1. NEOANALYTIC APPROACHES Chapter 3
INDIVIDUAL THERAPY
SSIT311
2015

2. EGO PSYCHOLOGY OVERVIEW AND CENTRAL CONSTRUCTS
Origins: Anna Freud (analysed by her father).
Known as one of the developers of child psychoanalysis and for her work on the development of theory about defenses.
Dominated American psychoanalysis for many decades.
Other important theorists: Heinz Hartmann and Margaret Mahler

3. Closely related to Freudian psychoanalysis, but drew more attention to the adaptive and defensive functions of the ego.
Retains the structural model of the mind (id, ego and superego), but instead of emphasising the instincts (id functioning), it emphasises the crucial role of the ego.
Ego is an independent psychic agency which develops on its own, not out of the need to curb id impulses (Freud: ego develops out of the id).

4. Interested in the ego’s executive and synthesising functions (linked to cognitive functioning/reality testing/defenses).
How does the ego organise incoming information and adapt to the environment (e.g. finding socially sanctioned ways to meet id and superego demands)
Ego has its own source of energy (separate from id) – derives from modifying instinctual energy into ego energy = neutralization

5. Introduced new defences:
Defenses: Anna Freud – identified three kinds of danger to the ego for which defenses are employed:
Wrath of the superego
The threat of the drives
Dangers of the outside world
Introduced new defences:
Identification with the aggressor: becoming like the feared object

6. Asceticism: renouncing all desire/pleasure (usually in response to threat of sexual desires)
Altruistic surrender: fulfilling one’s own desires by meeting the needs of others
Turning against the self: redirecting threatening impulses aginst the self rather than others
Isolation: removing feelings or meaning from events
Undoing: using rituals to cancel out threatening thoughts or behaviors (OCD)

7. Conflict free sphere: Hartmann
Not all psychological functioning is in relation to conflict between the id, ego, superego and the outside world
There are some types of ego functioning which are distinct from the id and superego, such as thinking, perception, memory and learning.
Average acceptable environment: Hartmann
Refers to the kind of environment in which the infant is able to develop normally. If the average acceptable environment is in place, then the infant, who is born with the capacity to adapt and use the environment, will develop in healthy ways.

8. HEALTH AND DYSFUNCTION
The quality of early stages of life and the adequacy of the environment are important for development.
Compromise formations: conflict is found in the interplay between four psychic motivations: needs of the drives (id); the demands of the superego; ego’s adaptation to reality and the ego’s needs to avoid or minimise anxiety and depression.

9. OBJECT RELATIONS
Based on research and direct observation of the behaviour between mothers and their babies.
Interpersonal relationships represented intrapsychically (internally).
Move away from instincts to focus on nature and quality of relationships, particularly early relationships.
Centre on early developmental sequences – early experience of the self shifts in relation to awareness of the other.
Self/other patterns influence later relationships.

10. Melanie Klein
Developed psychoanalytic theory
through her psychoanalysis of children.
Discovered that children’s anxieties and
conflicts arose due to the nature of the relationship they had with adults (both real and imagined). For Klein it was the imagined or phantasy relationship with internal objects that played a crucial role in early development.
Construct image of what the inner life of an infant is like.
This inner world is dominated by strong impulses and emotions in response to the actions of external ‘objects’ (the mother/father/primary caregiver) that become internalised .

11. Two positions involved in development: Paranoid-schizoid Position
Baby in first months experiences the mother as a “part-object” – breast (early relationship is centred around feeding).
This part object is experienced as a ‘good’ or ‘bad’ object.
The infant splits ‘good’ and ‘bad’ object in order to protect the one from the other.
With time, the infant begins to perceive that the ‘good’ and ‘bad’ object are one and the same.

12. Depressive Position
With the realisation that the ‘good’ and ‘bad’ part-object are actually part of the same object (whole-object) comes sadness, despair and anxiety of what might have been done to the object – reparation and empathy.
Sense of loss and separation – recognises the separateness of the mother – whole-object relating.  

13. Donald Winnicott
Was originally a Paediatrician. Therefore had keen insight into the relationship between mothers and their babies.
“There is no such thing as a baby” – there is always a baby and a mother. Without a mother, there would be no baby – highlights the importance of the real relationship between infant and mother.
Introduced the concept of the “good-enough” mother as necessary for healthy emotional development – holding environment.
Also introduced the concept of “transitional objects” and the therapeutic space as a transitional space in which clients could rediscover a sense of playfulness.

14. HEALTH AND DYSFUNCTION
Healthy individual as good object relations – coherent sense of self and inner drives do not significantly distort current relationships.
Do not have split internal objects (good/bad), but rather have whole object relating.

15. PROCESS OF THERAPY AND TECHNIQUES
Countertransference: this is the therapist’s feelings in relation to the client – might originate in the therapist or it might be in response to projections from the client. Provides useful diagnositic information, as well as insight into object relations.
Providing a holding environment is seen as therapeutic in itself (Winnicott). The client, who is developmentally stuck at the stage where parenting failed, can get unstuck and move forward.