[Episode 5] In this lecture, I discuss key elements of Freud's theory of personality and how that translated into his approach to therapy. The central goal of Freudian psychoanalysis is to make the unconscious conscious.
Transcript
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In today’s podcast, we're looking at two of the major figures in psychodynamic therapy: Sigmund Freud and Alfred Adler. Sigmund Freud, of course, the father of psychoanalysis and Alfred Adler, developer of individual psychology. These two men had a lot in common, as did their approaches to therapy. In fact, the most common element to their therapies is that they were insight-oriented. These men believed that insight into why you do things is actually the key to making changes and living a happier, more successful life. The way that these men conceptualize change was very different and that’s what we'll be talking about in today’s podcast.
In Freudian psychoanalysis, which is also called Id Psychology, the goal of treatment is to make the unconscious conscious. For example, let's say you're working with a man who has a confirmed case of physical abuse against his children. His explanation as to why he beat his children is that they deserved it. However, during your treatment you discovered that this man hates his boss. He also hates his abusive father. It becomes clear that his boss reminds him of his abusive father.
But your client was unaware of this connection. That is, he was not
conscious of the connection between his emotions towards his father and his boss. Although his boss certainly has some characteristics of his father, you're able to point out to him that he’s employing a
defense mechanism called
displacement, where he is redirecting his feelings about his father to his boss. However, because he cannot act out his aggression towards his boss for fear of losing his job, he then displaces his anger on his children.
Freud would say that he is displacing his anger as a way of protecting himself, ultimately against addressing his deep-seated anger towards his father. In this example, by making your client aware of his unconscious anger, he’s able to gain insight into his behaviors and thereby he’s able to make not only situation-specific changes, but more importantly, changes in his personality. Now, this concept is key in understanding Freudian psychoanalysis.
Without a belief in the existence of an unconscious, Freud’s techniques and his approaches to treatment really make no sense. So, we're going to start out by talking about the topographical model: that is the conscious, the pre-conscious and the unconscious. Freud believed that the mind was divided into three layers.
You have the conscious layer, which was just a thin sliver on top and these were thoughts and ideas that we're aware of. So for example, if you ask me for a telephone number and I'm able to bring it up and say: “Oh yeah, the telephone number is 555-1212.” That telephone number is in my conscious. If you ask me for a phone number and then I have to think about it for a little bit, but I eventually come up with it, then Freud would have said that that phone number was in my pre-conscious (that was somewhere in between the conscious and the unconscious). I knew that it was pre-conscious and not unconscious because I was consciously able to recall it.
Information or data that we’re consciously able to recall can't be unconscious in Freud’s structure. By unconscious, I mean that these are things we're not aware of, also known as
repressed material. The clinical evidence that Freud used for postulating the existence of the unconscious included: dreams, slips of the tongue, post-hypnotic suggestion, material derived from free association, material derived from projective techniques (such as ink blots, Rorscharch’s, things like that) and the symbolic content of psychiatric symptoms.
In Freudian theory, personality development hinges on the successful resolution of each phase of development. Erikson shares this concept with Freud, but for Freud it is psychosexual development and particularly inadequate resolution of a particular phase of psychosexual development can lead to neurotic behaviors, such as phobias. Now, in adulthood, the inadequate resolution of particular [00:05:00] phases is directly linked to unconscious wishes and impulses that seek to satisfy conflicting internal drives.
The structure of the personality, as it develops, starts out with the id. The id is the demanding child and is ruled by the pleasure principle. An easy way to think about the id is to think of a 1-year-old, somebody in the oral stage. That child is ruled entirely by: what feels good, what's going to soothe it, what's going to make it full, what's going to allow it to go to sleep, what's going to calm it. The 1-year-old child doesn’t think too much about: "Well, maybe I should give mom a break because I kept her up all night screaming."
The 1-year-old child is interested in getting fed when he wants to get fed or going to the bathroom when she wants to go to the bathroom. So people who are ruled by pleasure principles are considered to be dominated by the id. That is their personality is dominated by the id. In contrast to the id, the super ego is the judge and this is the part of our personality that’s ruled by the moral principle. The moral principle is: do what's right. And the moral principle isn't necessarily good for us.
That is if we rule (if we lived entirely by the moral principle), then we wouldn’t necessarily be any better off than somebody who lives entirely by the id or the pleasure principle. So in order to have a balance between the id and the super ego, Freud postulates that there is the ego (sometimes thought of as a traffic cop) and the ego is ruled by the reality principle. This is where the ego takes into consideration some of the pleasure principle, some of the impulses of the id as well as some of the ideas of what's just and moral (imposed by the super ego) and then takes all that information into consideration and compares it to what is necessary in this situation in a realistic manner.
So it's not realistic to do everything you want all the time nor is it realistic to act god-like. We have to be real and that’s how we connect with other people. Now, ego defense mechanisms are defense mechanisms that are used by the ego. They're normal behaviors, which operate on an unconscious level, which tend to deny or distort reality. These defense mechanisms help individuals cope with anxiety and they prevent the ego from being overwhelmed.
So for example, denial is a classic defense mechanism. Denial is when the ego says: “No, that didn’t really happen.” Then you have the most fundamental defense mechanism of repression. And repression is literally when material is pushed into the unconscious so that we're not even aware of it. Now, it's common for people to say: “Oh, I totally repressed that.” But that’s actually an inaccurate use of the Freudian concept of repression. If we're conscious of repressing something, then it can't be unconscious. Instead what we're actually talking about is suppression: “I suppressed the memories of the party from the other night.” That would be suppression.
Finally, ego defense mechanisms can have adaptive value if they do not become a style of life to avoid facing reality. The therapeutic goals for Freudian psychoanalysis are to make unconscious motives conscious, because only then can an individual exercise choice. And when that happens, this ego can be strengthened so that behavior is based more on reality and less on instinctual cravings (that will be the id) or irrational guilt (which would be the super ego).
Essentially, psychoanalytic treatment revolves around uncovering and interpreting unconscious impulses and defending against them. Now Freud is famous for his psychoanalytic techniques and the reason why these techniques are so important is that in psychoanalysis the therapist, [00:10:00] the analyst, is the expert. The analyst is the expert in interpreting the material that the client brings up. And the reason why the analyst has to be the expert is because by theory the client is not aware of what it is that they're doing.
So for example, if I'm sitting in my therapist’s office and I'm free associating (which is one of Freud’s famous psychoanalytic techniques) and I'm talking about my work and I list a whole string of words that I associate with work and a whole bunch of ideas, I'm not necessarily going to be able to identify what unconscious material is being brought up. It is up to the therapist to say: “Uh-huh, it seems like this is what's going on.” And that’s the interpretation piece of psychoanalysis.
For this reason, classically trained psychoanalytic therapists had to go through their own psychoanalysis. So some of these psychoanalytic techniques include free association, (which I was just talking about) and this is when the client reports immediately without censoring any feelings or thoughts. Another technique is interpretation. In an interpretation, the therapist points out, explains and teaches the meanings of whatever is revealed.
Now Freud believes that we can only get in touch with the unconscious by interpreting what it seems to be indicating in our dreams, waking fantasies, slips of the tongue and so on. Freud believed that you could communicate on two levels at the same time, the conscious and the unconscious. For example, if you're having a professional conversation (that would be a conscious act) and engaging in intimate body language (that could be unconscious flirting) then you're accessing both your conscious and your unconscious simultaneously and only a trained psychoanalyst could point out what the unconscious material is. That’s why the traditional therapeutic relationship had to be expert-driven rather than collaborative.
A third psychoanalytic technique is dream analysis and dream analysis is called “the royal road to the unconscious.” During your dreams: images appear, ideas, scenes out of a movie will pop up in your head. And Freud believed that these were not realistic in the sense that, if I'm driving a car, it doesn’t actually just mean that I'm driving a car. There is important information in these images that are symbolic of something that’s going on in my unconscious.
Freud also believed that certain symbols were universal. For example, bodies of water always represented the unconscious in Freudian theory. So, if I was floating on a lake, I would be floating on my unconscious and that lake could be calm or it could be choppy and these would mean things in Freudian psychoanalysis.
Now transference is when the client reacts to the therapist as she does to an earlier significant other. Transference allows the client to experience feelings that would otherwise be inaccessible. In the analysis of transference, the therapist is able to achieve insight into the influence of the client’s past.
Countertransference is the reaction of the therapist towards the client that may interfere with objectivity. And remember in Freudian psychoanalysis, the analyst is considered to be a blank slate and objective, so these ideas of transference and countertransference are really key and very important. And I believe that these are two of the concepts that are actually most useful to draw on from traditional Freudian psychoanalysis.
For example, if you're working with the client and they start to talk to you as if you are their father or you are their grandson or possibly you are their girlfriend, they're somebody other than who you are, then Freud would say that they are transferring unconscious material onto [00:15:00] you.
Now one easy explanation for why this happens is because most of the time therapists do not spend a lot of time talking about themselves, in their lives, in the therapy room and so clients have to do something. They have to create some image of the therapist and when this happens, oftentimes they project information from their own lives. Now, this can be really useful if you're working with, say a woman who’s been in an abusive relationship, and she starts to interact with you as if you are an abuser. Now assuming that you're an ethical clinician and you are in fact not abusive, you can use this material to work in the moment with the client about these feelings and really work on these issues in a here and now way.
Although this isn't traditionally psychoanalytic, it is a modern adaptation of the concept of transference. If however, you're working in a session with a client and you find yourself looking at her as if she’s your daughter or perhaps your mother or even possibly if she were your lover, then that could suggest countertransference, reactions that you're having towards your client. And unless you're aware of these and are dealing with these actively, they can certainly interfere with your ability to provide a professional service to your client.
The last psychoanalytic technique that I'll talk about is resistance; and this is anything that works against the progress of therapy and prevents the production of unconscious material. These days in social work we don’t necessarily think of clients as being resistant. Resistant clients were traditionally conceptualized as clients who are actively trying to sabotage treatment. Today, if a client says: “That treatment is not working for me “or “I don’t want to do that,” we first look to ourselves and find out if we're doing a poor job of treatment matching for our clients.
The assumption is that if we find the right thing, if we've done our job at collaborating with our clients on identifying goals and developing treatment plans, then our clients will actually engage in the treatment, rather than saying that they don’t want to do it. In contemporary psychoanalysis, the relationship tends to be collaborative and although problems are grounded in the past, the focus is on alleviating current problems. Contemporary psychoanalysis also incorporates modern therapy techniques.
A modern day adaptation of Freud’s individual psychoanalytic therapy is psychoanalytic family therapy. Rather than emphasizing instincts and drives, the focus is on attachment objects and their role in individuation and personal growth. Now, the contributions of Freudian psychoanalysis are almost immeasurable. The concepts and ideas are so interwoven into our everyday lives that it's hard to really distinguish what is psychoanalytic and what is just the way we think about things.
For example, it's not uncommon to hear somebody complaining of somebody having an anal personality. It's also not uncommon to hear jokes that refer to some of the core concepts that Freud developed, as in this joke about Freudian slips. This joke was told to me by a British friend of mine:
Patience says to his doctor: “Doctor, I had a Freudian slip last night. I was eating dinner with my mother-in-law and I meant to say: ‘Please pass the butter.’ But instead I said ‘You silly cow, you’ve completely ruined my life.’”
Now what's true is that even though our everyday speech is full of concepts developed and popularized by Freud, Freudian psychoanalysis (or at least the traditional form of psychoanalysis) has fallen out of favor in contemporary psychotherapy. Although it was the dominant model through the 1970s, it is a long-term, insight-oriented therapy that doesn’t fit with our contemporary understanding of what people’s problems are, what solutions they're looking for, and perhaps most importantly, how managed care pays for services.
Even still, Freudian psychoanalysis (and particularly its modern day derivatives) contains ideas that are useful to anyone who’s involved in a therapeutic relationship, including those ideas of transference, countertransference and defense mechanisms.
In the next section of this podcast, we're going to talk about Alfred Adler, who took a very different approach to understanding people’s problems and therefore [00:20:00] what the solutions to those problems are.
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"Attachment-Based Family Therapy (ABFT) is a treatment for adolescents ages 12-18 that is designed to treat clinically diagnosed major depressive disorder, eliminate suicidal ideation, and reduce dispositional anxiety. The model is based on an interpersonal theory of depression, which proposes that the quality of family relationships may precipitate, exacerbate, or prevent depression and suicidal ideation. In this model, ruptures in family relationships, such as those due to abandonment, neglect, or abuse or a harsh and negative parenting environment, influence the development of adolescent depression. Families with these attachment ruptures lack the normative secure base and safe haven context needed for an adolescent's healthy development, including the development of emotion regulation and problem-solving skills. These adolescents may experience depression resulting from the attachment ruptures themselves or from their inability to turn to the family for support in the face of trauma outside the home. ABFT aims to strengthen or repair parent-adolescent attachment bonds and improve family communication. As the normative secure base is restored, parents become a resource to help the adolescent cope with stress, experience competency, and explore autonomy.
