Counseling and Psychotherapy - Группа авторов

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a specific trauma but from the ideas they developed in relation to it, and his research challenged the historical concept of what was believed to be a physical manifestation of a weak hereditary neurological system. He theorized that exposure to an emotional or physical trauma would result in chronic and debilitating conditions, including partial paralysis, hallucinations, and anxiety. Breuer, an Austrian physician and physiologist, is known as the founder of psychoanalysis based on his theory of unconscious processes and his assertion that the neurotic symptoms of hysteria could disappear when underlying causes became part of the conscious mind. The primary features of the theory were later adapted, refined, and popularized by Freud.

      Traditional Psychoanalysis

      Sigmund Freud diligently studied medicine at the University of Vienna and in 1882 began practicing medicine and researching medical pathology at Vienna General Hospital. His interest in the clinical presentation of aphasia and neuropathy in asylum patients led to collaborative research efforts with Charcot and Breuer. He coauthored “Studies on Hysteria” with Breuer, published in 1895, but then shortly thereafter abandoned hypnosis in favor of his talking cure, which he promoted as an effective psychological treatment for repressed trauma and its related emotions (Swartz, 2014). During the following years in private practice, he incorporated free association and dream analysis as techniques for treating anxiety, amnesia, unexplained paralysis, and psychosomatic complaints, primarily observed in his female patients. By 1896, Freud redefined hysteria in the psychological community and popularized the term psychoanalysis to refer to his new clinical method and the theories on which it was based (Gay, 2006).

      The psychoanalytic view of human nature is basically deterministic, whereby humans are driven by desires, fantasies, and unconscious factors that can include impulses and memories (Eremie & Ubulom, 2016). These unconscious elements remain unknown because they are threatening or culturally unacceptable and would cause psychological pain if brought into conscious awareness. Aggressive impulses and sexual feelings are present throughout all developmental stages, and are often repressed (Eremie & Ubulom, 2016). People are generally ambivalent about change and develop self-defeating patterns as a result of their interpretation of both the past and the present. Ultimately, people are motivated to repeat experiences that have previously resulted in tension reduction (Wedding & Corsini, 2014).

      Id, Ego, and Superego

      One of the most well-known constructs of psychoanalytic theory is that of an interactive system comprising the human personality. The instinctual and biological drives of the psyche are referred to as the id; the critical, moralizing function is the superego; and the organized, realistic part that mediates and seeks a balance between the former two is known as the ego. The id, the ego, and the superego are used to describe the structural model of the personality that drives and guides one’s functions and behavior. This concept is also the foundation for many other major constructs in psychoanalysis (Pigman, 2014).

      Psychosexual Stages of Development

      Additionally, traditional psychoanalysis assumes that personality develops through a series of childhood stages during which the pleasure-seeking energies of the id become focused on certain erogenous areas. Freud posited five psychosexual stages: oral stage, anal stage, phallic stage, latent stage, and genital stage. Psychosexual energy, or libido, is suggested to be the driving force behind behavior. At particular points in the developmental process, a single body part is particularly sensitive to sexual, erotic stimulation (Zepf, 2010). These erogenous zones are the mouth, the anus, and the genital region. A child at a given stage of development has certain needs and demands, and if these psychosexual stages are completed successfully, the result is a healthy functioning personality. However, frustration occurs when these needs are not met, and if these frustrations are not resolved in the associated psychosexual stage, the individual will become fixated and will exhibit dysfunctional symptomatology until this early conflict is resolved.

      Life and Death Instincts

      In the 20th century, psychoanalysis expanded to include a new class of drives in addition to those mentioned earlier: life instincts and death instincts. Life instincts are those that deal with basic survival, pleasure, and reproduction; behaviors commonly associated with the life instinct include love, cooperation, and other prosocial actions. These instincts are important for sustaining the life of the individual as well as continuing the species. These are often called sexual instincts because the energy created by the life instincts is the psychosexual energy conceptualized as libido, but they also include such constructs as thirst, hunger, and pain avoidance. Conversely, death instincts emerge as self-destructive behavior, self-harm, and self-sabotage. Death instincts are often expressed as aggression or violence and are tempered by the life instincts (Georgescu, 2011).

      Defense Mechanisms

      The concept of defense mechanisms can be observed daily across cultures and contexts, even among those who are not familiar with psychoanalytic theory. These defenses are a function of the ego and protect the individual from experiencing anxiety and guilt provoked by the discord between the id and superego. Each serves as a protective emotional shield against inappropriate emotional responses to situations. There are 11 primary defense mechanisms:

       Compartmentalization is a process of separating parts of the self from awareness of other parts and behaving as if one has separate sets of values.

       Compensation is a process of psychologically counterbalancing perceived weaknesses by emphasizing strength in other areas.

       Denial is refusing to accept reality and acting as if a painful event, thought, or feeling does not exist. It is considered one of the most primitive of the defense mechanisms because it is characteristic of very early childhood development.

       Displacement is the redirecting of thoughts, feelings, and impulses from an object that gives rise to anxiety to a safer, more acceptable one.

       Intellectualization is the use of a cognitive approach without the attendant emotions to suppress and attempt to gain mastery over the perceived disorderly and potentially overwhelming impulses.

       Projection is the attribution of one’s undesired impulses to another.

       Rationalization is the cognitive reframing of one’s perceptions to protect the ego in the face of changing realities.

       Reaction formation is the converting of wishes or impulses that are perceived to be dangerous into their opposites.

       Regression is the reversion to an earlier stage of development in the face of unacceptable impulses.

       Repression is the blocking of unacceptable impulses from consciousness.

       Sublimation is the channeling of unacceptable impulses into more acceptable outlets.

      Transference and Countertransference

      Transference, or the process of the client projecting their feelings onto another person or object, is one of the most important psychoanalytic concepts still utilized today. Once the transference is identified, the counselor assumes a blank screen position, engaging the client in exposing the unconscious motivation behind the individual’s defense mechanisms by welcoming all transferred attitudes, feelings, impulses, and desires that were generated in early life by adults whom the client considers important. It is assumed that the motivations will appear on their own during this process, and they may then be examined and redirected by the conscious.

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