Psychoanalysis is a set of therapeutic theories and techniques related to the study of the unconscious mind, which together form the method of treatment for mental-health disorders. This discipline was founded in the early 1890s by Austrian neurologist Sigmund Freud and derived part of the clinical work of Josef Breuer and others.
Freud first used the term psychoanalysis (in French) in 1896. Die Traumdeutung ( The Interpretation of Dreams ), which Freud saw as " most significant work ", appeared in November 1899. Psychoanalysis was then developed in different directions, mostly by Freud students such as Alfred Adler and Carl Gustav Jung, and by neo-Freudians like Erich Fromm, Karen Horney and Harry Stack Sullivan. Freud maintained the term psychoanalysis for his school of thought. The basic teachings of psychoanalysis include:
- a person's development is determined by events often overlooked in early childhood, not by inherited traits alone;
- human behavior and cognition is largely determined by an irrational impulse rooted in the unconscious;
- the effort to bring that impulse into consciousness triggers resistance in the form of defense mechanisms, especially oppression;
- The conflict between conscious and unconscious matter can lead to mental disorders such as neurosis, neurotic traits, anxiety and depression;
- unconscious matter can be found in unintentional dreams and actions, including behavior and slipping from the tongue;
- liberation from the effects of unconsciousness is achieved by bringing this material into the conscious mind through therapeutic intervention;
- "the center of the psychoanalytic process" is a transference, in which patients revive their childish conflicts by projecting into the analytic feelings of love, dependence and anger.
During a psychoanalytic session, which usually lasts 50 minutes and ideally lasts 4-5 times a week, the patient ("analysand") may lie on the couch, with analysts often sitting directly behind and invisible. The patient expresses his thoughts, including associations, fantasies, and free dreams, from which the analyst concludes the unconscious conflicts that cause symptoms and problems of the patient's character. Through the analysis of these conflicts, which include interpreting transference and countertransference, analysts face the patient's pathological defenses to help patients gain insights.
Psychoanalysis is a controversial discipline and its validity as a science of disagreement. Nevertheless, it remains a strong influence in psychiatry, more in some circles than others. The concept of psychoanalytic is also widely used outside the therapeutic arena, in areas such as psychoanalytic literary criticism, as well as in the analysis of films, fairy tales and other cultural phenomena.
Video Psychoanalysis
Histori
1890
The idea of ​​psychoanalysis (German: Psychoanalyse ) first began to receive serious attention under Sigmund Freud, who formulated his own theory of psychoanalysis in Vienna in the 1890s. Freud was a neurologist who sought to find effective treatments for patients with neurotic or hysterical symptoms. Freud realized that there was an unconscious mental process while he was employed as a neurological consultant at the Children's Hospital, where he noticed that many disadvantaged children do not have a clear organic cause for their symptoms. He then wrote a monograph on this subject. In 1885, Freud obtained a grant to study with Jean-Martin Charcot, a renowned neurologist, at SalpÃÆ'ªtriÃÆ'¨re in Paris, where Freud followed a clinical presentation of Charcot, mainly in the areas of hysteria, paralysis and anesthesia. Charcot has introduced hypnotism as an experimental research tool and developed a clinical representation of clinical symptoms.
Freud's first theory for explaining hysterical symptoms is presented in the Studies on Hysteria (1895), co-authored by his mentor, renowned physician Josef Breuer, who is generally seen as the birth of psychoanalysis. This work is based on Breuer's treatment of Bertha Pappenheim, mentioned in a case study under the pseudonym "Anna O.", a treatment that Pappenheim himself has dubbed "speech medication". Breuer writes that many factors can cause such symptoms, including various types of emotional trauma, and he also praises the work of others such as Pierre Janet; while Freud argues that at the roots of hysterical symptoms are repressed memories of sad events, almost always having direct or indirect sexual relationships.
Around the same time Freud attempted to develop the neuro-physiological theory of the unconscious mental mechanism, which he immediately released. It remained unpublished in his lifetime.
The first appearance of the term "psychoanalysis" (written psychoanalysis) is in Freud's essay published in French in 1896.
In 1896 Freud also published a so-called seduction theory proposing that the precondition for hysterical symptoms was sexual excitation in infancy, and he claimed to have found an oppressed memory of the incidents of sexual harassment for all his patients today. However, in 1898 he personally admitted to his friend and colleague Wilhelm Fliess that he no longer believed in his theory, although he did not publicly declare it until 1906. Although in 1896 he had reported that his patient "had no feelings of remembrance [ sexual] scenes, "and reassured her" firmly their unbelief ", in later accounts she claimed that they had told her that they had been sexually abused in infancy. This became an accepted historical record until it was challenged by some Freud scholars in the later part of the 20th century who argued that he had imposed previously established assumptions on his patients. However, based on his claims that patients reported experiences of child sexual abuse, Freud later argued that his clinical findings in the mid-1890s provided evidence of an unconscious fantasy, which was supposed to cover the memory of childhood masturbation. Only a short time later he claimed the same findings as evidence for Oedipal's wishes.
By 1899, Freud had theorized that dreams have symbolic meanings, and are generally specific to the dreamer. Freud formulates a second theory of psychology - hypothesizing that the unconscious has or is a "principal process" consisting of symbolic and viscous thoughts, and a "secondary process" of logical conscious minds. This theory was published in his 1899 book, The Interpretation of Dreams . Chapter VII is a previous "Project" rework and Freud outlines his "Topographic Theory". In this theory, largely replaced by Structural Theory, unacceptable sexual desire is pressed into "System Unconscious", unconscious because of public condemnation of premarital sexual activity, and this oppression creates anxiety. This "topographic theory" is still popular in much of Europe, though it is not favored in most of North America.
1900-1940s
In 1905 Freud published the Three Essays on the Theory of Sexuality where he laid his findings on the so-called psychosexual phases: oral (ages 0-2), anal (2-4), phallic- oedipal (days this is called the 1st genital) (3-6), latency (6-puberty), and genitals mature (puberty-forwards). The initial formulation includes the idea that because of social restrictions, sexual desire is suppressed into unconscious states, and that the energy of this unconscious desire can turn into anxiety or physical symptoms. Therefore, early treatment techniques, including hypnotism and abreaction, are designed to create subconscious awareness to reduce visible pressure and symptoms. This method would later be abandoned by Freud, giving the association a greater free role.
In On Narcissism (1915) Freud turned his attention to the subject of narcissism. Still using the energy system, Freud marked the difference between self-directed energy versus energy directed at others, called cathexis. In 1917, in "Mourning and Melancholia", he suggested that a certain depression is caused by altering the anger overwhelmed by guilt. In 1919 in "A Beaten Child" he began to address the problem of self-destructive behavior (moral masochism) and honest sexual masochism. Based on his experiences with depressed and self-destructive patients, and contemplating the World War I massacres, Freud became dissatisfied with only considering the oral and sexual motivations for behavior. In 1920, Freud discussed the power of identification (with leaders and with other members) in the group as a motivation for behavior (Group Psychology and Analysis of the Ego ). In the same year (1920), Freud suggested his theory of sexuality and "dual drive" aggression in Beyond the Pleasure Principle, to try to begin to explain the destruction of man. Also, it was the first appearance of a "structural theory" consisting of three new concepts, ego, and superego.
Three years later, he summarized the idea id, ego, and superego in The Ego and the Id . In the book, he revised the whole theory of mental functioning, now remembering that oppression is just one of many defense mechanisms, and it happens to reduce anxiety. Freud therefore defines repression as the cause and effect of anxiety. In 1926, in Freud's Inhibition, Symptom and Anxiety, Freud characterized how intrapsychic conflicts between the drive and the superego (desire and guilt) caused anxiety, and how anxiety could lead to inhibition of mental functions, such as intelligence and speech. Inhibition, Symptoms and Anxiety were written in response to Otto Rank, who, in 1924, published the Das Trauma der Geburt (translated into English in 1929 as The Trauma of Birth ), analyzing how art, myth, religion, philosophy and therapy are illuminated by separation anxiety in the "phases before the development of the Oedipus complex". Freud's theory, however, is not marked like a phase. According to Freud, the Oedipus complex, located at the center of neurosis, and is the basic source of all art, myth, religion, philosophy, therapy - indeed of all human cultures and civilizations. This is the first time that anyone in the inner circle has characterized anything other than the Oedipus complex as a contribution to intrapsic development, an idea which Freud and his followers rejected at the time.
In 1936, the "Multi-Functional Principle" was clarified by Robert Waelder. He widened the formulation that psychological symptoms are caused by and relieved conflict simultaneously. In addition, symptoms (such as phobias and compulsions) each represent elements of some drive desires (sexual and/or aggressive), superego, anxiety, reality, and defense. Also in 1936, Anna Freud, daughter of Sigmund, published her seminal book, The Ego and the Mechanisms of Defense, outlines many ways that can make the mind close the grief of consciousness.
1940s-present
When Hitler's power grew, Freud's family and many of their colleagues fled to London. Within a year, Sigmund Freud died. In the United States, also after Freud's death, a group of new psychoanalysts began to explore the function of the ego. Led by Heinz Hartmann, Kris, Rappaport, and Lowenstein, the group was built on the understanding of the synthetic function of the ego as a mediator in psychic functioning. Hartmann in particular is distinguished between the autonomous functions of ego (such as memory and intelligence that can be affected by secondary conflict) and the synthetic functions that are the result of compromise formation. These "Ego Psychologists" of the 1950s paved the way for focusing analytic work with regard to defense (mediated by the ego) before exploring deeper roots into unconscious conflict. In addition there is a growing interest in child psychoanalysis. Although criticized early on, psychoanalysis has been used as a research tool in childhood development, and is still used to treat certain mental disorders. In the 1960s, Freud's early thought on the development of female sexuality was challenged; This challenge leads to the development of various understandings of women's sexual development, many of which modify the timing and normality of several Freud theories (which have been taken from the care of women with mental disorders). Some researchers follow Karen Horney's research on social pressures that affect women's development. Psychoanalyst Mark J. Blechner argues that dreams reveal how the mind works when it does not care about communication.
In the first decade of the 21st century, there are about 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 more than 3,000 psychoanalytical graduates practicing in the United States. IPA accredits psychoanalytic training centers through "component organizations" around the world, including countries such as Serbia, France, Germany, Austria, Italy, Switzerland, and many others, as well as about six direct institutions in the United States..
Maps Psychoanalysis
Theory
The dominant psychoanalytic theory can be organized into several theories. Although these theoretical schools are different, most of them emphasize the influence of unconscious elements on consciousness. There is also much work done to consolidate the elements of conflicting theories (see Theodore Dorpat, B. Killingmo, and S. Akhtar). As in all areas of medicine, there are several ongoing conflicts over the specific causes of certain syndromes, and disagreements about the ideal treatment technique. In the 21st century, the psychoanalytic idea is embedded in Western culture, especially in areas such as child care, education, literary criticism, cultural studies, mental health, and especially psychotherapy. Although there is a mainstream of developing analytic ideas, there are groups that follow the rules of one or more of the later theorists. Psychoanalytic ideas also play a role in several types of literary analysis such as typical literary criticism.
Topographic theory
Topographic theory is named and first described by Sigmund Freud in The Interpretation of Dreams (1900). The theory hypothesizes that mental tools can be divided into the system of Conscious, Subconscious Mind, and No Mind. These systems are not brain anatomical structures, but mental processes. Although Freud maintained this theory throughout his life, he replaced it with Structural theory. Topographic theory remains as one of the meta-psychological point of view to illustrate how the function of the mind in classical psychoanalytic theory.
Structural Theory
Structural theory divides the soul into id, ego, and super-ego. Id is present at birth as a basic instinct repository, called Freud " Triebe" ("drive"): irregular and unconsciously, it operates only on the 'pleasure principle', without realism or foresight. The ego develops slowly and gradually, being concerned with the mediation between urgency id and the reality of the outside world; thus operating on the 'principle of reality'. The super ego is held to be part of the ego in which self-observation, self-criticism and other reflective and judgmental abilities develop. The ego and super-ego are both partially conscious and some unconscious. Theoretical and Clinical Approach
During the 20th century, many different clinical models and psychoanalytic theories emerged.
Ego Psychology
Ego psychology was originally suggested by Freud in Inhibition, Symptoms and Anxiety (1926). A major step forward is Anna Freud's work on defense mechanisms, first published in his book The Ego and the Mechanisms of Defense (1936).
This theory was perfected by Hartmann, Loewenstein, and Kris in a series of papers and books from 1939 until the late 1960s. Leo Bellak is the next contributor. This series of constructions, parallel to some later development of cognitive theory, includes the idea of ​​autonomous ego function: mental function is independent, at least at its origin, in intrapsychic conflict. These functions include: sensory perception, motor control, symbolic thinking, logical thinking, speech, abstraction, integration (synthesis), orientation, concentration, hazard assessment, reality testing, adaptive ability, executive decision making, hygiene, and self-preservation.. Freud notes that inhibition is one method that the mind can use to disrupt these functions in order to avoid painful emotions. Hartmann (1950s) suggests that there may be a delay or deficit in such functions.
Frosch (1964) describes the differences in people who show damage to their relationship to reality, but who seem to be able to test it. The deficit in the capacity to regulate the mind is sometimes referred to as blocking or loose association (Bleuler), and is a characteristic of schizophrenia. Deficits in abstraction and self-preservation also show psychosis in adults. Deficits in orientation and sensorium often indicate medical illness that affects the brain (and therefore, autonomous ego function). Deficits in certain ego functions are routinely found in children who are sexually or physically abused, where the powerful effects produced during childhood seem to have eroded some functional developments.
According to ego psychology, the power of the ego, later described by Otto F. Kernberg (1975), includes the capacity to control oral, sexual, and destructive impulses; to tolerate painful influence without becoming a mess; and to prevent the eruption into a peculiar awareness of symbolic fantasies. Synthetic functions, in contrast to autonomous functions, arise from ego development and serve the purpose of managing the conflict process. Defense is a synthetic function that protects the conscious mind from awareness of impulses and forbidden thoughts. One of the goals of ego psychology is to emphasize that some mental functions can be regarded as the basis, not the descendants of desire, influence, or defense. However, autonomous ego functions can be affected temporarily because of unconscious conflict. For example, a patient may have hysterical amnesia (memory being an autonomous function) due to intrapsychic conflict (hoping not to remember because it is too painful).
Taken together, the above theories present a group of metapsychological assumptions. Therefore, the inclusive group of different classical theories provide a cross-sectional view of human experience. There are six "points of view", five are described by Freud and six are added by Hartmann. Therefore, unconscious processes can be evaluated from each of these six points of view. "The point of view" is: 1. Topography 2. Dynamic (conflict theory) 3. Economics (energy flow theory) 4. Structural 5. Genetic (proposition of origin and development of psychological functions) and 6. Adaptation (Psychological phenomena related to the world outside).
Modern conflict theory
Modern conflict theory, the variation of ego psychology, is a revised version of structural theory, most notably different from changing concepts related to where the oppressed mind is kept (Freud, 1923, 1926). Modern conflict theory addresses emotional and character traits as complex solutions to mental conflicts. It distributes the concepts of id, ego and superego, and leads to conscious and unconscious conflicts between desires (dependent, controlling, sexual, and aggressive), guilt and shame, emotion (especially anxiety and depression) and defensive operations that shut off the awareness of some aspects of the others. In addition, a healthy (adaptive) function is also determined, to some extent, by conflict resolution.
The ultimate goal of modern conflict-theory psychoanalysis is to change the balance of conflict in patients by making the less adaptive aspects of the solution (also called "compromise formation") realized so that it can be rethought, and finding a more adaptive solution. The current theorist follows many of Brenner's suggestions (see especially Brenner's 1982 book, The Mind in Conflict ) including Sandor Abend, MD (Abend, Porder, & Willick, (1983), Patient Outline: Clinical Perspective ), Jacob Arlow (Arlow and Brenner (1964), The Concept of Psychoanalysis and Structural Theory ), and Jerome Blackman (2003), 101 Defenders: How Mind Shields Alone
The object relations theory
The theory of object relations tries to explain the rise and fall of human relationships through the study of how internal representations of self and others are governed. Clinical symptoms that point to the problem of object relationships (usually life-long developmental delays) include disturbances in the capacity of the individual to feel the warmth, empathy, trust, sense of security, identity stability, consistent emotional closeness, and stability in relationships with significant others. (It is not recommended that one should trust everyone, for example.) The concept of internal representation (also sometimes called "introspection", "self-representation and object", or "self and other internalization") though often associated with Melanie Klein, is actually first mentioned by Sigmund Freud in the early concept of drive theory ( The Three Essays on The Theory of Sexuality , 1905). Freud's 1917 "Mourning and Melancholia" paper, for example, hypothesizes that unresolved sorrows are caused by images internalized by the deceased who are united with the survivor, and then the survivor who transforms the unacceptable anger towards the deceased into a self now complex. picture.
Vamik Volkan, in "Connecting Objects and Connecting Phenomena", extends Freud's thinking on this subject, describes the syndrome of "Establishing pathological mourning" vs. "reactive depression" based on similar dynamics. Melanie Klein's hypothesis of internalization during the first year of life, leading to a paranoid position and depression, was then challenged by Renà ©  © Spitz (eg, First Year of Life, 1965), which divided the first year of life into phases coenesthetic from the first six months, and then the diacritic phase for the second six months. Margaret Mahler (Mahler, Fine, and Bergman, The Birth of Psychological Infants of Humans, 1975) and his group, first in New York, later in Philadelphia, described the different phases and subfaces of child development leading to "separation of individuation "during the first three years of life, emphasizes the importance of parental firmness, in the face of child destructive aggression, to the internalization of children, the stability of management influences, and the ability to develop healthy autonomy.
John Frosch, Otto Kernberg, Salman Akhtar and Sheldon Bach have developed a theory of self and object steadiness because it affects adult psychiatric problems such as psychosis and border states. Peter Blos explains (in a book titled On Adolescence , 1960) how the same struggle for separation of individuation occurs during adolescence, of course with different results from the first three years of life: teenagers usually, eventually, leave home parents (this varies with culture). During adolescence, Erik Erikson (1950-1960s) described the "identity crisis", which involved anxiety-identity diffusion. In order for an adult to experience "ETHICS-REAL" (warmth, empathy, trust, safeguarding the environment (Winnicott), identity, closeness, and stability) in relationships (see Blackman, 101 Defenders: How Shields Mind Itself , 2001), adolescents must solve problems with identity and re-develop the self and the firmness of the object.
Self psychology
Self psychology emphasizes the development of a stable and integrated self-consciousness through empathic contact with other human beings, another key person who is understood as "selfobject". Selfobjects meet the evolving needs of self for reflection, idealization, and twins, and thereby strengthen the developing self. The treatment process takes place through "internalization transmuting" in which the patient gradually internalizes the selfobject function provided by the therapist. Self psychology was originally proposed by Heinz Kohut, and has been further developed by Arnold Goldberg, Frank Lachmann, Paul and Anna Ornstein, Marian Tolpin, and others.
Jacques Lacan and Lacanian psychoanalysis
Psychoanalysis of lysis, which integrates psychoanalysis with Hegel's structural linguistics and philosophy, is very popular in France and parts of Latin America. The psychoanalysis of dolphins is a departure from traditional British and American psychoanalysis, dominated by Ego psychology. Jacques Lacan often uses the phrase "retourner ÃÆ' Freud" ("back to Freud") in his seminars and writings, as he claims his theory is an extension of Freud himself, contrary to Anna Freud, Ego Psychology, object relations and "self" theory as well claiming the need to read Freud's complete works, not just some of them. Lacan's concepts concern the "mirror stage", "Real", "Imaginary", and "Symbolic", and the claim that "the unconscious is structured as a language".
Despite the profound influence on psychoanalysis in France and parts of Latin America, Lacan and his ideas have been translated into English longer and he has less impact on psychoanalysis and psychotherapy in the English-speaking world. In England and the United States, his ideas are most widely used to analyze texts in literary theory. Due to his increasingly critical attitude to deviations from Freud's thinking, often choosing particular texts and readings from his colleagues, Lacan was excluded from acting as a training analyst at IPA, leading him to create his own school to maintain institutional structures for many candidates wishing to continue their analysis with himher.
Interpersonal psychoanalysis
Interpersonal psychoanalysis accents the nuances of interpersonal interaction, especially how the individual protects himself from anxiety by building collusive interactions with others, and the relevance of actual experience with others on a progressive basis (eg family and peers) as well as in the present. This contrasts with the superiority of intrapsychic forces, as in classical psychoanalysis. The interpersonal theory was first introduced by Harry Stack Sullivan, MD, and was further developed by Frieda Fromm-Reichmann, Clara Thompson, Erich Fromm, and others who contributed to the establishment of the William Alanson White Institute and Interpersonal Psychoanalysis in general.
Cultural psychoanalysis
Some psychoanalysts have been labeled culturalists , for their superiority links culture in the origins of behavior. Among other things, Erich Fromm, Karen Horney, Harry Stack Sullivan, has been called the psychoanalysts culturalist . They are famous in conflict with orthodox psychoanalysts.
Feminist psychoanalysis
The psychoanalytic feminist theory emerged before the second half of the twentieth century, in an attempt to articulate the feminine, maternal and sexual differences and developments from the point of view of the subject of women. For Freud, men are subject and women are objects. For Freud, Winnicott and object relations theory, the mother was composed as the object of infant rejection (Freud) and destruction (Winnicott). For Lacan, "woman" can accept phallic symbols as objects or transform into less in a symbolic dimension that informs the structure of the human subject. Post-Freudian and post-Lacanian feminist psychoanalysis with theorists such as Toril Moi, Joan Copjec, Juliet Mitchell, Teresa Brennan and Griselda Pollock are rethinking the Art and Mythology following French feminist psychoanalysis, sexual views and differences in, from and from feminine. French theorists such as Luce Irigaray challenge phallogocentrism. Bracha Ettinger offers a "matrixal" subject dimension that takes into account the prenatal stage (matrix connectivity) and suggests feminine-maternal Eros, matrix gazes and Primal-phantasies mothers. Jessica Benjamin discussed feminine issues and love. Feminist psychoanalysis informs and incorporates theories of gender, queer and post-feminist.
Adaptive paradigm psychoanalysis and psychotherapy
"The adaptive paradigm of psychotherapy" evolved from the work of Robert Langs. The adaptive paradigm interprets psychic conflict especially in terms of conscious and unconscious adaptation to reality. The work of Langs has recently been in some measure back to Freud before, where Langs prefers a modified version of the mind (conscious, unconscious, unconscious) topographic model above the structural model (id, ego, and super-ego) including the stress of formers on trauma (although Langs saw trauma associated with death rather than sexual trauma). At the same time, Langs's mind model differs from Freud in terms of understanding the mind in terms of evolutionary biological principles.
Relational psychoanalysis
Relational psychoanalysis combines interpersonal psychoanalysis with object relations theory and with inter-subjective theory as important for mental health. It was introduced by Stephen Mitchell. Relational psychoanalysis emphasizes how an individual's personality is shaped by real and imagined relationships with others, and how this relationship pattern is reacted in the interaction between the analyst and the patient. In New York, key supporters of relational psychoanalysis include Lew Aron, Jessica Benjamin, and Adrienne Harris. Fonagy and Target, in London, have put forward their views on the need to assist certain isolated and isolated patients, developing the capacity for "mentalization" associated with thinking about relationships and themselves. Arietta Slade, Susan Coates, and Daniel Schechter in New York also contribute to the application of relational psychoanalysis for the treatment of adult patients as parents, clinical studies of mentalization in parent-infant relations, and transmission of intergenerational and traumatic linkages.
Interpersonal-relational psychoanalysis
The term interpersonal-relational psychoanalysis is often used as a professional identification. Psychoanalysts under the broader umbrella debate about exactly what the differences between the two schools are, without a clear consensus today.
Intersubjective Psychoanalysis
The term "intersubjectivity" is introduced in psychoanalysis by George E. Atwood and Robert Stolorow (1984). The intersubjective approach emphasizes how the development of personality and therapeutic processes is influenced by the interrelationships between the patient's subjective perspective and the perspective of others. The authors of the interpersonal-relational and intersubjective approach: Otto Rank, Heinz Kohut, Stephen A. Mitchell, Jessica Benjamin, Bernard Brandchaft, J. Fosshage, Donna M. Brange, Arnold "Arnie" Mindell, Thomas Ogden, Owen Renik, Irwin Z. Hoffman, Harold Searles, Colwyn Trevarthen, Edgar A. Levenson, Jay Greenberg, Edward R. Ritvo, Beatrice Beebe, Frank M. Lachmann, Herbert Rosenfeld, and Daniel Stern.
Modern psychoanalysis
"Modern psychoanalysis" is a term coined by Hyman Spotnitz and his colleagues to describe a body of theoretical and clinical approaches aimed at extending Freud's theories so as to make it applicable to a full spectrum of emotional disturbances and extend the potential for the treatment of pathology. considered untreatable by the classical method. Interventions based on this approach are primarily intended to provide emotional maturation communication to patients, rather than to promote intellectual insight. This intervention, beyond the intended purpose, is used to resolve the resistance presented in the clinical setting. This psychoanalytic school has developed training opportunities for students in the United States and from countries around the world. The Journal of Modern Psychoanalysis has been published since 1976.
Psychopathology (mental disorder)
Adult patient
Various psychoses involve deficits in autonomous ego functions (see above) integration (organization) thinking, abstraction abilities, in relation to reality and in reality testing. In depression with psychotic features, self-preservation functions can also be damaged (sometimes by tremendous depressive influences). Because of the integrative deficits (often causing so-called general psychiatrists "loose association", "blocking", "idea breakout", "verbigeration", and "mind-drawing"), the development of self-representation and objects is also disrupted. Clinically, therefore, psychotic individuals manifest limitations in warmth, empathy, trust, identity, closeness and/or stability in relationships (due to problems with fuss anxiety of self objects) as well.
In patients whose autonomous ego function is more intact, but which still shows problems with object relations, diagnosis often falls into a category known as "boundary". Borderline patients also exhibit deficits, often in controlling impulse, affect, or fantasy - but their ability to test reality remains more or less intact. Adults who do not experience guilt and shame, and who enjoy criminal behavior, are usually diagnosed as psychopaths, or, using DSM-IV-TR, antisocial personality disorder.
Panic, phobia, conversion, obsessions, compulsions, and depression (analysts call it "neurotic symptoms") are usually not caused by function deficits. Instead, they are caused by an intrapsychic conflict. These conflicts are generally between desires, guilt and shame, and aggressive and hostile realities. Conflict may be conscious or unconscious, but it creates anxiety, depression, and anger. Finally, the various elements are managed by defense operations - essentially turning off brain mechanisms that make people unaware of the element of the conflict. "Repression" is a term given to a mechanism that closes the mind of consciousness. "Isolation of influence" is the term used for the mechanism that closes the sensation out of consciousness. Neurotic symptoms can occur with or without deficits in ego function, object relation, and ego strength. Therefore, it is not uncommon to find obsessive-compulsive schizophrenic patients, panic patients who also suffer from a threshold personality disorder, etc.
This section above is partial to the ego's psychoanalytic theory of "autonomous ego function". Since the theory of "autonomous ego function" is only a theory, it may not have been proved wrong.
Origin of childhood
Freudian theory holds that adult problems can be traced to unresolved conflicts from certain phases of childhood and adolescence, caused by fantasy, derived from their own drives. Freud, based on data collected from his patients early in his career, suspects that neurotic disorders occur when children are sexually abused in childhood (so-called seduction theory). Later, Freud came to believe that, although child abuse occurs, neurotic symptoms are unrelated to this. He believes that neurotic people often have unconscious conflicts involving incest fantasies that come from different stages of development. He found the stage from about three to six years (preschool year, today called the "first genital stage") to be filled with fantasies of having a romantic relationship with both parents. Various arguments were quickly generated in early twentieth-century Vienna on whether adult seduction, child sexual abuse, was the basis of neurotic disease. There is still no complete agreement, although today professionals recognize the negative effects of child sexual abuse on mental health.
Many psychoanalysts working with children have studied the actual effects of child abuse, which includes ego and object-link deficits and severe neurotic conflicts. Much research has been done on the types of trauma in childhood, and the adult sequelae of them. In studying the factors of childhood that initiated the development of neurotic symptoms, Freud discovered a constellation of factors that, for literary reasons, he called the Oedipus complex (based on the game by Sophocles, Oedipus Rex , in which the protagonist unwittingly kills his father Laius and married his mother Jocasta). The validity of the Oedipus complex is now much debated and rejected. The short term, "oedipal" - later described by Joseph J. Sandler in "On the Concept Superego" (1960) and modified by Charles Brenner in The Mind in Conflict (1982) - refers to the strong attachment made the children to their parents in the preschool years. This attachment involves sexual fantasies with one (or both) parents, and, therefore, a competitive fantasy against one (or both) parents. Humberto Nagera (1975) has been very helpful in clarifying the many complications of children over the years.
"Positive" and "negative" oedipal conflict are related to heterosexual and homosexual aspects respectively. Both seem to occur in the development of most children. Finally, children's concessions that develop into reality (that they will not marry parents or eliminate others) lead to identification with parental values. This identification generally creates a series of new mental operations regarding values ​​and guilt, including in terms of "superego". In addition to superego development, children "resolve" their preschool odeal conflicts through the channeling of wishes into something that their parent ("sublimation") approval and development, during school age ("latency") of obsessive-compulsive defensive maneuvers according to age ( rules, recurring games).
Treatment
Using various analytic and psychological techniques to assess mental problems, some believe that there is a special constellation of problems that are particularly suited for analytic treatment (see below) whereas other problems may be better responding to medications and other interpersonal interventions. To be treated with psychoanalysis, no matter what the problem arises, the person asking for help should indicate the desire to begin the analysis. People who want to start an analysis must have the capacity to speak and communicate. In addition, they must be able to have or develop trust and insight in psychoanalytic sessions. Potential patients had to undergo an early stage of treatment to assess their ability for psychoanalysis at that time, and also to enable the analyst to form a working psychological model, which the analyst would use to direct the treatment. Psychoanalysts primarily work with neurosis and hysteria in particular; However, customized forms of psychoanalysis are used in working with schizophrenia and other forms of psychosis or mental disorders. Finally, if a prospective patient is suicidal, a longer early stage may be used, sometimes with a session that has a twenty minute break in the middle. There are many modifications in the technique under the title of psychoanalysis because of the individualistic nature of personality both in the analyst and the patient.
The most common issues that can be dealt with psychoanalysis include: phobias, conversions, compulsions, obsessions, anxiety attacks, depression, sexual dysfunction, various relationship problems (such as marital dating and disputes), and various character problems (eg, painful shame, cruelty, aggravation, workaholism, hyperseductivity, hyperemotionality, hyperfastidiousness). The fact that many of these patients show the deficit makes diagnosis and treatment selection difficult.
Analytical organizations such as IPA, APSAA and the European Federation for Psychoanalytic Psychotherapy have established procedures and models for the indication and practice of psychoanalytic therapy for participants in the analysis. The compatibility between analysts and patients can be seen as another factor contributing to indications and contraindications to psychoanalytic treatment. The analyst decides whether the patient is suitable for psychoanalysis. This decision is made by the analyst, in addition to being made on the usual indications and pathology, is also based on a certain degree by "conformity" between the analyst and the patient. The person's suitability for analysis at any given time is based on their desire to know something about where their illness came from. Someone unfit for analysis says there is no desire to know more about the root cause of their illness.
The evaluation may include one or more independent opinions of other analysts and will include discussion of the patient's financial and insurance situation.
Technique
The basic method of psychoanalysis is the interpretation of the patient's subconscious conflicts that interfere with current functions - conflicts that cause painful symptoms such as phobias, anxiety, depression, and compulsions. Strachey (1936) stresses that finding out how the patient's distorted perception of analysts leads to an understanding of what might have been forgotten (see also Freud's paper "Repeating, Remembering and Doing"). In particular, unconscious unconscious feelings toward the analyst can be found in negative and symbolic reactions to what Robert Langs later called the "skeleton" of therapy - a setting that includes session time, cost payments, and the need to speak. In patients who make mistakes, forget, or show other uniqueness about time, cost, and speech, analysts can usually find unconscious "rejection" of the thought flow (sometimes called free associations).
When the patient lies on the couch with the analyst's view, the patient tends to remember more, experience more resistance and transference, and is able to rearrange the mind after the development of insight - through the interpretive work of the analyst. Although the life of fantasy can be understood through the examination of dreams, the fantasies of masturbation (see Marcus, I. and Francis, J. (1975), Masturbation from Childhood to Aging are also important. The analyst is interested in how the patient reacts and avoids such fantasies (see Paul Gray (1994), The Ego and Analysis of Defense ). Various memories of early life are generally distorted - Freud calls them "screen memory" - and in any case, a very early experience (before the age of two) - can not be remembered (See the child's study of Eleanor Galenson's "intriguing memory").
Variations in techniques
There is what is known among psychoanalysts as a "classical technique", although Freud throughout his writing deviates from this, depending on the patient's problem. The classical technique is summarized by Allan Compton, MD, as part of the instruction (telling patients to try to say what's on their mind, including distractions); exploration (ask); and clarification (rephrasing and summarizing what has been described by the patient). In addition, analysts can also use confrontation to bring aspects of function, usually defense, to the attention of the patient. The analyst then uses a variety of interpretive methods, such as dynamic interpretation (explains how to be an excessively good guard against guilt, eg - defense vs. affect); genetic interpretation (explaining how past events affect the present); interpretation of resistance (showing patients how they avoid their problems); Interpretation of transference (showing how old patient conflicts arise in current relationships, including with analysts); or dream interpretation (get the patient's mind about their dreams and connect this with their current problems). Analysts can also use reconstruction to estimate what might have happened in the past that created some current problems.
These techniques are mainly based on conflict theory (see above). When the theory of object relations evolved, complemented by the work of John Bowlby and Mary Ainsworth, techniques with patients who had more severe problems with basic belief (Erikson, 1950) and a history of maternal loss (see Augusta Alpert's works) led to new techniques with adults. This is sometimes called interpersonal, intersubjective (see Stolorow), relational, or corrective object correlation techniques. These techniques include expressing empathic attunement to the patient or warmth; show a little personal life or analyst attitude to the patient; allows patient autonomy in a form of dispute with the analyst (see I.H. Paul, Letter to Simon ); and explain the motivation of others who are abused by the patient. Ego concept of psychological deficit in function leads to improvement in supportive therapy. These techniques are especially applicable to psychotic and near-psychotic patients (see Eric Marcus, "Psychosis and Near-Psychosis"). This supportive therapy technique includes discussion of reality; urge to stay alive (including hospitalization); psychotropic drugs to reduce the effects of extreme depression or extraordinary fantasies (hallucinations and delusions); and suggestions about the meaning of things (to counter the failure of abstraction).
The idea of ​​"silent analyst" has been criticized. In fact, listening analysts use the Arlow approach as defined in "The Genesis of Interpretation", using active intervention to interpret resistance, defenses create pathology, and fantasy. Silence is not a technique of psychoanalysis (see also research and opinion paper Owen Renik, MD). "Analytical neutrality" is a concept that does not mean silent analyst. This refers to the position of the analyst to be impartial in the patient's internal struggle. For example, if a patient feels guilty, the analyst may investigate what the patient has done or think is causing the error, but does not convince the patient not to feel guilty. Analysts may also explore identification with parents and others who cause guilt.
The interpersonal-relational psychoanalyst emphasizes the idea that it is impossible to be neutral. Sullivan introduced the term "participant-observer" to show that analysts inevitably interact with analysand, and suggest detailed inquiry as an alternative to interpretation. A detailed investigation involves taking notes where the analysand leaves important elements of an account and records when the story is obscured, and asks careful questions to open the dialogue.
Group therapy and play therapy
Although single client sessions remain the norm, psychoanalytic theories have been used to develop other types of psychological treatments. Psychoanalytic group therapy was spearheaded by Trigant Burrow, Joseph Pratt, Paul F. Schilder, Samuel R. Slavson, Harry Stack Sullivan, and Wolfe. Child-centered counseling for parents was instituted at the beginning of analytical history by Freud, and later developed further by Irwin Marcus, Edith Schulhofer, and Gilbert Kliman. Psychoanalytic-based pair therapy has been enacted and explained by Fred Sander, MD. Techniques and tools developed in the first decade of the 21st century have made psychoanalysis available to patients who can not be treated with previous techniques. This means that the analytic situation has been modified so that it will be more suitable and more likely to help these patients. M N. Eagle (2007) believes that psychoanalysis can not be an independent discipline but must be open to influence from and integration with the findings and theories of other disciplines.
Psychoanalytic construction has been adapted for use with children with treatments such as play therapy, art therapy, and storytelling. Throughout his career, from the 1920s to the 1970s, Anna Freud adapted psychoanalysis for children through games. It's still used today for kids, especially those who are still teenagers (see Leon Hoffman, Center for New York Psychoanalytic Institutions for Children). By using toys and games, children are able to show, symbolically, their fears, fantasies, and defenses; though not identical, this technique, in children, is analogous to the goal of free association in adults. Psychoanalytic play therapy allows children and analysts to understand children's conflicts, particularly defenses such as disobedience and withdrawal, which have guarded against unpleasant feelings and hostile desires. In art therapy, counselors may have children drawing portraits and then telling stories about portraits. Counselors pay attention to recurring themes - regardless of whether it is with art or toys.
Cultural variations
Psychoanalysis can be adapted to different cultures, as long as the therapist or counselor understands the client's culture. For example, Tori and Blimes found that defense mechanisms are valid in the normative sample of 2,624 Thai. The use of certain defense mechanisms associated with cultural values. For example, Thai appreciates serenity and collectivity (because of Buddhist belief), so they are low on regressive emotions. Psychoanalysis is also applicable because Freud uses techniques that enable him to gain subjective perceptions of his patients. He takes an objective approach by not confronting his client during a speech therapy session. He meets his patients wherever they are, as when he uses free association - where the client will say whatever comes to mind without self-censorship. There is little or no maintenance for most cultures, especially Asian cultures. Therefore, it is more likely that the Freudian constructs will be used in structured therapy (Thompson, et al., 2004). In addition, Corey postulates that it is necessary for a therapist to help clients develop a cultural identity as well as an ego identity.
Cost and duration of care
Costs for psychoanalytic care patients vary from place to place and between practitioners. Low cost analyzes are often available at psychoanalytic training clinics and graduate schools. Otherwise, the costs set by each analyst vary with the training and experience of the analyst. Because, in most locations in the United States, unlike in Ontario and Germany, the classical analysis (which usually takes three to five sessions per week) is not covered by health insurance, many analysts can negotiate their fees with patients they feel can help , but who are experiencing financial difficulties. Modified analyzes, which include psychodynamic therapy, brief therapy, and certain types of group therapy (see Slavson, SR, Textbook in Analytical Group Therapy ), are conducted on a rarer basis - usually once, twice , or three times a week - and usually the patient sits facing the therapist. As a result of defense mechanisms and lack of access to unexpected elements of unconsciousness, psychoanalysis can be an expansionary process involving 2 to 5 sessions per week over several years. This type of therapy depends on the belief that reducing the symptoms will not really help with the root cause or irrational impulse. Analysts are usually a 'blank screen', revealing very little about themselves so that clients can use space in relationships to work on their unconscious without outside interference.
Psychoanalysts use various methods to help patients become more self-conscious and develop insight into their behavior and to the meaning of symptoms. First and foremost, psychoanalysts seek to develop a secret atmosphere where patients can feel safe reporting their feelings, thoughts, and fantasies. Analysts (as analysts referred to) are asked to report whatever comes to mind without fear of retaliation. Freud calls this the "fundamental rule". Analysts are asked to talk about their lives, including their early life, the current life and hopes and aspirations for the future. They are encouraged to report their fantasies, "cross the mind" and dreams. In fact, Freud believed that dreams were, "the way of the kingdom to the unconscious"; he devoted the entire volume to dream interpretation. Also, psychoanalysts encourage their patients to lie on the couch. Usually, the psychoanalyst sits, not visible, behind the patient.
The task of psychoanalysts, in collaboration with analysand, is to help deepen analysand's understanding of these factors, beyond their consciousness, which encourages their behavior. In a safe environment of psychoanalytic arrangement, analysand became attached to the analyst and soon he began to experience the same conflict with his analyst as he experienced with key figures in his life such as his parents, his superiors, other important ones, etc. It is the psychoanalyst's role to show these conflicts and interpret them. The transfer of this internal conflict to the analyst is called "transference".
Much research has also been done on shorter "dynamic" treatments; it is wise to measure, and explain the therapeutic process to some extent. Brief Relational Therapy (BRT), Short Psychodynamic Therapy (BPT), and Limited Dynamic Therapy-Time Therapy (TLDP) limit treatment to 20-30 sessions. On average, classical analysis can last for 5.7 years, but for phobias and depression that are not complicated by the ego deficit or the object relations deficit, the analysis may run for a shorter period of time. Longer analysis is indicated for those with more serious disorders in object relationships, more symptoms, and more character pathology.
Training and research
United States
Psychoanalytic training in the United States involves personal psychoanalysis for trainees, about 600 hours of classroom teaching, with a standard curriculum, over a period of four or five years.
Typically, this psychoanalysis should be done by the Supervisor and Training Analyst. Most institutes (but not all) in the American Psychoanalytic Association, require that the Supervisory and Training Analyst become certified by the American Board of Psychoanalysts. Certification requires a blind review in which psychoanalytic work is examined by psychoanalysts outside their local community. After getting certified, these psychoanalysts face another hurdle in which they are specifically examined by senior members of their own institutions. The Supervisory and Training analysts adhere to the highest clinical and ethical standards. In addition, they are required to have extensive experience of doing psychoanalysis.
Similarly, classroom instruction for psychoanalytic candidates is very strict. Class usually meets several hours a week, or for a full day or two every other weekend during the academic year; this varies with the institute.
Candidates generally have one hour of supervision each week, with Counselors and Training Analysts, in every psychoanalytic case. The minimum number of cases varies between agencies, often two to four cases. Cases of men and women are needed. Supervision should last at least several years in one or more cases. Supervision is done at the supervisory office, where trainees present material from psychoanalytic work that week. In surveillance, the patient's subconscious conflict is explored, also, the transference-countertransference constellation is examined. Also, clinical techniques are taught.
Many psychoanalytic training centers in the United States have been accredited by special committees of APSAA or IPA. Due to theoretical differences, there are independent institutions, usually established by psychologists, who until 1987 were not allowed access to the psychoanalytic training institutes of the APSAA. There are currently between 75 and 100 independent agencies in the United States. Also, other agencies are affiliated with other organizations such as the American Academy of Psychoanalysis and Dynamic Psychiatry, and the National Association for the Advancement of Psychoanalysis. In most psychoanalytic institutions in the United States, qualifications for admission include terminal degrees in mental health, such as Ph.D., Psy.D., MSW, or MD Some institutions limit applicants to those who already have MD or Ph.D., and most institutes in Southern California awarded Ph.D. or Psy.D. in psychoanalysis after graduation, which involves completing the necessary requirements for the state council who awarded the doctorate. The first training institute in America to educate non-medical psychoanalysts was The National Psychological Association for Psychoanalysis (1978) in New York City. It was founded by analyst Theodor Reik. The Freudian Contemporary (originally New York Freudian Society) branch of the National Psychological Association has a branch in Washington, DC. It is a component/institute or science community.
Some psychoanalytic training has been established as a post-doctoral scholarship in university environments, such as at Duke University, Yale University, New York University, Adelphi University, and Columbia University. Other psychoanalytic institutions may not be directly linked to universities, but faculty in those institutions usually hold contemporary teaching positions with psychology Ph.D. programs and/or with a medical school psychiatry residency program.
Science is the world's premier accrediting and regulatory body for psychoanalysis. Their mission is to ensure the continued strength and development of psychoanalysis for the benefit of psychoanalytic patients. He works in partnership with his 70 constituent organizations in 33 countries to support 11,500 members. In the US, there are 77 psychoanalytical organizations, associations in the United States, scattered throughout the state of America. APSaA has 38 affiliated communities that have 10 or more active members who practice in a specific geographic area. The goals of APSaA and other psychoanalytic organizations are: to provide continuing education opportunities for its members, stimulate the development and research of psychoanalysis, provide training and organize conferences. There are eight study groups affiliated in the United States. The study group is the first integration level of the psychoanalytic body in the IPA, followed by the temporary community and ultimately the community members.
The Psychoanalytic Division (39) of the American Psychological Association (APA) was founded in the early 1980s by several psychologists. Until the establishment of the Psychoanalytic Division, psychologists who have been trained in independent institutions have no national organization. The Psychoanalysis Division now has about 4,000 members and about 30 local branches in the United States. The Psychoanalysis Division holds two annual meetings or conferences and offers continuing education in theory, research and clinical engineering, as well as affiliated local chapters. The European Federation of Psychoanalysis (EPF) is an organization that combines all European psychoanalytic societies. This organization is affiliated with IPA. In 2002 there were about 3,900 individual members in 22 countries, with 18 different languages. There are also 25 psychoanalytic communities.
The American Association of Psychoanalysis in Clinical Social Work (AAPCSW) was founded by Crayton Rowe in 1980 as a division of the Federation of Clinical Societies of Social Work and became an independent entity in 1990. Until 2007, the organization was known as the National Membership Committee on Psychoanalysis. This organization was founded because although social workers represent more people who are trained to become psychoanalysts, they are under-represented as supervisors and teachers at the institutes they attend. AAPCSW now has more than 1000 members and has more than 20 chapters. It holds bi-annual national conferences and annual local conferences.
The experiences of psychoanalysts and psychoanalytic psychotherapists as well as research on infant and child development have given rise to new insights. The theories have been further developed and empirical research results are now more integrated in psychoanalytic theory.
United Kingdom
The London Psychoanalytical Society was founded by Ernest Jones on 30 October 1913. With the expansion of psychoanalysis in England, the Society was renamed the British Psychoanalytical Society in 1919. Soon after, the Institute of Psychoanalysis was established to administer the Society's activities. These include: psychoanalytic training, the development of psychoanalytical theory and practice, the provision of care through the London Clinic of Psychoanalysis, the publication of books in The New Library of Psychoanalysis and Psychoanalytic Ideas. The Institute of Psychoanalysis also publishes the International Journal of Psychoanalysis, maintains libraries, researches further, and holds public lectures. The public has a Code
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