Psychoanalytic Therapy

Levels of Consciousness 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)

The Structure of Personality Id — (biological and unconscious component) Ego — (psychological component) Superego — (social component)

Ego-Defense Mechanisms Are normal behaviors Help the individual cope with anxiety and prevent the ego from being overwhelmed Deny or distort reality while operating on an unconscious level Have adaptive value if they do not become a style of life to avoid facing reality

The Development of Personality 1. Oral Stage (0-1 year): mistrust of others, rejecting others, fear of inability to form intimate relationship. 2. Anal Stage (1-3): learning independence or accepting personal power. 3. Phallic Stage (3-6): how parents respond to child’s 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.

View of human nature Deterministic: Behavior is determined by irrational forces, unconscious motivation, and biological instinctual drives. The first 6 years of life determined your personality Libido: a source of motivation and energy

Therapeutic Goals Make the unconscious conscious Strengthen the ego, so that behavior can be more on reality Explore past to increase self-understanding and gain insight Conduct a successful analysis in order to change a person’s personality

Therapist’s function and role Foster a transference relationship Help clients to gain insight and understand “why” for their symptoms make unconscious conscious Build relationship, listen, interpret, and pay attentions on resistances Assess the client’s readiness to change

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

Psychoanalytic Techniques Free Association Dream Analysis Interpretation Transference Counter-transference Resistance

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.

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

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

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 into the influence of the past

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

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?

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

From a multicultural perspective Contribution to multicultural counseling Help clients to build ego and cultural identity Help therapists become aware their own source of contertransference, bias, prejudices, and stereotypes. Limitations for multicultural counseling Cost, Upper- and middle-class values Ambigurity (vs. Asian prefers structured and concrete solution) Blame clients vs. blame external factors (social, cultural, or political factors)