Psychoanalysis is designed to bring hidden feelings and motives to conscious awareness so that the person can deal with them more effectively.
In Freudian psychoanalysis, the client is instructed to talk about whatever comes to mind. This process is called free association. Freud believed that the resulting “stream of consciousness” would provide insight into the person’s unconscious mind. During the early stages of psychoanalysis, the analyst remains impassive, mostly silent, and out of the person’s sight. The analyst’s silence serves as a “blank screen” onto which the person projects uncon- scious thoughts and feelings.
Eventually, clients may test their analyst by talking about desires and fantasies that they have never revealed to anyone else. When clients discover that their analyst is not shocked or disgusted by their revelations, they are reassured and transfer to their analyst feelings they have toward authority figures from their childhood. This process is known as transference. It is said to be positive transference when the person feels good about the analyst.
As people continue to expose their innermost feelings, they begin to feel increasingly vulnerable. Threatened by their analyst’s silence and by their own thoughts, clients may feel cheated and perhaps accuse their analyst of being a money grabber. Or they may suspect that their analyst is really disgusted by their disclosures or is laughing at them behind their backs. This negative transference is thought to be a crucial step in psychoanalysis, for it pre- sumably reveals negative feelings toward authority figures and resistance to uncovering repressed emotions.
As therapy progresses, the analyst takes a more active role and begins to interpret or suggest alternative meanings for clients’ feelings, memories, and actions. The goal of interpretation is to help people to gain insight—to become aware of what was formerly outside their awareness. As what was unconscious becomes conscious, clients may come to see how their childhood experi- ences have determined how they currently feel and act. By working through old conflicts, clients have a chance to review and revise the feelings and beliefs that underlie their problems. In the example of a therapy session that follows, the woman discovers a link between her current behaviors and childhood fears regarding her mother, which she has transferred to the analyst.
Therapist: (summarizing and restating) It sounds as if you would like to let loose with me, but you are afraid of what my response would be.
Patient: I get so excited by what is hap- pening here. I feel I’m being held back by needing to be nice. I’d like to blast loose sometimes, but I don’t dare.
Therapist: Because you fear my reaction? Patient: The worst thing would be that
you wouldn’t like me. You wouldn’t speak to me friendly; you wouldn’t smile; you’d feel you can’t treat me and dis- charge me from treatment. But I know this isn’t so; I know it.
Therapist: Where do you think these atti- tudes come from?
Patient: When I was 9 years old, I read a lot about great men in his- tory. I’d quote them and be dramatic, I’d want a sword at my side; I’d dress like an Indian. Mother would scold
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free association A psychoanalytic technique that encourages the person to talk without inhibition about whatever thoughts or fantasies come to mind.
transference The client’s carrying over to the analyst feelings held toward childhood authority figures.
The consulting room where Freud met his clients. Note the position of Freud’s chair at the head of the couch. In order to encourage free association, the psychoanalyst has to function as a blank screen onto which the client can project his or her feelings. To accomplish this, Freud believed, the psycho- analyst has to stay out of sight of the client.
insight Awareness of previously unconscious feelings and memories and how they influence present feelings and behavior.
me, “Don’t frown; don’t talk so much. Sit on your hands,” over and over again. I did all kinds of things. I was a naughty child. She told me I’d be hurt. Then, at 14, I fell off a horse and broke my back. I had to be in bed. Mother told me that day not to go riding. I’d get hurt because the ground was frozen. I was a stubborn, self-willed child. Then I went against her will and suffered an accident that changed my life: a fractured back. Her attitude was, “I told you so.” I was put in a cast and kept in bed for months.
Therapist: You were punished, so to speak, by this accident. Patient: But I gained attention and love from Mother for the first time. I
felt so good. I’m ashamed to tell you this: Before I healed, I opened the cast and tried to walk, to make myself sick again so I could stay in bed longer.
Therapist: How does that connect with your impulse to be sick now and stay in bed so much?
Patient: Oh. . . . (pause) Therapist: What do you think? Patient: Oh, my God, how infantile, how ungrownup (pause). It must be so. I want
people to love me and feel sorry for me. Oh, my God. How completely child- ish. It is, is that. My mother must have ignored me when I was little, and I wanted so to be loved.
Therapist: So that it may have been threatening to go back to being self-willed and unloved after you got out of the cast (interpretation).
Patient: It did. My life changed. I became meek and controlled. I couldn’t get angry or stubborn afterward.
Therapist: Perhaps if you go back to being stubborn with me, you would be returning to how you were before, that is, active, stubborn, but unloved.
Patient: (excitedly) And, therefore, losing your love. I need you, but after all, you aren’t going to reject me. But the pattern is so established now that the threat of the loss of love is too overwhelming with everybody, and I’ve got to keep myself from acting selfish or angry (Wolberg, 1977, pp. 560–561).
Only a handful of people who seek therapy go into traditional psychoanalysis, as this woman did. As Freud recognized, analysis requires great motivation to change and an abil- ity to deal rationally with whatever the analysis uncovers. Moreover, traditional analysis may take 5 years or longer, with three, sometimes five, sessions a week. Few can afford this kind of treatment, and fewer possess the verbal and analytical skills necessary to discuss thoughts and feelings in this detailed way. And many want more immediate help for their problems. For those with severe disorders, psychoanalysis is ineffective.
Since Freud’s invention around the turn of the 20th century, psychodynamic personal- ity theory has changed significantly. Many of these changes have led to modified psychoan- alytic techniques as well as to different therapeutic approaches (McCullough & Magill, 2009; Monti & Sabbadini, 2005). Freud felt that to understand the present we must under- stand the past, but most neo-Freudians encourage clients to cope directly with current problems in addition to addressing unresolved conflicts from the past. Neo-Freudians also favor face-to-face discussions, and most take an active role in analysis by interpreting their client’s statements freely and suggesting discussion topics.