Psychoanalytic therapy is an intensive and prolonged technique for exploring the patient’s unconscious motivation, with special importance attached to the earliest sources of conflict and repression. Its aim is to bring to consciousness such repressed memories and conflicts and to help the individual resolve them in the light effects a radical change in the individual’s basic personality structure. Psychoanalysts use several techniques for bringing repressed conflicts to consciousness and helping the patients to solve them. These include free association, dream analysis,analysis of resistances, and analysis of transference in psychoanalytic.
Free association; The principal procedure used in psychoanalysis to probe the unconscious and release repressed material is free association. The patient sits comfortably in a chair or lies in a relaxed position on couch and lets his mind wander freely, giving a running account of his thoughts, wishes, physical sensation, and mental images as they occur. He is encouraged to reveal his every thought, regardless of how personal, painful, or seemingly unimportant. The therapist often takes a position behind the patient, where he will not serve as a distraction or disrupt the flow of association.
Although considerable catharsis is achieved in this “talking out” process, psychoanalysis is not fundamentally a client-centered technique in psychoanalytic. Rather, emphasis is placed on the authority of the therapist, who interprets to the patient the meaning of the thoughts, wishes, and attitudes expressed in the free association. As the stream of consciousness reaches deeper and deeper into the unconscious, the repressed urges which are uncovered often reveal themselves in disguised and experience to remove the disguises from the subject’s revelations and thus explain their real significance in psychoanalytic .
Dream analysis: Psychoanalytic therapists can gain further insight into the patient’s unconscious motivation by the technique of dream analysis. When the individual is asleep, his ego is presumably less on guard against the unacceptable impulses originating in the id, so that a motive which cannot be expressed in waking life may find expression in a dream. Some motives are so unacceptable to thee conscious self, however, that they cannot be revealed openly even in dreams but must be expressed in disguised or symbolic form. Thus a dream has two parts, or contents. The manifest (openly visible) content of the dream is that which we remember and report upon awakening. It usually is not painful and, in fact, often seems quite amusing. Beneath thee manifest content is the latent (hidden) content–the actual motives which are seeking expression but which are so painful or unacceptable to us that we do not want to recognize their existence. A trained therapist can often uncover these hidden motives by studying the symbols which appear in the manifest content of the dream and finding out what particular meaning they have for the dreamer.
The unconscious process which transforms the emotionally painful latent content of the dream into the less painful manifest content is called dream work. Dream work distorts the content of a dream in various ways, making the motives expressed in it less obvious to the dreamer. For example, a student who is filled with anxiety about failing an examination and being expelled from school may express his fear symbolically by dreaming that he is pushing his way through a heavy snowstorm, pursued by wild animals. Or, with rather less disguise, a woman who feels hostility toward her husband might dream of killing a rat–the significance of this symbol being revealed by her often referring to her husband as “the little rat.”
Free association, with the manifest content of the dream as the point of departure, gives the analyst clues as to the latent content and enables him to interpret the real meaning to the patient. Skilled therapists who are familiar with are frequently able to locate a conflict of which the patient is not aware.
Analysis of resistances; During the process of free association,the patients may show resistances–that is, inability or unwillingness to discuss certain ideas, desires, or experiences. Resistances prevent the return to consciousness of repressed material which is painful to recall, such as material connected with the individual’s sexual life or with hostile, resentful feelings toward his parents. Sometimes a resistance is shown by the patient’s coming late to his appointment or “forgetting” it altogether.
The psychoanalyst of the Freudian school attaches particular importance to subjects which the patient does not wish to discuss, believing that they are most closely related to the repressed experiences that are presumably causing the present difficulties. The aim of psychoanalysis is to break down resistances and bring the patient to face these painful ideas, desires, and experiences. Breaking down resistances is a long and difficult process but is considered absolutely essential in order to bring the whole problem into consciousness where it can be solved.
Analysis of transference; During the course of psychoanalytic treatment, the patient usually develops an emotional reaction toward the therapist, identifying him with some person who has been at the center of an emotional conflict in the past. This phase of therapy in psychoanalytic is known as transference. In most cases the analyst is identified with a parent or lover. The transference is called positive transference when they consist of hostility or envy Often the patient’s attitude is ambivalent–that is, he experiences both positive and negative feelings toward the therapist, as children often do toward their parents.
The analyst’s task in handling the transference is a difficult and dangerous one because of the patient’s emotional vulnerability, but it is a crucial part of treatment. The therapist helps the patient to interpret the transferred feelings and to understand their source in earlier experiences and attitudes.
Criticisms of psychoanalytic therapy;
The differences in emphasis appears in neo-Freudian therapy, which is aimed at understanding the patient’s present situation as well as his past experiences. Also, most neo-Freudian psychotherapists believe that a cure cannot be effected simply by helping the patient understand his unconscious feelings but rather that the patient must be directed along the path of changing himself and his inadequate modes of adjustment.
From a practical standpoint, psychoanalysis has also been criticized on the grounds that it requires a great deal of the patient’s time and money. Psychoanalysis aims to create a fundamental and permanent alteration in the individual’s personality structure, a goal that usually requires at least two or three year of frequent sessions with the analyst. Thus period of time does not seem inordinately long, however, when we consider that the patient’s problems may have been building up for most of a lifetime.
Even when the individual can afford to spend the time and money necessary for a complete course of analytic treatment, the results are not always satisfactory. Because psychoanalysis relies heavily upon the patient’s achieving great personal insight, it is best adapted to individuals who are above average in intelligence and who do not have severe mental illness. The following reasons have been cited as the primary causes of failures in psychoanalytic treatment; (1) the analyst’s difficulty in applying psychoanalytic techniques because of his lack of ability or training, (2) environmental conditions which interfere with the patient’s attempts to readjust, and (3) application of psychoanalytic techniques in cases which are too severe to be handled by this method alone (Oberndorf, 1950).