1. 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)

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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)

8. 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

9. 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)

10. 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

11. 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