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Patrick Colm Hogan

Arguments were quickly generated in early 20th-century Vienna about whether adult seduction of children, i. There still is no complete agreement, although nowadays professionals recognize the negative effects of child sexual abuse on mental health. Many psychoanalysts who work with children have studied the actual effects of child abuse, which include ego and object relations deficits and severe neurotic conflicts.

Much research has been done on these types of trauma in childhood, and the adult sequelae of those.

Affect Studies and Literary Criticism

In studying the childhood factors that start neurotic symptom development, Freud found a constellation of factors that, for literary reasons, he termed the Oedipus complex based on the play by Sophocles , Oedipus Rex , where the protagonist unwittingly kills his father Laius and marries his mother Jocasta. The validity of the Oedipus complex is now widely disputed and rejected.

Sandler in "On the Concept Superego" and modified by Charles Brenner in The Mind in Conflict — refers to the powerful attachments that children make to their parents in the preschool years. These attachments involve fantasies of sexual relationships with either or both parent, and, therefore, competitive fantasies toward either or both parents. Humberto Nagera has been particularly helpful in clarifying many of the complexities of the child through these years. Both seem to occur in development of most children.

Eventually, the developing child's concessions to reality that they will neither marry one parent nor eliminate the other lead to identifications with parental values. These identifications generally create a new set of mental operations regarding values and guilt, subsumed under the term "superego".

Besides superego development, children "resolve" their preschool oedipal conflicts through channeling wishes into something their parents approve of "sublimation" and the development, during the school-age years "latency" of age-appropriate obsessive-compulsive defensive maneuvers rules, repetitive games. Using the various analytic and psychological techniques to assess mental problems, some believe that there are particular constellations of problems that are especially suited for analytic treatment see below whereas other problems might respond better to medicines and other interpersonal interventions.

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To be treated with psychoanalysis, whatever the presenting problem, the person requesting help must demonstrate a desire to start an analysis. The person wishing to start an analysis must have some capacity for speech and communication. As well, they need to be able to have or develop trust and insight within the psychoanalytic session.

Potential patients must undergo a preliminary stage of treatment to assess their amenability to psychoanalysis at that time, and also to enable the analyst to form a working psychological model, which the analyst will use to direct the treatment. Psychoanalysts mainly work with neurosis and hysteria in particular; however, adapted forms of psychoanalysis are used in working with schizophrenia and other forms of psychosis or mental disorder.

Finally, if a prospective patient is severely suicidal a longer preliminary stage may be employed, sometimes with sessions which have a twenty-minute break in the middle. There are numerous modifications in technique under the heading of psychoanalysis due to the individualistic nature of personality in both analyst and patient. The most common problems treatable with psychoanalysis include: phobias , conversions , compulsions , obsessions , anxiety attacks , depressions , sexual dysfunctions , a wide variety of relationship problems such as dating and marital strife , and a wide variety of character problems for example, painful shyness, meanness, obnoxiousness, workaholism, hyperseductiveness, hyperemotionality, hyperfastidiousness.

The fact that many of such patients also demonstrate deficits above makes diagnosis and treatment selection difficult. Analytical organizations such as the IPA, APsaA and the European Federation for Psychoanalytic Psychotherapy have established procedures and models for the indication and practice of psychoanalytical therapy for trainees in analysis. The match between the analyst and the patient can be viewed as another contributing factor for the indication and contraindication for psychoanalytic treatment.

The analyst decides whether the patient is suitable for psychoanalysis. This decision made by the analyst, besides made on the usual indications and pathology, is also based to a certain degree by the "fit" between analyst and patient. A person's suitability for analysis at any particular time is based on their desire to know something about where their illness has come from.

Someone who is not suitable for analysis expresses no desire to know more about the root causes of their illness. An evaluation may include one or more other analysts' independent opinions and will include discussion of the patient's financial situation and insurances. The basic method of psychoanalysis is interpretation of the patient's unconscious conflicts that are interfering with current-day functioning — conflicts that are causing painful symptoms such as phobias, anxiety, depression, and compulsions. Strachey stressed that figuring out ways the patient distorted perceptions about the analyst led to understanding what may have been forgotten also see Freud's paper "Repeating, Remembering, and Working Through".

In particular, unconscious hostile feelings toward the analyst could be found in symbolic, negative reactions to what Robert Langs later called the "frame" of the therapy [71] — the setup that included times of the sessions, payment of fees, and necessity of talking. In patients who made mistakes, forgot, or showed other peculiarities regarding time, fees, and talking, the analyst can usually find various unconscious "resistances" to the flow of thoughts sometimes called free association.

When the patient reclines on a couch with the analyst out of view, the patient tends to remember more experiences, more resistance and transference, and is able to reorganize thoughts after the development of insight — through the interpretive work of the analyst. Although fantasy life can be understood through the examination of dreams , masturbation fantasies cf.

Marcus, I. The analyst is interested in how the patient reacts to and avoids such fantasies cf. There is what is known among psychoanalysts as "classical technique", although Freud throughout his writings deviated from this considerably, depending on the problems of any given patient. Classical technique was summarized by Allan Compton, MD, as comprising instructions telling the patient to try to say what's on their mind, including interferences ; exploration asking questions ; and clarification rephrasing and summarizing what the patient has been describing.

As well, the analyst can also use confrontation to bringing an aspect of functioning, usually a defense, to the patient's attention. The analyst then uses a variety of interpretation methods, such as dynamic interpretation explaining how being too nice guards against guilt, e. Analysts can also use reconstruction to estimate what may have happened in the past that created some current issue. These techniques are primarily based on conflict theory see above. As object relations theory evolved, supplemented by the work of John Bowlby and Mary Ainsworth , techniques with patients who had more severe problems with basic trust Erikson , and a history of maternal deprivation see the works of Augusta Alpert led to new techniques with adults.

These have sometimes been called interpersonal, intersubjective cf. Stolorow , relational, or corrective object relations techniques. These techniques include expressing an empathic attunement to the patient or warmth; exposing a bit of the analyst's personal life or attitudes to the patient; allowing the patient autonomy in the form of disagreement with the analyst cf. Paul, Letters to Simon ; and explaining the motivations of others which the patient misperceives. Ego psychological concepts of deficit in functioning led to refinements in supportive therapy.

These techniques are particularly applicable to psychotic and near-psychotic cf. These supportive therapy techniques include discussions of reality; encouragement to stay alive including hospitalization ; psychotropic medicines to relieve overwhelming depressive affect or overwhelming fantasies hallucinations and delusions ; and advice about the meanings of things to counter abstraction failures. The notion of the "silent analyst" has been criticized. Actually, the analyst listens using Arlow's approach as set out in "The Genesis of Interpretation", using active intervention to interpret resistances, defenses creating pathology, and fantasies.

Silence is not a technique of psychoanalysis also see the studies and opinion papers of Owen Renik, MD. It refers to the analyst's position of not taking sides in the internal struggles of the patient. For example, if a patient feels guilty, the analyst might explore what the patient has been doing or thinking that causes the guilt, but not reassure the patient not to feel guilty. The analyst might also explore the identifications with parents and others that led to the guilt.

Interpersonal—relational psychoanalysts emphasize the notion that it is impossible to be neutral. Sullivan introduced the term "participant-observer" to indicate the analyst inevitably interacts with the analysand, and suggested the detailed inquiry as an alternative to interpretation. The detailed inquiry involves noting where the analysand is leaving out important elements of an account and noting when the story is obfuscated, and asking careful questions to open up the dialogue. Although single-client sessions remain the norm, psychoanalytic theory has been used to develop other types of psychological treatment.

Schilder, Samuel R. Slavson , Harry Stack Sullivan , and Wolfe. Child-centered counseling for parents was instituted early in analytic history by Freud, and was later further developed by Irwin Marcus, Edith Schulhofer, and Gilbert Kliman. Psychoanalytically based couples therapy has been promulgated and explicated by Fred Sander, MD.

Techniques and tools developed in the first decade of the 21st century have made psychoanalysis available to patients who were not treatable by earlier techniques. This meant that the analytic situation was modified so that it would be more suitable and more likely to be helpful for these patients. Eagle believes that psychoanalysis cannot be a self-contained discipline but instead must be open to influence from and integration with findings and theory from other disciplines.

Psychoanalytic constructs have been adapted for use with children with treatments such as play therapy , art therapy , and storytelling. Throughout her career, from the s through the s, Anna Freud adapted psychoanalysis for children through play. Using toys and games, children are able to demonstrate, symbolically, their fears, fantasies, and defenses; although not identical, this technique, in children, is analogous to the aim of free association in adults.

Psychoanalytic play therapy allows the child and analyst to understand children's conflicts, particularly defenses such as disobedience and withdrawal, that have been guarding against various unpleasant feelings and hostile wishes. In art therapy, the counselor may have a child draw a portrait and then tell a story about the portrait. The counselor watches for recurring themes—regardless of whether it is with art or toys. Psychoanalysis can be adapted to different cultures , as long as the therapist or counselor understands the client's culture.

For example, Tori and Blimes found that defense mechanisms were valid in a normative sample of 2, Thais. The use of certain defense mechanisms was related to cultural values. For example, Thais value calmness and collectiveness because of Buddhist beliefs , so they were low on regressive emotionality. Psychoanalysis also applies because Freud used techniques that allowed him to get the subjective perceptions of his patients. He takes an objective approach by not facing his clients during his talk therapy sessions.

He met with his patients wherever they were, such as when he used free association — where clients would say whatever came to mind without self-censorship. His treatments had little to no structure for most cultures, especially Asian cultures. Therefore, it is more likely that Freudian constructs will be used in structured therapy Thompson, et al.

In addition, Corey postulates that it will be necessary for a therapist to help clients develop a cultural identity as well as an ego identity. The cost to the patient of psychoanalytic treatment ranges widely from place to place and between practitioners. Low-fee analysis is often available in a psychoanalytic training clinic and graduate schools. Otherwise, the fee set by each analyst varies with the analyst's training and experience.

PSYCHOTHERAPY - Sigmund Freud

Since, in most locations in the United States, unlike in Ontario and Germany, classical analysis which usually requires sessions three to five times per week is not covered by health insurance, many analysts may negotiate their fees with patients whom they feel they can help, but who have financial difficulties. The modifications of analysis, which include psychodynamic therapy, brief therapies, and certain types of group therapy cf.

Slavson, S. As a result of the defense mechanisms and the lack of access to the unfathomable elements of the unconscious, psychoanalysis can be an expansive process that involves 2 to 5 sessions per week for several years. This type of therapy relies on the belief that reducing the symptoms will not actually help with the root causes or irrational drives.

The analyst typically is a 'blank screen', disclosing very little about themselves in order that the client can use the space in the relationship to work on their unconscious without interference from outside. The psychoanalyst uses various methods to help the patient to become more self-aware and to develop insights into their behavior and into the meanings of symptoms. First and foremost, the psychoanalyst attempts to develop a confidential atmosphere in which the patient can feel safe reporting his feelings, thoughts and fantasies. Analysands as people in analysis are called are asked to report whatever comes to mind without fear of reprisal.

Freud called this the "fundamental rule". Analysands are asked to talk about their lives, including their early life, current life and hopes and aspirations for the future. They are encouraged to report their fantasies, "flash thoughts" and dreams. In fact, Freud believed that dreams were, "the royal road to the unconscious"; he devoted an entire volume to the interpretation of dreams. Also, psychoanalysts encourage their patients to recline on a couch. Typically, the psychoanalyst sits, out of sight, behind the patient. The psychoanalyst's task, in collaboration with the analysand, is to help deepen the analysand's understanding of those factors, outside of his awareness, that drive his behaviors.

In the safe environment of the psychoanalytic setting, the analysand becomes attached to the analyst and pretty soon he begins to experience the same conflicts with his analyst that he experiences with key figures in his life such as his parents, his boss, his significant other, etc. It is the psychoanalyst's role to point out these conflicts and to interpret them. The transferring of these internal conflicts onto the analyst is called "transference".


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Many studies have also been done on briefer "dynamic" treatments; these are more expedient to measure, and shed light on the therapeutic process to some extent. On average, classical analysis may last 5. Psychoanalytic training in the United States involves a personal psychoanalysis for the trainee, approximately hours of class instruction, with a standard curriculum, over a four or five-year period.

Typically, this psychoanalysis must be conducted by a Supervising and Training Analyst. Most institutes but not all within the American Psychoanalytic Association, require that Supervising and Training Analysts become certified by the American Board of Psychoanalysts. Certification entails a blind review in which the psychoanalyst's work is vetted by psychoanalysts outside of their local community. After earning certification, these psychoanalysts undergo another hurdle in which they are specially vetted by senior members of their own institute.

Supervising and Training analysts are held to the highest clinical and ethical standards. Moreover, they are required to have extensive experience conducting psychoanalyses. Similarly, class instruction for psychoanalytic candidates is rigorous. Typically classes meet several hours a week, or for a full day or two every other weekend during the academic year; this varies with the institute.

Candidates generally have an hour of supervision each week, with a Supervising and Training Analyst, on each psychoanalytic case. The minimum number of cases varies between institutes, often two to four cases. Male and female cases are required. Supervision must go on for at least a few years on one or more cases. Supervision is done in the supervisor's office, where the trainee presents material from the psychoanalytic work that week.

In supervision, the patient's unconscious conflicts are explored, also, transference-countertransference constellations are examined. Also, clinical technique is taught. Because of theoretical differences, there are independent institutes, usually founded by psychologists, who until were not permitted access to psychoanalytic training institutes of the APsaA.

Currently there are between 75 and independent institutes in the United States. As well, other institutes are affiliated to other organizations such as the American Academy of Psychoanalysis and Dynamic Psychiatry , and the National Association for the Advancement of Psychoanalysis. At most psychoanalytic institutes in the United States, qualifications for entry include a terminal degree in a mental health field, such as Ph. A few institutes restrict applicants to those already holding an M. It was founded by the analyst Theodor Reik.

Some psychoanalytic training has been set up as a post-doctoral fellowship in university settings, such as at Duke University, Yale University, New York University, Adelphi University and Columbia University. Other psychoanalytic institutes may not be directly associated with universities, but the faculty at those institutes usually hold contemporaneous faculty positions with psychology Ph. The IPA is the world's primary accrediting and regulatory body for psychoanalysis.

Their mission is to assure the continued vigor and development of psychoanalysis for the benefit of psychoanalytic patients. It works in partnership with its 70 constituent organizations in 33 countries to support 11, members. In the US, there are 77 psychoanalytical organizations, institutes associations in the United States, which are spread across the states of America. APSaA has 38 affiliated societies which have 10 or more active members who practice in a given geographical area.

The aims of APSaA and other psychoanalytical organizations are: provide ongoing educational opportunities for its members, stimulate the development and research of psychoanalysis, provide training and organize conferences. There are eight affiliated study groups in the United States.

A study group is the first level of integration of a psychoanalytical body within the IPA, followed by a provisional society and finally a member society. Until the establishment of the Division of Psychoanalysis, psychologists who had trained in independent institutes had no national organization. The Division of Psychoanalysis now has approximately 4, members and approximately 30 local chapters in the United States.

The Division of Psychoanalysis holds two annual meetings or conferences and offers continuing education in theory, research and clinical technique, as do their affiliated local chapters. This organization is affiliated with the IPA. In there were approximately 3, individual members in 22 countries, speaking 18 different languages. There are also 25 psychoanalytic societies. Until it was known as the National Membership Committee on Psychoanalysis. The organization was founded because although social workers represented the larger number of people who were training to be psychoanalysts, they were underrepresented as supervisors and teachers at the institutes they attended.

It holds a bi-annual national conference and numerous annual local conferences. Experiences of psychoanalysts and psychoanalytic psychotherapists and research into infant and child development have led to new insights. Theories have been further developed and the results of empirical research are now more integrated in the psychoanalytic theory. With the expansion of psychoanalysis in the United Kingdom the Society was renamed the British Psychoanalytical Society in Soon after, the Institute of Psychoanalysis was established to administer the Society's activities.

These include: the training of psychoanalysts, the development of the theory and practice of psychoanalysis, the provision of treatment through The London Clinic of Psychoanalysis, the publication of books in The New Library of Psychoanalysis and Psychoanalytic Ideas. The Institute of Psychoanalysis also publishes The International Journal of Psychoanalysis , maintains a library, furthers research, and holds public lectures. The society has a Code of Ethics and an Ethical Committee. The society, the institute and the clinic are all located at Byron House.

The society is a component of the IPA, a body with members on all five continents that safeguards professional and ethical practice. All members of the British Psychoanalytical Society are required to undertake continuing professional development. Annals of the New York Academy of Sciences , , Caldji, C. Maternal care during infancy regulates the development of neural systems mediating the expression of fearfulness in the rat. Carhart-Harris, R. Mourning and melancholia revisited: Correspondences between principles of Freudian metapsychology and empirical findings in neuropsychiatry.

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Additional topics

Project for a scientific psychology. Three essays on the theory of sexuality. Remembering, repeating and working-through: Further recommendations in the technique of psycho-analysis. Beyond the pleasure principle. Inhibitions, symptoms and anxiety. The question of lay-analyses. New introductory lectures on psycho-analysis: The dissection of the psychical personality. Constructions in analysis. An outline of psychoanalysis.

Furmark, T.


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    Affect Studies and Literary Criticism - Oxford Research Encyclopedia of Literature

    Journal of the American Psychoanalytic Association , 33 , Log out of Readcube. Click on an option below to access. Log out of ReadCube. Freud's view that art satisfi es psychic needs has been taken to mean that art has its source in the unconscious and that it unifi es pleasure and reality. The author argues that there is a third point that Freud repeatedly emphasizes, which should not be overlooked, that art infl uences our emotions. The author examines what Freud means by this claim, in particular, his reading of Michelangelo's Moses.

    Freud's focus here on emotions as fundamental to subjective experience, as subject to regulation and as potentially healthy forms of communication serves to supplement and even challenge what he says in his theory of affect. The author concludes by making inferences about a contemporary psychoanalytic theory of affects: that it ought to be inclusive of science more receptive to neurobiology and less bound to Freud as well as art preserving the focus on subjective experience, especially the processing of complex emotions , which is illustrated with the concept of mentalized affectivity.

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