Alya Putri Khairani / 130110110220 / B5

Sigmund Freuds Psychoanalytic Theory

Psychoanalysis is a clinical therapy originally developed by Sigmund Freud (18561939) for the treatment of neuroses. The term refers as well to a theory of psychopathology underlying the therapeutic practice; a general theory of the mind based on the understanding arising from the clinical procedure and other sources, and a mode of research into mental life that is inherent in, and inextricably intertwined with, the therapeutic process Freuds Technical Evolution The Project Interpretation of Dreams Theory of Libido The Ego, Superego, and Id Phases of Psychosexual Development Ego Defense Mechanism Melancholia

Narcissism and the Dual Instinct Theory

THE PROJECT The Project was based on two principal theorems: First the idea that the nervous system was composed exclusively of neurons, separated by contact barriers (Freud's expression for synapses), and second a quantitative concept of neural excitation (Qn) transmitted from cell to cell in the nervous system and either stored or discharged, thus accounting for various forms of nervous activity. The basic model employed in the Project centered on a reflex apparatus whose function was withdrawal from stimuli, particularly excessive stimuli, and discharge of accumulated excitation as governed by the constancy principle, and the necessity of withdrawing from excessive stimulation in accordance with the unpleasure principle. Freud used psychic energy both as a device to describe observable phenomena and as a construct in his model of the mind. Probably after 1900, Freud became increasingly aware of the limitations of his theory FREUDS TECHNICAL EVOLUTION With the collaboration with Breuer, Freud form Studies of Hysterica which he can conclude: (1) The patient had undergone a traumatic experience, by which Freud meant an experience that stirred up intense emotion and excitation, that was intensely painful or disagreeable to the individual (2) The traumatic experience represented to the patient some idea or ideas incompatible with the dominant mass of ideas constituting the ego (3) This incompatible idea was intentionally dissociated or repressed from consciousness (4) The excitation associated with the incompatible idea was converted into somatic pathways, resulting in hysterical manifestations and symptoms (5) What was left in consciousness was merely a mnemonic symbol only connected with the traumatic event by associative links that are frequently enough disguised (6) If the memory of the traumatic experience can be brought into consciousness and if the patient is able to sufficiently release the strangulated affect associated with it, then the affect is discharged and symptoms disappear The Studies on Hysteria provide a valuable picture of the evolution in Freud's development of technical approaches to the treatment of cases of hysteria. In the beginning, he used hypnotic suggestion to enable patients to rid themselves of their symptoms. It became quickly obvious, however, that although patients responded to hypnotic suggestion and were relieved of symptoms, the symptoms would nonetheless reassert themselves after a period of time. The beneficial effects of hypnotic treatment seemed to be transitory; they tended to last, or seemed effective, only as long as the patient remained in contact with the physician. Freud began to suspect that alleviation of symptoms was actually dependent in some manner on the personal relationship between patient and physician.

Through this progressive evolution, the basic rule of psychoanalysisfree associationcame into focus and was established. The procedure persisting in the practice of psychoanalysis is the customary use of the couch evolved with increasing reliance on the patient's capacity to freely manifest mental contents without suggestive interference
INTERPRETATION OF DREAMS Dreams give expression to unconscious wishes in disguised form and generally represent their fulfi llment or gratifi cation. Analysis of dreams can provide conscious access to unconscious drives, wishes, fantasies and associated repressed infantile memories, providing what Freud called the Royal Road to the Unconscious. The dream that is remembered on awakening is referred to as the Manifest dream. Its component elements include sensory stimuli occurring during sleep, the Day Residue and the Latent Dream Content. The day residue consists of experiences of events of the preceding day or days, often associated in the mind with unconscious wishes. The latent dream content is the set of unconscious infantile urges, wishes, and fantasies that seek gratification during the dreaming state of blocked motor discharge and regression In psychoanalytic treatment, the analysis of dreams attempts to take this process backward, starting with the patients narration of the dream and then observing the patients associations to the manifest elements, with the goal of obtaining insight into the dreamers unconscious wishes, memories and infantile fantasies, and processes of defense. THEORY OF LIBIDO Freuds continued consideration of the sources and nature of the sexual drives led to his dynamic model of the mind referred to as libido theory. This theory attempted to explain the observation that behavior and mental activity are not only triggered by external stimuli (as in the

Alya Putri Khairani / 130110110220 / B5

reflex arc) but also generated by primary internal processes. The sexual instinct has four defining components: Source, Pressure (or Impetus), Aim, and Object. Source refers to the biological substrate of the instinct. Pressure is the amount of force or demand for work of the instinct. The aim is the action designed to accomplish release of tension and satisfaction. An Object is the target of desire, the person or thing through which gratification is accomplished. Although Freud had given up the idea that sexual traumatization was always the cause of psychoneurotic symptoms, he maintained the view that the sexual instinct played an etiological role in the neuroses and that sexual stimulation exerted a predominant force on mental activity throughout life NARCISSISM AND THE DUAL INSTICT THEORY Freud's examination of narcissism and its related clinical phenomena led to an increasing concern with the origins and functions of the ego. In exploring aspects of pathological narcissism, Freud observed that in cases of dementia praecox (Schizophrenia), libido appeared to have been withdrawn from other persons and objects and turned inward. He concluded that this detachment of libido from external objects might account for the loss of reality contact so typical of these patients. He speculated that the detached libido had then been reinvested and attached to the patient's own ego, resulting in megalomaniacal delusions and suggesting that this libidinal reinvestment found expression in its grandiosity and omnipotence. Freud also became aware at the same time that narcissism was not limited to these psychotic manifestations. It might also occur in neurotic and, to a certain extent, even in normal individuals under certain conditions. Freud had originally considered two types of instincts, the Sexual and the Ego (self-preservative) instincts, and considered sadism to represent a fusion of the two, with hostility occurring in the context of frustrated libidinal strivings. However, this theory did not adequately address psychological situations in which destructive tendencies seem to be operating independently of libidinal or self-preservative drives THE EGO, SUPEREGO, AND ID *may find in another Learning Issue EGO DEFENSE MECHANISM *may find in another Learning Issue PHASES OF PSYCHOSEXUAL DEVELOPMENT Freud believed that the psychological conflicts which produced morbidity arose during infancy and childhood. He developed a theory which attempted to explain the development of sexuality in children. He visualised four phases, characterised by particular satisfactions and conflicts. Inability to resolve conflicts at a particular stage would lead to subsequent adult problems Oral Stage Definition Description Earliest stage of development in which the infant's needs, perceptions, and modes of expression are primarily centered in mouth, lips, tongue, and other organs related to oral zone and around the sucking reflex Oral zone maintains dominance in psychic organization through approximately first 18 months of life. Oral sensations include thirst, hunger, pleasurable tactile stimulations evoked by the nipple or its substitute, sensations related to swallowing and satiation. Oral drives consist of two components: Libidinal and Aggressive. States of oral tension lead to seeking for oral gratification, as in quiescence at the end of nursing. Oral triad consists of wishes to eat, sleep, and reach that relaxation that occurs at the end of sucking just before onset of sleep To establish a trusting dependence on nursing and sustaining objects, establish comfortable expression and gratification of oral libidinal needs without excessive conflict or ambivalence from oral sadistic wishes Excessive oral gratifications or deprivation can result in libidinal fixations contributing to pathological traits. Such traits can include excessive optimism, narcissism, pessimism (as in depressive states), or demandingness. Envy and jealousy are often associated with oral traits Successful resolution of the oral phase results in capacities to give to and receive from others without excessive dependence or envy, capacity to rely on others with a sense of trust as well as with a sense of self-reliance and selftrust. Oral characters are often excessively dependent and require others to give to them and look after them, and are often extremely dependent on others for maintaining self-esteem Anal Stage The stage of psychosexual development promoted by maturation of neuromuscular control over sphincters, particularly the anal sphincter, permitting greater voluntary control over retention or expulsion of feces This period extends roughly from 1 to 3 years of age, marked by recognizable intensification of aggressive drives mixed with libidinal components in sadistic impulses. Acquisition of voluntary sphincter control is associated with an increasing shift from passivity to activity. Conflicts over anal control and struggles with parents over retaining or expelling feces in toilet training give rise to increased ambivalence, together with conflicts over separation, individuation, and independence The anal period is marked by greater striving for independence and separation from dependence on and control of parents. Objectives of sphincter control without overcontrol (fecal retention) or loss of control (messing) are matched by attempts to achieve autonomy and independence without excessive shame or self-doubt from loss of control Maladaptive character traits, often apparently inconsistent, derive from anal erotism and defenses against it. Orderliness, obstinacy, stubbornness, willfulness, frugality, and parsimony are features of anal character. When

Objectives Pathological traits

Character traits

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Alya Putri Khairani / 130110110220 / B5

defenses against anal traits are less effective, anal character reveals traits of heightened ambivalence, lack of tidiness, messiness, defiance, rage, and sadomasochistic tendencies. Anal characteristics and defenses are typically seen in obsessive-compulsive neuroses Character traits Successful resolution of the anal phase provides the basis for development of personal autonomy, a capacity for independence and personal initiative without guilt, a capacity for self-determining behavior without a sense of shame or self-doubt, a lack of ambivalence, and a capacity for willing cooperation without either excessive willfulness or selfdiminution or defeat Urethral Stage This stage was not explicitly treated by Freud but serves as a transitional stage between anal and phallic stages. It shares some characteristics of anal phase and some from subsequent phallic phase. Characteristics of the urethral phase are often subsumed under phallic phase. Urethral erotism, however, refers to pleasure in urination as well as pleasure in urethral retention analogous to anal retention At stake are issues of control and urethral performance and loss of control. It is not clear whether or to what extent objectives of urethral functioning differ from those of anal period, except that they are expressed in a later developmental stage The predominant urethral trait is competitiveness and ambition, probably related to compensation for shame due to loss of urethral control. This may instigate development of penis envy, related to feminine sense of shame and inadequacy in being unable to match male urethral performance. This may also be related to issues of control and shaming Besides healthy effects analogous to those from the anal period, urethral competence provides a sense of pride and self-competence based on performance. Urethral performance is an area in which the small boy can imitate and try to match his father's more adult performance. Resolution of urethral conflicts sets the stage for budding gender identity and subsequent identifications Phallic Stage Phallic stage begins sometime during 3rd year and continues until approximately end of 5th year. The phallic phase is characterized by a primary focusing of sexual interests, stimulation, and excitement in the genital area. The penis becomes the organ of principal interest to children of both sexes, with lack of penis in females being considered as evidence of castration. The phallic phase is associated with an increase in genital masturbation accompanied by predominantly unconscious fantasies of sexual involvement with the opposite-sex parent To focus erotic interest in genital area and genital functions. This lays the foundation for gender identity and serves to integrate residues of previous stages into a predominantly genital-sexual orientation

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Oedipus complex The young boy focuses his erotic attraction towards his mother and develops resentment towards his father who blocks his total possession of her. Because of his hostility towards his father and following his observation of the difference between males and females, he imagines his father may take revenge by castrating him (castration anxiety). This anxiety leads to repression or resolution of the desire for exclusivity in maternal relations and the child enters the latent phase. Electra complex In young girls there is also an erotic desire for the mother and initial hostility towards the father as a rival. Due to her absence of a penis there is penis envy which becomes expressed as hostility towards the mother who she feels has handicapped her in her desires. This envy leads to an acceptance that she cannot compete with her father due to her lack of a penis and so the desire is transformed into a desire to have a baby as a penis substitute. The young girl then develops an Oedipal attachment towards her father as a potential father for this baby before again repressing these desires and entering the latent phase

Character traits

The phallic stage provides the foundations for an emerging sense of sexual identity, of a sense of curiosity without embarrassment, of initiative without guilt, as well as a sense of mastery not only over objects and persons in the environment but also over internal processes and impulses Latency Stage This is the stage of relative instinctual quiescence or inactivity of sexual drive during the period from the resolution of the Oedipus complex until pubescence (from about 5 to 6 years until about 11 to 13 years) The institution of the superego at the close of the oedipal period and further maturation of ego functions allow for considerably greater degrees of control of instinctual impulses and motives. Sexual interests are generally thought to be quiescent. This is a period of primarily homosexual affiliations for both boys and girls, as well as a sublimation of libidinal and aggressive energies into energetic learning and play activities, exploring the environment, and becoming more proficient in dealing with the world of things and persons around them The primary objective is further integration of oedipal identifications and consolidation of gender and sex-role identity. Relative quiescence and control of instinctual impulses allow for development of ego apparatuses and mastery of skills. Further identificatory components may be added to the oedipal ones on the basis of broadening

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Alya Putri Khairani / 130110110220 / B5

contacts with other significant figures outside the family, e.g., teachers, coaches, and other adult figures Pathological traits Dangers in the latency period can arise either from the lack of development of inner controls or an excess of them. Lack of control can lead to failure to sufficiently sublimate energies in the interest of learning and the development of skills; an excess of inner control, however, can lead to premature closure of personality development and precocious elaboration of obsessive character traits The child can develop a sense of industry and capacity for mastery of objects and concepts that allows autonomous functioning and a sense of initiative without risk of failure or defeat or a sense of inferiority. These are all important attainments that need to be further integrated, ultimately as the essential basis for a mature adult life of satisfaction in work and love Genital Stage The genital or adolescent phase extends from the onset of puberty from approximately ages 11 to 13 until young adulthood. Current thinking tends to subdivide this stage into preadolescent, early adolescent, middle adolescent, late adolescent, and even postadolescent periods Physiological maturation of systems of genital (sexual) functioning and attendant hormonal systems leads to intensification of instinctual, particularly libidinal, drives Primary objectives are the ultimate separation from dependence on and attachment to parents and establishment of mature, nonincestuous, heterosexual object relations. Related are the achievement of a mature sense of personal identity and acceptance and integration of adult roles and functions that permit new adaptive integrations with social expectations and cultural values Pathological deviations due to failure to achieve successful resolution of this stage of development are multiple and complex. Defects can arise from a whole spectrum of psychosexual residues, since the developmental task of adolescence is in a sense a partial reopening and reworking and reintegrating of all of these aspects of development This provides the basis for a capacity for self-realization and meaningful participation in areas of work, love, and in creative and productive application to satisfying and meaningful goals and values

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MELANCHOLIA In Mourning and Melancholia Freud (1917), developed a theory to explain processes of guilt, internal self-punishment and depression. To do this, he contrasted states of grief or mourning with the condition of melancholia, now called depression. Both have in common the experience of pain and sadness, and both are brought on by the experience of loss, but the person in mourning maintains her or his positive self-regard, whereas the person with melancholia feels dejected, loses interest in the world, shows a diminished capacity to love, inhibits all activities and exhibits low self-regard in the form of self-reproaches. In mourning, libido is gradually withdrawn from the object attachment; in melancholia, the ego feels depleted or comes under attack as though one part of the ego sets itself over against the other, judges it critically, and as it were, takes it as its object.

References: Kapplan and Sadock: Comprehensive Textbook of Psychiatry Oxford Handbook of Psychiatry Wiley: Jerald Kay & Allan Tasman: Essentials of Psychiatry