Ch 4. Psychoanalytic Therapy – Flashcards

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The Psychosocial perspective is not at all compatible with the psychosexual view of development.
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False
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Children who do not experience the opportunity to differentiate self from others may later develop a narcissistic personality disorder.
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True
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The contemporary trends in psychoanalytic theory are reflected in object relations theory, the self psychology model, and the relational model.
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True
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Brief psychodynamic therapists assume a neutral therapeutic stance as a way to promote transference.
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False
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Analytic therapy is oriented toward achieving insight.
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True
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Working through is achieved almost totally by catharsis, including getting out deeply buried emotions.
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False
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From the Freudian perspective, resistance is typically a conscious process.
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False
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The contemporary psychoanalytic approaches place emphasis on the unconscious, the role transference and countertransference, and the importance of early life experiences.
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True
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Object-relations theorists focus on symbiosis, separation, differentiation, and integration.
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True
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In object-relations theory there is an emphasis on early development as a decisive factor influencing later development.
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True
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Who of the following is not considered an object-relations theorist?
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D. Erik Erikson
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Which of the following is not a contemporary psychoanalytic approach?
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D. classical psychoanalysis
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Which of the following is not a characteristic of the new psychoanalytic thinking?
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C. People are classified as compliant, aggressive, or detached types.
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All of the following are concepts developed by Carl Jung except?
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B. normal infantile autism
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According to Erikson's psychosocial view, the struggle between industry and inferiority occurring during.
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C. school age
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Erikson's preschool-age phase corresponds to which Freudian stage?
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C. phallic
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Which term refers to the repition of interpretations and the overcoming of resistance so that clients can resolve neurotic patterns?
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A. working through
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Analysis of transference is central to psychoanalysis because it...
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B. allow clients to relive their past in therapy to gain insight
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In brief psychodynamic therapy (BPT) the therapist...
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C. assumes an active role in quickly formulating a therapeutic focus that goes beyond the surface of the presenting problem.
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With respect to applying the psychoanalytic approach to group counseling, which statement(s) are true?
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E. all the above -In psychodynamic therapy groups, members re-create their social situations, implying that the group becomes a microcosm of their everyday lives. -Members can profit from identifying and exploring their transferences within the group. -Projections onto the therapist and other members provide a clue to a member's unresolved conflicts. -One's ways of relating within the group provides clues to patterns outside of the group.
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Borderline and narcissistic disorders have been give much attention by?
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C. object-relations theory
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During psychoanalytic treatment, clients are typically asked
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C. not to make radical changes in their life style.
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Countertransference refers to
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B. the irrational reactions therapists have toward their client's.
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"Maintaining the analytic framework" refers to
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E. all the above. -the whole range of procedural factors in the treatment process. -the analyst's relative anonymity. -agreement on the payment of fees. -the regularity and consistency of meetings.
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In psychoanalystic therapy (as opposed to classical analysis), which of the following procedures is least likely to be used?
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A. the client lying on the couch
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Animus (anima)
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The biological and psycho- logical aspects of masculinity and femininity, which are thought to coexist in both sexes.
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Anxiety
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A feeling of impending doom that results from repressed feelings, memories, desires, and experiences emerging to the surface of awareness. From a psychoanalytic perspective, there are three kinds of anxiety: reality, neurotic, and moral anxiety.
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Archetypes
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The images of universal experiences contained in the collective unconscious.
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Blank Screen
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An anonymous stance assumed by classical psychoanalysts aimed at fostering transference.
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Borderline personality disorder
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A disorder characterized by instability, irritability, self destructive acts, impulsivity, and extreme mood shifts. Such people lack a sense of their own identity and do not have a deep understanding of others.
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Brief psychodynamic therapy (BPT)
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An adaptation of the principles of psychoanalytic theory and therapy aimed at treating selective disorders within a preestablished time limit.
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Classical psychoanalysis
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The traditional (Freudian) approach to psychoanalysis based on a long-term exploration of past conflicts, many of which are unconscious, and an extensive process of working through early wounds
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Collective unconscious
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From a Jungian perspective, the deepest level of the psyche that contains an accumulation of inherited experiences.
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Compensation
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An ego-defense mechanism that consists of masking perceived weaknesses or developing certain positive traits to make up for limitations.
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Contemporary psychoanalysis
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Newer formulations of psychoanalytic theory that share some core characteristics of classical analytic theory, but with different applications of techniques; extensions and adaptations of orthodox psychoanalysis
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Countertransference
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The therapist's unconscious emotional responses to a client that are likely to interfere with objectivity; unresolved conflicts of the therapist that are projected onto the client.
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Crisis
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According to Erikson, a turning point in life when we have the potential to move forward or to regress. At these turning points, we can either resolve our conflicts or fail to master the developmental task.
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Death instincts
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A Freudian concept that refers to a tendency of individuals to harbor an unconscious wish to die or hurt themselves or others; accounts for the aggressive drive.
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Denial
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In denial there is an effort to suppress unpleasant reality. It consists of coping with anxiety by "closing our eyes" to the existence of anxiety-producing reality.
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Dialectical behavior therapy (DBT)
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A blend of cognitive behavioral and psychoanalytic techniques that generally involves a minimum of one year of treatment.
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Displacement
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An ego-defense mechanism that entails redirection of some emotion from a real source to a substitute person or object
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Dream analysis
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A technique for uncovering unconscious material and giving clients insight into some of their unresolved problems. Therapists participate with clients in exploring dreams and in interpreting possible meanings.
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Dream work
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The process by which the latent content of a dream is transformed into the less threatening manifest content.
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Ego
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The part of the personality that is the mediator between external reality and inner demands.
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Ego-defense mechanisms
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Intrapsychic processes that operate unconsciously to protect the person from threatening and, therefore, anxiety- producing thoughts, feelings, and impulses.
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Ego psychology
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The psychosocial approach of Erik Erikson, which emphasizes the development of the ego or self at various stages of life.
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Fixation
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The condition of being arrested, or "stuck," at one level of psychosexual development.
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Free association
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A primary technique, consisting of spontaneous and uncensored verbalization by the client, which gives clues to the nature of the client's unconscious conflicts.
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Genital stage
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The final stage of psychosexual development, usually attained at adolescence, in which heterosexual interests and activities are generally predominant.
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Id
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The part of personality, present at birth, that is blind, demanding, and insistent. Its function is to discharge tension and return to homeostasis
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Id psychology
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A theory stating that instincts and intrapsychic conflicts are the basic factors shaping personality development (both normal and abnormal).
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Identification
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As an ego defense, this may involve individuals identifying themselves with successful causes in the hope that they will be seen as worthwhile.
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Identity crisis
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A developmental challenge, occurring during adolescence, whereby the person seeks to establish a stable view of self and to define a place in life.
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Individuation
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The harmonious integration of the conscious and unconscious aspects of personality
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Interpretation
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A technique used to explore the meanings of free association, dreams, resistances, and transference feelings.
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Introjection
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A process of taking in the values and standards of others.
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Latency stage
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A period of psychosexual development, following the phallic stage, that is relatively calm before the storm of adolescence.
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Latent content
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Our hidden, symbolic, and unconscious motives, wishes, and fears.
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Libido
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The instinctual drives of the id and the source of psychic energy; Freudian notion of the life instincts.
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Life instincts
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Instincts oriented toward growth, development, and creativity that serve the purpose of the survival of the individual and the human race.
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Maintaining the analyst frame
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Refers to a range of procedures, such as an analyst's anonymity, regularity, and consistency of meetings, as a structure for therapy.
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Manifest content
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the dream as it appears to the dreamer
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Moral anxiety
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The fear of one's own con-science; people with a well-developed conscience tend to feel guilty when they do something contrary to their moral code.
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Multiple transferences
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A process whereby group members develop intense feelings for certain others in a group; an individual may "see" in others some significant figure such as a parent, life-partner, ex-lover, or boss.
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Narcissism
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Extreme self-love, as opposed to love of others. A narcissistic personality is characterized by a grandiose and exaggerated sense of self-importance and an exploitative attitude toward others, which hides a poor self-concept.
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Narcissistic personality
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Characterized by a grandiose and exaggerated sense of self-importance and an exploitive attitude toward others, which serve the function of masking a frail self-concept.
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Neurotic anxiety
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The fear that the instincts will get out of hand and cause one to do something for which one will be punished.
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Object relatedness
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Interpersonal relationships as they are represented intrapsychically.
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Object relations
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Interpersonal relationships as they are represented intrapsychically.
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Object-relations theory
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A newer version of psychoanalytic thinking, which focuses on predictable developmental sequences in which early experiences of self shift in relation to an expanding awareness of others. It holds that individuals go through phases of autism, normal symbiosis, and separation and individuation, culminating in a state of integration.
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Oral stage
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The initial phase of psychosexual development, during which the mouth is the primary source of gratification; a time when the infant is learning to trust or mistrust the world.
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Persona
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The mask we wear, or public face we present, as a way to protect ourselves.
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Phallic stage
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The third phase of psychosexual development, during which the child gains maximum gratification through direct experience with the genitals.
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Pleasure principle
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The idea that the id is driven to satisfy instinctual needs by reducing tension, avoiding pain, and gaining pleasure.
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Projection
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An ego-defense mechanism that involves attributing our own unacceptable thoughts, feelings, behaviors, and motives to others.
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Psychodynamic psychotherapy
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Psychoanalytically oriented psychotherapy involves a shortening and simplifying of the lengthy process of psychoanalysis.
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Psychodynamics
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The interplay of opposing forces and intrapsychic conflicts that provide a basis for understanding human motivation.
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Psychosexual stages
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The Freudian chronological phases of development, beginning in infancy. Each is characterized by a primary way of gaining sensual and sexual gratification.
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Psychosocial stages
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Erikson's turning points, from infancy through old age. Each presents psychological and social tasks that must be mastered if maturation is to proceed in a healthy fashion.
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Rationalization
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An ego-defense mechanism whereby we attempt to justify our behavior by imputing logical motives to it.
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Reaction formation
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A defense against a threatening impulse, involving actively expressing the opposite impulse.
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Reality anxiety
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The fear of danger from the external world; the level of such anxiety is proportionate to the degree of real threat.
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Reality principle
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The idea that the ego does realistic and logical thinking and formulates plans of action for satisfying needs.
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Regression
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An ego-defense mechanism whereby an individual reverts to a less mature form of behavior as a way of coping with extreme stress.
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Relational analysis
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An analytic model based on the assumption that therapy is an interactive process between client and therapist. The inter- personal analyst assumes that countertransference is a source of information about the client's character and dynamics.
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Relational model
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A model that characterizes therapy as an interactive process between client and therapist in which countertransference provides an important source of information about the client's character and dynamics.
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Repression
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The ego-defense mechanism whereby threatening or painful thoughts or feelings are excluded from awareness.
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Resistance
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The client's reluctance to bring to awareness threatening unconscious material that has been repressed.
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Self-psychology
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A theory that emphasizes how we use interpersonal relationships (self objects) to develop our own sense of self.
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Shadow
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A Jungian archetype representing thoughts, feelings, and actions that we tend to disown by projecting them outward.
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Sublimation
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An ego defense that involves diverting sexual or aggressive energy into other channels that are socially acceptable
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Superego
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That aspect of personality that represents one's moral training. It strives for perfection, not pleasure.
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Time-limited dynamic psychotherapy (TLDP)
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Through this form of psychoanalytically oriented therapy, clients gain a sense of what it is like to interact more fully and flexibly within the therapy situation. They are helped to apply to the outside world what they are learning in the office.
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Transference
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The client's unconscious shifting to the therapist of feelings and fantasies, both positive and negative, that are displacements from reactions to significant others from the client's past.
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Transference relationship
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The transfer of feelings originally experienced in an early relationship to other important people in a person's present environment.
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Unconscious
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That aspect of psychological functioning or of personality that houses experiences, wishes, impulses, and memories in an out-of-awareness state as a protection against anxiety.
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Working through
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A process of resolving basic conflicts that are manifested in the client's relationship with the therapist; achieved by the repetition of interpretations and by exploring forms of resistance.
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Key Figures and Major Focus
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Original key figure: Sigmund Freud, father of psychoanalysis. Ego psychologist: Erik Erikson. Object relations: Margaret Mahler. Historically, psychoanalysis was the first system of psycho- therapy. It is a personality theory, a philosophy of human nature, and a method of therapy.
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Philosophy and Basic Assumptions
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Although the Freudian view of human nature is basically deterministic and focuses on irrational forces, biological and instinctual drives, and unconscious motivation, later developments in psychoanalysis stressed social and cultural factors. Contemporary psychoanalytic thinking emphasizes the development of the ego and the differentiation and individuation of the self. The contemporary psychoanalytic approaches deviate significantly from traditional or Freudian psychoanalysis, yet these modern versions retain the emphasis on the unconscious, the role of transference and countertransference, and the importance of early life experiences.
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Key Concepts
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Key notions include the division of the personality into the id, ego, and superego; the unconscious; anxiety; the functioning of ego-defense mechanisms; an understanding of transference and countertransference; a focus on the past for clues to present problems; and the development of personality at various stages of life. Healthy personality development is based on successful resolution of both psychosexual and psychosocial issues at theappropriate stages throughout the life span. Psychopathology is the result of failing to meet some critical developmental task or becoming fixated at some early level of development. Freudian psychoanalysis is basically an id psychology, whereas the newer formulations of psychoanalytic therapy are based on an ego psychology. The contemporary psychoanalytic approaches include object-relations, self psychology, and relational psychoanalysis. These newer formulations concentrate on the development of the ego, and they pay more attention to the social and cultural factors that influence the differentiation of an individual from others. Contemporary psychoanalysis gives increased emphasis to the therapeutic relationship and views therapy as an interactive process between client and therapist.
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Therapeutic Goals
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A primary goal is to make the unconscious conscious. Both psychoanalysis and psycho- analytically oriented therapy seek the growth of the ego through analysis of resistance and transference, allowing the ego to solve the unconscious conflicts. The restructuring of personality is the main goal, rather than solving immediate problems. Contemporary analytically-oriented therapists are interested in their clients' pasts, but they intertwine that understanding with the present and with the future. The past is relevant to the extent that it sheds light on a client's present and future direction.
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Therapeutic Relationship
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In classical psychoanalysis the anonymity of the therapist is stressed, so that clients can project feelings onto the therapist. The focus is on resistances that occur in the therapeutic process, on interpretation of a client's life patterns, and on working through transference feelings. Through this process, clients explore the parallels between their past and present experience and gain new understanding that can be the basis for personality change. With the modern psychoanalytic approaches, the therapist does not remain anonymous, emphasis is given to the here-and-now interactions between client and therapist, and therapists can decide when and what to disclose to clients. Both transference and countertransference are central aspects in the relationship that are addressed. Contemporary relational theorists have challenged the authoritarian nature of classical analysis and replaced it with a more egalitarian model.
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Techniques and procedures
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All techniques are designed to help the client gain insight and bring repressed material to the surface so that it can be dealt with in a conscious way. Major techniques of traditional psychoanalysis include maintaining the analytic framework, free association, interpretation, dream analysis, analysis of resistance, and analysis of transference. These techniques are geared to increasing awareness, gaining intellectual insight, and beginning a working- through process that will lead to a reorganization of the personality. In contemporary psychoanalytic practice, more latitude is given to the therapist in using a diverse range of techniques and in developing the therapeutic relationship. In contemporary relational psychoanalysis, the therapist does not strive for a nonparticipating, detached, and objective stance, but is attuned to the nature of the therapeutic relationship, which is viewed as a key factor in bringing about change. The newer psychoanalytic theorists have enhanced, extended, and refocused classical analytic techniques.
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Applications
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Good candidates for analytic therapy include professionals who wish to become therapists as well as people who have been helped by intensive therapy and want to go further. This therapy demands sacrifices of time, money, and personal commitment and is typically along-term process. Psychoanalytic concepts and techniques can be adapted to both time- limited therapy and group therapy. Brief psychodynamic therapy makes use of these psychodynamic concepts: impact of stages of development, the unconscious and resistance, the usefulness of interpretation, stressing the working alliance, and the reenactment of past emotional issues in relation- ship to the therapist. Psychodynamically oriented group therapy is based on many of the same concepts as brief therapy. Especially useful in group therapy are these facets: understanding transference and multiple transferences, understanding and monitoring leader countertransference, and exploring interpersonal relationships within the here-and-now context of the group. A basic tenet of psychodynamic therapy groups is the notion that group participants, through their interactions within the group, re-create their social situation, implying that the group becomes a microcosm of their everyday lives.
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Multicultural Perspectives
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The psychosocial approach that emphasizes turning points at various stages of life has relevance for understanding diverse client populations. As well as examining intrapsychic influences, therapists can assist clients in identifying and dealing with the influence of environmental situations on their personality development. Traditional psychoanalysis has many limitations from a multicultural perspective. However, the goals of brief psychodynamic therapy can provide new experiences and new understanding for clients. With this briefer form of psychoanalytically oriented therapy, clients can relinquish old patterns and establish new patterns in their present behavior.
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Contributions
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Many other models have developed as reactions against psychoanalysis. The theory provides a comprehensive and detailed system of personality. It emphasizes the legitimate place of the unconscious as a determinant of behavior, highlights the profound effect of early childhood development, and provides procedures for tapping the unconscious. Several factors can be applied by practitioners with nonanalytic orientations, such as under- standing how resistance is manifested, how early trauma can be worked through so that a client is not fixated, the manifestations of transference and countertransference in the therapy relationship, and the functioning of ego-defense mechanisms.
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Limitations
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Classical psychoanalysis involves lengthy training for the therapist and a great amount of time and expense for clients. The approach stresses the role of insight but does not give due recognition to the importance of action methods. The model is based on the study of neurotic individuals, not of healthy people. The orthodox Freudian approach, with its stress on instinctual forces, does not give adequate attention to social, cultural, and interpersonal factors. The techniques of this long-term approach are of limited applicability to crisis counseling, working with many culturally diverse client populations, and social work.
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