To this end, I critique the cul-de-sacs into which some psychoanalytic scholars have directed us, and conclude with the hope that the current state of affairs can be remedied.
Freud used each of these three facets of psychoanalysis iteratively to progress our understanding of human mental functioning. This insight underpinned a paradigm shift in thinking about the mental functioning of human beings, for which there was a scant vocabulary and embryonic conceptualizations.
The theory that organized early clinical observations gradually unfolded, many precepts of which have entered the psychological lexicon as givens, concepts that are now taken for granted. Three of these bedrock concepts are the existence of the Unconscious, the notion of hidden meaning and the idea of repression. The concept of repression is essential, not only to an understanding of the Unconscious but to psychoanalysis itself. In fact, Freud viewed repression as the mental process that creates the Unconscious.
The Unconscious refers to the existence of thoughts and feelings of which we are not aware that motivate our strivings and behaviour. It is the locus of dynamic psychic activity — the place where wishes, impulses and drives reside, a place not beholden to the realities of logic or time or the constraints of socially acceptable behaviour.
Repression is a defence mechanism that keeps unconscious material out of conscious awareness. However, the excluded material continues to influence behaviour because it is so emotionally charged that it demands expression. Prior to , Freud believed that most neurotic symptoms were related to the repressed experiences of infantile sexuality. After this time, Freud gave primacy to the experience of trauma, a position that became a central tenet of subsequent psychoanalytical theorizing and speculation Miliora, ; Mills, ; Muller, ; Naso, ; Oliner, The traumas of war and the constant imminent threat to survival must surely come closest to repeating the feeling of infant helplessness and its associated anxiety.
The proximal trauma triggers the distal archaic infant anxieties, resulting in a traumatic neurosis. Freud understood the symptoms, including repeated nightmares and reliving of the war trauma as an attempt to master the trauma psychologically. The helplessness and dependency that we all experience as infants are re-activated in subsequent experiences of threat, anxiety and loss. Freud thus proposed that infantile traumas are universal and differ only in their intensity between individuals and that such traumas have an impact on all subsequent development.
Thus the desire for contact and attachment is born of fear and is thus a secondary instinct. This position was subsequently challenged by the attachment theorists Bowlby, , In summary, the affect-trauma model proposed that the symptoms of hysterical patients had hidden psychological meaning related to major emotional traumata that the patient had repressed Freud, a, b, c, d.
The topographical and structural models In The Unconscious, Freud revisited and reworked his ideas. Freud subsequently renamed his depth psychology, metapsychology, in which all psychological phenomena were examined from three different perspectives: The topographical analysis identified the system in which the psychic action was occurring; the economic analysis assessed the quantity of psychic energy being expended and the dynamic analysis explored the conflict between the pressures from instinctual drives wishes, strivings and the ego defences that are deployed to prevent the release of the forbidden material from repression Quinodoz, This model re-focused attention on the importance of the social environment and the role of relationships with primary caregivers Mayer, Freud proposed three structures, which he termed id, ego, and superego.
The id, the home of unconscious drives and impulses, operates according to a primary process that is very different from conscious thought, or secondary process thinking. It has no allegiance to rationality, chronology or order, and is fantasy-driven via visual imagery. As the child develops, so does the ego, the reality tester, the rational part of the personality. The ego protects itself from the Unconscious by developing repressing forces defences mechanisms that keep repressed material from breaking through to consciousness Freud, Gradually the child learns to delay immediate gratification, to compromise, accept limits and cope with inevitable disappointments.
Freud defined the ego in two ways; firstly, as the structure needing protection from the Unconscious; secondly, as the repressing force that keeps disturbing material at bay.
Since the process of repression is itself unconscious, there must be an unconscious part of the ego. With this understanding came a change in the understanding of the role of anxiety.
In his early theorizing, anxiety was understood to be related to the fear of discharge of unacceptable sexual or aggressive drives. Subsequently, Freud understood anxiety to be, simultaneously, an affective signal for danger and the motivation for psychologically defending against the perceived danger. Freud believed at first that repression caused anxiety; he subsequently came to the view that it was anxiety that motivated repression Freud, When an individual senses one of these danger-situations, motivation for defending against the anxiety is triggered.
Freud distinguished between traumatic primary anxiety, which he defined as a state of psychological helplessness in the face of overwhelmingly painful affect, such as fear of abandonment or attack, and signal secondary anxiety, which is a form of anticipatory anxiety that alerts us to the danger of re-experiencing the original traumatic state by repeating it in a weakened form such that measures to protect against re-traumatization can be taken.
He also revised his view about what was repressed, concluding that it was not traumatic experiences or memories but conflicted impulses, wishes and desires with their attendant anxiety that motivate repression. Hence, Freud shifted his focus from external trauma to a focus on inner conflict as the core of psychoanalytic theory and psychoanalysis Eagle, Contemporary psychoanalytic theory reversed this shift, re-focusing on external mostly interpersonal trauma as the locus of psychopathology.
According to Freud, the superego develops between the ages of four and six years. Subsequently, psychoanalytic scholars tried to integrate the topographical and structural models, but a discussion of this is beyond the scope of this paper — see Sandler and Sandler for a detailed exposition.
The schematic representation Figure 1 below captures the essential elements of the integrated topographical and structural aspects of this psychoanalytic meta-theory.
His technique was intuitive and evolutionary; theory followed to explain the observed clinical phenomena. Freud himself viewed this discovery as pivotal to the psychoanalytic process. In the transference the analyst-patient relationship comes to resemble the mother-child relationship Freud, Transference phenomena are unconscious and from the outset, serve both the functions of resistance and revelation.
Transference is encouraged in the analytic situation through the adoption of an accepting and non-judgmental stance. It has a long history in the arts beginning with its first recorded appearance in a comic play The Clouds by the ancient Greek playwright, Aristophanes, in which the subject was instructed by the character playing Socrates to lie on the couch and say whatever came into his mind Rogers, In the second stage of technique development, Freud abandoned both hypnosis and abreaction, replacing them with a new focus on free association and the analysis of the resistance.
The analysand is instructed to allow a free flow of associations, emotions, and images to emerge. When a defensive blocking of those associations occurs within the analysand, this blocking is called repression.
When it is motivated by the analyst-analysand dyad via the transference, it is called resistance. Freud hoped that the technique of free association would simultaneously expose and undo both repression and resistance Boag, Free association required the patient to say whatever came into his mind, with no attempt to censure or organize his thoughts, thereby becoming a passive observer of his own stream of consciousness. Freud b was so impressed with free association that he thought the material arising from its outcomes warranted a new name — psycho-analysis.
Interpretation The technique of interpretation was developed to explain the influence of primary process, which is accessed via free association. It has many functions, including making connections between seemingly disparate utterances of the patient, confirming, clarifying, confronting patients with their contradictions, correcting misrepresentations, pointing out omissions or distortions, giving insight, synthesising, asking occasional, judicious questions and interpreting dreams.
Silence is also part of the process of interpretation. It is applied to increase the frustration of the patient to an optimal level.
Interpretations may be directed at the resistances Castelnuovo-Tedesco, , content Blomfield, or transference Schafer, ; Stewart, In all forms of interpretation, the task of the analyst is to help the patient become aware of the repressed aspects of his mind Freud, Transference interpretations are directed to the unconscious, with the aim of making unconscious sources of pain conscious and thus available for scrutiny. Resistance and defence Freud was intrigued by the phenomenon of resistance — it appeared early and frequently in his writing.
He emphasized that although psychoanalytic technique had undergone major revisions, the …aim of these different techniques has, of course, remained the same. Descriptively speaking, it is to fill in gaps in memory; dynamically speaking, it is to overcome resistances due to repression Freud, g, p. Patients enter psychoanalysis with both hope and dread Mitchell, Guilty secrets and aggressive and sexual fantasies emerge that arouse fears of retaliation and punishment, or loss of self-esteem and the esteem of others.
The anger may be expressed directly or in the form of resentment, depression or discouragement. Although Freud believed that frustration, of itself, was not an effective form of treatment, he viewed frustration as the main source of action in effective psychoanalysis.
Winnicott distinguished regression and reassurance, which he considered should rarely form part of psychoanalytic technique.
Winnicott and most who came after him, argued that in the transference, the past comes into the present of the analytic relationship; in regression, the present becomes the past.
The purpose of this process of regression is to provide the basis for the emergence of hope and a new beginning Winnicott, Termination We will complete this brief overview of Freudian analytic technique with a few words about termination. Termination has always been a vexed issue Ekstein, ; Klein, , even today Awad, ; Ferro, and although many areas of psychoanalytic theory, technique and practice are contested, issues related to termination remain among the most problematic.
Nonetheless, Freud imagined that a satisfactory outcome of psychoanalysis would fulfil two requirements: In Analysis Terminable and Interminable, Freud concluded: The business of the analysis is to secure the best possible psychological conditions for the functions of the ego p. There were four main reasons for the schisms: Several new theories and therapeutic approaches emerged in rapid succession, which I briefly review here.
Phantasies are the stuff from which the ego defences of introjection and projection arise. Klein introduced two stages of psychic development i. The notion of the encapsulated, solipsistic mind of the Kleinian infant cannot be sustained because the origin of the original contents of the mind cannot be explained. Another key interest in post-Freudian theorizing was the role of the environment in shaping personality.
Repeated failure of validating experiences of these tender emotions from caregivers results in a chronic sense of personal devaluation, dysphoria, emptiness and worthlessness. Future exposure or expression of these feelings risks the experience of shame, which is felt with devastation.
For a detailed discussion, see Cortina and Marrone Both the new wave of psychoanalysts and existential phenomenologists e. I have argued elsewhere that this is a somewhat extreme view that is not supported by research in infant development and the mother-infant dyad that shows the interactive mutual influence between mothers and their infants as separate agentic beings-in-relationship Kenny, Spitz was responsible for critical new conceptualizations of the role of the mother in development, the reciprocal influence of the mother-infant dyad, and stranger anxiety, all concepts derived from observations, interviews and longitudinal follow up of mother-infant dyads.
Other influential developmental ego psychologists were Margaret Mahler and Edith Jacobson. Self-psychology One of the most influential thinkers to emerge from ego psychology was Heinz Kohut His work departs in significant ways from his predecessors in that he conceptualized human experience, not in terms of forbidden wishes, conflict and guilt, but in terms of self-experience, of isolation and alienation from oneself and others, that gave rise to a sense of meaninglessness and an absence of inner vitality or sense of joie de vivre.
These are the need to: Each of these developmental self object needs are reproduced in psychoanalysis in three transference relationships, termed the mirroring transference, the idealizing transference and the alter ego or twinship transference, respectively. There is empirical support for the existence and independence of the three types of self object needs proposed by Kohut as well as their association with attachment quality and affect regulation Bacal, Perhaps the greatest shift from classical psychoanalysis in self-psychology is the centrality assigned to the curative power of attunement and empathy, rather than insight or interpretation.