Therapies 513

Psychotherapy Any psychological technique used to facilitate positive changes in a person’s personality, behavior, or adjustment.

Demonology In medieval Europe, the study of demons and the treatment of persons “possessed” by demons.

Hysteria (now called somatoform disorders) An outdated term describing people with physical symptoms (such as paralysis or numbness) for which no physical causes can be found.

Psychoanalysis A Freudian therapy that emphasizes the use of free association, dream interpretation, resistances, and transference to uncover unconscious conflicts.

Free association In psychoanalysis, the technique of having a client say anything that comes to mind, regardless of how embarrassing or unimportant it may seem.

Resistance A blockage in the flow of free association; topics the client resists thinking or talking about.

Slowly, Freud became convinced that hysteria was related to deeply hidden unconscious conflicts and developed psychoanalysis in order to help patients gain insight into those conflicts (Knafo, 2009). Because it is the “granddaddy” of more modern therapies, let’s examine psychoanalysis in some detail.

Psychoanalysis—Expedition into the Unconscious

Gateway Question 15.2: Is Freudian psychoanalysis still used? Isn’t psychoanalysis the therapy for which the patient lies on a couch? Freud’s patients usually reclined on a couch during therapy, while Freud sat out of sight taking notes and offering interpretations. This procedure was supposed to encourage a free flow of thoughts and images from the unconscious. However, it is the least impor- tant element of psychoanalysis, and many modern analysts have abandoned it.

How did Freud treat emotional problems? Freud’s theory stressed that “neurosis” and “hysteria” are caused by repressed memories, motives, and conflicts—particularly those stemming from instinctual drives for sex and aggression. Although they are hidden, these forces remain active in the personality and cause some people to develop rigid ego defenses and compulsive, self- defeating behavior. Thus, the main goal of psychoanalysis is to reduce internal conflicts that lead to emotional suffering (Fayek, 2010).

Freud developed four basic techniques to uncover the uncon- scious roots of neurosis (Freud, 1949). These are free association, dream analysis, analysis of resistance, and analysis of transference.

Free Association The basis for free association is saying whatever comes to mind without worrying whether ideas are painful, embarrassing, or illogical. Thoughts are simply allowed to move freely from one idea to the next, without self-censorship. The purpose of free associa- tion is to lower defenses so that unconscious thoughts and feelings can emerge (Hoffer & Youngren, 2004).

Dream Analysis Freud believed that dreams disguise consciously unacceptable feel- ings and forbidden desires in dream form (Rock, 2004). The psy- choanalyst can use this “royal road to the unconscious” to help the patient work past the obvious, visible meaning of the dream (its manifest content) to uncover the hidden, symbolic meaning (its latent content). This is achieved by analyzing dream symbols (images that have personal or emotional meanings).

Suppose that a young man dreams of pulling a pistol from his waistband and aiming at a target as his wife watches. The pistol repeatedly fails to discharge, and the man’s wife laughs at him. Freud might have seen this as an indication of repressed feelings of sexual impotence, with the gun serving as a disguised image of the penis.

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