During the history of psychology and counselling a wide range of attitudes and approaches have been developed in order to provide individuals with the ability to explore his or her inner world through varied strategies and modes of interaction. The aim was to increase the level of awareness as well as the level of motivation and changes (Sarnoff, 1960). According to Stefflre & Burks (1979), Counselling doesn’t just occur between two people, “it denotes a professional relationship between a trained counsellor and a client. This relationship is usually person-to-person, although it may sometimes involve more than two people”, it also focuses upon the stimulation of personal development in order to maximize personal and social effectiveness and to forestall psychologically crippling disabilities (p.14). For this assignment the Psychoanalytic Theoretical approach to Counselling will be examined, along with its theorist Sigmund Freud and the therapeutic techniques associated with this theoretical approach. Before one can begin to explore techniques of psychoanalysis, it is important to briefly review Freud’s psychoanalytic theory, the developmental personality and his stages of psychological development.
Psychoanalytic theory and its practice originated in the late nineteenth century in the work of Sigmund Freud. According to Sarnoff (1960), psychoanalytic theory is considered to be the historical foundation of therapy. It describes the “mechanisms of ego defence which serve to protect the individual against external and internal threat” it also offers a distinctive way of thinking about the human mind and how it responds to psychological distress (p. 251). This theory has evolved into a complex, multifaceted and internally fractured body of knowledge situated at the interface between the human and natural sciences, clinical and counselling practice and academic theory. Therefore the term psychoanalysis refers to both Freud’s original attempt at providing a comprehensive theory of the mind and also the associated treatment (Wachtel & Messer, 1997, p.39-42). Freud viewed human nature as dynamic, that is, he believed in the transformation and exchange of energy within the personality.
These dynamic concepts consist of instincts, libido, cathexis, anticathexis and anxiety and are related to the way one distributes psychic energy (Hergenhahn & Olson, 2007). In attempting to account for why human beings behave as they do, Freud invented the topographic and structural models of personality. The topographical model or “iceberg” of the mind was intended to help analysts understand how patients repress wishes, fantasies, and thoughts. In the topographical model, the mind is divided into conscious, preconscious, and unconscious systems (Passer & Smith, 2007, p.443-445). The conscious system includes all that we are subjectively aware of in our minds. The preconscious includes material that we are capable of becoming aware of, but do not happen to be aware of currently. According to Freud (as cited in Passer & Smith, 2007, p.444), the metaphor of “the psyche is like an iceberg” was proposed.
Like an actual iceberg only the upper ten percent of it is visible or conscious and the rest is submerged and unseen below the water’s surface. So likewise, most human behaviour results from unconscious motivation, hence the unconscious system includes material that we have defensively removed from our awareness by means of repression and other defence mechanisms. So when unconscious materials attempt to enter the conscious level, a “censor” function (repression) pushes it back or lets it through in a disguised form (Ewen, 1992). As a result, counsellors try to move unconscious material to the preconscious and then to the conscious mind, to increase the patient’s self-awareness. With this model Freud realized that their was certain explanatory limitations, such as the model’s inability to account for certain forms of psychopathology and as a result developed an alternative that explained normal and abnormal personality development.
This alternative is known as the structural model (Brammer, Shostrum & Abrego, 1989). According to Freud (as cited in Gladding, 2000, p.187-188), the structural model for psychoanalysis consists of three psychic structures the id, ego and superego, which differ in terms of power and influence. These parts symbolise the different aspects of a person’s personality. The id and superego are confined to the unconscious and the ego operates mainly in the conscious but also interacts with the preconscious and unconscious of the topographical model. The id which develops within the next three years of an individual’s life is the source of ones motivation, and includes sexual and aggressive drives. Sigmund Freud’s theory believed that both the sexual and aggressive drives are powerful determinants of why people act as they do; it involves an analysis of the root cause or causes of behaviour and feelings by exploring the unconscious mind and the conscious mind’s relation to it.
This id demands the satisfaction of the antisocial instincts and obeys an inexorable ‘pleasure principle’. The id is viewed as not having any logic, values or ethics, for example the id wants whatever feels good at a certain time (Hergenhahn & Olson, 2007). Therefore Freud saw that it was urgent to control the pleasure principle and he postulated that there must be a ‘super-ego’ to control the id. The ego can be viewed as the executive of personality; it consists of a group of mechanisms such as reality-testing, judgment and impulse control. It incorporates these techniques so it is able to control the demands of the id and of other instincts, becoming aware of stimuli, and serving as a link between the id and the external world (Pervin, Cervone & John, 2005). As an individual’s ego develops so does the perception of reality and a wider view beyond, the pleasures of subjective gratification, is attained. Therefore the pleasure principle that was developed by Freud was replaced by the reality principle (Garcia, 1995).
As described by the psychoanalytic theory, the psychological conflict that the ego faces, in respect to dealing with the demands of the superego and the id, is an intrinsic and pervasive part of human experience. For example, if an individual is under pressure and the balance is tipped too far towards one element, thus creating excessive anxiety, the ego is forced to take extreme measures to relieve the pressure, by incorporating what is know as defence mechanisms (Passer & Smith, 2007, p.444-445). These principle defences consists of repression, projection, reaction formation, displacement, regression, rationalization, denial and identification, these are used to defend the ego and are known in therapy as denial or repression. Therefore the way in which a person characteristically resolves the instant gratification versus longer-term reward dilemma, in many ways comes to reflect on their “character” (Kleep, 2008). In contrast to the id is the superego, which is developed at around age five.
It is the internalized representation of the traditional values, ideas and moral standards of society and strives for perfection (Pervin et al., 2005). Counsellors who use the structural model commonly focus on helping patients handle conflicts that occur between these three mental agencies by assessing the level of functioning of the client’s id, ego, and superego, the specific areas of weakness and strength in each (Garcia, 1995). For example, counsellors usually diagnose a patient as psychotic if his or her ego suffers a severe impairment in reality-testing. Freud believed that human social and personality development occurs through his psychoanalytic theory of development. This theory consists of five stages the oral, anal, phallic, latency and genital. These are characterized by a dominant mode of achieving libidinal pleasure and by specific development tasks. An individual’s personality according to Freud has been shaped by the age of five and he believes this time is the most critical for an individual (Hergenhahn & Olson).
During these years if an individual is able to successfully negotiate these stages, then healthy personality develops. However, if through “over-gratification” or “under-gratification”, conflicts are not resolved adequately specific traits and characters develop and continue through to adulthood. Therefore, Freud believed that the three early stages of development often brought individuals to counselling because there were not properly resolved (Pervin et al., 2005). According to Gladding (2000),”Counsellors who work psychoanalytically should understand at which stage a client is functioning because the stages are directly linked to the plan of treatment” (p.189). Children experience conflicts in different stages of development. In each stage, conflict centers on a different theme. In Freud’s oral sensory stage, which occurs from birth to one year, conflict at this point centers on feeding. Children in this stage want to eat things that the Ego tells them is not good for them.
Freud believed that some individuals do not pass this stage successfully and remained dependent and overly optimistic. Such people also find it hard to make intimate friends with others and fear loss which may be accompanied by ‘greed’ (Passer & Smith, 2007, p.443-445). Individuals who are considered to have an oral personality are usually narcissistic which means according to the DSM IV-TR “enduring pattern[s] of inner experience and behaviour” that are sufficiently rigid and deep-seated to bring a person into repeated conflicts with his or her social and occupational environment” (Barlow & Durand, 2005, p.445). In other words the individual is characterized by an inflated sense of self-importance, need for admiration, extreme self-involvement, and lack of empathy for others. However, this disorder is only diagnosed when these behaviours become persistent and very disabling or distressing (Barlow & Durand, 2005). In the second stage which is known as the anal stage and occurs in the second year of life, conflict centers on bowel training. In counseling this stage involves two phases, one is an aggressive phase.
This allows the client to share information that was stored up. The other phase is the retentive phase, where clients may hold on to their negative beliefs and attitudes until they are ready to release them. The reason for such behavior by clients is because they may find some pleasure in resisting and withholding this information (Garcia, 1995). The controversial “Oedipal complex” for boys or “Electra complex” for girls occurs in the phallic stage and happens around three to five years. This stage is seen by counselors as the phase of initiation and transition. According to Garcia (1995), “Counselors may act as initiators by providing appropriately challenging experiences within the scope of each individual’s potential for mastery” (p.499). Freud proposed children at this stage compete with the same sex parent for the affection of the opposite sex parent for example boys desire to have their mother but are prevented by the presence of their father (see Appendix 1).
Fear of punishment forces repression of such desires and consequently the superego is developed. To unsuccessfully go through this stage is believed to be associated with obsessive compulsive behaviours (Passer & Smith, 2007, p.446-447). Psychoanalysts pointed out several reasons why the Oedipal complex seem unreal to individuals. Firstly, individuals are unable to comprehend their own Oedipal complex when they were children and what was comprehended was energetically repressed almost as soon as individuals became aware of it. Secondly, individuals gradually accept their culture’s perception for their sexual and aggressive life (Klepp, 2008). In the Caribbean for example boys have more freedom than girls and they learn that they must become like their father, who is stereotypically aggressive, ambitious, powerful, and in direct contrast to his mother, who is stereotypically passive, obedient and nurturing and according to societal norms girls should also possess such traits. Therefore because of societal perspectives on an individual’s life, it is considered as the norm and is accepted for a man to possess more than one female.
However it is unorthodox and frowned upon for females to behave in this manner. The fourth stage which is known as the Latency occurs from age six years until puberty. In this stage sexual instincts are repressed and superego is fully developed. At this time clients may be initiating and cultivating new and transitional alliances outside of the helping relationship (Garcia, 1995). The fifth and last stage which is known as the genital stage begins with puberty and continues for the rest of adult life. Mature sexuality is the theme of this stage. This stage is also known as the definitive phase of the counseling process and marks the end of the counseling process and the beginning of its outcome which would be demonstrated over time (Garcia, 1995). Freud suggested strongly that personality was essentially established when the Oedipus and Electra complexes were successfully resolved (Hergenhahn & Olson, 2007, p.40-43).
Patients usually get in contact with a psychoanalytic counsellor when defences have failed and anxiety has developed. Therefore, the primary goal of counselling, within a psychoanalytic frame of reference, is to make the unconscious conscious. By doing so any material that is repressed is brought to the conscious level and can be dealt with (Wachtek & Messer, 1997). According to Freud (as cited in, Pervin, Cervone & John, 2005, p. 74-82), unhealthy individuals are unaware of the many factors that cause their behaviour and emotions and as a result these unconscious factors have the potential to produce unhappiness, which in turn is expressed through a score of distinguishable symptoms, including disturbing personality traits, difficulty in relating to others and disturbances in self-esteem or general disposition.
The counsellor employs a variety of techniques to tap into a patient’s unconscious such as free association, dream analysis, analysis of transference, analysis of resistance and interpretation. All these methods have the long-term goal of strengthening the ego (Gladding, 2000, p.192-194). Free association is a method that replaced hypnosis in Freud’s therapy. It consists of a patient speaking about any subject matter one basically abandons his or her customary conscious control over one’s behaviour and gives free verbal expression to every thought, feeling or impulse of which one becomes aware. Conclusions are then based on what was said and by doing this the counsellor is hoping that the client will abandon all normal forms of censoring, or editing their thoughts (Rieber, 2006).
An example of the use of free association is lying on a couch, in dim light and in a peaceful room, the patient produces the following free association: “I am thinking of the fluffy clouds I seem to see with my very eyes. They are white and pearly. The sky is full of clouds but a few azure patches can still be seen here and there…” (Ewen, 1992, p.57). Colby (1960) pointed out that, this technique often leads to some recollection of past experiences and at times a release of intense feelings such as catharsis that have been blocked but resistance may occur during free association (p.54-58).. This means that the patient is unable to recall traumatic past events. Therefore, one task of the counsellor would be to overcome resistance. Blocking or disruptions in associations serve as cues to anxiety arousing material. According to Grünbaum (1986), free association is not a valid method of accessing the patients’ repressed memories because there is no way of ensuring that the analyst is capable of distinguishing between the patients’ actual memories and imagined memories constructed due to the influence of the analyst’s leading questions (p. 226).
Another type of technique that is related to free association is transference. Pervin et al., (2005) stated that, “transference refers to a patient’s development of attitudes towards the counsellor based on attitudes held by that patient toward earlier parental figures” (p.129). In other words it is the client’s unconscious shifting to the counsellor of feelings and fantasies that are reactions to significant others in the patient’s past and present (Stefflre & Burks, 1979). This process is encouraged by the client reclining vulnerably on a couch, with the counsellor out of sight and remaining a “blank slate” as much as possible. At this time a parent child relationship is developed among client and counsellor and therefore transfers the patient’s old emotions with his or her actual parents unto the counsellor. This makes for an extremely difficult situation in which the counsellor has a huge amount of influence, which is necessary but requires care and restraint (Sue & Sue, 2007).
Freud initially believed transference was a hurdle in counselling. However, he eventually recognized that transference is a universal phenomenon and also occurs outside of the counselling session. But in order for the counselling section to produce change the transference relationship must be work through. Work through occurs after transference in the case of most learning, the insights gained through psychoanalytic counselling must be practiced to integrate them in one’s life. It other words it allows the client to understand the influence of the past on his or her present situation, to accept it emotionally as well as intellectually, and to use the new understanding to make changes in present life. By doing this the client will also learn to avoid repressing the material (Schaeffer, 1998; Ewen, 1992). Ewen (1992) pointed out, several disadvantages to the transference technique. Firstly, this technique can not be effectively applied to group counselling.
Secondly, “it is possible for the transference to become extremely negative as when powerful distrust or obstinacy is displaced from a castrating parent to counsellor” and the counsellor must be very careful not to aggravate deserved love or hate which would give the client a valid excuse for refusing to recognise and learn from the transference technique (p.59). Warwar & Greenberg (2000) discussed recent changes in psychoanalytic theory. Rather than presenting a problem, countertransference currently is considered to be a fundamental, useful component of the psychoanalytic counselling process, because it provides the counsellor with useful information about the counselling relationship (p.571-600). Countertransference occurs when the counsellor begins to project his or her own unresolved conflicts unto the client.
While transference of the client’s conflicts unto the counsellor is considered a healthy and normal part of psychoanalytic counselling, the counsellor’s job is to remain neutral as not to breech any of the ethical codes of counselling (Rosenberger & Hayes, 2002). Individuals are seen as being motivated by their past and present relationships, rather than by biological urges when this technique is in use, therefore the counselling relationship is seen as real. Thus client’s behaviour is not seen primarily as transference, but as responses in a current relationship. In addition, change is understood to be the result of the constructive emotional experience of the counselling relationship, rather than the result of insight. This new emphasis on the reality and importance of this type of relationship appears to be integrated into other approaches to counselling as well (Sue & Sue, 2007). Some criticisms of countertransference are that it can be damaging if not properly managed.
With proper monitoring, however, some sources show that counter-transference can play an important role. Counsellors are encouraged to pay close attention to their feelings in respect to this technique, and to seek peer review and supervisory guidance as needed. Rather than eliminating counter-transference altogether, the goal is to use those feelings productively rather than harmfully (Schaeffer, 1998). The basic method of psychoanalysis is interpretation. Brammer, Shostrum & Abrego (1989) states, “interpretation is an attempt by the counsellor to impart meaning to the client. Interpretation means presenting the client with a hypothesis about relationships or meanings among his or her behaviours” (p.175). In psychoanalytic counselling the counsellor is silent as much as possible, in order to encourage the patient’s free association and to interpret resistances and repressions that the client has not yet understood, but is capable of tolerating and incorporating, so as to better understand the unconscious conflicts that are interfering with daily functioning, such as phobias and depression (Clark, 1995).
Interpretations by the counsellor appear to be the critical variable in counselling success, along with client insight about underlying motivations, in order to achieve client goals. Therefore the goal of interpretation is to enable the ego to assimilate new material and to speed up the process of uncovering further unconscious materials (Wachtel & Messer, 1997). According to Clark (1995) Interpretation was rejected by critics as a valid technique because, “ it was perceived as undermining the counsellors relationship, minimizing or subverting client responsibility and restricting the counselling process to an intellectual endeavour” (p.486). Freud (as cited in Passer & Smith, 2007, p.170-172) saw dreams as the major source of insight into the unconscious and as very important. Dreams are seen as the “royal road to the unconscious” and are not literal in nature but symbolic. Dreams also consist of two levels of content the latent and manifest.
Dream Analysis is a very imperfect science, as there are many levels of distortion between the patient’s unconscious and the counsellor’s interpretation, bearing in mind, according to Freud, dreams are interpreted in terms of phallic meanings (Hergenhahn & Olson, 2007). For example it is amazing how many ordinary items can be interpreted as being a penis such as chair legs or a vagina such as purses. Each fragment of a dream leads quickly to the disclosure of unconscious memories and fantasies and then unto associations of other topics. Another technique that is involved in the psychoanalytic process of counselling is Analysis of resistance.
Although a client may feel the need to change and truly desire help for themselves through the counsellor many things can enter the picture to alter this change; these things are referred to as resistance. Resistance refers to any idea, attitude, feelings or action which can be conscious or unconscious that fosters the status quo and gets in the way of change. For example: missed or being late for appointments, rambling on about the economy or politics, any type of distraction that seems to keep the client from actually focusing on the real issues is considered resistance (Sue & Sue, 2007,p.98). According to Gladding “a counsellor’s analysis of resistance can assist clients gain insight to their situation and other behaviours (p.193). Psychoanalytic theory has been applied to counselling in terms of the assessment of personality. This theory is the underlining factor of the performance based or projective tests used in psychoanalytic counselling. These assessments assist counsellors in the analysis of individuals’ unconscious thoughts, motives, feelings, conflicts and repressed problems from early childhood.
These types of test generally have an unstructured response format, meaning that respondents are allowed to respond as much or as little as they like (free association) to a particular test stimulus, which is normally ambiguous (Pervin et al., 2005). The most common type of test used in this area includes the Rorschach Inkblot test. This test is a method used in psychological evaluation; it can be administered to children as young as three, adolescents and adults. This assessment tries to probe the unconscious minds of clients. The counsellor will show the subject a series of ten irregular but symmetrical inkblots and ask the client to identify the inkblot. As the patient is examining the inkblots the counsellor writes down everything the patient says or does, no matter how trivial the subject’s responses.
These responses are then analysed in various ways noting not only what was said but the time taken to respond and which aspect of the drawings was focused on. At this time if a client consistently sees the images as threatening and frightening the counsellor might infer that the subject may be suffering from paranoia. Major criticisms of this test include a lack or reliability and validity. Individuals who benefit the most from psychoanalytic counselling are those middle aged clients who are searching for a meaning to life (Pervin et al., 2005). The principal concepts of psychoanalytic counselling can be grouped as structural, dynamic, and developmental concepts. This theory is a method for learning about the mind and insights into whatever the human mind produces. It is a way of understanding the processes of everyday mental functioning and the stages of development (Sue & Sue, 2007). Freud’s approach is subject to several criticisms.
Firstly, it is too time consuming, expensive and generally ineffective to those who seek help from a psychoanalytic counsellor who has less disruptive developmental or situational problems and disorders. Secondly, techniques involved in psychoanalysis, such as Freud’s ideas on the interpretation of dreams and the role of free association, have been criticized. For instance, one counsellor may observe one phenomenon and interpret it one way, whereas another counsellor will observe the same phenomenon and interpret it in a completely different way that is contradictory to the first psychoanalyst’s interpretation (Stefflre & Burks, 1979). Despite the weaknesses of psychoanalysis, there are many strengths of the theory that are extremely significant.
It offers an empathetic and non-judgemental environment where the client can feel safe in revealing feelings or actions that have led to stress or tension in his or her life. It also lends itself to empirical studies and provides a theoretical base support for a number of diagnostic tests (Gladding, 2000, p.194-195).Therefore, the psychoanalysis is a theory that should not be disregarded. Although it was developed a long time ago it is still applicable and an effective method of treating mental disorders such as paranoia, schizophrenia and obsessive compulsive reactions in today’s societies. In addition, a good theory, according to many philosophers of science, is falsifiable, able to be generalized, leads to the development of new psychological theories and hypotheses. Psychoanalysis meets many of these criteria (Klepp, 2008).
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