Chapter 4 - Psychoanalytic Therapy Unconscious - At the deepest level of our minds resides a

repository of the processes that drive our behavior,

"Unexpressed emotions will never die. They are buried alive including primitive and instinctual desires (McLeod, 2013)
and will come later in uglier ways” - Sigmund Freud
The Unconscious mind
Psychoanalytic therapy is a form of talk therapy based on
Sigmund Freud's theories of psychoanalysis. Specifically, it The unconscious cannot be studied directly but is inferred
examines how your experiences (often from childhood) from behaviour. Clinical evidence for postulating the
may be contributing to your current experience and unconscious includes the following:
actions.  Dreams, which are symbolic representation of
History and Proponent unconscious needs, wishes, and conflicts.
 Slips of the tongue and forgetting.
Sigmund Freud was born in Austria and spent most of his  Posthypnotic suggestions.
childhood and adult life in Vienna. He entered medical  Material derived from free-association techniques.
school and trained to become a neurologist, earning a  Material derived from projective techniques.
medical degree in 1881.  The symbolic content of psychotic symptoms.
Soon after his graduation, he set up a private practice and Anxiety
began treating patients with psychological disorders. His
attention was captured by a colleague's intriguing Also known as the feeling of "Dread” that results from
experience with a patient; the colleague was Dr. Josef repressed feelings, memories, desires, and experience that
Breuer and his patient was the famous "Anna O.," who emerge to the surface of awareness. Anxiety usually
suffered from physical symptoms with no apparent develops out of a conflict among the Id, Ego, and Superego
physical cause. over control of the available psychic energy.

Dr. Breuer found that her symptoms abated when he

helped her recover memories of traumatic experiences
that she had repressed, or hidden from her conscious
mind.

This case sparked Freud's interest in the unconscious

mind and spurred the development of some of his most
influential ideas.

Fundamental Concepts & Goals

View of Human mind

The Freudian view of human nature is basically

deterministic. According to Freud, our behaviour is Structures of personality
determined by irrational forces, unconscious
motivations and biological and instinctual drives as In his famous psychoanalytic theory, Freud states that
these evolve through key psychosexual stages in the first personality is composed of three elements known as the id,
years of life. the ego, and the superego. These elements work together
to create complex human behaviors.
Instincts are central to Freudian approach. Although he
originally used the term Libido refer to sexual energy, he
later broadened it to include the energy of all the life
instincts.

Models of the mind

Conscious - This is where our current thoughts, feelings,

and focus live. For Freud, consciousness is a thin slice of a
total mind.

Preconscious - Sometimes called the subconscious. This is

the home of everything we can recall or retrieve from our
memory.
Defense Mechanisms
Freud believed these three parts of the mind are in resistances, defenses, and the therapeutic relationship
constant conflict because each part has a different primary itself. The functions of interpretations are to enable the ego
goal. Sometimes, when the conflict is too much for a person to assimilate new material and to speed up the process of
to handle, his or her ego may engage in one or many uncovering further unconscious material.
defense mechanisms to protect the individual.
Procedure:
 Repression: The ego pushes disturbing or Interpretation is grounded in the therapist's assessment of
threatening thoughts out of one's consciousness. the client's personality and of the factors in the client's
 Denial: The ego blocks upsetting or overwhelming past that contributed to his or her difficulties.
experiences from awareness, causing the Interpretations are provided in a collaborative manner to
individual to refuse to acknowledge or believe help clients make sense of their lives and to expand their
what is happening. consciousness
 Projection: The ego attempts to solve discomfort
4. Dream Analysis - Freud theorized that dreams reflect
by attributing the individual's unacceptable
unconscious wishes and urges. He often referred to dreams
thoughts, feelings, and motives to another person.
as "the royal road to the unconscious". Dream Analysis is
 Displacement: The individual satisfies an impulse
an important procedure for uncovering unconscious
by acting on a substitute object or person in a
material and giving the client insight into some areas of
socially unacceptable way.
unresolved problems.
 Regression: As a defense mechanism, the
individual moves backward in development in Procedure:
order to cope with stress. During the session, therapist may ask clients to free
 Sublimation: This defense mechanism involves associate to some aspect of the manifest content of a
satisfying an impulse by acting on a substitute but dream for the purpose of uncovering the latent meanings.
in a socially acceptable way. Therapists participate in the process by exploring client's
association with them.
Goal: The main goal of psychoanalytic therapy is to bring
unconscious material into consciousness and enhance the
functioning of the ego, helping the individual become less
controlled by biological drives or demands of the superego.

Therapeutic process & procedures

1. Maintaining the analytic framework - Refers to a

whole range of procedural and stylistic factors, such as the
analyst's relative anonymity, maintaining neutrality and
objectivity, the regularity and consistency of meetings,
starting and ending the sessions on time, clarity on fees,
and basic boundary issues such as the avoidance of advice
giving or imposition of the therapist's values. 5. Analysis of Resistance - It is a concept fundamental to
the practice of psychoanalysis is anything that works
2. Free association - In free association, clients are against the progress of therapy and prevent the client from
encouraged to say whatever comes to mind, regardless of producing previously unconscious material. Freud viewed
how painful, silly, trivial, illogical, or irrelevant it may seem. resistance as an unconscious dynamic that people use to
Free association is one of the basic tools used to open the defend against the intolerable anxiety and pain that would
doors to unconscious wishes, fantasies, conflicts, and arise if they were to become aware of their repressed
motivation. impulses and feelings.
Procedure: Procedure:
During the free-association process, the therapist's task is During free association or an association to dreams, the
to identify the repressed material that is locked in the client may evidence an unwillingness to relate certain
unconscious. The sequence of associations guides the thoughts, feelings and experiences. The therapist points
therapist in understanding the connections clients make out and interpret the most obvious resistance to lessen the
among events. The therapist interprets the material to possibility of clients' rejecting the interpretation and to
clients, guiding them toward increased insight into the increase the chance that they will begin to look at their
underlying dynamics. resistive behavior.
3. Interpretation - It consists of the analvst's point out, 6. Analysis of Transference - Transference occurs when
explaining, and even teaching the client the meaning of client's project their feelings about another person onto
behavior that is manifested in dreams, free association,
the psychoanalyst. They will then interact with them as if
they were that other person. This technique can help the
psychoanalyst understand how client interact with others.

Procedure:
The therapist functions as a "blank screen," allowing
individuals to transfer unconscious feelings that may have
been directed toward a significant person in their past, like
a parent, onto the analyst.

Therapist's Function and Role

- In classical psychoanalysis, analysts typically

assume an anonymous stance, which is sometimes
called the "blank-screen" approach. They engage
in very little self disclosure and maintain a sense
of neutrality to foster a transference relationship,
in which their clients will make projections onto
them.
- One of the central functions of analysis is to help
clients acquire the freedom to love, work, and play.
- The process of psychoanalytic therapy is
somewhat like putting the pieces of a puzzle
together.

Client's Experience in Therapy

- After some face-to-face sessions with the analyst,

clients lie on a couch and engage in free
association; that is, they try to say whatever
comes to mind without self-censorship. This
process of free association is known as the
"fundamental rule".

Relationship between Client & Therapist

A significant aspect of the therapeutic relationship is

manifested through transference reactions. Transference
is the client's unconscious shifting to the analyst of feelings
and fantasies that are reactions to significant others in the
client's past.

The working-through process consists of repetitive and

elaborate explorations of unconscious material and
defenses most of which originated in early childhood.

Countertransference is viewed as a phenomenon that

occurs when there is inappropriate affect, when therapists
respond in irrational ways, or when they lose their
objectivity in a relationship because their own conflicts are
triggered.

Limitations and critique of psychotherapy