An Introduction to the Basic Psychoanalytic Model Learning about psychoanalysis Developmental psychopathology—study of the origins and course of individual patterns of maladaptation (Sroufe & Rutter, 1984) Psychoanalysis—understanding of the psychological processes that underlie continuity and change in patterns of adaptation or maladaptation Psychoanalytic view of development—active, dynamic process Individuals attribute meaning to experience Attributed meanings alter the consequences Developmental ideas explain maladaptive pathways through life Psychoanalytic understanding of the mind is relevant to cognitive-behavioral therapy (CBT) and humanistic therapy as well as psychodynamic therapy (PDT)

An Introduction to the Basic Psychoanalytic Model The basic assumptions of psychoanalysis Psychic determinism—representation of past experience (its interpretation and meaning, conscious or unconscious) determines individual’s reaction to his or her external world and capacity to adapt to it (transference) Unconscious mental processes Responsible for conscious thinking and behavior Associated with wishes for instinctual gratification or safety (i.e., secure base) Responsible for affect regulation Responsible for the ability to cope with social environment Unconscious ideas  emotional states  organization of mental functions Experience of self with others is internalized, creating representational structures of interpersonal interactions

An Introduction to the Basic Psychoanalytic Model Psychic conflict is ubiquitous, causing unpleasure or lack of safety Adverse childhood experiences can exacerbate psychic conflict Reduction of capacity to resolve conflict Unconscious wishes unacceptable to conscious thought are modified through a developmental hierarchy of defense mechanisms Hierarchy reflects degree of pathology More severe pathology = developmentally earlier defensive processes Communication and symptoms carry multiple meanings Behavior and symptoms can be viewed as irrational and rational Multiple meanings reflect the existence of multiple mental representations

An Introduction to the Basic Psychoanalytic Model Focus of therapy—relationship to therapist Transference—transference of repudiated aspects of self or past or current relationships Exploration of role relationships—understood most deeply through transference Individual exists in the context of environment, past relationships, and adaptations to both Therapeutic relationship creates the possibility of reintegration of internal world Therapeutic relationship produces a healthy resolution of past conflict and reparation of deficits The assumption of developmental continuity Developmental point of view permeates psychoanalytic theory Disorders of the mind = residues of childhood experiences and primitive modes of mental functioning All psychoanalytic theories clearly articulate a developmental theory of psychopathology

An Introduction to the Basic Psychoanalytic Model The developmental approach to psychopathology Developmental continuity—”empirically elusive and conceptually complex problem” (p. 6) Concern with the creation of the individual’s psychological world over the course of childhood General critiques of psychoanalytic theory The evidential basis of theories Use of indirect, clinical evidence as only form of validation Emphasis on abnormal rather than normal development Psychoanalytic variables are difficult to operationalize Problem of generalizing from individual cases (e.g., Oedipus complex) Clinical data can build theories but not distinguish good from bad theories (i.e., validation) Data-gathering methods can change the object of observation

An Introduction to the Basic Psychoanalytic Model The assumption of uniformity There is a one-to-one correspondence between childhood experience and adult psychopathology (too facile) Psychoanalysis needs to pay more attention to cases that do not fit the theory Alternative psychoanalytic accounts—no comparison of theoretical accounts of clinical observations The stance toward the environment Tendency to view the origin of psychopathology as endogenous and genetically inherited (e.g., Freud, Klein) or maternally caused (e.g., Kohut, Bowlby, Stern) Transactional approach (bidirectional influences) is more contemporary view Lack of attention to cultural forces

An Introduction to the Basic Psychoanalytic Model Issues of gender: the feminist critique Phallocentric vision of feminine development Weak superego, dependency of women Emphasis on penis envy in women Mature women’s sexuality is naturally passive and masochistic Vision of women as ruled by biological urges and condemned to serve men Clitoral orgasms = immaturity and hypermasculinity Reduction in the importance of women’s accounts of childhood sexual abuse Lack of specificity Nonspecific explanations for different forms of psychopathology Lack of explanation for varying prevalence of disorders across the lifespan (e.g., crime wave peak in late adolescence)

An Introduction to the Basic Psychoanalytic Model The weakness of the developmental perspective Unjustified confidence in tracing particular forms of psychopathology to specific phases (e.g., BPD to rapprochement subphase) Overemphasis on early experience Tendency to adultomorphize infancy (e.g., autistic, symbiotic phases) Trauma, reconstruction, memories, and fantasies Knowability of reality beyond the mind Narrative truth versus veridical truth An overview of psychoanalytic theory Freud and drive theory Recognition of infantile sexuality Struggle to become acceptable to society

An Introduction to the Basic Psychoanalytic Model Ego psychology Evolution of child’s adaptive capacities Focus on ego functioning in struggle with biological needs Genetic endowment and interpersonal experience both critical in determining child’s developmental path Mahler and American object relations theory Developing separate identity means giving up highly gratifying closeness with caregiver (safety) Caregivers facilitate this separation/individuation process Melanie Klein’s British object relations theory Splitting objects into all good and all bad parts Close control that primitive mental function can exert over therapist’s mind (projective identification)

An Introduction to the Basic Psychoanalytic Model Independent school of British object relations “False self”—defensive structure created to master trauma Traumatic effects of early maternal failure, particularly depression Kohut, Kernberg, and American object relations theory Narcissistic personality disorder (NPD) Borderline personality disorder (BPD) Interpersonal/relational theory Therapist-patient relationship more egalitarian Therapists also participate in transference and enactments John Bowlby and attachment theory Child develops expectations regarding caregiver’s behavior and his or her own behavior Internal working models are intergenerationally transmitted

An Introduction to the Basic Psychoanalytic Model Peter Fonagy/Mary Target and mentalization theory Child develops capacity to interpret one’s own and others’ behaviors as the product of mental states (e.g., feelings, beliefs, intentions) The development or use of mentalization can fail under certain environmental conditions