An introduction to Psychoanalysis

this will be a rather subjective introduction to psychoanalysis I will try to show you the points I consider most important many other people will not agree with me I'm sure some might be in the audience and then hopefully we will discuss after I finish so the introduction to psychoanalysis is based on the idea of basic concepts today and then in a month we will discuss the fundamental psychoanalytic cases starting with the one I will be mentioning today the famous honor or case and then going somewhere toward the 1970s so how do these basic concepts relate to the clinical practice of psychoanalysts the basic concepts I will try to discuss today we'll all in all be 6 and hopefully you will find them somehow useful and interesting the first one of them historically the first one and the revolutionary concept of psychoanalysis is the idea that mental disorders have meaning so this is from Foucault from the history of madness that for thousands of years psychiatry was a monologue of reason about matters if you look at literature if you look at testimonies books whatever until the second half of the 19th century you will never find except for a very very few single-digit number exceptions of people we would call psychiatric patients today who are writing their memoir their experiences their testimonies of what it looks like I will try briefly to show you what the world looked like before psychoanalysis hopefully you will appreciate living in this age and having psychoanalysis at your disposal more this is a drawing a sketch by Hieronymus Bosch for the ship of fools a rather famous oil painting the ship of fools is a very important motif in the Central Europe and in England until probably the 15th century whoever you have in your town that you don't want people we would call psychotic today beggars homeless prostitutes infected with this or that disease tuberculosis especially plague at certain moments you put them on a ship you set the ship on sale downstream from your town or to the Stute to the sea or the ocean and then you can forget about them that is the attitude we have toward these people until probably 1450 or something just get rid of them send them out of your community I hope you can read this the reason for me to offer you this quotation is twofold this is from Thomas Moore the author of utopia the year is 1533 so so the mid 16th century it says literally did a certain psychotic person had therefore been put up in bedlam that that's the first psychiatric hospital that was founded in London and afterward by beating and correction gathered his remembrance so that is the basic form of treatment we have for psychotic persons in the mid 16th century beating and correction as soon as he was set free and could walk around Moore says his old fancies began to fall again in his head so the conclusion I believe you should make his unless you beat him and you put him in a sort of a prison hospital you can only expect trouble very soon the English publication of this book is translation from Latin the guy is English Bartholomew anglich use tells you that he is from England the book is published in Paris in 1595 in Latin and then translated into English so deep in the 16th century there is a belief that there are four basic humors running through your body and which one is prevalent decides on how you're going to feel and if any of them is so to say too prevalent then you will suffer from that mental disorder so in this case portal mute discusses melancholy and says if you have most of this humor in your body then this will be the signs of the symptoms of the disorder first the color of your skin will change into black and blue then what you will feel in your mouth will change into sharp earthy feeling and then you will be faint fearful in your heart without reason and very often sad some people suffering from that dread that other people will be their enemies and some love and desire death so that's a description with which we come to the age of Shakespeare the early modern period and if you can read this I hope you can you can see what the English language look like at that time it to me is hilarious this is a book from 1586 by a person called him to bright who wrote the first book claiming that depression melancholy is a disease like other diseases that it doesn't have anything to do with demons which is that it is not the thing for priests and exorcists but for the world of medicine this is 1730's Hoggart famous rakes progress a visit to bedlam to the london-based hospital and there you can see people in chains here is one who's delusional and believes to be Pope here is one who's delusional believes to be an artist and here is the upper-class London citizens who come there to visit on Sundays they pay entrance to get a ticket we would say today in order to be able to enter and then see people here chains in prison like circumstances this is believe it or not 1860 so Freud is already born psychoanalysis is not that far away in a psychiatric hospital in the United States they've made a list of causes for mental diseases of 193 they very honestly say 456 they have no idea where the disease came from but they are wonderful reasons again I hope you can read them my favorite one is intense study but there's also three times loss of children two times loss of wife and one time loss of a husband so make your conclusions if you will there is for instance in one case sudden cessation of bleeding from the nose how that causes insanity I have no idea this is the second half the beginning of the second half of the 20th century this procedure was called lobotomy this is the person who came up with this wonderful idea to take a needle or a nail or a spike put it under the eyelid then use this hammer that doctors used to test your reflexes and the knocked needle or whatever he has here in his hand under your bone and then to do several times left to right so that he can cut between the frontal and prefrontal parts of your cortex with all consequences for the other parts of the brain bleeding and so on and so on thousands of people were in this situation several persons holding your hand holding your body even more persons watching what is going on what is happening to you yet no one asks you how you feel what you want or anything else deep into the 20th century but there say even nowadays in many situations no one asks patients what they would like to say the different strand in the world of mental health care in a way starts with this person this is jean-martin charcot and this is the famous Paris based Hospital Salpetriere again they are Paris intellectual observing the scene they're interested in what is going on there is a female patient they call them hysterics agents and what Charcot is doing he's using hypnosis this woman may have various sorts of symptoms and Charcot is the first to figure out when he puts her under hypnosis symptoms disappear when he gives her a suggestion that for instance for half an hour after waking up from hypnosis she does something and doesn't do something she will follow the instruction and have no idea why so still Charcot is not really talking to the patient but he figures out there is something in us we have no control of that influences our behavior and our mental disorders the true revolution starts with this person her real name was better poppin hime she lived in Vienna and then later on in western Germany near Frankfurt and she was treated in Vienna as a young girl young woman by a medical doctor whose name was Joseph Freud and Breuer was a very well known medical doctor in Vienna at that time used whatever was at his disposal to try to treat her symptoms and one day this patient told him of all you're trying to do what helps me best is that you let me talk when you let me talk as much as I want after that I feel better so Breuer started doing that coming yet at that time doctors would visit patients at home coming to her house at the end of his working day and letting her talk as much as she wants and whatever she wants to talk about for a certain reason that that is not clear at least not clear to me for a certain time she wouldn't speak German she would speak English only that's 1870s English was not nearly as popular as it is nowadays and she came up with these two expressions talking cuher was what helped her most and chimney sweeping I think nowadays the more popular expression for that would be venting out so she told Rohr as long as he would apply his talking cure instead of Bath's and exercise and diets and so on and as soon as talk would help her vent out she would feel better I think this is this is definitely the beginning of psychoanalysis however you want to define psychoanalysis and this is also a very important lesson that whatever is most important will learn from patients out of this came book published in 1895 where Breuer is author of the major part of the book and Freud contributed just one clinical case and this is in the studying of psychoanalysis point zero the first book the first publication that is really psychoanalytic yes Freud wrote about these things before some other people wrote about that this is like the major turning point the case of Anna always described in the book not historically very accurately and one very important idea coming out of the book that will end the friendship and collaboration between Breuer and Freud is Freud's insistence on the repressed sexuality being the cause of mental disorders Breuer it seems was less ambitious more friendly and more open to simply talking to patients and learning from them Freud seems to be more ambitious and more focused on his discovery however that not all we can learn from that book my concept number two is that the meaning of mental disorders psychoanalysis claims is unconscious the reason someone is disorder the reason you may have a symptom or a disorder is unconscious you are not aware of it you cannot figure it out on your own and you cannot change it on your own so in the case that I just mentioned Brewer noticed that when his patient would understand connect what happened in the past with the symptom of today things would change and symptoms would disappear probably the most obvious detail about this Ana [ __ ] had trouble drinking water she suffered from he might called hydrophobia everyone was worried about it it's obvious how important water is and so on but there was no reason there was no way to influence her and change anything one day as she was talking and talking and talking she stumbled upon so to say a memory of seeing a dog drink water from a glass that was put on the floor and she remembered how disgusted she were of that and how water became disgusting because of that and immediately Brewer says as she remembered the fear and the disgust disappeared and she could start drinking water again so the basic idea of early psychoanalysis is that as soon as you discover the unconscious meaning of the symptom or the repressed traumatic incident that led to the symptom the symptom will disappear that is the beginning of the science I don't know whether you can recognize this illustration here it is like a set for the dream scene from Hitchcock's movie spellbound if you watch Hitchcock this is probably I think early 1950s black and whites probably not very popular nowadays but several movies are based on this idea the solution for the crime will come through the psychoanalytic exploration of the symptoms and when the main character remembers how the symptoms began that will solve his neurotic disorder and that will solve the murder mystery psychoanalysis is not a discipline psychoanalyst sir not people who have discovered the concept of the N countries here is just one example this person here was a rather well-known philosopher of the mid 19th century one german university nowadays has his name in Giessen or one of the smaller cities and these are some of the things he wrote at the time when Freud was ten or twelve years old and when no one like younger Ferentz your mental decline were even born the key to the conscious life lives lies in the unconscious one there is absolute partly in secondary encounters the unconscious knows only now its tireless it's always moving it has its own rules absolutely determined it does not know any learning it does not make any mistakes consciousness borrows energy and health from the unconscious and I believe you will very soon see how this is all ingrained in Freud's theory when you retreat everything is there when you reach Roddick and Jung I think even more what is the contribution of psychoanalysis then if psychoanalyst did not discover the unconscious here are several ways how psychoanalysis as a method of study can in a way prove that the unconscious exists for us nowadays that may not be such a big point although if you discuss this with cognitive psychologists it may still be contended contested the first point which Freud considered the Royal Road to the unconscious is dreams you wake up in the morning and you are sure there were some images in your mind while you were asleep you have no idea where they where they came from you have no idea what they might mean you cannot influence them you cannot make them appear again or you cannot stop them from appearing the next night again and psychoanalysts believe if you focus on analyzing those you will learn a lot about yourself the second one is I mentioned post hypnotic suggestion someone hypnotizes you and tells you like you may have seen that in Woody Allen movies you wake up from the hypnosis and then every time you hear a certain word you start behaving in a completely rational way then Freud's famous book psychopathology of everyday life how you may make slips in talking writing remembering something you cannot remember your mother's name or her birthday you cannot remember a friend's name and it turns out you had a quarrel several days ago you want to write something and all of a sudden the word is not there that you need and so on Freud wrote the book to prove that these slips are not accidental but unconsciously motivated then narratives may be incoherent someone asks you to tell something about your childhood and you can very fluently easily talk about some memories and then you come to the moment of a loss or a separation from an important figure and that is very difficult to talk about and you see that there are something from the unconscious influencing you there is a mechanism Freud described in great detail negation when you're trying to say that something is not important by saying the first thing someone asks you what might be important about that and the first thing you say well this definitely is not important so by saying it's not you actually say that unconsciously you know it is then things that you have repressed and symptoms like this is probably not not the best illustration of the PTSD related symptom of returning the memories and and and scenes from the traumatic incident so you see that in the night during the dream or in the day you are like brought back to the moment when something horrible happened you feel you're at that place you feel you are surrounded by those people you feel actually at that moment something horrible is going on there is no way for it to be brought in to you from the outside it obviously was somewhere in the unconscious and by some trigger made relevant again so I assume many movies for instance about Vietnam War show that as as a clear illustration so we believe by now that we have several ways to prove that the unconscious exists and more moreover that the unconscious influences us and it is an important factor when it comes to our current decisions and choices and what we what we want to do or say at a certain moment there are several models in the world of psychoanalysis that should tell us what the unconscious is this is the famous iceberg metaphor it is supposed to show that what you can see on the above and what is your conscious mind is very limited and has very little influence when it comes to where this iceberg is going to move and whether it's going to move at all the at conscious mind is this huge part below the surface that you cannot see that you may be completely unaware of but that influence is your life incomparably more powerfully than the conscious mind can how did we come to the idea that the unconscious can be something we can talk about in Psychological terms if you think again about the dog and water in the case of a know the question you may raise you where were the memories in the meantime something horrible happens you'll forget about it you develop symptoms but where does the memory disappear and where from does it appear again so one of the ideas about the unconscious was that it's like a huge Depot a huge storage space where you put whatever you don't want to think about whatever you don't want to be aware of and now the revolutionary idea described at the beginning of the 20th century is the idea of the dynamic unconscious so before roughly the year 1900 and conscious was described in many ways but it was never clearly shown that the unconscious actually influences the conscious that these are not just two descriptions of two spaces so to say that exist in parallel but this one influences this one very strongly and then psychoanalyst try to describe how through which mechanisms and then what can we do about that in the early 1920s this is the structural model that was offered as an explanation of what the unconscious looks like what it consists of that is nowadays still very influential in the world of psychoanalysis it is supposed to consist of three instances one completely unconscious where our drives and our biological makeup is one partly conscious but mostly unconscious the ego your eye the instance that's trying to negotiate with the social environment and the inner environment and try to find a plan as to how life may might go on and the super-ego where your conscious your ideals your preferences are this one tells you all the time that satisfaction should arrive immediately and this one tells you all time that satisfaction is not ethical decent polite good prepared at that moment and so on and so on so there is a lot of pressure on the ego from one too and then the the external environment has the third tyrant so to say the two models overlap to a certain extent but not to much the basic facts about the unconscious when it comes to psychoanalysis is conflict however psychoanalysts may differ in their understanding of the unconscious they always think there is a conflict in there if some of you studied psychology you may remember the story about the humanistic psychology as a reaction to this dark side of psychoanalysis and a psychological model that is conflict free where people are understood to be able to live without the conflict not so in psychoanalysis so there are various types of conflicts that psychoanalyst have tried to describe as I've mentioned a minute before the unconscious against the countries then memories or representations that are indica in the unconscious that are trying to return from this zone repressed but there is the censorship barrier which will not allow the memories or the images to return to the consciousness so that's another form of conflict so then there's drives as I mentioned in prohibitions you'd like all of the toys to be yours and your parents will not allow you you'd like all of the Nutella that exists in the world to be yours but your parents hopefully will not allow you then there's drives and defense mechanisms like repression rationalization denial and so on in the opinion of some psychoanalyst defense mechanisms exist to somehow put drives under a little bit of control drives are always more powerful but defenses are trying some to deal with them there is a very important description of two basic principles that govern the human mind one being the pleasure principle the principle that want satisfaction immediately and the other being the reality principle which says okay let's consider the circumstances let's make a plan and then let's see what we can get what is realistic to expect at this moment Freud described those in 1911 and probably 80 years later or about 80 or 90 years later I don't know the exact year one now very famous person won the Nobel Prize for economy by describing a dual process theory where there are two principles which to my mind and I believe some other people would agree sound completely the same as for it has described them here then there is the idea of drives being in conflict among themselves in the end Freud believed there were to some other psychoanalysts believe there were more in the beginning Freud also believed there were more one that was constant in the thinking of psychoanalyst is libido the sexual drive and then several other drives were supposed to oppose it while in the end Freud who described the conflict between libido and death drive there are many other ideas like drive towards knowledge curiosity and so on and and many other ideas later on if you look at psychoanalytic descriptions of what is the basic thing you will find in the unconscious then I believe there are four different conceptions this is like a chronological organization of it the first one was that if you'd be able to look into the unconscious of every human being Freud believed anywhere in the world what you'd find there is basically sexuality and we'll Freud like to call Oedipus complex a child in the age between three and five all of a sudden having very very tender feelings for the parent of the opposite gender and feeling rivalry or jealousy or hate toward the parent of the same gender and this triangular situation where the child has completely different emotions in attitudes toward different parents and is aware that parents have a relationship of their own completely different than the relationship the child has been with either of them is something psychoanalysis in the early decades thought was the basic pattern of our countries a hugely important discovery at that time that made psychoanalysis both famous and notorious and also a limiting attitudes because there's most probably so much else in the unconscious the second point is that if you'd be able to look at the unconscious what you'd see is destruction you would find the death drive not just as a metaphor not just as a poetic or philosophical notion but it's something that is a part of your organism and your psyche that is working all the time that is making you aggressive or afraid and that you don't know what to do about especially when you're very small in the domain of child psychoanalysis there were descriptions of object relations and defenses small children must use because the death drive is working all the time and they're not strong enough psychologically to defend from it this is another very controversial point in the world of psychoanalysis because probably at least one half of the psychoanalytic community does not consider death drive to be something realistic while the other one considers it to be the focal point of everything the third possibility is that when you look in the unconscious what you will find is that humans per definition are dependent on other people in bad circumstances or with bad outcomes on substances that we cannot survive survive without the others and that there are many different psychological mechanisms we are using in order to gain something from other people to attract them to communication to develop this communication and so on but that until the end of our lives we are never completely independent hopefully as adults we will not be as dependent as we were in childhood or in infancy but we will always need other people in order to be human beings and finally the most recent formulation that I'm aware of is the idea that the unconscious is just a set of unform elated experiences things were happening to you you didn't know what to do with them either they were too fast or they were too painful or no one told you no and showed you how to deal with them and then being unform elated and spoken and not introduced into a dialogue with other people they remain remain in fog they remain unform elated and you don't know what to do with them here the unconscious is not a space where you're putting something it is not a part of your personality these are just experiences you had no idea what to with I'm moving too to the concept number three and that's interpreting this is now not how psychoanalysts understand what we are made of this is how psychoanalysts hope to be able to work the basic idea is that you cannot be cured by operations or medication or baths or diet or whatever you can be cured only by gaining insight into what truth is so as long as you don't know the reasons for your suffering the suffering will not go away the way to treat that is to fight against forgetting neurotic suffer from the forgetting psychoanalytic treatment should help them remember what happened understand how that influenced their life and then the problem will disappear as long as you cannot remember you will have to repeat you may divorce but each time you will marry the same psychological type of person you may get rid of one addiction but you will immediately find the next one you may get rid of one type of symptoms but immediately other symptoms will appear there is a distinction a dichotomy in the world of psychoanalysis between thinking and action in my opinion this is overemphasized but psychoanalysts believe that what should happen in the treatment is that you think and you try to help your client start thinking but it you should not should do nothing you should not be active in any way you just think and you just say what is the result of your thoughts the truth in the case of mental disorders and symptoms is not something the person can achieve on their own otherwise they wouldn't come for treatment otherwise there wouldn't be a major complaint the task of the psychoanalyst is to provide this truth to the patient and then as a consequence of that the patient will gain an insight into the unconscious conditions and constellations the insight is not me cognitive understanding is it not it is not like the explanation of a theory even a theory in psychoanalysis it is something that is followed by the emotional side of it which shows you in a way not cognitive maybe not verbal that this is something important I have just realized something important there is something special in this moment of realization this has led to psychoanalysis for a long time being actually a talking cure where the importance of words of interpretations was extremely high I believe again this is overemphasized for a long period of the development of psychoanalysis and sometimes even being in silence together or actually doing small things for the client may be as beneficial or more beneficial than the actual words this is the basic rule of psychoanalysis this is where everything starts when it comes to the clinical situation one most important thing that is required of the client is to speak his or her mind this is the the free association idea so this is one of the formulations that can be varied in different ways to please say everything that comes to your mind no matter if it may seem to you irrelevant embarrassing or stupid so the client is invited most often to be on the couch and just speak his or her mind say whatever comes to their mind if it seems completely irrelevant we believe in the end we are going to discover that there is an unconscious chained and unconscious red thread that collects that that connects all of those the basic theoretical idea behind this is that we need to reassociate what Troma has dissociated so like honor all talk in talking and talking hopefully the client will stumble upon something that's very important and hopefully the analyst will be listening carefully enough to be able to understand which moments are important there are believe it or not various books devoted to the issue of the analytic listening how it's different than other forms of listening initially in the world of psychoanalysis the basic recommendation was that the analyst should be like a blank screen mostly silent one influential psychoanalyst wrote in a book that I think was published 1949 psychoanalytic treatment starts when the patient realizes not only that the analyst is silent but that the analyst is going to remain silent and then the unconscious hopefully of the patient will start working and expressing itself and as long as the analyst is like a blank screen whatever is on the screen will be the projection of the unconscious world of the patient and then we will be able to understand it observe it see it understand it and interpret it these are some of the details about how psychoanalytic interpretations should be used one of the things I would like to emphasize in the world of classical psychoanalysis probably until 1960s and 1970s these were the only thing psychoanalyst would say interpretations many psychoanalyst around the globe would not say good morning or have a nice weekend or anything of the kind and interpretation sometimes would be one precession one per week the analyst would be there but as you may have seen psychoanalysis portrayed in movies or caricatures psychoanalyst mostly used to sit in silence and provide these cherished interpretations only from time to time interpretations are what you act is most in your supervisions especially in your first control case the the art of interpretation how to find the exact moment when the interpretation should be provided how to phrase it and so on and so on is something you practice for years and probably even after you finish with your supervisions you practice it for life psychoanalysts have tried to interpret everything I cannot think of any form of human activity that psychoanalyst did not write at least one paper so dreams Arts Society various cultural products Wars and politics on one side and then consumer society or Facebook and similar things and then many of the things psychoanalyst see as being opposite to what we believe they are and in a case that is in a way not completely confirmed historically when Freud was asked what about his cigars because Freud was heavily addicted to cigars some claimed he smoked 20 of those a day and these are not cigarettes but cigars Freud allegedly said well cigars are sometimes belts of cigars sometimes just a cigar and this is if true an attitude that I don't like at all because psychoanalyst analyzed everything and everyone but then when they are supposed to be analyzed all of a sudden the story is over and this attitude of self-reflection I believe is the most important thing you can gain gain from psychoanalysis when it comes to the clinical work there are two major phenomena interpretations or focused on one is resistance resistance is a phenomenon maybe in a way you may be all familiar with it that although you are coming there regularly you are finding enough time in an money to be there come several times per week travel across the city and there is pain in you you're suffering from something you would like to improve there is still something in you that opposes any improvement the world as you know it now the pain as you know it now is something predictable for you the pain away you enter the moment of unpredictability you have no idea what the world will look without these symptoms so there is some ambivalence in you you want to feel better and at the same time you want everything to stay the same so that's a very important obstacle a very important barrier psychoanalysts need to work partly with and partly against so there are various forms of resistance sometimes your character may be a resistance and when faced with something when confronted with something in in a psychoanalytic session you may say well I'm just that kind of a person so the resistance that you have in you is so familiar you cannot see it from a distance and try to work on it and sometimes transference can be resistant and we'll we'll return to that in a moment and I hope this claim will be clear that so the second very important phenomenon that interpretations are focused on is transference and that is my fourth point for today transference is probably the most important discovery in the world of early psychoanalysis and without that discovery psychoanalysis is a clinical method probably wouldn't work nearly as well today as it does it is also a very popular topic and if you ever watch a movie with a psychoanalyst in it transference will be causing some earthquakes somewhere and then it's the most discussed element of psychoanalysis probably we can fill this whole room with books and psychoanalysis in any book about psychoanalytic technique transference take the major part of the book maybe one quarter of the book goes to transference and then all the other phenomena take the rest transference is a situation that especially in long-term psychoanalytic treatments especially in high-frequency psychoanalytic Britain so three four five sessions per week there will be very intense emotions that the client will develop about the analyst that are objectively not connected to the personality or the behave behave Europe the analyst and will not be based on the information that's coming from the analyst or anyone else here is one very brief example Missy felt that her therapist tradition of taking a two-week summer vacation indicated that she was inattentive to the needs of her patients so this is this is from a textbook from an American textbook I would like to point out a couple of things here one form of behavior is not discussed or questioned yet there is an opinion a feeling that the analyst is inattentive and these may lead to very painful very important emotions some people give up on the treatment because of summer vacations some people's symptoms return because of summer vacations that's a very major point that for a certain time the analyst will not be available and that the analyst might have someone else they spend their free time with this most probably this specific form of the expression of transference most probably is connected to some early experiences most probably this person felt someone else was inattentive back then so transference most often or always is connected to something that happened probably decades ago the second point I would like to make is that a to week summer vacation is something horrible in the United States I assume one week summer vacation is horrible in Japan and I can tell you all Italian analysts take fair Agosto and don't work for months and I know people who don't work the whole of July and August so differences in the world of psychoanalysis depends on so many different issues transference was initially considered to be a very specific situation when one mental image in the region of preconscious is connected by another mental image that is in the unconscious and the images which are in the unconscious have a lot of energy with it they are powerful and when they touch so to say when they electrify the image in the preconscious then something very very important will help so what in the preconscious are mostly things that are going on right now you can be aware of them if you work on them a little bit so most probably your image of your analyst is in your preconscious but there is another image in the unconscious that somehow is associated with it maybe even just by one element by just one association or with many could be age or gender or something in the looks or a sentence that you've heard something and then the connection is established and then the energy a lot of energy from the unconscious electrifies the image in the preconscious and then you start having very intense emotions in the actual situation later on transfers what transference was understood as a mistaken belief about the connection between old and new about a mistaken taking old for new you're talking to a person on this day in this year and all of a sudden you have emotions you have attitudes you have beliefs from your past you completely mix the past relationship with the past tuition with the current one so the emotions are very intense because most probably their origin is in your childhood transference can be positive and negative in the case of the positive one you think everything wonderful about your analyst this is the best person in the world absolutely wise and helpful and kind and pretty and so on and so on or you may think your analyst is completely not helpful and then indecent and inattentive as we saw and so on we believe transference is sometimes such that we consider the analyst to be a maternal figure completely unrelated to the gender to the actual gender of the person we need them in that role to be supportive caring sustaining and so on or negative paternal transference for instance is you're too strict you're too harsh you're punishing me all the time I'm afraid of you and so on in many situations at the peak of transference relationship there will be some erotic elements in it being in love with the analyst sometimes dreams about holding hands or even dreams about having children together or when is this analysis is going to be over so that we can get married and so on some authors write even about a rata size transference and this expression should be different from from from the former in the sense that the client cannot control it in any way the erotic transference is something usually clients can reflect upon they can tell you a dream and then think about it and try to figure out what it means a rata size transference is the situation when the client does not have the control over the feelings anymore in terms of clinical differences we believe that neurotic patients form different four of transference and psychotic patients form completely different forms of transference this one should be theoretically expected to be focused on the Oedipus complex situation and this one may go toward the areas of completing measurement tool Occidental identity and so on and so on on the other hand transference neurosis and transference psychosis mean that at the peak of the transference all of the basic symptoms will appear in the transference situation whatever bothers me whatever is the real complaint which made me come to therapy will become evident in the room whatever I suffer from I'm afraid of I'm angry about and so on will be actual in the room the same way I will be afraid of the analyst hate the analyst and so on and so on and that is supposed to make it possible for the analyst to work with something that is very alive very actual and not just reminiscences recollections or retelling I said at the beginning of explaining transference that it may be the most important discovery in the history of psychoanalysis and the reason for that is that it shows that the unconscious very very rarely if you are extremely talented and creative or if you're completely psychotic or if you are a small child the unconscious may speak in isolation in most cases the unconscious opens up through a relationship in a dialogue unconscious maybe a phenomenon that is developed and revealed in a dialogue so that leads me to the point number five and that is mutuality despite the early beginnings contemporary psychoanalysis believes that everything that is important developmentally and clinically develops in a space we build together with other persons so these are some of the expressions for this most important task to create a transitional space or the analytic third like there's one person and there's another person the analyst and the client and they need to build the analytic third something that is very unique for their relationship and that single therapy and that is different than one person alone in the other person alone and did they share the other word that is used very very frequently in the world of psychoanalysis today is intersubjectivity both persons are subjects that are involved in the situation with their conscious and unconscious parts they have initiatives and flaws and all of those are present in the field what is specific about analytic mutuality is it it is asymmetrical so it is not a friendship where two or more friends are all equal a law and all share in the same way there are relationship the analytic relationship being one of them that are asymmetrical one person offers more of something and the other person offers more of something else the most typical relationship of that kind kind is Parenthood if we would try to follow the idea that infants and toddlers can have symmetrical mutuality with their parents everything would be destroyed within a several days watch south park carefully if you don't believe me the same in analysis the analyst will not say everything will not reveal all of his or her thoughts will require of the client to say everything yet the analyst will share some of the thoughts some of the emotions that he or she believe are beneficial for the client can help in understanding and improvement I will I will show you only bits of this field that is now growing very very fast this is the usual old I would say psychoanalytic understanding of development so there are different developmental stages based on different erogenous zones and their tasks and disorders the develop if these are not these do not go well oral anal phallic latency in genital stages I guess are common knowledge by now why am I talking about them now in Freud's opinion these develop as a biological law a child is born here or any other part of the planet today or any moment in the past and these will simply follow no way for the society to influence no way to skip or introduce another one it does not depend on us this is a very popular thing III believe you're all familiar with this expression attachment theory I don't have time unfortunately to talk about it in too much detail these are four attachment patterns if you're not very familiar with them I hope you can remember these characters and they will show you what the idea is during the 1960's attachment theory was developed on the premise that the most important thing you need to have in the childhood is a relationship with someone who can provide what's called secure base that this person can provide comfort when you're a conscious and inspiration to explore when you're not afraid anymore and this secure base that you receive usually from the mother or another grown-up who cares about you should become a part of your personality and then the expression for it is internal work model you should have two internal working models anxiety and avoidance as a part of your personality they work hypothetically as sets of expectations for socials in interactions in future so I have to leave it here this is something we can talk about work for months attachment Theory changes the focus of psychoanalysis completely because the suggestion now is that we should not focus on drives but on the issues of security and survival because attachment theory has very strong evolutionary background the idea is that when you think about our predecessors 50,000 years ago 250,000 years ago the major issue for the human infants which are completely hopeless if left alone is how to survive in nature so the idea is that infants survive because they are born equipped with important knowledge and that is not languages or math or anything like that but this is the knowledge this is the phrasing right I came up with I I don't know whether you would find it in bold be like that various mechanisms for initiating modulating maintaining and interrupting social interaction so infants can smile at you in order to attract you to start playing with them they can cry to make you afraid so that you can come and try to help them solve the problem they can show you when they don't want to play anymore they can show you that it's time for a break and so on and so on language and everything else will come later on when these important things are taken care of our usual adult cognitive world is something of absolutely secondary importance this is a more recent line of research in the same field there are authors in the United States mostly who make videos of mother infant interactions these boys four months sold and two cameras are used and then edited so that you can see both faces at the same time and then they observe them and analyze them frame by frame so one twenty-fourth part of a second and then the next and the next and I'm sorry I have to say you have to trust me when I say this I I don't have time to show it to you today when you watch it frame by frame it's a completely different world when you watch 30 seconds in real time there is nothing very interesting when you watch frame by frame all of a sudden you see a completely different world based on what they do with the age for months they can make very strong predictions on what will happen with babies at 12 months and then six years how based on individual elements of social interaction based on the synchrony of what the baby is sending is a message and what the mother understands and then does for instance insecure attachment will develop if the child very clearly does what I just shown a couple of minutes ago break so hands in front of the face head back into the right if the mother understands this leans back in her chair and waits for the child to engage again most probably this child goes towards secure attachment just this one thing has very high predictability if to this the mother reacts by going forward protruding through the hands of the child most probably we are going toward insecure attachment because probably the mother cannot deal with several moments of being alone separated from the baby so two basic grains of salt from this infants are relational beings from the very beginning without being relational we wouldn't survive and then it takes too for one person to be able to think if left in isolation in childhood or in moments in adulthood when anxiety is high you cannot think you need another mind to help your mind develop or be able to use your capacity to think about emotions so clinically this has introduced huge changes because now interpretations and words do not have to be the most important part of psychoanalytic working sometimes being with a client waiting being supportive may be far more important the time for interpretations may come in faraway future the analytic situation is now very often understood in in terms of something like psychoanalytic constructivism there is no truth that the psychoanalyst is supposed to reveal to you but there is a meaning of the situation or of a memory or of a dream that two persons are supposed to develop jointly this is a joint work now where the analyst should be a little bit better in understanding some things or dealing with anxiety but both should do it together questions that are in the focus of psychoanalytic thinking in the last decade are disclosure so how much the analyst should say about him or herself which moments which type of stuff and so on and then the focus is on counter transference what happens inside of us and how does it influence the clinical situation this topic that in the first half of the 20th century was almost undiscussed is now in the center of attention how do we contribute to the good and the bad moments in the analysis the most current understanding of this is this concept here Co transference so transference would be on the part of the of the patient countertransference will be on the part of the analyst contemporary authors think this distinction is meaningless this is one and the same process that two persons contribute to at the same moment so it should be called Co transference and finally believe it or not there will be the end my concept number six is curiosity about the mind as simple as that there are many references I can I can give this slide send it or whatever so that you can follow them if you want but there is a history of papers there is a tradition in the world of psychoanalysis that is focused on the idea of how important it is to be self-reflective how important it is to be curious about your mind and I personally considered that to be a sorry to be the highest ambition I can have in my clinical work if a person who was not becomes curious about his or her mind we're on a good track and most probably the outcome will be quite positive this curiosity about the mind sometimes contemporary authors use the word mentalization for it again the word that has very long tradition what mentalization research shows us is that high curiosity and high capacity to think and understand the mind develops in the secure attachment circumstances and leads to higher IQ higher school achievement better mental health and better outcomes in all ways while lower curiosity and lower capacity to understand the mind most often leads to borderline personality disorder many other mental disorders and delinquent behavior in adolescence so how much you think about your mind and how effectively you can understand your mind is crucially important curiosity seems to be connected to lower voidance so if you're not afraid of exploring of playing with physical environment toys trees benches balls whatever if you are not afraid of exploring the social environment entering relationships seeing how you play with different types of friends and if you are not afraid of exploring your mind you most probably go toward these positive outcomes this is not just for the child this is for the mother as well if your mother is high on avoidance she probably will not give you what is necessary for free curious exploration of the world in the world of psychoanalysis this is called internalization of the analytic attitude through sessions and sessions hundreds and hundreds and thousands and thousands of analytic sessions what used to be the activity and the attitude of your analyst becomes a part of your personality this attitude basically is everything deserves consideration everything is a potential analytic material patient comes late to the session patient pays too much pace too little pays too early pace too late may mean nothing but always have a question in your mind what might be the unconscious meaning of this behavior very current research the first study I've seen published in 2010 shows that psychoanalysis lasts longer than 18 months is the most effective form of psychotherapy treatment and then why because of post treatment effects when an analysis is over something still works most probably the patient keeps asking him or herself the same questions and thinking about what was the part of it so things that may show you that this is going on the client is developing relationships of a new kind client can recognize the problems in a certain relationship and can now build relationships that were foreign to him or her before the client shows capacity to learn new things all of a sudden in the middle of a psychotherapy treatment someone starts learning dancing or a foreign language or driving whatever but the capacity in the curiosity to acquire something new is born again people start keeping dream Diaries or Diaries where all of a sudden start writing poems but they sit and spend some time okay nowadays typing but writing something that includes self-reflection and finally there are some private creativity you don't have to aspire to be a new Rembrandt but you're painting something there is playfulness you are playing with the life with emotions with with what is at hand you're making something new without much ambition without any purpose for the outside world but you're doing something about it so the basic ambition that I can imagine being exist in the world of psychoanalysis and I hope connects us again to the idea of Berlin psychoanalytic is to have a community of people with the attitude that is popular among psychoanalyst in London don't just do something stand there the world is not just about running and doing something sometimes it is about standing there surviving and then when possible thinking about the mind thank you very much I hope this was not absolutely too long and I hope it was interesting in use thank you [Applause]

Channel: Berlin Psychoanalytic

Views: 5,136

Rating: 4.9496856 out of 5

Keywords: psychoanalysis, introduction, depthpsychology, psychology, sigmundfreud, freud

Id: dZxg9zRAXmo

Length: 70min 46sec (4246 seconds)

Published: Mon Jun 10 2019