Patrick Mahony - Psychodynamic theory and therapy

1. Sigmund Freud
and
Classical Psychoanalysis

2. The Constancy Principle
States that the aim of the psychic apparatus (i.e., mind)
is to keep stimulation to near zero if at all possible
Studies on Hysteria (Breuer & Freud, 1895)
Generated from an now outdated neurological
conception
Quiescence = pleasant
Excitement = unpleasant
Classical Psychoanalysis 2Mark W. Matthews, PhD

3. The psychic quantity that the constancy principle
regulated (required to discharge) were the affects
1. An event (e.g., interpersonal exchange)
2. Reaction
Sexually excited, angry, frightened, pleased
3. Affect determined by
Individual personality
Event itself
Culture determines which affects are acceptable
Classical Psychoanalysis 3Mark W. Matthews, PhD

4. 4. This interplay (individual & culture) determine
which affects are “embroiled in conflict” (G & M, p. 27)
5. The memory associated with these affects become
subject to repression
Note: in this form, there are no irreducible forces or
fundamental passions (i.e., drive)
Classical Psychoanalysis 4Mark W. Matthews, PhD

5. Drive is an energy source
Activates the psychic apparatus [structure]
Determines humanity’s essential nature
Quotes:
“a demand made upon the mind for work”
“the ultimate cause of all activity”
“every psychical act begins as an unconscious one”
Classical Psychoanalysis 5Mark W. Matthews, PhD

6. Two drives
Sexual
Self-preservation
Later to be incorporate in ego
Later to become death/destruction
Classical Psychoanalysis 6Mark W. Matthews, PhD

7. Psychosexual Stages
Oral
Incorporative(0 - 8 months): focus on the mouth, lips,
tongue, swallowing, and sucking
Incorporative character: smoker, eater
Sadistic (8 - 12 months): biting and devouring
Sadistic character: sarcastic
Classical Psychoanalysis 7Mark W. Matthews, PhD

8. Anal (2 - 3 years)
Child is learning how to control physiological functions
Expulsive: releasing feces
Expulsive character: messy, untidy
Retentive: holding feces
Retentive character: neat, tidy, obsessive
Classical Psychoanalysis 8Mark W. Matthews, PhD

9. Phallic (4 - 5 years)
Oedipus Complex
Reverse Oedipus Complex
Latency (6 - 12 years)
Sexual instincts are sublimated until genital stage
Genital (12 years +)
Sexual instincts are not primarily autoerotic
Health defied as the establishment of appropriate
relationships with whole objects
Classical Psychoanalysis 9Mark W. Matthews, PhD

10. 1. Sexual drive not yet organized
2. Composed of component/partial drives
3. Partial drives through their dependent relationship
to the self-preserving drives are carried outside of the
infant’s own body
4. Set of experiences develops
Frustrating
Satisfying
Classical Psychoanalysis 10Mark W. Matthews, PhD

11. 5. These experiences, especially the satisfying
experiences create an image or representation of what
satisfaction is like
6. “The association of these satisfactions with the
conditions under which they were experienced leads
to object formation”
(G & M, p. 41)
Classical Psychoanalysis 11Mark W. Matthews, PhD

12. “Because within the drive model the object is the
creation of drive, object relations remain a function of
drive”
(G & M, p. 42, italics in original)
Objects are passive receptacles or recipients of
cathexis
Classical Psychoanalysis 12Mark W. Matthews, PhD

13. Topographic
unconscious (Ucs)
preconscious (Pcs)
conscious (Cs)
Introduced in The Interpretation of Dreams
Doubt about mechanisms the Ucs, Pcs and Cs use
Classical Psychoanalysis 13Mark W. Matthews, PhD

14. One of the biggest areas changed as he
accommodated his theory and created the structural
model
Addition of Narcissism, identification, and the ego ideal
were too much for the system
Classical Psychoanalysis 14Mark W. Matthews, PhD

15. Structural
Finally gives structures to functions and the psychic
apparatus written about
id
all unconscious
ego
mostly unconscious
navigates reality
superego
mostly unconscious
generated from resolution of Oedipus Complex
Classical Psychoanalysis 15Mark W. Matthews, PhD

16. Actual Neuroses
Anxiety neuroses
Neurasthenia
A psychological disorder characterized by chronic fatigue
and weakness, loss of memory, and generalized aches and
pains, formerly thought to result from exhaustion of the
nervous system.
Dysfunction of current sexual life
Related to hypothesized chemical sexual substances
(i.e., physiological)
Classical Psychoanalysis 16Mark W. Matthews, PhD

17. Psychoneuroses
Not neurological or physiological
Available for psychoanalytic treatment
Result of a conflict brought about the incongruity of
ideas and the ensuing failure to release affect
Seduction Theory
“Early seduction provides a traumatic experience precisely
because the immature sexual apparatus is poorly equipped
to handle the excitations that are stimulated, nor is the
immature personality equipped to deal with their emotional
concomitants”
(G & M, p. 28).
Classical Psychoanalysis 17Mark W. Matthews, PhD

18. Phase 1: Defense Model
Repression of unacceptable affects exercise a
“pathogenic force”
Sexuality was considered the most likely area resulting
in unacceptable affects, but still only one of a myriad of
possible areas
Incompatibility and conflict are pathogenic (regardless
of source)
“Dominant mass of ideas”
Classical Psychoanalysis 18Mark W. Matthews, PhD

19. Phase 2: Resistance and Repression
Dominant mass of ideas = social structure
The tension between one’s impulses and the social structure
into which one must fit is what determines repression
Wants to make repression deriving from humanity’s
biological nature
Postulates “organic repression”
Ontogeny reiterating phylogeny
Morality without society
Purest form of drive/structure model
Classical Psychoanalysis 19Mark W. Matthews, PhD

20. Phase 3: Anxiety and Late Affect Theory
Anxiety near universal
Affect relegated to secondary position
No longer affect that is defended against
Affect (specifically anxiety) is an indication that
repression was partially failing
With drive being primary, specific aspects of affects
were disregarded, except as the affects indicated or
revealed the nature of the repressed drive impulse
Classical Psychoanalysis 20Mark W. Matthews, PhD

21. “In Freud’s early view of the actual neuroses he saw
anxiety as the product of dammed-up libido which had
become ‘toxic’; because there were no opportunities for
discharge, the libido had become (physiologically)
transformed. The theory of anxiety in psychoneuroses,
and the theory of affect generally, was imported from
this approach to the actual neuroses. Anxiety was seen
as the result of a damming-up, not in the case because
of inadequate sexual opportunity, but because of
repression”
(G & M, p. 65)
Classical Psychoanalysis 21Mark W. Matthews, PhD

22. “All neurotic psychopathology represents a
compromise between a repressed unacceptable wish
and an unconscious fear. Where as all behavior
represents a compromise between the demands of
inner drives and external reality, neurotic behavior is
a second-best solution, reflecting the individual’s
effort to accommodate not only to the real world but
also to the restrictions imposed by his unconscious
fear”
(MacKinnon & Michels, 1971, p. 74)
Classical Psychoanalysis 22Mark W. Matthews, PhD

23. Symptoms
Sharply defined
Ego-dystonic
Generally Axis I
Anxiety
Depression
Phobias
Obsessions
Compulsions
Classical Psychoanalysis 23Mark W. Matthews, PhD

24. Character
More generalized behaviors
Part of a persons personality
Ego-syntonic
Generally Axis II
Mistrust
Irresponsibility
Impulsiveness
Narcissism
Classical Psychoanalysis 24Mark W. Matthews, PhD

25. Symptoms are uncovered through what the patient
talks about
Character is uncovered and revealed in the way and
manner the patient talks and how the patient relates
to others
Symptoms not only defend against forbidden wishes,
symptoms also partially gratify the wish.
Classical Psychoanalysis 25Mark W. Matthews, PhD

26. Neurosis
The ego responds to intolerable id demands by
renouncing the id’s demands (i.e., repression)
Psychosis
The ego responds by renouncing the reality that makes
the id’s demands intolerable (i.e., disavowal)
This defense is against perceptions
This defense is directed outwards
Classical Psychoanalysis 26Mark W. Matthews, PhD

27. Early Phases
Hypnosis moving toward free association
Abreaction/Catharsis
Pathology happens when affect cannot be discharged
(constancy principle)
Pent up affects result in neurotic symptoms
Recovery of the repressed memories result in
abreaction
Classical Psychoanalysis 27Mark W. Matthews, PhD

28. Later Phases
Treatment requires the uncovering of the libidinal force
which has led to the appearance of a given affect
Described like chess
Classical Psychoanalysis 28Mark W. Matthews, PhD

29. Transference
Distortion based on history
Acting in vs. Acting out
Patient is unconsciously reenacting a latter-day version of
forgotten childhood memories, repressed fantasies, and
other material with the therapist
Classical Psychoanalysis 29Mark W. Matthews, PhD

30. Interpretation
Helps patient distinguish
reality and fantasy
past and present
self and others
Provides broader perspective on how childhood impacts
present
Enlightens how the patient responds automatically and in
stereotyped ways
Classical Psychoanalysis 30Mark W. Matthews, PhD

31. Working Through
Once or twice is never enough!
Classical Psychoanalysis 31Mark W. Matthews, PhD

32. First personality theorist
Ideas have permeated all of society
Art & Literature
Popular Culture
Freudian Slip
Dream Analysis
Id, Ego, Superego
Classical Psychoanalysis 32Mark W. Matthews, PhD

33. Acknowledged presence and power of a dynamic
unconscious
Developed a cohesive theory of personality structure
Pioneered a developmental model of diagnosis and
treatment
Different ages and stages with different needs and
struggles
Classical Psychoanalysis 33Mark W. Matthews, PhD

34. Concerned with psychopathology
Wrested with the “Seduction Theory”
First theorist to talk about “object relations”
Treatment Concepts
Transference/Countertransference
Resistance
Dream Work
Free Association
Classical Psychoanalysis 34Mark W. Matthews, PhD

35. Drive/Structure Model
Constancy Principal
Pleasure Principal
Reality Principal
Psychosexual Stages
Pathology has developmental characteristics
Talking Cure
Classical Psychoanalysis 35Mark W. Matthews, PhD

36. Development of Drive/Structure Model
Drive
Fundamental human urges
Elemental passions
Id expresses true purpose
Structure
Mental topography is a fiction
Stresses metaphorical nature by assigning common names
Classical Psychoanalysis 36Mark W. Matthews, PhD

37. Greenberg, J. R., & Mitchell, S. A. (1983). Object
relations in psychoanalytic theory. Cambridge, MA:
Harvard University Press.
MacKinnon, R. A., & Michels, R. (1971). The
psychiatric interview in clinical practice. Philadelphia:
W. B. Saunders.
Classical Psychoanalysis 37Mark W. Matthews, PhD