Evaluation of Psychoanalysis as a Form of Therapy

Brief Introduction

From looking into the psychodynamic approach, the unconscious mind is predominately thought to be the influence on behavior (Silverman, 2017). The unconscious mind is fully responsible for the feelings, thoughts, urges and specific memories in which our body is not fully aware of it (Karbelnig, 2019). In most cases, the unconscious mind can involve a pleasant or unpleasant memory. Individuals can develop defense mechanisms to erase the memories to protect themselves from re-experiencing the event. These defense mechanisms can reduce stress, anxiety and any internal conflict. 

Literature Review

A review of literature, Sigmund Freud, the father of psychoanalysis, developed the psychoanalytic theory (Silverman, 2017). Freud believed that the conscious mind and unconscious mind is thought to be the influence on behavior (Silverman, 2017). The five major components that are associated with the theory are: (1) motivation and behavior, (2) domains of consciousness, (3) the structure of personality, (4) stages of development, and (5) defense mechanisms. Expansion for this theory includes the object relations theory and ego psychology.

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For motivation and behavior, Freud simply believed that all behaviors had some type of meaning/purpose behind it. Unconscious, multiply determined and drives are some examples that correspond with motivation and behavior. For domains of consciousness, Freud believed that the human mind resembles an iceberg. Examples under this component consist of conscious processes and the preconscious. For the structure of personality, this component will be later analyzed in this theory discussion. For stages of development, Freud believed that five crucial stages immediately begin at infancy through adolescence with the major focus on the first five or six years of life. Examples include the oral, anal, phallic, latent and genital stages (Silverman, 2017). For defense mechanisms, Freud believed that individuals can overcome their challenges by operating towards an unconscious level that will help uplift those unpleasant feelings and anxieties.

Freud strongly believed that the human mind consisted of three separate elements which are the id, the ego, and the superego. Firstly, the id is the personality module which is made up of unconscious energy in which individuals can simply satisfy urges, needs, and desires. For example, a client from a hostile childhood may carry over the abusive traits from his father towards his relationships with his peers. Abusive people often show kindness and anger in which a client demonstrates with his peers by complimenting them first and later then saying something derogatory according to the pleasure principle (Silverman, 2017).

 Secondly, the ego is primarily responsible for the correlation of the id, the superego and the reality within an individual’s personality. The ego doesn’t allow individuals from acting on specific urges but does allow individuals to accomplish the equilibrium between morals and idealistic principles. For example, a client’s impulsive behaviors can be ways to be rebellious against all authoritative figures. The power struggle between a client and an authoritative figure proves that they are recklessness and anti-authority mindset. The client wants to be in control but they are not able to.

Lastly, superego is the module within an individual’s personality in which they learn mostly from parents and society. The superego wants to conceal the urges from urges of the id to make the ego perform morally rather than realistically. For example, a client that comes from a hostile childhood environment can represent himself as a criminal and a bad boy image to look tough towards others. Over the years, this client will developed defense mechanisms to erase the painful memories to protect themselves from re-experiencing those abusive events. 

Research

Psychoanalysis is the most serious form of an approach to the treatment of psychodynamic therapy. The reason for psychodynamic therapy is to bring up unconscious material and to process it fully to consciousness. The psychodynamic approach can be used as an example of eating disorders in adolescents (Latzer and Stein, 2016). Eating disorders within adolescents can have long-term correlation effects with personality disorders rather than the eating disorder itself. The keenness for relationships, isolation, the opinions from others and anxiety are some examples that adolescents experience which results in their eating disorders (Latzer and Stein, 2016). Eating disorders do not start in adolescent but they do start early in childhood with the lack of relationships with others. To solve this problem, psychologists can use psychoanalysis which is the most serious form of an approach to the treatment of psychodynamic therapy.

Client Populations

The debate to practice psychoanalysis serves as an appropriate function of social work remains as a contentious question regardless of the evidence that much of the psychoanalysis in this nation is widely used by social workers. Psychoanalysis is the most serious form of an approach to the treatment of psychodynamic therapy. The most common techniques that are used throughout psychodynamic therapy are free association, dream interpretation and observing resistance and transference while engaging through a client’s severe memories and/or strenuous issues to develop healthy therapeutic relationships.

For example, it can be used to analyze the verbal and physical abuse that a client experienced throughout his life. The psychological abuse towards a client can have long-term correlation effects especially with conduct and depressive disorders. The keenness for having relationships, isolation, the negative opinions from others and anxiety are some examples that a client could experience. Establishing a strong therapeutic relationship with that client is a major component to understand while working through these difficult challenges that they have experienced in their lifetime.

Theoretical Strength(s)

Despite receiving a great quantity of criticism from others, there are some strengths within Freud’s theories. Freud’s theories of psychodynamic thinking heavily contributed to experimental psychology and were an influence on other great psychodynamic thinkers including Eric Erickson. In addition to Freud’s five psychosexual stages, Erickson created eight more psychosocial stages based on the entire life rather than just after puberty. Erickson shared Freud’s philosophy about human development that he accepted the id, ego, and superego of the personality. The human development process requires the resolution of stage-specific conflicts and that early developmental experiences have a substantial impact on later development. For an example, in a client’s oral stage, psychoanalytic theory can accurately explain that he did not get enough sucking activities in which can explain mistrust and rejecting of others due to their unfriendly and uncaring environment during his childhood.

Theoretical Criticism(s)

During and after the development of the psychoanalytic theory, Freud received numerous amounts of criticisms of which many believed that Freud’s theories were overstressed about the unconscious mind, sex, aggression and personal childhood experiences (Breger, 2012). For example, psychoanalysis resorts heavily on the social worker’s interpretation of what the patient may perceive. According to Freud, a client’s reaction to the social worker proposed interpretation can be acceptable. If the client openly accepts the interpretation, then it is most likely correct. If the client rejected the social worker’s interpretation, they may be resistant due to their conscious mind to an unacceptable but some accurate interpretation by the social worker. The conflict with this scenario demonstrates the social worker as winning both ways due to the client’s acceptance or denial of an interpretation as authenticating evidence that the interpretation is right.

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Taking this approach with a client can also be very time consuming due to their compliance with opening up about their past. According to Freud, “the patient attempts to escape by every possible means. First, he says nothing comes into his head, then that so much comes into his head that he can’t grasp any of it. At last, he admits that he really cannot say anything, he is ashamed to. So goes on, with untold variations” (Madison, 1961, p. 50).

Conclusion

The psychoanalytic theory does account of the influence of social privileges and social oppressions (Tummala-Narra, 2016). The investigation of social privileges and social oppressions involves a strong rapport transformation from the client and the social worker. The psychoanalytic can focus primarily on transference, counter-transference and the continuous patterns that serve the investigation of social privileges and social oppressions (Tummala-Narra, 2016). For example, a social worker may open up their true perceptions about stereotypes and assumptions conniving towards a client’s personal experience of oppression. Therefore, it is the social worker’s responsibility to note and justify the client’s personal experiences of oppression on a routine basis. In some cases, this strategy can help implicit the role of social justice in psychoanalytic therapy.

A social worker who holds a minority title and a majority status in regards to a particular race, religion, culture, political view or social class who acknowledge their backgrounds of oppression may positively affect their rapport with clients (Tummala-Narra, 2016). The psychoanalytic theory can also be beneficial while discussing the numerous forms of social privileges and social oppressions witnessed by individuals and families. For example, the social worker may want to analyze how a client may have witnessed racism in one situation and ableism in a different situation and how did the client accommodate these experiences.

With the right social worker and/or possible wraparound services, a client has the opportunity to change despite all the verbal and physical abuse that they have experienced throughout their lifetime. It is the social workers’ responsibility into learning more information about the client’s story which will allow the proper knowledge to understand and appreciate this vulnerable population. It is the social workers’ responsibility to create enhancement/maintenance tools to stabilize our clients physically, psychologically and socially into assisting them back into society. Every day our clients go through numerous difficult obstacles from society including making a healthy lifestyle, going to school and keeping up with societal demands. We need to feel our clients as if we are them and picture ourselves in their shoes to know exactly how they live.

References

• Breger, L. (2012). Freud: Darkness and Vision. Psychodynamic Psychiatry,40(2), 211-242. doi:10.1521/pdps.2012.40.2.211
• Karbelnig, A. M. (2019). The theater of the unconscious mind. Psychoanalytic Psychology. doi:10.1037/pap0000251
• Latzer, Y., & Stein, D. (2016). Bio-Psycho-Social Contributions to Understanding Eating Disorders. doi:10.1007/978-3-319-32742-6
• Madison, P. (1961). Chapter IV: Resistance. In Freud’s concept of repression and defense: Its theoretical and observational language (p. 50). Minneapolis, MN: University of Minnesota Press.
• Silverman, M. A. (2017). On the Birth and Development of Psychoanalytic Field Theory, Part 1. The Psychoanalytic Quarterly,86(3), 699-727. doi:10.1002/psaq.12164
• Tummala-Narra, P. (n.d.). Cultural competence from a psychoanalytic perspective. Psychoanalytic Theory and Cultural Competence in Psychotherapy.,63-84. doi:10.1037/14800-004