Psychodynamics Chart 1 Sigmond Freud Ego Psychology Harry Stack Sullivan Demographics Male, white, born mid 1800s, Jewish background during a high time of antisemitism (very persecuted, barely escaped nazis), very unhappy, medical doctor, mental health issues, prolific dreamer, sexuality was taboo as he was growing up. -Worked with upper class neurotics and hysterics Margaret Mahler (worked with psychotic children), Edith Jacobson (worked with kids, teacher), Anna Freud (created school and worked with kids), Heinz Hartmann, Rene Spitz. European born and fled Nazi persecution, most physicians and psychiatrists, very conservative, medical model, Isolated as a child, schizophrenic, struggled to develop intimate relationships as an adult, gay but didn't come out of closet, mid 1900’s, part of Chicago school of psychiatry but disagreed with medical model -treated schizophrenics and obsessive patients Major Focus Dreams, transference and resistance, unconscious, theory of infantile seduction to sexuality, pleasure principle, id’s impulses -Defense Mechanisms, Ego and Ego Deficits, Ego Function. -How environment shapes infant -Need to pay attention to all 3 psychic structures and the conflict between them -Anxiety and splitting -Humans are social and naturally want to be in healthy relationships -People pick up emotions from others -Integrating tendencies (need for satisfaction draws us to connect with others) and disintegrating tendencies (anxiety, which separate us from others) Model -Structural Model: self is made up of unconscious parts, the ego, id, superego -Topographical Model: preconscious, unconscious and conscious Jacobson created new model of how psyche develops in relationship to drive, separation individual process of development Interpersonal model Psychodynamics Chart 2 Nature of the Drives We are born with urges to seek Same as Freud. 3 drives: sexuality pleasure and avoid pain and and aggression fuel the ego, then the impulses crescendo at death drive neutralizes Oedipus phase. 2 drives are always in conflict -Disagreed with this concept of drives as impulse. -What drives people is the desire to be in relationship with others. Nature of the Internal Objects No internal object The libidinal object is internalized so that when caregiver is not around, the child still feels attached to them Baby’s does something and mom responds with anxiety or positive emotion and baby internalizes it as ‘I’m good or I’m bad’ Nature of the External Objects Libidinal object (breast) which does not have value aside from providing gratification. Meets a need and provides pleasure -LIbidinal object provides not just satisfaction but connection to humans, which is necessary for development. (Spitz) -Libidinal object is not automatically formed, rather it’s a psychological achievement of being able to establish a personal attachment -Good mother and Bad motherbaby sees mom as sometimes anxious and sometimes not. -External objects help us develop mutually beneficial relationships with others. Etiology of Psychopathology The repressed material and impulses in the unconscious bubble up as neurosis or psychopathology Caused by developmental setbacks in childhood. Unresolved conflicts between ego, id and superego Lack of healthy connection with others caused by anxiety (which comes from outside world), symptoms are distractions and ways of managing anxiety Nature of Treatment Help client uncover & release unconscious trapped id fantasies through free association, dream interpretation & hypnosis. Help client ground id’s fantasies with reality Explore how the ego, id and superego are functioning and help strengthen the ego and its defenses to manage them Help patient become aware of what they do in relationships other people. Observe how patient interacts with therapist and point out how that may be happening with other Psychodynamics Chart 3 relationships Role of the Mother Mother is primary attachment figure for child Provide infant with functions of the ego so they can deal with the world until ego is fully developed Mother is primary attachment figure. Mom’s anxiety encourages child to split into good and bad, mom’s role is to help mold child’s personality. Role of the Father Father is the object of the mother's desire, mediates between mother and child which helps the child internalize the norms of society and thus doesn’t have to distort themself to please parents in order to stay alive Same as Freud -No major emphasis -Similar to Freud- father serves as mediating third Nature of the Ego -Ego seeks pleasure (not objects/relationships) -Develops from conflict with psychic structures. -Represses the socially unacceptable material from the unconscious Born with ego. Makes sense of the unconscious and creates defenses to manage and sublimate socially unacceptable impulses Self system is relational and shaped through interactions growing up. It is first developed within infant and overtime through relationship with others Nature of Aggression Death drive: rage, envy, hatred, disgust Not an independent drive, it is a learned reaction Aggression is only negative if creates anxiety in caregivers, which can differ depending on family culture Nature of Libido LIfe drive, warm and loving feelings. Libido functions not just to provide pleasure but connection Motivation to be in relationship to other people Psychodynamics Chart Stages of Development 4 Psychosexual stages driven by need for pleasure: oral (food), anal (potty training), phallic (sexual impulses towards parents/ oediups complex), latent, and genital Infant and mother are merged in beginning and over first 18 months, baby begins to separate and individuate. Nature of the Unconscious Repository for socially repressed thoughts, unconscious is constantly speaking Repository for socially repressed thoughts Repository for socially repressed thoughts Emphasis on Oedipus -Developed it. -Aggressive and libidinal drives culminate in this period -Child’s desire for parent and desire to kill off other parent as a threat are seen as dangerous and thus mind develops to repress them - Child’s fear of castration (superego) is what resolves this complex. Superego attempts to repress Oedipal complex, creates more conflict between 3 psychic structures n/a Erikson’s 8 Psychosocial stages of development-Each significant developmental event is associated with a psychological conflict that when resolved, leads to confidence Epochs of development: there is a need for different types of relationships at various ages, which are integrated at each stage -infancy: need for exclusive adult relationships -age ⅘: need for peer relations -preteen: need for single best friend -teen: need for sexual and emotional intimacy Psychodynamics Chart 5 Melanie Klein British Object Relations School Heinz Kohut Demographics From Vienna but moved to Britain and started British school, late 1800s to 1960, suffered from depression and rough marriage. Worked with infants and children Emerged in Britain 1940’s’ -Fairbairn: isolated in Scotland, work with abused children -Winnicot, public figure, pediatrician, worked with children and people with false self disorder - Harry Guntrip -Michael Balint & Sandor Ferenczi worked with more disturbed patients -John Bowlby (worked with maladjusted kids Austrian moved to Chicago, Jewish, 1950’s-70’s, worked with narcissistic and other personality disorders, disturbed patients Major Focus -Projective identification: seeing part of yourself in others that you cannot accept -Management and containment of aggression -Paranoid-schizoid and Depressive Positions -Infants are wired to face anxiety and good parenting helps mitigate and contain that Role of mother in healthy psychological development -Natural development is healthy psychological development -Object relations (seeking connection) are present from begging of life, not derived from drives -attachment theory Narcissism, empathy that leads to appropriate action Model Object relations model -Fairbairn changed Klein’s object relations model to say that children are ‘externally facing’ and only create internal objects to cope with bad parenting -Winnicott changed object Self Psychology model Psychodynamics Chart 6 relations by saying that in early infancy, primary maternal preoccupation is necessary for healthy development Nature of the Drives Libidinal and aggressive drives are ways of experiencing oneself and others as good (loved, loving) and bad (hated and destructive) Disagreed with this concept, what motivates people is connection with others No drive theory. Libido and aggression are not intrinsic, they are reactions to narcissistic injury. People strive for self expression and self organization Nature of the Internal Objects -Parts of aggressive and libidinal impulses are internalized as sense of self as loving or hateful -Child creates fantasized presences that are part of all experience, inevitable -Inner sense of goodness -Only come from bad parenting, fantasized substitution for real relationships with people (Fairbairn) Instead of internal and external objects, the child creates selfobjects (self and parent dyad), where the child is unable to realize that they are separate. The parent provides empathy and mental functions for the child and overtime, the child develops the ability to do this for himself/herself Nature of the External Objects -Projects part of loving and hateful impulses externally as good and bad Other -Objects are built into the impulse itself as an image, not separate. -Very important to development -Child seeks connection with external objects (parents) and from theses relationships learns patterns of attachment and how to relate with others Instead of internal and external objects, the child creates selfobjects (self and parent dyad), where the child is unable to realize that they are separate. The parent provides empathy and mental functions for the child and overtime, the child develops the ability to do this for himself/herself Etiology of Psychopathology -Inability to integrate good and bad objects because of fear of destroying good object (on which -Lack of good enough mothering impinges on necessary childhood experience and forces Parents did not provide empathy to child and thus the child’s self object needs were unmet, Psychodynamics Chart 7 one depends and thus destroying oneself) -Severe psychopathology is caused by envy. Envy contaminates person’s love and thus they cannot overcome destructive impulses child to deal with reality too soon -person’s attachment style which comes from relationship to early caregivers leads to in adulthood repeating painful ways they connected to inadequate parents as a child. They do this with other people and internally with painful states of mind and harmful patterns of behavior preventing the child to develop and regulate their self esteem Nature of Treatment -client needs to start believing in their reparative ability (aka that that their love can survive their destructiveness) so that they can integrate love and hate in themselves and others Through therapeutic relationship, provide a holding container, in which patient learns to relate in new ways by becoming aware of patterns and through experiencing relating to analyst Empathise with patient in their developmental stage and analyst allows themself to play the developmental role needed. 3 types of self object transference needed to build strong sense of self and finish developmental process: mirroring, idealizing and alter ego/kinship Role of the Mother Only significant for role in providing experiences of satisfaction and being loved and experiences of frustration and being hated -Provide a container where child can have true or false self experiences -Child is shaped by parents (like imprinting) -Mother reflects cultural values through childrearing onto the baby, which shapes their identity -Soothe and indulge narcissistic seed so healthy sense of self develops Role of the Father n/a Mediating third, show infant that mother has other needs and relationships. This provides an opportunity for them to learn to overcome disappointment and self soothe Provides external rules that are internalized as superego, mediates between mother and child Psychodynamics Chart 8 Nature of the Ego Ego projects part of itself onto outside object like breast and directs it’s aggression towards that object (bad breast). It does the same for the libidinal drive towards the good breast. -Present from birth -Ego seeks relationships with others (objects) Ego develops in interpersonal and cultural context, it’s subjective and relational Nature of Aggression Aggressive impulse is to hate and destroy, image it contains is of a hateful and hating object. Way of experiencing oneself as bad (hated and destructive) Aggression is not a drive, but rather a response to perceived threats or to feel powerful Reaction to narcissistic injury, response to vulnerability, not intrinsic drive Nature of Libido -Way of experiencing oneself as good (loved, loving). LIbidinal impulse is to love and protect and contains an image of a lovable object -Libido comes from feeling of remorse for destroying the breast, which turns out is the same one baby loves and thus shows up as reparative fantasies, love and concern -Seeks objects imprinted from childhood caregiving (duckling) and looks for connection based on same pattern -Part of ego that splits into hopeful and longing self Reaction to narcissistic injury, not intrinsic drive Stages of Development -Born wavering between two loving and being lovable and destructive and hateful. Gradually we integrate both sides into people and return throughout life in these states (Paranoid Schizoid Position and Depressive Position) -all throughout life, we continue to struggle with these fears of death and abandonment -Infant and mother are like one mind (primary maternal occupation). Child believes they are all powerful -child has a transitional object which teaches child that people have other desires and have to accommodate -gradually infant realizes mother has other needs and is separate person Parent empathizes with child in each of 3 self object experiences: confirm child’s sense of joy, adults who child can look up to, adults who child can feel similarly to Psychodynamics Chart 9 Nature of the Unconscious More than a repository of repressed material,. There are images in the unconscious that child can understand Repository of repressed material n/a Emphasis on Oedipus -Very different than Freud -Infant experiences version of Oedipus complex much earlier than Freud’s vision (incestuous fantasizes and fear of punishment) -The mind does not culminate/stabilize at the oedipus stage, but is always fluid -Same as Klein -Infant experiences version of Oedipus complex much earlier than Freud’s vision (incestuous fantasizes and fear of punishment) n/a Psychodynamics Chart 10 Otto Kernberg Jacques Lacan Demographics Born in Austria and grew up in Chile to escape nazis, then become psychiatrist in US, worked with personality disorders French forensic psychiatrist, influenced by philosophy, abandoned religion, worked with psychotic patients Major Focus -Developmental Model of hierarchy of psychopathology -Struggle between love and hate (between drives) -Nature of and capacity for love and why that’s challenging for some (based on failure in early developmental) Demand vs Desire, Lack in Being, Jouissance, Mirror stage Model Developmental model 3 registers: imaginary, real and symbolic Nature of the Drives -We are not born with them, they develop in relationship to others in early childhood. -They are still powerful -Both drives are always in conflict -Not biological impulses, but rather a desire that is not easily satisfied that motivates people -Believed that drives are organized around the oedipal phase (like Freud) and in psychopathology, the drives are lacking organization and/or control Nature of the Internal Objects As the baby separates from merged state with mom, the external and internal objects are formed. The baby has to keep good and bad internal objects (self images) separate n/a Psychodynamics Chart 11 and has to learn to integrate them as a whole self image. -Internalized parents Nature of the External Objects As the baby separates from merged state with mom, the external and internal objects are formed. The baby has to keep good and bad objects separate and has to learn to integrate them as a whole object (both loving and frustrating). n/a Etiology of Psychopathology Lack of enough positive experiences in childhood, the negative experiences build up and the external world seems persecutory and full of terrible people. The split does not heal and people cannot see others as whole beings Repressed parts of the unconscious Confront the narcissist (aka patient) to help client build relationships and increase their ability to overcome difficulties in Neurosis: Help patient uncover truths about themself through free association, scansions, punctuation, and work towards Nature of Treatment -Neurosis: too much ego and superego control of drives, patient sees themself through lens of parents “symbolic other’ and feels inadequate, guilty (Conflict with authority or social expectations) -psychosis: missing paternal function (didn’t develop superego to repress unacceptable impulses), patient views peers as trying to take his/her place “imaginary other, unable to contain/organize drives Psychodynamics Chart 12 relationships -Analyst does Interpret the struggle between the impulses and the need to repress them via defenses. -Free association and interpretation and explore the transference and countertransference owning those truths by speaking about them and sitting with them. Role of the Mother Establish boundaries with child so that child can integrate them into their relationship patterns and will be able to set boundaries in their relationships with others Child learns from mom that they are desirable and experiencing desiring mom (represents satisfaction/ jouissance) Role of the Father Establish boundaries with child so that child can integrate them into their relationship patterns and will be able to set boundaries in their relationships with others Forces child to give up source of primary satisfaction aka jouissance (desiring mom and being her sole desire), child learns that desire for closeness with mom is wrong and represses it Nature of the Ego Ego is the self, the part that interacts with external world Ego is like a hall of mirrors, made up of your mom’s wishes and not grounded in reality. Not helpful to focus on the ego, which is a distraction from focusing on more intimate aspects of person Nature of Aggression Experiences of dissatisfaction and frustration (bad affective states) consolidate overtime into this drive Viewed the death drive as similar to jouissance (excess of life) (Hewitson, 2015) Nature of Libido Pleasureable interactions in He focused on the pleasure Psychosis: help patient learn the paternal function, which was never there to begin with Psychodynamics Chart 13 childhood (good affective states) consolidate over time into libidinal drive principle, which can keep jouissance (excess of life) in check (Hewitson, 2015) Stages of Development 1st Task: We are born merged psychologically with mom, but then need to realize what is ourself vs others 2nd Task: Reconcile good and bad into whole objects (paranoid schizoid to depressive) 3rd- Sense of self emerges -Mirror stage: infant recognizes themself and feels competent, but also inadequate comparing to that ideal in the mirror. The ego is developed here -Introduction of the father’s ‘no’ representing a world outside the mother child-relationship Nature of the Unconscious Repressed material Not a place- it’s a process. Unconscious opens and closes with erupting unconscious formations Emphasis on Oedipus Big emphasis- similar as Freud’s concept that sexual and aggressive drives peak at the oedipal phase. Superego develops to resolve this complex -When one learns to reign in the drives -Changed it to be that by father prohibiting relationship with mom, child learns that desiring satisfaction is wrong. Child learns this foundational meaning “paternal metaphor” References Hewitson, O. (July 3, 2015). What does Lacan say about... Jouissance? Lacan Online. https://www.lacanonline.com/2015/07/whatdoes-lacan-say-about-jouissance/ Mitchell, S. A., & Black, M. J. (2016). Freud and beyond (2nd ed.). Basic Books.
