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PSYCHOANALYSIS.
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Evolvement of the therapy.... More...
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Paper Abstract:
Evolvement of the therapy. History of psychoanalysis. Theories and contributions of Freud as foundation of modern psychoanalytic technique and other theories and treatment approached. Freud's method. His "talking cure" and transference. John Bowlby's attachment theory. Family therapy and the psychoanalytic approach. Self psychology. Usefulness and limitations of psychoanalysis.
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ABSTRACT
This paper examines one of the fundamental approaches to both individual and family therapy, psychoanalysis. Although professional understanding of the psychoanalytic approach has undergone some essential changes since the theory was pioneered by Sigmund Freud at the end of the 19th century, many of its essential tenets - talking and other communications, interpretation, and transference - remain useful to the modern therapist. It has continued to evolve as counselors have refined its precepts and adapted its techniques to the cases of specific clients. In applying these techniques to family work, the contemporary counselor can use a psychoanalytic approach both to work with the family group as a whole and to work in individual sessions with members needing the additional help of a one-on-one focus. This paper examines the ways in which classical psychoanalysis has been adapted both to newer theories and to the interesting demands of family therapy. It also looks at the approach’s potential pitfalls and criticisms, considering both its usefulness as a tool and its limitations.
PSYCHOANALYSIS: THE FOUND
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For the therapist, in particular, these differing roles must be keptvery clear, in order to facilitate this complex psychological interchange.Pinsof (1995) observes: A psychotherapeutic approach can be divided into context and orientation components. In A. Although professionalunderstanding of the psychoanalytic approach has undergone some essentialchanges since the theory was pioneered by Sigmund Freud at the end of the19th century, many of its essential tenets - talking and othercommunications, interpretation, and transference - remain useful to themodern therapist. The context component, sometimes referred to as the modality aspect of a therapy, addresses the interpersonal structure of an approach, specifying who is consistently involved in the direct system of the patient system. C. . Flaskas (2 2,November 6) quotes David Pocock (1997), who, she writes: has argued that historically psychoanalysis has functioned as the discredited "other" in family therapy, conveniently used in establishing the legitimacy of current thinking and practices in our own field. In family and other grouptherapy settings, however, psychoanalysis becomes a subtly differentprocess because of the introduction of other people into the therapist-client relationship. Borderline clients: Practiceimplications of recent research. . John E. 1). Taken to the extreme, this approach put the patient in a relatively passive position as the recipient of the analyst's understanding (p. Another evolution of psychoanalysis is self psychology. (1999). Pinsof, W. Psychoanalysis and Freudian psychology have come under considerablecriticism over the years, and this criticism is itself another potentialhazard for the family therapist considering using it. Developmental therapy evolved from thepsychoanalytic approach as a means of working with children, who could notparticipate in or benefit from classic psychoanalysis to the same degree asadults. Sigmund Freud was a Jewish physician, practicing in Vienna in thelate 18 s, one of whose specialties was the study of a disorder then knownas hysteria. Even Freud's specific methods have been refined. Kaslow, F. 32-74. She (2 2, November 6) writes, "I dothink that in family therapy we have been prone to construct our owndevelopments in knowledge as always new, constructed in opposition not justto what exists in 'outside' therapy frameworks, but to what has come beforein our own history" (p. . Pinsof(1995) describes self psychology as "a more recent development withinmodern psychoanalysis" (p. In the late 19th century, a flurry of thought laid the groundwork forwhat would become modern psychology. When Sigmund Freud began to work with hysterical patients in the late18 s in Vienna, science had just started to recognize the existence of theunconscious. . References Flaskas, C. 45). By transferring feelingsonto the therapist, the patient begins to learn how to deal moreeffectively with past events and emotions. The evolution of psychoanalysis: Contemporarytheory and practice. Even before the existence of the unconscious became widelyaccepted, human beings struggled with conflicting feelings, unexplainedbehaviors, and powerful emotions. In addition, as American society becomes increasingly multi-cultural,language itself becomes more nuanced and multilingual. Integrative problem-centered therapy: Asynthesis of family, individual, and biological therapies. However, psychoanalysis does not rely solely on the analysis andinterpretation of the spoken word, and neither should a family therapistusing the technique. ABSTRACT This paper examines one of the fundamental approaches to bothindividual and family therapy, psychoanalysis. 32). . While most contemporary therapists use a variety of techniques andtheoretical approaches in doing their work, Freud's "talking cure" remainsa powerful influence on modern counseling. Theessence of psychoanalytic technique is still useful, both for work withindividuals and for work with families. In addition, since human beings do not live individually but areinstead the products of their families of origin, understanding humanpsychology also requires understanding family dynamics, emotions, andbehaviors. Freud pioneered a method that encourages patients to talk, recounttheir dreams, free associate with given words, and offer the analyst otheraccess to their subconscious thoughts as a means of uncovering hiddenreasons for their behavior, thoughts, and discomfort. Peter Fonagy and Mary Target (1998) define the essence of thepsychoanalytic approach: Implicit in the understanding of [psychoanalysis] is the idea that procedures, or patterns of actions rather than individual experiences, are retained from infant-caregiver interactions and that these procedures come to organize later behavior . While psychoanalytic approaches continue to be used and to evolveinto related ways of working with individuals and families in therapy, theyare not without their limitations. (Undated). 48). As Hurry (1998) argues: Our developmental potential can be fulfilled only in a social context, and the first social context is the interactive relationship with the parents, in which infants find - but also, in part, create - the objects that they need. Even those who disagreed with his most fundamental ideas have beeninfluenced by his revolutionary thinking and by the "talking cure" that hedeveloped and that many of his followers have perfected into what is nowknown as psychoanalytic technique. Yet his work became the foundation for modern psychoanalytictechnique and for many of the other theories and approaches to treatmentthat have come to constitute the wide range of counseling techniques in usetoday. Bowlby argued that children who develop the rightbalance in becoming secure learn this security from the care given by theirparents. Differenttechniques may be more effective in the large-group work, supplemented byseparate sessions that focus more on talking, interpretation, andtransference in a one-on-one setting. She (2 2, November 6) writes: Family therapy has chosen very particular theory influences as the main expression of postmodernist thought, and narrative and social constructionist theory have really dominated the stage in our discussions and understandings of postmodernism. Johnson, H. He (1999) writes, "The intellectualhistory of psychoanalysis over the past generation can equally well bedescribed either as a chronicle about a discipline breaking intoirreconcilable fragments under the impact of philosophical differences orone about the emergence of a new paradigm that transcends the differencesof opinion that characterized the discourse of the preceding era" (p. London: Karnac. Transference allowsthe patient to confront what may be powerful feelings and even to recallevents previously relegated to the subconscious. (2 2, November 6) Practice experience and theoryboundaries: An argument for theory diversity in family therapy.http://www.anzjft.com/articles/Flaskas.html. The patient mayor may not embrace these interpretations, and the process can take years oftalking, listening, reflecting, interpreting, and responding tointerpretations before any significant progress is made. Johnson (1991, March) notes, "Psychotherapeutic . (1995). Gedo, J. 44). Psychoanalytic approaches, while by no means the onlymeans for treating psychological problems for individuals and for families,seem certain to retain an important central position in the range oftheories, methodologies, and ways of thinking about this challenging work. Hestarted to notice connections between some of the remarks that thesetechniques elicited in his patients and past events that might haveinfluenced otherwise unexplained behavior. The analyst listensand interprets the meanings, both explicit and unconsciously expressed, inwhat is communicated, sharing these interpretations with the patient asanalysis continues. 48), and, in some respects,especially this one, the therapist becomes the parent that the child needsin order to relearn more effective attachments, build a more securepsychological base from which to operate, and deal with the world inbetter, more emotionally healthy ways. Similarly, in psychoanalytic developmental therapy, patients find or create in the therapist an appropriate "developmental" object (p. For example,Harriette C. In the 197 s and 8 s, John Bowlby formulated the attachment theory,arising from Freud's speculations about the critical importance of theparent-child link. .approaches indicate that providing a structured, supportive, consistent'holding' environment is helpful for most borderline clients, whereasintensive psychodynamic therapy is necessary for only a small subset" (p.17 ). This can be a difficulttransition for the counselor who has been trained in individualpsychoanalytic technique who is now trying to apply this approach to workwith families. Nevertheless, psychoanalysis continues to exist as an important forcenot because of any historical reverence for Freud's pioneering thinking butbecause it continues to provide useful ways of touching the subconsciousand helping people to better understand why they do what they do. Social Work, 36(2), 166-173. The patient talks or communicates with the analyst in other ways, andthe analyst then uses clues both spoken and unspoken to interpret thesubconscious forces at work. It also looks at the approach'spotential pitfalls and criticisms, considering both its usefulness as atool and its limitations. New York: Other. Whatever form it may take, Freud's work continues to offerexceptional insights and intriguing methods for unraveling the mystery atthe heart of human beings and their families. 2 ). In his words, "Self psychology examinesand attempts to improve the self-object transferences within familysystems" (p. 2). His observations led him todevelop a considerable theoretical body, much of it controversial even tothis day. Pinsof (1995) writes, "The self isthe most basic psychological structure - the molecule of dynamicpsychology" (p. An interpersonal view of theinfant. These two components - interpretation of what the patientcommunicates and transference - are the central features of psychoanalysisas a way of working with individual patients. Modern psychoanalysis maystill take longer than many other methods, but it has, as its ultimategoal, a point at which the client no longer needs the therapist. . Florence W. This fits with the extent to which psychotherapy is a languaged activity, and it certainly has allowed space for thinking about the way in which we come to know our 'selves' in the very particular context of intimate relationships and in our social and cultural environment. Because the 2 th century was one in which the conquest of private individual and family space became more clearly defined and valued, the notion of needing to rebuild intimacy and better health and life quality became imperative. The family counselor who includes psychoanalytic workas part of a family's treatment must pay particular attention not only todecoding the individual family's vocabulary and particular meanings forlanguage but also must examine other ways in which members communicate (oravoid communicating) that do not use words at all. Freud's work with Josef Breuer on patients diagnosed as sufferingfrom hysteria led him to experiment with hypnosis and free association. It is traditional for psychiatrists in training to undergo yearsof psychoanalysis as part of their education, not only to teach them thesubtler techniques that have been developed to carry out the approach, butalso to allow them to grow psychologically by becoming more deeply self-aware before beginning to help others. Anne Hurry (1998) writes, "Theterm 'psychoanalysis' has been used . She (undated)writes: In a country where the utilization of psychotherapy, through the introduction of psychoanalysis in the 195 s and psychoeducational approaches in the 198 s had become so extensive, it was inevitable that there would be a search for group and brief therapy approaches. Psychoanalysis, client- centered therapy, and rational emotive therapy specify the individual as the direct system. 3-3 . It has continued to evolve as counselors have refinedits precepts and adapted its techniques to the cases of specific clients.In applying these techniques to family work, the contemporary counselor canuse a psychoanalytic approach both to work with the family group as a wholeand to work in individual sessions with members needing the additional helpof a one-on-one focus. . In both narrative and social constructionist ideas, language is central. 29). David L. Approaching psychoanalysis: An introductorycourse. W. The wide range of therapeutic approaches, theories, and techniquesnow available allows the counselor to select an approach or combination ofapproaches best suited to the family and client being served.Psychoanalytic techniques can be particularly effective in certain types ofcases, while they may not be as well suited for others. Smith (1999) writes, "Freud was a member of aninternational intellectual community that included psychologists,neuroscientists, psychiatrists, and philosophers" (p. to cover both classical (insight-oriented) and developmental (interactional/relational) treatment for nearlya hundred years, and this usage is now unalterably established" (p. Hurry (1998) observes, "Interpretation doesmore than clear obstacles holding back development. Given the greater flexibility of the social spaces and of the lesser controls Argentines were exposed to in the latter decades of the 2 th century, family issues became more easily accessible to treatment (p. In this case study of the relationship of systemic family therapy to the "outside" framework of psychoanalysis, Pocock queries the function of borders in establishing and protecting professional identities and defending professional territories (p. 11). 9). 213).In other words, one of the most significant evolutions from classicalpsychoanalysis to a way of working with clients in the present day is theembrace of the client's full partnership in the process. . Hurry (Ed.), Psychoanalysis and developmental theory, pp. As psychoanalytic work continued, it underwent a number ofalterations and adaptations. Secure infants have a much better chance of growing up intosecure adults than do those whose early relationships make them questiontheir place in the world. Psychoanalysis and developmental theory. William M. Kaslow (undated) points out that psychoanalysis was originallyconceived as a means of working between two people, client and therapist,and that adapting it to family therapy requires "an epistemological changefrom psychoanalytic to systemic thinking, and from the individual to thefamily as the unit of treatment" (p. In a family therapy settingthat uses a psychoanalytic approach, patient is expected to transferfeelings toward other participants onto the therapist, a process which canmake dealing with strong emotions easier but which can cause considerableconfusion, even for the therapist who is expecting the transfer to occur.For example, a child dealing with parental conflicts, in a treatmentprogram with that parent, may find the transference process, in whichfeelings for the parent are now transferred to the therapist, especiallyconfusing. One of the first substantial attemptsto apply psychological principles to helping to treat mental disturbancealso developed into one of the most important. A therapist relyingon the use of the "talking cure" will probably need to become fluent in atleast several languages in order to keep up with his or her client base. . L. The implication of this change of focus for the goal of treatment is that termination is appropriate when the analysand has learned to perform self-inquiry without assistance (p. Carmel Flaskas observes that the use of talking and the power oflanguage that are central features of psychoanalysis are part of the appealof the approach in using psychoanalytic techniques in working withfamilies. So may the parent and the therapist. Smith, D. Hurry, A. Gedo (1999) observes that, while researchers andpsychologists continue to refine and challenge many of Freud's theories,there has been less revision of his basic methods of talking, listening,interpreting, and transferring. Security is also transgenerational, in thatsecure parents are much more likely to raise secure infants (Fonagy &Target, 1998, p. The goal of therapy . Kaslow examines the development of family therapyoutside of the United States and the role that psychoanalysis played inthat development in many different countries around the world. http://www.ifta-familythearapy.org/journal/kaslow_article.html. The argument in both narrative and social constructionist theory is that we come to that knowledge through language, and that our emotional and social landscapes are constructed in language (p. Hurry (1998) argues, "Psychic development is a lifelong process,subject to both inner and outer influences, the outcome of a continuousinteraction between what is innate or has become inbuilt in us and therelationships and circumstances that we encounter" (p. London: Karnac. The transference aspect of the relationship to the analyst was of central importance: through it, the patient could revive past relationships and conflicts, and these could then be understood and worked through by means of transference interpretations. Fonagy, P., & Target, M. 2). Argentina'sculture, for instance, has historically embraced individual psychoanalysis,making its willingness to incorporate the approach in family therapyefforts a logical extension of this cultural acceptance. . Hurry (1998) remarks, "Analysisis repeatedly compared to parenting" (p. 4).These patterns are established early in life, some beginning at or nearlyat birth and many others shortly thereafter. Talking is apowerful means of communication among adults, especially within families,who often develop their own shorthand languages and certainly their ownspecific meanings for much of the vocabulary they use in their exchanges. The direct context of couple therapy involves at least two people from the same generation within a patient system. 197). 9). E. 36).At its heart, classical psychoanalysis consists of just these two elements,interpretation and transference, though of course the way each element isapproached and administered remains a complex art rather than a cut-and-dried science. Thinkers of each age tried to understandthese unexplained responses to the world and to determine what could bedone to either help people modify their behavior or to rid society of thedisruptions that what was eventually called psychopathology caused. For instance, Flaskas (2 2, November6) points out one of the potential problems in relying too heavily on apsychoanalytic approach alone: "There is a great impoverishment in beinglimited to understandings of experience as (only) languaged experience whenwe try to meet and understand both the lived experience of our clients, andindeed our own lived experience of therapy and life" (p. Hurry (1998) describes classical Freudian analysis: For many years, the effective element in analysis was thought to be the making conscious of the unconscious via interpretation. . Psychoanalytic methods can be used with the family as a group and canalso be used individually as an adjunct to group work. Gedo (1999)observes: In my judgment, the best argument for a change of technical focus has been provided by Gardner (1983), who redefines the ideal analytic process as one of "assisted self-inquiry." He means that it is helping the analysand to master methods of self-inquiry that is central for effective analysis, not the elucidation of any particular mental content . (1998). 4).Flaskas argues that, in fact, the field's apparent need to reinvent itselfregularly may encourage family therapists to periodically and unnecessarilythrow out older, more traditional approaches in favor of new ones, adoptedmore because of their novelty than because they necessarily representimprovements on existing techniques. (1998). New York:Basic. is, then, the observation of patterns of interaction, the identification of maladaptive models, and the correction of such models, principally through strengthening an overarching mental capacity to selectively activate alternative models of interaction (p. Thepsychoanalytic approach centers on the individual psyche and the balance(or, more often, lack of balance) that genes and circumstance have allowedthe individual to maintain. (1991, March). During the process of talking and interpreting what is said,transference occurs, as the patient passes on feelings regardingindividuals from his or her past onto the therapist. 4). In the course of treatment, the patient eventuallytransfers important feelings to the analyst, allowing him or her to beginto work out complex relationships and unconscious emotions that have beenaffecting behavior and the ability to function. London:Karnac. Classic psychoanalysis assumes that every human being could benefitfrom the introspection and revelations that the process is designed toelicit. While Freudtended to view his subjects paternalistically, the modern therapistencourages clients to take an active role in therapy and, eventually, tomove beyond the client-counselor relationship. Although Freudbegan his career as a neuroscientist, his work led him to join the emergingfield of scientific psychiatry, born out of the work of Wilhelm Griesinger. Family therapy can be particularly dynamic because it often includesthe actual individuals with whom the central patient is struggling toreconstruct and reorder damaged relationships. 35). 34).Psychoanalytic approaches and approaches drawn from them that concentrateon developmental aspects and helping patients to work through blockedaspects of their development continue to prove important to contemporarytherapists in all schools, whether or not they use the traditional terms oraccept any of Freud's underlying theories. In A.Hurry (Ed.), Psychoanalysis and developmental theory, pp. M. This paper examines the ways in which classicalpsychoanalysis has been adapted both to newer theories and to theinteresting demands of family therapy. It may be experiencedas a new kind of recognition, and validation of previously warded-offaspects of the self may permit a new integration" (p. Family therapy includes at least two people from different generations (parent and child) of the same patient system in the direct system . Kaslow (undated) describes the variety of approaches that are part offamily therapy around the world: "The field now exhibits a multihuedpatchwork quilt of many different, though interconnected, philosophic andtheoretical schools of thought that undergird clinical practice andresearch" (p. The orientation component of a psychotherapeutic approach specifies its theories of problem formation and problem resolution" (p. PSYCHOANALYSIS: THE FOUNDATION OF INDIVIDUAL AND FAMILY THERAPY From the time that science started to develop theories about theworkings of the human mind, scientists were also searching for ways toapply that understanding to a treatment of psychological disorders anddisturbances. (1999). 11). It has more recently been used as a methodology for working withadults, as well. History of family therapy: Evolutionoutside of the U.S. Doctors and philosophers were only starting to recognize thathuman thoughts and behaviors cannot be dissected on the autopsy table forexamination and analysis, and the behaviors and emotions that they exhibitare complex manifestations of a strange phenomenon known as humanpsychology.
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