Psychoanalysis

PSYCHOANALYSIS. What thoughts come to mind regarding this word?

Generally speaking, most people will associate psychoanalysis with Freud (completely understandably so). Certainly, he was a pioneer of the development of psychoanalysis. Whether you like the guy or not, there was something about him that got us all thinking. However, Freud is not the only person who contributed toward psychoanalysis and the Freudian undertsanding of psychoanalysis is not the only interpretation that exists.

In my particular training, I have been exposed to a more relational approach to psychoanalysis. Relational psychoanalysis involves processes such as attachment theory as well as object relations theory. Both these interpretations have a slightly more nuanced understanding of what the key concepts of psychoanalysis actually mean (e.g. the unconscious).

Some other names involved in a psychoanalytic approach to theory: Karen Horney (who was very much focused on exploring competition and the various dynamics around it); Carl Jung (who was a most ecclectic therapist and theorist who explored a multiple range of different influences in terms of understanding the human psyche and he had a slightly different take than Freud in that he was much more optimistic and empowering of his clients); Melanie Klein; Donald Winnicott; Alfred Adler just to name a few. Even Ana Freud herself! Jessica Benjamin explored the idea of intersubjectivity 

In my training, I have been encouraged not to view psychoanalysis solely in relation to Freud. His classical psychoanalysis is absoultely a great foundation to start with but there were considerable developments, diagreements, divergencies, extensions and adaptations of the classical Freudian approach. Having said that, many of his key tenants have remained consistent throughout the years. Their interpretations, however, can be vastly different.

There are multiple interpretations of what the unconscious actually is. Freud had quite a reductionistic approach; taking something quite complex and trying to reduce it to something quite simple; tending to miss out on all the other components actually associated with the unconsious. He believed a lot of behaviour, thought and feeling was motivated by certain drives. Highlighted a sexual drive and an aggressive drive – apparently biologically based. Not necessarily saying this may not be true, but we know that what drives, motivates, maintains, influences, modifies behaviour cannot just be put down to biological drives. One of the criticisms of the classical approach is that it tends to be reductionist. We cannot simply take a complex process like ‘behaviour’ and reduce it to one possible causal element.

Understanding the context; the history of psychoanalyis is really important in understanding how and why the theory has taken it’s particular pathway.

Attachment theory is a philosophy very much situated in terms of the mother-infant relationship and how that sets the foundation for later relationships in life. The cruz of this particular theory (hugely simplified) is that, through psychoanalysis (talking and relationship with the therapist), a person can actually change some of those attachment patterns. If one can change some of the unhealthy/ dysfunctional attachment patterns, then ultimately the person will feel more satisfaction and have better, healthier relationships with others. The main drivers of this theory were John Bowlby and Mary Ainsworth .

Important elements:

  1. The attachment behaviour system and how it responds to/ activates in the presence of certain emotional triggers
  2. Attachment style: how one engages in particular relationships (see The Strange Situation)

The other relational theory: object relations theory is also very much referred to the infant-caregiver relationship. The idea here is that the internal object becomes part of the person’s psychic structure of self. They are not just a representation of the external object, but actually based on the relationship between caregiver and infant. The infant starts to internalise a sense of the external person but it becomes a part of their own psychic structure. It is not just a representation or memory or an image, its an acual part of the person’s psychic structure. This means it has a lot more influence in how the person engages and responds to their outside world. When this internal representation/ idea was created, it was very much based around that child’s capacity/ functioning/ skills/ executive capacity. This means it might have been a slightly skewed/ limited/ unrealistic understanding of the external object and the relationship that developed. The idea in object relations theory is that if you can work on the relationship (the person’s internal object relations as well as the external) that you can produce some kind of shift in how people relate to other people. This should essentially change their psychic structure.

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How psychoanalysis is useful from a counselling space:
> In terms of therapeutic goals and mechanisms (emotional insight, symptom remission, resolving internal conflict; personality integration; exploring unknown aspects of self, resolution of painful experiences…)
> Familiarising oneself with the client’s history in order to understand them contextually (the history informs the present and helps bring sense to future goals)
> Awareness of transference & countertransference, the unconscious, object relations/ attachment, the therapeutic alliance, resistance/ defences
> Proven effective for a range of conditions and populations

Greatest benefit of psychoanalytic thought:
> Awareness of implicit mental life, recurring patterns and themes in oneself
> Focus on interpersonal relations (Attachment theory/ object relations/ therapeutic alliance/ transferrence…)
> Oldest methodology (the ‘father’ of all modalities of Psychology as a field in itself) It is the ‘active ingredients’ of other therapies which tend to include its core techniques & processes. Cannot discredit its influence in treatments which followed.

Challenges/ disadvantages of psychoanalysis:
> long-term treatment with loosely defined open-ended goals (may not be effective for all) –> time & financial restraints; ability for self-reflection (not suitable for highly disorganised personalities)
> Can be too threatening/ traumatic reliving past experiences, leaving the client raw and unravelling in the present (things may get worse before they feel better)
> Clients in a state of immediate crisis/ emotional distress may find this approach meaningless & frustrating (as they need immediate solutions)
> Abstract & controversial ideas (e.g. drive theory)
> Empirical evidence (bias in dissemination of research findings; findings rest of few studies; unrepresentative research samples)
> Past psychoanalytic thought = arrogant, authoritative, dismissive toward research & criticism –> misrepresented (myths & misunderstanding)
> Therapists practicing the same treatment still practice differently
> Mistmatch between psychotherapy aims & what studies measure (How to determine/ measure/ quantify change and improvement in client?)
> Original psychoanalysis view of the therapist as objective, neutral observer (blank screen for the client to project onto) as opposed to therapist & client being co-participants of a process
> Profoundly Western worldview with overemphasis on individualism (although moving toward psychoanalytic pluralism…)

Mechanisms/ processes/ techniques which helped me personally shift/ change:
> The realisation that my experiences & actions are influenced by psychological processes not always part of my consious awareness
> Understanding my triggers and defenses
> Awareness of my own attachment style and transference in relationships (how my internal representations of others shape my ongoing relationships and experiences)

(I realised after the readings and reflections this week that Psychoanalytic thought has probably been one of the most valuable tools in my own personal growth – something I wasn’t neccessarily cognisant of before. I sort of dimissed the theory, having a distaste for some of the controversies and the elitism it resembled. This week has helped me see psychoanalytic/dynamic theory in a new light and I have come to appreciate its role in my own journey).

Which theoretical approach this most aligns with?
I feel that pychoalalytic theory and psychodynamic therapy could cetrainly be the dominant therapeutic approach to family and play therapy in a flexible conceptualisation.

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