Techniques of Psychotherapy II Midterm Rreview

Why is it important to diagnose?

Best preduictor of therapy is

Major Players in PSYCHOANALYTIC THEORY

Sigmund Freud:

Sex, Aggression, Food (Avoid Pain – Gain Pleasure)

a. Structural Model
b. preverbal and infantile. No sense of time or who they are/ “what I
feel is what mommy needs to feel.” It is self centered and selfish

a. Structural Model
b. Moral part of the brain. ____ Strength understands right from
wrong. It’s about knowing how to appropriately satisfy your needs.

a. Structural Model
b. Strict.

“become like daddy to get someone like mommy”

“become like mommy to get someone like daddy”

a. Oral stage:
b. Anal Stage: Toilet Training
c. Phallic Stage: They realize they have privates.
d. Latent Stage:
e. Genital Stage:

1. Mother exists for the child before child is born
2. Mother determines the way the child responds to the external
world and all other relationships.
3. Development of the child’s death instinct is responsible for the
child’s view of the world as GOOD or EVIL.
4. EVIL VIEW IS PROJECTED ONTO OBJECTS IN THEIR WORLD. (i.e.,
malevolent people)
5. GOOD LIBINAL ENERGY IS PROJECTED ONTO GOOD OBJECTS.
6. Split world between destructive and benevolent objects.
7. Mom can be either GOOD or BAD. We will be in the depressive
position.

Child is afraid of dying and they generalize everything.

motive force from his perspective.

Focused on operation of dependency in the relationship rather than the destructive fantasies.

W.R.D Fairbairn:

Three Phases:

Mechanism of splitting

used to describe how the child deals with an inconsistent unsatisfactory world; which is an inconsistent and ungratifying mother. By ______ the mother, the child is able to maintain his dependent ties without constantly feeling threatened.

1. MOTHER-CHILD RELATIONSHIP as KEY in UNDERSTANDING the
PSYCHOLOGICAL GROWTH of a CHILD!!!
2. Bipolar intrapsychic representations:
a. Image of Self
b. Image of Other
c. Affective Coloring: What affect is at play here?!?!
3. Introjection: taking the view point of others
4. Identification: replaces introjections- its appreciation of others.
5. EGO IDENTITY: Most mature form of functioning

a. Image of Self
b. Image of Other
c. Affective Coloring: What affect is at play here?!?!

taking the view point of others

replaces introjections- its appreciation of others.

Most mature form of functioning

1. Worked with autistic and psychotic children.
2. Separation-Individuation marked by three phases:
a. Autistic Phase: first few weeks of child’s life. If they feel
something then so should you. They need to feel connection
(i.e., by touch)
b. Symbiotic Phase: Understanding that others exist in the world.
c. Separation-Individuation: knowing you are separate from others.
3. Separation-Individuation: Autonomy vs staying fused with
mother.
4. Completion of phases results in child being able to internalize
the mother and maintain a stable inner vision of her in her
absence.

a. Autistic Phase: first few weeks of child’s life. If they feel
something then so should you. They need to feel connection
(i.e., by touch)
b. Symbiotic Phase: Understanding that others exist in the world.
c. Separation-Individuation: knowing you are separate from others.

Autonomy vs staying fused with mother.

1. Children need their parents to satisfy their needs.
2. Psychopathology occurs when the need of a child are not met.
3. FOCUSED ON NARCISSISTIC INDIVIDUALS
4. Concrete and Empathic Communication
5. TWO NARCISSITIC NEEDS a CHILD SEEKS through OBJECT
RELATIONS
6. PATHOLOGY: Inability to transcend the narcissistic
internalization of infancy
7. Mirroring and Idealizing needs

1. IMPERFECT ATTENTIVE MOM makes a better mom than a PERFECT INATTENTIVE MOM
2. Holding Environment: All children need to be held and feel supported
3. Transitional Object: security objects (i.e., blanket, bear) Symbol from Mom and/or DAD. Helps with separation anxiety.
4. All about DEPENDENCE!!!

All children need to be held and feel supported

security objects (i.e., blanket, bear) Symbol from Mom and/or DAD. Helps with separation anxiety.

something I don’t like about me

Anxiety that motivates me is an example

We are driven to seek pleasure, We seek relationships because they satisfy us.

mental events are determined and set in motion by prior mental events.
Regulatory Principles, pain principle

getting stuck in a Stage

Ex: stuck in anal phase- anal retentive
Regression:

Focused on the aspect that if the child was ________ or ________. He/she would be fixated at specific stages. We see these in pathological behaviors.

psychological stages of development we develop our personality through our life

psychological stages of development we develop our personality through our life.

“Stage we are in”

things that play a role in our development

Autistic Phase
Symbiotic Stage
Interdependence: child is separated and this is healthy

1. ID: Primary Process
2. Primitive Drives, impulses, fantasies
3. Operates under the Pleasure Principle SOLELY
4. It’s Preverbal and Prelogica: Primary Process Thought
5. It’s unconscious but its existanse can be derived from thoughts,
acts, and emotions
6. Psychotic patients function under the ID-PRIMARY PROCESS.

1. Mediator/ finds ways to adapt and handle ID’s Striving
2. Develops continuously through life
3. Secondary Process Thought
4. Ranges from fully conscious to fully unconscious
5. Therapeutic Split in the EGO: necessary condition of effective
analytic therapy
6. EGO STRENGTH: Ability to deal with things
7. Emotional Flexibility: people with mature defenses tend to have
emotional flexibility

1. Formed mainly during Oedipal Complex through identification and
parental values
2. Psychic agency

1. Importance of Caretaker
2. Severe psychopathology demonstrated the disturbance of internal
objects
3. Client-therapist relationship appeared to mirror the child-parent
relationship
4. Allow us to be empathetic with our patients
5. Parallel Process: You can take in your patients roles and feelings
6. Counter transference: Therapist projects onto client his or her
emotions.

1. Individuals are void of objects
2. Need for mirroring was essential in the conceptualization
3. Mirroring parents and their actions
4. Who do we want to be like???
5. Objectives:
6. Symptom relief usually appears once therapeutic relationship is
secure.
7. Insight:
8. Agency:
9. Empowerment:
10. Identity:
11. Self-Esteem:

Self-Psychology:

a. Increase insight
b. Sense of identity
c. Increase self esteem
d. Improve ability to identify feelings
e. The lower the function the more physical aggressive
f. Inability to use words
g. Withdraw
h. Enhance Ego strengths: ability to cope
i. Increase their pleasure
j. Work on treating your patients

key to healing, make unconscious-conscious. What Drives your behavior?

increasing sense of agency

recent theoretical construct

develop a more cohesive self- feel less scared and understand who they are.

can be very fragile. Client must see therapist as NOT perfect. Be HONEST WITH YOUR PATIENT

Emotional Maturity

ability to cope and handle stress. Helps adapt to reality

They begin as healthy, creative adaptations and they continue to work adaptively throughout life.
When they are operating to defend the self against threat, they are discernible as defenses.

Primary/ Primitive Defense Mechanisms:

process whereas what is inside is misunderstood as coming from the outside. This is the basis for empathy

process whereby what is outside is misunderstood as coming from inside. Can be very destructive process just like projection. For example identification with all aggressor, mourning and its relation to depression.

A quality of Projective identification- a natural consequence of a person being disturbed enough to have primitive ways of perceiving reality. Short of psychosis.

a boundary b/w self and outer world

internal boundaries. More mature. They have already individuated. They differentiate between what coming from the inside vs what’s coming from the outside.

take the self out of the situation (autistic nature).

1. Understanding the world by withdrawing from reality into fantasy.
2. Seen with schizoid characterAutistic fantasy: they understand their
world by withdrawing from reality into fantasy

first reaction to catastrophe in all individuals. (if I don’t acknowledge it, it doesn’t exist)

Denial:

Avoids issues: everything will be ok.

1. They and the world are one experience.
2. They feel others have their same needs.

Omnipotent Control: Preverbal.

Primitave Idealization:

1. Narcissistic personalities need constant reassurance of their
attractiveness and perfection.
2. Results from the condition of dependence of this defense.
3. Since self-esteem strivings in people who are organized around idealizing

Primitive Idealization/ Devaluation:

1. Lack of psychological boundries b/w the self and the world.
2. No differentiation
3. Projection and Introjection = Projective Identification

Projection and Introjection: