Lecture
Plan.
one.
In order to understand the essence of this approach, it is necessary to turn to the basics of the theory of the personality of its creator Sigmund Freud. The psychodynamic approach claims that a person’s thoughts, feelings and behavior are determined by unconscious mental processes. Freud compared the personality of an individual with an iceberg: the tip of the iceberg is consciousness, but the main mass, located under water and not visible, is unconscious. Personality, according to Freud, consists of three main components. The first component, the "id" (it), is a reservoir of unconscious energy, called libido. The second component of personality is “ego” (i). This is the mind. "Ego" is looking for ways to satisfy the instincts, taking into account the norms and rules of society. "Ego" - the executive power of the individual. The third component of personality is “super-ego”. This component develops in the process of education as a result of the internalization of parental and social values. Freud uses the term "introjection" for this process. "Superego" operates on the basis of the moral principle, a violation of its norms leads to a sense of guilt.
The instincts (id), mind (ego) and morality (superego) often do not get along with each other, come into collision - intrapsychic, or psychodynamic, conflicts arise. Freud believed that the number of these conflicts, their nature and methods of resolution give the form of personality and determine many aspects of behavior. Personality is reflected in how a person solves the problem of meeting a wide range of needs.
Normally, adaptive behavior is associated with a small number of conflicts or with their effective solution. The most important ego function is the formation of defense mechanisms against anxiety and guilt. Protection mechanisms are an unconscious psychological tactic that helps protect a person from unpleasant emotions, Neurotic anxiety, according to Freud, is a signal that unconscious impulses threaten to overcome defense mechanisms and reach consciousness.
Thanks to the action of defense mechanisms, the unconscious becomes difficult to explore, but Freud developed a method for this - psychoanalysis. Psychoanalysis includes the interpretation of free associations, dreams, everyday behavior (slips, memory errors, etc.), the analysis of transference.
Psychoanalysis (and any other method in the framework of the psychodynamic approach) has two main objectives:
1. Achieve the patient's awareness (insight) of intrapsychic, or psychodynamic, conflict.
2. To work out the conflict, that is, to trace how it affects the actual behavior and interpersonal relations.
This work then helps the patient to realize how an unconscious conflict and its associated defense mechanisms create interpersonal problems. Thus, the patient's hostility towards the boss, senior employee, or other “parent figure” may be a symbolic, unconscious response of children's conflicts with the parent.
The essence of the psychodynamic approach in psychotherapy can be expressed as follows: it is an approach that emphasizes the importance for understanding the genesis and treatment of emotional disorders of intrapsychic conflicts, which are the result of a dynamic and often unconscious struggle of contradictory motifs within the personality.
This term denotes: 1) the direction of depth psychology, considering the unconscious as determinants of the development and functioning of the personality; 2) psychotherapeutic system, which is based on the identification of features of experiences and actions of a person, caused by unconscious motives.
In “Ego and Id”, Z. Freud (Freud S.) wrote: “Psychoanalysis is a tool that enables the Ego to achieve victory over Eid”. He believed that in psychoanalysis, the main efforts are aimed at "strengthening the ego, making it more independent from the superego, expanding the scope of perception and strengthening its organization ... Where it was Eid, there will be an Ego". The purpose of psychoanalysis, Freud saw to make the unconscious conscious; he argued that "the business of analysis is to ensure, as far as possible, good conditions for the functioning of the ego."
The key, defining concepts of psychoanalysis are: free association, transference, and interpretation.
The classical analytical technique includes daily (5 times a week) meetings with the patient, laying him on a couch, avoiding all sorts of advice, prescribing medications, refraining from managing his life, restricting expressions by interpretations and instructing on the implementation of the basic rule of free association. Psychoanalysis can be described as a long-term, intensive, interpretative psychotherapy.
The technique of free association is based on three assumptions: all thoughts are directed towards what is meaningful; the patient's need for psychotherapy and the importance of being treated is led by his associations in the direction of the meaningful, except in the case when resistance is acting ; resistance manifests itself during the sessions in the impossibility to associate freely. In accordance with the instructions of the psychoanalyst, the patient must follow the “basic rule,” that is, communicate his thoughts unconditionally and not attempt to concentrate during this.
The second key concept of analysis is the transference, the process by which the patient transfers to the psychoanalyst feelings, thoughts, fantasies, etc., caused by the figures that previously existed in the patient's life. Thanks to the transfer, the patient gives the psychoanalyst the significance of another, usually a pre-existing object. The first description and discussion of the role of transference is given by Freud in his work on hysteria. Transference is an experience of feelings, motives, fantasies and defenses in relation to a person in the present, which is not suitable for this, but it is a repetition of reactions formed in relation to significant figures of early childhood. The main importance of transference reactions stems from the fact that the patient experiences in the treatment situation and in relation to the psychoanalyst all the significant human feelings of his past. Transference is a special kind of relationship, the main characteristic of which is the experience of certain feelings that really appeal to another person. The patient reacts to the person in the present as if he were a person from the past. The transference is a repetition, a new “edition” of old object relations. This is an anachronism, a temporary error; displacement takes place: impulses, feelings and defenses in relation to the individual in the past are shifting to the present person. Since this is an unconscious phenomenon, the person who reacts with the transference feelings is for the most part unaware of the distortion. The definition of transfer includes 4 basic statements: transfer is a type of object relation; the phenomena of transference repeat the past relation to the object; the movement mechanism plays an important role in the transfer reactions; transference is a regressive phenomenon.
There are many ways to classify the various clinical forms of the transference response. In accordance with the object of transference and the repeated stage of development of sexuality, the transference can be paternal, maternal, oedipal, preoedipal. The transference can be objective or narcissistic, according to whether the patient represents his psychoanalyst as an external person on whom he depends, whom he loves or hates, or as part of himself. The transfer can be positive or negative, depending on whether the patient regards the psychoanalyst as a benevolent or unfriendly figure.
Freud described the transference neurosis when, during psychoanalysis, a patient replaces his usual neurosis with this neurosis, involving a psychoanalyst. The author used this concept to designate a set of transference reactions, in which the analysis and the psychoanalyst become the center of the patient’s emotional life, and the patient’s neurotic conflict comes to life again in an analytical situation. The psychoanalytic technique aims to ensure maximum development of the transfer neurosis.
The countertransference is described by Freud in “Recommendations to doctors practicing psychoanalysis”, which emphasizes the need for a psychoanalyst for “psychoanalytic purification”. In order to allow transference, the psychoanalyst must observe anonymity: “The physician should be impenetrable to his patients, and, like a mirror, he should not show them anything other than what is shown to him.” The author saw in the transference a substantial part of the therapeutic process: “Ultimately, every conflict must be transferred to the transference sphere”.
The next key concept of psychoanalysis is interpretation. In his statements, the psychoanalyst ascribes to the dreams, symptoms and chain of patient's free associations some additional significance compared to how the patient himself regards these phenomena. The interpretation of the transference establishes a link between the behavior and associations of the patient and his attitude towards the psychoanalyst. Interpretation of content refers to unconscious impulses and fantasies and does not concern those protective processes that support them as unconscious. Direct interpretations are based only on the psychoanalyst's knowledge of symbolism, irrespective of the patient's association. Correct interpretations adequately explain the material being interpreted, are formulated in this way and are communicated at such times that they have relevance for the patient.
Interpretation is the most important analytical procedure. The process of analyzing involves confrontation, when the phenomenon should become apparent to the patient's conscious ego. Clarification refers to those actions that aim to place the analyzed mental phenomenon in a clear focus. The next step in analyzing is interpretation, which in psychoanalysis is the final and decisive action. To interpret is to make unconscious phenomena conscious. The interpretation function is aimed at increasing self-awareness, facilitates integration through the patient’s awareness of internal processes. The last step in the analysis - a thorough study. This term refers to a set of procedures and processes that are observed after an insight .
A classic example of interpretation is the interpretation of dreams. Psychoanalysis is based on the belief that dreams have a psychological meaning, which can be approached through interpretation. Freud believed that dreams have an original text, the announcement of which runs into censorship, so that the dream has to be rewritten in a form incomprehensible to the censor. The initial sketch is the hidden content, its rewriting constitutes the dream work, and the final, announced version is the visible content. The author argued that dreams express desires as fulfilled: “The thought expressed in the desired mood was replaced by a representation in the present tense”.
An important concept in psychoanalysis is resistance, which means opposition in the course of analysis to the transformation of unconscious processes into conscious ones. In a state of resistance, the patient rejects the interpretation of the psychoanalyst. The term “resistance” refers to all the forces within a patient who are in opposition to the procedures and processes of psychoanalytic work. Resistance is a repetition of those defensive operations that the patient used in his usual past life. All variants of psychic phenomena can be used for the purposes of resistance, but, regardless of what serves as its source, resistance acts through the patient's Ego. Although some aspects of resistance can be realized, a significant part of them remains unconscious. Freud wrote: “Resistance accompanies treatment step by step. Every association, every action of a person during treatment includes resistance and represents a compromise between the forces that seek recovery and the forces that counteract it. ”
In a psychoanalytic situation, defense mechanisms appear as resistance. The author used these terms as synonyms in most of his works. During the course of psychoanalysis, the resistance forces use all the mechanisms, forms, methods, methods and defenses that the Ego uses in the external life of the patient.
Resistance analysis includes several basic procedures. The psychoanalyst should: recognize resistance, demonstrate it to the patient, clarify the motives and the form of resistance (what specific painful affect causes the patient to resist; what specific form and method the patient uses to express his resistance); interpret resistance (to identify which fantasies or memories are the cause of affects and motives behind the resistance; to engage in history and unconscious objects of affect data and motives or events during analysis, out of analysis and in the past); to interpret the form of resistance, for which purpose you should analyze this and similar forms of activity during and outside the analysis; trace the history and unconscious goals of this activity in the patient’s present and past. The last procedure is a thorough study.
Closely related to resistance is the concept of protection - “a common name for all the special techniques that the ego uses in conflicts that can lead to neurosis.” The purpose of protection is to prevent awareness of impulses, memories, to protect the ego. Protection mechanisms can be triggered by anxiety caused by an increase in instinctive tension, by threats to the superego, or by real danger. Since the psychic factor that triggers the defense must perceive the threatening percept before it becomes accessible to consciousness, Freud replaced the concept of "consciousness" with the Ego, since the Ego is partially unconscious and capable of automatic, unconscious responses to changes in internal stress. According to the author, neuroses are caused by violations in the mechanisms of protection.
Classical psychoanalysis includes the theory of the psychological origin of neurosis. In the classical theory the following types of neurosis are distinguished.
1. Psychoneurosis, which is caused by reasons related to the past and can be explained only in terms of personality and life history. There are 3 types of psychoneuroses - hysterical conversion, hysterical fear (phobia) and obsessive-compulsive neurosis. The symptoms of these neuroses can be interpreted as a conflict between the ego and the id.
2. Actual neurosis is due to causes related to the present, and will be explained in terms of the patient's sexual habits. It is the physiological consequence of disorders in sexual functioning. Freud distinguished two forms: neurasthenia as a result of sexual excesses and anxiety neurosis as a result of the absence of relief from sexual arousal.
3. Narcissistic neurosis, in which the patient is not capable of forming a transfer.
4. Neurosis of character - in this case, the symptoms are character traits.
5. Traumatic neurosis, which is caused by shock.
6. With a transference neurosis that develops during psychoanalysis, the patient takes an obsessive interest in the psychoanalyst.
The psychoanalyst argues that psychoneuroses are caused by a neurotic conflict, i.e., an unconscious conflict between the stimulation of an id seeking to defuse and the protection of the ego that prevents direct discharge or access to consciousness. Thus, a conflict is neurotic only if one party is unconscious and / or if it is resolved by applying protection mechanisms other than sublimation. Psychoanalysis treats a symptom as a compromise between the suppressed desire and the demands of the overwhelming factor. The appearance of the symptom is due to symbolization, which Freud characterized as "an ancient, but obsolete way of expression." A complex role in the neurotic conflict is played by the superego. It is the Super-Ego that makes the Ego feel guilty even for the symbolic and distorted discharge that manifests itself as symptoms of a psychoneurosis. Consciously, it feels very painful. Thus, all parts of the mental apparatus are involved in the formation of a neurotic symptom.
2
Analytical psychotherapy is one of the directions of psychoanalysis, the author of which is a Swiss psychologist, psychiatrist and cultural studies specialist, theorist and practitioner of deep psychology K.G. Jung (Jung, S. G., 1875-1961).
The study of various cultures promoted Jung's notion of a “collective unconscious”, which became key for the entire A. n. In his later works, Jung paid great attention to various religions, wrote a lot, while continuing private practice.
The basic concepts and methods of Analytical psychotherapy are formulated by the author in Tavistock lectures (London, 1935). The structure of the psychic being of man, according to Jung, includes two fundamental spheres - consciousness and the mental unconscious. Psychology is first and foremost a science of consciousness. It is also the science of the content and mechanisms of the unconscious. Since the direct study of the unconscious is not yet possible, since its nature is unknown, it is expressed in consciousness and in terms of consciousness. Consciousness is largely a product of perception and orientation in the outside world, however, according to Jung, it does not consist entirely of sensory data, as psychologists of past centuries say. The author also challenged the position of Freud, bringing the unconscious from consciousness. He posed the question in the opposite way: everything that arises in the consciousness is not obviously realized at first, and awareness flows from an unconscious state. In his mind, Jung distinguished ectopsychic and endopsychic functions of orientation. The author attributed to the ectopsychic functions of consciousness the orientation system dealing with external factors obtained through the senses; to endopsychic - a system of links between the content of consciousness and processes in the unconscious. Ectopsychic functions include: 1) sensations, 2) thinking, 3) feelings, 4) intuition. If the sensation says that something is, then thinking determines that there is this thing, that is, it introduces the concept; feeling informs about the value of this thing. However, this knowledge does not exhaust information about a thing, since it does not take into account the category of time. The thing has its past and future. Orientation relative to this category is carried out by intuition, foreboding. Where concepts and evaluations are powerless, we are totally dependent on the gift of intuition. These functions are presented in each individual with varying degrees of severity. The dominant function determines the psychological type. Jung deduced the regularity of the subordination of ectopsychic functions: with the dominance of the mental function of the subordinate is the function of feeling, with the dominance of feeling in the submission turns out to be intuition, and vice versa. Dominant functions are always differentiated, we are “civilized” in them and presumably have the freedom of choice. Subordinate functions, on the contrary, are associated with archaic personality, lack of control. Ectopsychic functions do not exhaust the conscious sphere of the mental; its endopsychic side includes: 1) memory, 2) subjective components of conscious functions; 3) affects, 4) invasions, or invasions. Memory allows you to reproduce the unconscious, to make connections with what has become subconscious - depressed or discarded. Subjective components, affects, invasions still more play the role assigned to endopsychic functions — they are the very means by which unconscious content reaches the surface of consciousness. The center of consciousness, according to Jung, is the Ego-complex of mental factors, constructed from information about one's own body, existence, and from certain sets (series) of memory. The ego has tremendous energy of attraction - it attracts both the content of the unconscious and impressions from outside. Only that which is connected with the Ego is realized. Ego-complex manifests itself in a volitional effort. Если эктопсихические функции сознания контролируются Эго-комплексом, то в эндопсихической системе лишь память, и то до определенной степени, контролируема волей. Еще в меньшей степени контролируются субъективные компоненты функций. Аффекты и вторжения и вовсе контролируются «одной лишь силой». Чем ближе к бессознательному, тем менее Эго-комплекс осуществляет контроль над психической функцией, другими словами, мы можем приблизиться к бессознательному только благодаря свойству эндопсихических функций не контролироваться волей. То, что достигло эндопсихической сферы, становится осознанным, определяет наше представление о себе. Но человек не статичная структура, он постоянно изменяется. Часть нашей личности, пребывающая в тени, пока неосознанная, находится в стадии становления. Таким образом, потенциалы, заложенные в личности, содержатся в теневой, неосознанной стороне. Бессознательная сфера психического, не поддающаяся прямому наблюдению, проявляется в своих продуктах, переходящих порог сознания, которые Юнг делит на 2 класса. Первый содержит познаваемый материал сугубо личностного происхождения. Этот класс содержаний Юнг назвал подсознательным разумом, или личностным бессознательным, состоящим из элементов, организующих человеческую личность как целое. Другой класс содержаний, не имеющих индивидуального происхождения, автор определил как коллективное бессознательное. Содержания эти принадлежат типу, воплощающему свойства не отдельного психического бытия, а всего человечества как некоего общего целого, и, таким образом, являются коллективными по природе. Эти коллективные паттерны, или типы, или образцы, Юнг назвал архетипами. Архетип — определенное образование архаического характера, включающее равно как по форме, так и по содержанию мифологические мотивы. Мифологические мотивы выражают психологический механизм интроверсии сознательного разума в глубинные пласты бессознательной психики. Сфера архетипического разума — ядро бессознательного. Содержания коллективного бессознательного не контролируются волей; они не только универсальны, но и автономны. Юнг предлагает 3 метода для достижения сферы бессознательного: метод словесных ассоциаций, анализ сновидений и метод активного воображения. Тест словесных ассоциаций, принесший Юнгу широкую известность, заключается в том, чтобы испытуемый как можно более быстро ответил на слово-стимул первым пришедшим ему в голову словом-ответом. Время каждой реакции фиксируется. Эксперимент после первого чтения повторяется снова. Юнг описал 12 различных типов нарушения реакции: увеличение время реакции; реакция более чем одним словом; реакция, выраженная не словесно, а мимикой; неправильное воспроизведение и т. д. Нарушенные реакции рассматриваются как «индикатор комплекса». Под комплексом понимается сочетание ассоциаций, нечто вроде слепка более или менее сложной психологической природы — иногда травматического, иногда просто болезненного, аффектированного характера. Комплекс, связанный с физиологическими реакциями и обладающий собственной энергией, имеет тенденцию «образовывать как бы отдельную маленькую личность». Бессознательное, таким образом, состоит из неопределенного (неизвестного) числа комплексов, или фрагментарных личностей, персонификация которых может стать патологическим условием. В том случае, когда цель исследователя не выявление комплексов, а выяснение, «что бессознательное делает с комплексами», автор применял метод анализа сновидений. Отдавая дань заслуге Фрейда, поставившего проблему сновидений в изучении бессознательного, Юнг в толковании снов занимал принципиально отличную от него позицию. Если, по Фрейду, сон есть «искажение, которое маскирует оригинал» и преодоление которого ведет к комплексам, согласно Юнгу, сон ничего не скрывает, он сам по себе закончен и целостен. Сон выполняет компенсаторную функцию, являясь «естественной реакцией саморегуляции психической системы». Юнг видел в сновидении сигнал бессознательного о том, что индивид «отклонился от собственного пути». Задача исследователя — понять этот сигнал, опираясь на чувства сновидца по поводу тех или иных образов сновидения, так как сны всегда являютcя реакцией на сознательную установку и ключ к их пониманию поэтому находится у самого сновидца. Появление в снах мифологических, архетипических образов свидетельствует о движении к целостности, индивидуальной завершенности, другими словами, погружение в глубины бессознательного приносит исцеление. В связи с этим важное место в интерпретации сновидений Юнг Отводил архетипическим, мифологическим образам. Процесс излечения является процессом идентификации с целостной личностью, с «самостью» — ключевым архетипом в А. п. Важное место в психотерапии пациента — на пути к его целостности — Юнг отводил осознанию transfer .. Психологический процесс переноса он рассматривал как частную форму более общего психологического механизма проекции, возникающей между двумя людьми. Перенос, по Юнгу, в отличие от фрейдовского понимания, несет не только эротическое, но и все активные содержания бессознательного. Эмоции спроектированных содержаний всегда образуют некое динамическое соотношение между субъектом и объектом — это и есть перенос, который по своему характеру может быть положительным и отрицательным. Перенос, возникающий в процессе анализа, часто свидетельствует о трудностях установления эмоционального контакта между врачом и пациентом — дистанцию между ними бессознательное пациента пытается «покрыть» и возводит компенсаторный мост. Интенсивность переноса пропорциональна важности проектируемого содержания, значительности его для пациента. Чем дольше практикуется содержание, тем больше аналитик заключает в себе эти «ценности» пациента. Задача психотерапевта — «вернуть» их пациенту, иначе анализ не будет завершен. Для снятия переноса необходимо добиться от пациента осознания субъективной ценности личностного и безличностного содержаний его переноса.
Юнг выделял 4 стадии терапии переноса. На первой стадии пациент осознает факт проекции личностного бессознательного и вырабатывает субъективную оценку тех содержаний, которые создают проблему. Он должен ассимилировать эти образы со своим собственным психическим бытием, понять, что приписываемые объекту оценки являются его собственными качествами. Лечение невроза, означающее требование стать целостной личностью, предполагает «узнавание и ответственность за свое целостное бытие, за его хорошие и плохие стороны, возвышенные и низменные функции». Если снятие проекции личностных образов состоялось, но тем не менее перенос имеет место, наступает вторая стадия лечения — разделение личностных и безличностных содержаний. Проекция безличностных образов сама по себе носит опосредованный характер, поэтому аннулировать здесь можно лишь сам акт проекции, но никак не ее содержание. На третьей стадии терапии переноса происходит отделение личного отношения к психотерапевту от безличностных образов. Это существенная часть процесса «индивидуации», понимаемой Юнгом как «путь к себе», или «самореализация», целью которой является осознание пациентом некоего центра внутри его психического бытия (но не внутри его Эго), позволяющее ему не связывать более свое будущее счастье, а иногда и жизнь с некими внешними посредниками, будь то люди, идеи, обстоятельства.
Significant fame in psychology was the selection of extraverted and introverted personality types by Jung. Extroverts direct all their interest to the outside world; the object acts on them, as Jung puts it, like a magnet, and, as it were, alienates the subject from itself. For introverts, all life energy is directed at itself, at its psychic being. At the heart of the differences of these types, Jung sees the state of affective tension. The high tension of emotions of the introvert determines the duration and brightness of the impressions he received; the emotional saturation of external extrovert impressions quickly falls, leaving no significant mark, and only the novelty of the object can cause a rapidly dying out emotional outburst. The weakness of extroverts on their inner world determines, according to Jung, the immaturity and archaic nature of the sphere. their unconscious psyche, manifested in egocentrism, selfishness and vanity. Turning out is expressed in the desire of extroverts to impress others. The opposite is the mental image of the introvert. The personality typology proposed by Jung is currently used in psychoanalytic practice.
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The basics of psychotherapy
Terms: The basics of psychotherapy