34 Therapeutic process- Freud Psychoanalytic theory of personality

S. Madhumathy

1. Introduction

The word therapy is derived from the Greek word “therapeia” meaning healing. Psychotherapy means healing the mind or the soul. A therapeutic process involves the steps of diagnosing an illness, identifying the treatment procedure and implementing the treatment plan effective. Any psychological conditions can be overcome only when all these steps have been followed properly.

2. Learning Objectives

• Understanding the meaning of psychoanalysis
• Learning  about  the  key  concepts,  the  counselling process    and techniques   of psychoanalysis
• Understanding the psychoanalytic theory of counselling

3.    Freud’s Psychoanalytic theory of counselling: background information

Sigmund Freud (6t h May 1856 – 23rd September1939) was a neurologist of neurologist of Austrian origin. He was known as “the father of psychoanalysis.” He was the founder of the psychoanalytic school of psychology. He proposed his theory that the motives of the unconscious mind control much of human behaviour. According to him, specific unconscious thoughts and memories, especially sexual and aggressive ones are the sources of neurosis. He felt that neurosis could be treated by bringing out these unconscious thoughts and memories to the consciousness through psychoanalytic therapy. He developed the techniques of free association and dream analysis and “the talking cure.” These were the main concepts of psychoanalysis.

The Psychoanalytic theory proposes that thoughts, memories and desires exist below our consciousness and exert a significant influence on behaviour. Psychoanalysts see the existence of the unconscious revealed in dreams, “slips of the tongue,” sexual drives, etc. It attempts to explain a long list of phenomena including personality, mental disorders, motivation, and behaviour in terms of the unconscious. This theory proposes that things in the depths of our psyche or unconscious need to be integrated with our conscious minds in order to produce a healthy personality.

According to this theory, the client is ignorant and is not aware of the reason for his problems and difficulties. These reasons are deeply embedded in the unconscious. The client is therefore helpless and needs help. The problems faced by adults are mainly due to their repressed feelings according to Freud. Psycho analysis is a method of bringing out these repressed feelings. This therapy is time consuming and expensive.

Psychoanalytical therapy is one of the few popular therapies that focus on aspects of human personality and it is used to treat a wide variety of conditions. It is particularly suited for problems to do with personalities and past and present relationship. The goals of Psychoanalysis are client self-awareness and understanding of the influences of the past and present behaviour.

In its simplest form a psychodynamic approach enables the client to examine unresolved conflicts and symptoms that arise from earlier dysfunctional relationships which manifest themselves in the need and desire to abuse substances.

4. The Psycho Sexual stages of Development

According to Freud, psychological development in childhood takes place in a series of fixed stages. These are called psychosexual stages because each stage represents the fixation of libido (sexual drives or instincts) on a different area of the body. With increasing age, certain areas of their body become important as sources of potential frustration (erogenous zones), pleasure or both. He viewed personality development as a gradual succession of stages. He

proposed that each stage is characterized by a dominant mode of achieving libidinal pleasure and by specific developmental tasks.

According to Freud, the individual is psychically not fully formed at birth. The child has no real awareness of self and is an unconscious mass of instinctive desires which is seeking to fulfil the pleasure principle. The child assumes that it is the world, complete and self-sufficient. The child is thus totally driven to seek pleasure for getting immediate satisfaction. Freud believed that personality characteristics are well established by the age of six years. Gratification during each stage is important to avoid fixation. The five developmental stages of Freud’s

psychosexual stages are presented below:

5. View of human nature

Freud did not give importance to the influence of the social environment. He believed that human personality consists of id, ego and the superego. According to him, t he id is the source of all energy and functions on the pleasure principle. It is full of desires. The ego functions on the reality principle and often turns down the demands of id. When this happens, tensions develop between the id and ego and cause mental disorders. Superego is the moral governor of the individual or the conscience.

6. Key Concepts

6.1 The id, ego and superego

Freud proposed that the unconscious mind has a particular structure. According to him the unconscious was divided into three parts: Id, Ego, and Superego.

Id-Id is a reservoir of unconscious psychic energy constantly striving to satisfy basic drives to survive, reproduce, and show aggression. The id operates on the pleasure principle and it seeks immediate gratification.

Ego– Ego is the conscious, “executive” part of personality. According to Freud, ego mediates the demands of the id, superego, and reality. The ego operates on the reality principle, satisfying the id’s desires in ways that will realistically bring pleasure ra ther than pain. The Ego stands in between both to balance our primitive needs and our moral/ethical beliefs. A healthy ego provides the ability to adapt to reality and interact with the outside world in a way that accommodates both Id and Superego.

Superego-represents internalized ideals and provides standards for judgment (the conscious) and for future aspirations. It is the conscience which helps the individual to choose between right and wrong or good and bad.

6.2 Catharsis -The word catharsis is derived from the Greek word meaning ‘cleansing’ or ‘purification’. It describes a sudden and dramatic change in emotion, occurring as the result of experiencing strong feelings (such as sorrow, fear, pity, or even laughter). It can be described as the moment when a person clearly remembers and shares a past memory with the psycho therapist. The person will be able to feel the pain fully and after the cathartic episode the person will be free from the pain of the past. According to psychoanalytic theory, this emotional release is linked to a need to release unconscious conflicts. The end result is a positive change. Freud described catharsis as an involuntary, instinctive body process, for example crying.

6.3 Fixation– fixation means a persisting focus on pleasure-seeking energies at a previous psychosexual stage, where conflicts were unresolved. It is characterized by a strong attachment to a person or thing, especially such an attachment formed during early childhood and later expressed as immature or neurotic behaviour that remains throughout life.

6.4 Oedipal Complex

• A boy’s sexual desire for his mother and feelings of jealousy and hatred for the rival father is called as the oedipal complex.
• Unconscious desire of a boy for his mother, desire to replace his father
• Castration anxiety is the conscious or unconscious fear of losing all or part of the sex organs

6.5 Electra Complex

• A girl’s desire for her father is called the Electra complex.
• Electra complex: Unconscious desire of a girl for her father, desire to replace her mother
• Penis envy refers to the theorized reaction of a girl during her psychosexual development to the realization that she does not have a penis.

According to Freud, children cope with threatening feelings by repressing them and by identifying with the rival parent. Through this process of identification, their superego gains strength and motivates them to incorporate their parents’ values into their personalities.

6.6 Freudian Slips : Freudian slips are also called parapraxia. They are verbal slips of the tongue or a mistake in speech or writing. They are believed to reveal an unconscious and repressed motive, wish, attitude, belief, thought or emotion . They are usually excused as harmless mistakes. The Freudians believe that there are no such things as “mis”takes or items that are “mis”placed. According to psychoanalytical thinking, there is an unconscious motivation for everything we do. If we cannot remember a person’s name, there is a reason for it; if we misplace our keys, there is a reason for it too.

7. The Counselling Process

The primary goal of the counselling process in psychoanalysis is to help the client to accept and to bring forward the unconscious thoughts and feelings into the conscious mind. It is the transfer of psychic or mental energy between the levels of consciousness within people’s minds. In Classical psychoanalysis the bringing of unconscious thoughts and feelings to consciousness is brought about by techniques like “free association” and “dream analysis”. Analysis or interpretation of dreams is also a central part of therapy.

Psychoanalysis emphasizes the importance of unconscious influences on how people behave and function in life situations. Psychotherapy aims to increase a client’s abilities to gain greater conscious control over their lives and develop a strong ego. Therapy is long-term and focuses on exploring unconscious issues through interpretation, dream analysis, free association, transference and other methods. The therapist is detached, objective and neutral so that the client can project onto the therap ist things from the client’s unconscious.

Freud noted that during psychoanalysis, the following events occur:

Resistance: Resistance is a patient’s stubborn refusal to report certain thoughts, motives and experiences. The patient may also resist the analyst’s interpretations. Resistance occurs because patients wish to avoid experiencing anxiety as painful thoughts are brought closer to consciousness during psychoanalysis.

Transference: Psychoanalysis is also characterized by a lack of direct involvement on the part of the analyst, which is meant to encourage the patient to project thoughts and feelings onto the analyst. This is called as “transference” and the patient can reenact and resolve repressed conflicts, especially childhood conflicts with parents. Traditionally, transference is a projection of unconscious desires onto the therapist. Patients react towards the analyst as they did to someone who played a crucial role in their early lives for example, one of their parents. Thus through transference a patient may express intense feelings of love or hate towards the analyst. Freud believed that as a patient’s insight increases transference gradually decreases.

Counter Transference: Projections are made by the therapist onto the client through a process called as Counter transference.

8. Techniques

The theory and associated techniques proposed by Freud were called as psychoanalysis. Several techniques were suggested and used to uncover the unconscious. Some of them are discussed below.

8.1 Free Association

Free association is a technique used in psychoanalytic the rapy to help patients learn more about what they are thinking and feeling. Freud used free association to help his patients discover unconscious thoughts and feelings that had been repressed or ignored. When his patients became aware of these unconscious thoughts or feelings, they were better able to manage them or change problematic behaviors.

In traditional psychoanalysis, the patient lies on a cot with the analyst sitting near his or her head so that the patient is not looking at the analyst. The patient is then asked to say whatever comes to his/her mind. Psychoanalysts believe that the represses thoughts and subconscious thoughts and conflicts will be given freedom to come out through the conscious mind. Initially there is a great struggle within the patient to share his or her innermost thoughts. This is termed as ‘resistance’. During the free association, the analyst must remain patient and non judgmental.

8.2 The inte rpretation of dreams

The interpretation of dreams is an important work of Freud. The most significant contribution Freud has made to modern thought is his conception of the unconscious. The concept of the unconscious was groundbreaking in that he proposed that awareness existed in layers and that there were thoughts occurring “below the surface.” Dreams, which he called the “royal road to the unconscious”, provided the best access to our unconscious life. Freud argued that the unconscious exists and described a method for gaining access to it.

According to Freud all dreams are cantered around a person’s life and are under the person’s psychic control. Every dream is a revelation of an unfulfilled wish. Freud said that the initial wish is fought by the ego and thus is pushed back into the conscious mind by means of a dream. He believed every dream to be a confession, repressed, anxious thoughts, unfulfilled sexual desires and expressions of guilt. He said that nightmares were caused due to self-punishment from the superego

8.3 Defence Mechanisms

According to Freud, the defence mechanisms are the methods by which the ego can solve the conflicts between the superego and the id. They are ways through which people deal with stresses in their lives. They are used as a means to try to solve problems, hide or counterbalance feelings or actions. Defence mechanisms do not usually get rid of the problem, and are often negative or not a very effective way to deal with stress. Their overuse or reuse rather than confrontation can lead to either anxiety or guilt which may result in psychological disorders such as depression. The defence mechanisms include denial, reaction formation, displacement, repression/suppression, projection, intellectualization, rationalization, compensation, sublimation and regressive emotionality.

Denial: Denial means that someone will not (deliberately) admit to the truth. The person doesn’t acknowledge the validity of the matter but acknowledges its presence. For example, an alcoholic expresses, “I may like to drink, but I’m not an alcoholic.” Or a smoker concludes that the evidence linking cigarette smoking to health problems is false.

Reaction formation: It takes place when someone takes the opposite approach consciously compared to what he wants unconsciously. For example, someone may engage in violence against another race because, he claims, they are inferior, when unconsciously it is he himself who feels inferior.

Displacement: Displacement involves taking out our frustrations, feelings, and impulses on people or objects that are less threatening. Displaced aggression is a common example of this defence mechanism. Rather than express our anger in ways that could lead to negative consequences (like arguing with our boss), we instead express our anger towards a person or object that poses no threat (such as our spouse, children, or pets)

Repression: The person forces the unacceptable or threatening feeling out of awareness to a point where he/she becomes unaware of it. An example could be when a person is asked, “how do you get along with your mother” and he responds, “just fine” as he turns pale. Negative feelings about the mother are so unacceptable that he represses his true feelings.

Projection: The person attributes one’s own perceived negative attributes onto someone else. For example, Mohan blames the teacher for a bad grade even though he didn’t study. Or Savitha says, “You envy me,” when Savitha is the one who really envies the other person. Or a person cheats on his spouse and blames the spouse for cheating.

Intellectualization: It involves removing one’s self, emotionally, from a stressful event. Intellectualization is often accomplished through rationalization rather than accepting reality. For example a person who loses his dog in an accident may say “our dog is really better off dead, he was feeble and also going blind”

Rationalization: Occurs when we tell an element of the truth, but deny the larger truth of the matter. For example, “I could have won the race but the track was wet.” The larger truth was that someone was faster. Or “I got fired, because the boss was a not a good man.” Failur es are a threat to the ego while rationalization reduces the hurt.

Compensation: It occurs when someone takes up one behaviour because one cannot accomplish another behaviour. For example, the second born child may clown around to get attention since the older child is already an accomplished scholar.

Sublimation: Sublimation is a defence mechanism that allows us to act out unacceptable impulses by converting these behaviours into a more acceptable form. It is the channeling of impulses to socially accepted behaviours. For example a person experiencing extreme anger might take up kick-boxing as a means of venting frustration. Freud believed that sublimation was a sign of maturity that allows people to function normally in socially acceptable ways.

Regression: When adult defence mechanisms stop working for us, we regress to a personality we had at childhood. For example, when an adult doesn’t take responsibility, he says, “It’s not my fault, it’s her fault.” Immature patterns of behaviour emerge such as bragging.

The greatest problems arise when defence mechanisms are overused in order to avoid dealing with problems. In psychoanalytic therapy, the goal may be to help the client uncover these unconscious defence mechanisms and find better, more healthy ways of coping with anxiety and distress.

9.1 Summary and Evaluation

Psychodynamic therapy is used in treatment to help patients understand themselves more fully. This approach involves learning to identify unconscious conflicts. It also involves assisting clients to understand how certain types of adverse childhood experie nces have left them feeling troubled, incomplete, anxious or insecure. Such a situation usually reduces productivity in an adult. This type of therapy is based on the belief that our mental well-being is influenced by unconscious conflicts, significant childhood experiences and painful feelings that are hidden behind a variety of defence mechanisms.

Freud’s model of psycho-sexual development has been criticized from different perspectives. Some have objected to Freud’s claim that infants are sexual beings (and, implicitly, Freud’s expanded notion of sexuality). Others have accepted Freud’s elaborate concept of sexuality. But critics have argued that this pattern of development is neither universal, nor necessary for the development of a healthy adult. Instead, they have emphasized on the social and environmental sources of patterns of development. They have also called attention to social dynamics which Freud ignored completely.

9.2 Contemporary issues

Freud’s psychological theories are disputed today and many leading psychiatrists disregard him. On the other hand, there are also many psychiatrists who can agree at least with the core of his work. Although Freud was long regarded as a genius, psychiatry and psychology have been recast as scientific disciplines in recent times. Psychiatric disorders are now considered purely diseases of the brain, the causes of which is mainly considered genetic. This indicates that childhood and environment don’t have muc h influence on the human mind and its well-being. However, many people reject this view as an over-simplification. Some also criticize Freud’s rejection of positivism.

Behaviourism, evolutionary psychology, and cognitive psychology reject psychoanalysis as a pseudoscience. Humanistic psychology maintains that psychoanalysis is a demeaning and incorrect view of human beings. The other schools of psychology have produced a lternative methods of psychotherapy to psychoanalysis, including behaviour therapy, cognitive therapy, and person cantered psychotherapy.

Psychoanalysis, as practiced by Freud, has lost popularity as research has gained a more scientific perspective regarding motivation and mental health. However, the influences of Freud’s theories can be found throughout psychology, and components are incorporated in many current variations of therapy.

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