Hockenbury Discovering Psychology 5th txtbk

Psychoanalytic Therapy583Freud’s Famous Couch During psychoanalyticsessions, Freud’s patients would lie onthe couch. Freud himself sat at the head ofthe couch, out of the patient’s view. Freudbelieved that this arrangement encouragedthe patient’s free flow of thoughts, feelings,and images. Although some traditionalpsychoanalysts still have the patientlie on a couch, many psychoanalysts todayfavor comfortable chairs on which analystand patient sit, facing each other.Blocks in free association, such as a sudden silence or an abrupt change of topic,were thought to be signs of resistance. Resistance is the patient’s conscious or unconsciousattempts to block the process of revealing repressed memories and conflicts(Luborsky & Barrett, 2006). Resistance is a sign that the patient is uncomfortablyclose to uncovering psychologically threatening material.Dream interpretation is another important psychoanalytic technique. Becausepsychological defenses are reduced during sleep, Freud (1911) believed that unconsciousconflicts and repressed impulses were expressed symbolically in dream images.Often, the dream images were used to trigger free associations that might shed lighton the dream’s symbolic meaning.More directly, the psychoanalyst sometimes makes carefully timed interpretations,explanations of the unconscious meaning of the patient’s behavior, thoughts,feelings, or dreams. The timing of such interpretations is important. If an interpretationis offered before the patient is psychologically ready to confront an issue, shemay reject the interpretation or respond defensively, increasing resistance (Prochaska& Norcross, 2010).One of the most important processes that occurs in the relationship between thepatient and the psychoanalyst is called transference. Transference occurs when thepatient unconsciously responds to the therapist as though the therapist were a significantperson in the patient’s life, often a parent. As Freud (1940) explained, “Thepatient sees in his analyst the return—the reincarnation—of some important figureout of his childhood or past, and consequently transfers on to him the feelings andreactions that undoubtedly applied to this model.”The psychoanalyst encourages transference by purposely remaining as neutral aspossible. In other words, the psychoanalyst does not reveal personal feelings, takesides, make judgments, or actively advise the patient. This therapeutic neutrality isdesigned to produce “optimal frustration” so that the patient transfers and projectsunresolved conflicts onto the psychoanalyst (Magnavita, 2008).As the transference becomes more intense, the patient relives unconscious emotionalconflicts that have been repressed since childhood. Only now, these conflictsare being relived and played out in the context of the relationship between the psychoanalystand the patient.All of these psychoanalytic techniques are designed to help the patient see how pastconflicts influence her current behavior and relationships, including her relationshipwith the psychoanalyst. Once these kinds of insights are achieved, the psychoanalysthelps the patient work through and resolve long-standing conflicts. As resolutions occur,maladaptive behavior patterns that were previously driven by unconscious conflictscan be replaced with more adaptive emotional and behavioral patterns.The intensive relationship between the patient and the psychoanalyst takes time todevelop. The traditional psychoanalyst sees the patient three times a week or more,often for years (Schwartz, 2003; Zusman & others, 2007). Freud’s patients were onthe couch six days a week (Liff, 1992). Obviously, traditional psychoanalysis is a slow,expensive process that few people can afford. For those who have the time and themoney, traditional psychoanalysis is still available.The resistance accompanies thetreatment step by step. Every singleassociation, every act of the personunder treatment must reckon with theresistance and represents acompromise between the forces thatare striving towards recovery andopposing ones.—SIGMUND FREUD (1912)psychoanalysisA type of psychotherapy originated bySigmund Freud in which free association,dream interpretation, and analysis of resistanceand transference are used to explorerepressed or unconscious impulses, anxieties,and internal conflicts.free associationA technique used in psychoanalysis in whichthe patient spontaneously reports all thoughts,feelings, and mental images as they cometo mind, as a way of revealing unconsciousthoughts and emotions.resistanceIn psychoanalysis, the patient’s unconsciousattempts to block the revelation of repressedmemories and conflicts.dream interpretationA technique used in psychoanalysis in whichthe content of dreams is analyzed for disguisedor symbolic wishes, meanings, andmotivations.interpretationA technique used in psychoanalysis in whichthe psychoanalyst offers a carefully timedexplanation of the patient’s dreams, freeassociations, or behaviors to facilitate therecognition of unconscious conflicts ormotivations.transferenceIn psychoanalysis, the process by whichemotions and desires originally associatedwith a significant person in the patient’s life,such as a parent, are unconsciously transferredto the psychoanalyst.