Transference Neurosis, when all vital unconscious conflicts are focused on the therapist
Psychoanalysis: 3 types of anxiety
(Freud 1926)
Realistic Anxiety: of the physical world
Moral anxiety: threats to the ego
Neurotic anxiety: fear of being overwhelmed by the id
Psychoanalysis: Development of neurosis
(Auld, Hyman & Rudzinski 2005)
1) Infantile wish (pregenital sexual wish) is stimulated
2) Wish cannot be gratified, which leads to frustration
3) Defenses develop which also reduce adaptability to the world
4) Verbal (secondary process system) is suppressed and child is stuck in primary process thinking
5) Handicapped by repression, the child repeats mistakes (repetition compulsion)
6) if repression weakens and adult neurosis develops, symptoms emerge which are ego dystonic
Freudian Depressive Personality
(Freud 1905)
Over or under-indulgence at oral phase (leads to addiction, dependence, depression)
Freudian Obsessional Personality
(Freud 1905)
Over or under-indulgence at anal phase (orderliness, perfectionism, control or cruelty, impulsiveness, rebelliousness, disorganization)
Freudian Hysterical Personality
(Freud 1905)
Rejection or seduction at the phallic/oedipal phase
Psychoanalysis: Curative Factor
(Freud 1926)
1) Make the unconscious conscious by undoing repression
2) Helping the patient to develop compromise formations (modifying the ego) by deciding to renounce gratification, allowing it, or some combination
Psychoanalysis: Goals for Treatment
(Freud 1923) EACH DICE Ego Strength Adaptation Common understanding (patient and therapist) Hopefulness Defense Identification and Internalize Consciousness Energy
How to explain therapy to a patient psychoanalytically
(Freud 1923)
- Discuss goals of treatment for the first few sessions
- Become curious about the self, explore past to understand present
- Expression of things not fully aware; everything is important
A. Freud’s contributions
(A. Freud, 1936)
- Highlighted the impact of environment on child
- Ego develops out of frustration which leads to development of defenses
- When ego development is disturbed, primitive and rigid defenses develop
- Goal is to develop an observing ego
Ego Psychology: Curative factor
- Gaining insight (developing an observing ego)
- Developing mature and flexible defenses
Ego Psychology: Technique
- Therapist acts as the observing ego (interpreting defenses)
- Interpret superego functioning
- Foster identification with the therapist to facilitate development of ego
