| >>Note: Today psychoanalysis comprises several interlocking theories concerning the functioning of the mind. The term also refers to a specific type of treatment where the analyst, upon hearing the thoughts of the "analysand" (analytic patient), formulates and then explains the unconscious basis for the patient's symptoms and character problems. Unconscious functioning was first described by Sigmund Freud, who modified his theories several times over a period of almost 50 years (1889-1939) of attempting to treat patients who suffered with mental problems. In the past 70 years or so, infant and child research, and new discoveries in adults have led to further modification of theory. During psychoanalytic treatment, the patient tells the analyst various thoughts and feelings. The analyst listens carefully, formulates, then intervenes to attempt to help the patient develop insight into unconscious factors causing the problems. The specifics of the analyst's interventions typically include confronting and clarifying the patient's pathological defenses, wishes and guilt. Through the analysis of resistance (unconscious barriers to treatment), and transference to the analyst of expectations, psychoanalysis aims to unearth wishes and emotions from prior unresolved conflicts, in order to help the patient perceive and resolve lingering problems. [http://en.wikipedia.org/wiki/Psychoanalysis] |
| | Origins of psychoanalysis |
| | >>Note: Psychoanalysis was devised in Vienna in the 1890s by Sigmund Freud, a neurologist interested in finding an effective treatment for patients with neurotic or hysterical symptoms. Freud became sensitized to the existence of mental processes that were not conscious as a result of his neurological consulting job at the Kinderkrankenhaus (Children's Hospital), where he noticed that many aphasic children had no organic cause for their symptoms. He wrote a monograph about this (Freud, S (1891). On Aphasia. NY: International Universities Press, 1953. ). He also became aware of the experimental treatment, a combination of hypnotism and "catharsis" done by "abreaction", his older mentor and colleague, Dr. Josef Breuer, was using to treat the now famous patient, [Anna O.] In the late 1880s, Freud obtained a grant to study with Jean-Martin Charcot, the famed neurologist and syphilologist, at the Salpetriere in Paris. Dr. Charcot had become interested in patients who had symptoms that mimicked general paresis, the psychotic illness that occurs due to tertiary syphilis. Charcot had found that many patients experienced paralyses, pains, coughs, and a variety of other symptoms with no demonstrable physical etiology (cause). Prior to Charcot's work, women were thought to have a wandering uterus (the name hysteria means this in Greek). But Freud learned that men could have psychosomatic symptoms as well. As a result of talking with patients, Freud learned that the majority complained of sexual problems, especially coitus interruptus as birth control, which surprised him greatly. He first suspected their problems stemmed from cultural restrictions on sexual expression, and devised in 1900 what today is called "topographic theory", in Chapter VII of one of his most famous books, The Interpretation of Dreams. In this theory, which he later more or less discarded in 1923, unacceptable sexual wishes were repressed into the "System Unconscious" unconscious due to "society's" condemnation of premarital sexual activity, and this repression created anxiety. Freud also discovered what most of us take for granted today: that dreams were symbolic and specific to the dreamer. Often, dreams give clues to unconscious conflicts, and for this reason, Freud referred to dreams as the "royal road to the Unconscious." After several theoretical modifications, the discovery of narcissism in 1915, and the study of paranoia, masochism, and depression in 1917, Freud eventually reorganized his data into what became known as structural theory in a small book called The Ego and the Id in 1923. This new theory, which addressed the cause of neurotic symptoms — phobias, compulsions, obsessions, depressions, and "hysterical" conversions — amongst others, suggested that such problems were created by conflicts among various wishes and guilt, which produced anxiety. To handle the anxiety, the mind forgot or repressed certain conflicting thoughts. In other words, now he felt that anxiety produced repression, not the other way around. [http://en.wikipedia.org/wiki/Psychoanalysis#Origins] |
| | >>Note: Although theoretical "schools" of psychoanalysis differ, most of them continue to stress the strong influence of unconscious elements affecting people's mental lives. There has also been considerable work done on consolidating elements of conflicting theory (cf. the work of Theodore Dorpat, B. Killingmo, and S. Akhtar). As in all fields of medicine, there are some persistent conflicts regarding specific causes of some syndromes, and disputes regarding the best treatment techniques. Today psychoanalytic ideas are embedded in the culture, especially in childcare, education, literary criticism, and in psychiatry, particularly medical and non-medical psychotherapy. Though there is a mainstream of evolved analytic ideas, there are groups who more specifically follow the precepts of one or more of the later theoreticians. It also plays a role in literary analysis. [http://en.wikipedia.org/wiki/Psychoanalysis#Theories] |
| | >>Note: Conflict Theory, which theorizes that emotional symptoms and character traits are complex solutions to intrapsychic conflict. See Brenner (2006), Psychoanalysis: Mind and Meaning, New York: Psychoanalytic Quarterly Press. This revision of Freud's structural theory (Freud, 1923, 1926) dispenses with the concepts of a fixed id, ego and superego, and instead posits unconscious and conscious conflict among wishes (dependant, controlling, sexual, and aggressive), guilt and shame, emotions (especially anxiety and depressive affect), and defensive operations that shut off from consciousness some aspect of the others. Moreover, healthy functioning (adaptive) is also determined, to a great extent, by resolutions of conflict. A major goal of modern conflict theorist analysts is to attempt to change the balance of conflict through making aspects of the less adaptive solutions (also called compromise formations) conscious so that they can be rethought, and more adaptive solutions found. Current theoreticians following Brenner's many suggestions (see especially Brenner's 1982 book, "The Mind in Conflict") include Sandor Abend, MD (Abend, Porder, & Willick, (1983), Borderline Patients: Clinical Perspectives), Jacob Arlow (Arlow and Brenner (1964), Psychoanalytic Concepts and the Structural Theory), and Jerome Blackman (2003), 101 Defenses: How the Mind Shields Itself). Conflict theory is the prevalent analytic theory taught in psychoanalytic institutes, throughout the United States, accredited by the American Psychoanalytic Association. [http://en.wikipedia.org/wiki/Psychoanalysis#Theories] |
| | >>Note: Ego Psychology, which has a long history. Begun by Freud in Inhibitions, Symptoms and Anxiety (1926), the theory was refined by Hartmann, Loewenstein, and Kris in a series of papers and books from 1939 through the late 1960s. Leo Bellak picked up the work from there. This series of constructs, parallelling some of cognitive theory, includes the notions of autonomous ego functions: mental functions not dependant, at least in origin, on intrapsychic conflict. Such functions include: sensory perception, motor control, symbolic thought, logical thought, speech, abstraction, integration (synthesis), orientation, concentration, judgment about danger, reality testing, adaptive ability, executive decision-making, hygiene, and self-preservation. Freud noted inhibition as a way the mind may interfere with any of these functions to avoid painful emotions. Hartmann (1950s) pointed out that there may be delays or deficits in such functions. Frosch (1964) described differences in those people who demonstrated damage to their relationship to reality, but who seemed able to test it. Deficits in the capacity to organize thought are sometimes referred to as blocking or loose associations (Bleuler), and are characteristic of the schizophrenias. Deficits in abstraction ability and self-preservation also suggest psychosis in adults. Deficits in orientation and sensorium are often indicative of a medical illness affecting the brain (and therefore, autonomous ego functions). Deficits in certain ego functions are routinely found in severely sexually or physically abused children, where powerful affects generated throughout childhood seem to have eroded some functional development. Ego strengths, later described by Kernberg (1975), include the capacities to control oral, sexual and destructive impulses; to tolerate painful affects without falling apart; and to prevent the eruption into consciousness of bizarre symbolic fantasy. Defensive activity, which shuts certain conflictual thoughts, fantasies, and sensations out of consciousness, is also sometimes included here, although defensive operations are different from autonomous functions. Nevertheless, the term "ego defense" has become common. [http://en.wikipedia.org/wiki/Psychoanalysis#Theories] |
| | >>Note: Object relations theory, which attempts to explain vicissitudes of human relationships through a study of how internal representations of self and of others are structured. The clinical problems that suggest object relations problems (usually developmental delays throughout life) include disturbances in an individual's capacity to feel warmth, empathy, trust, sense of security, identity stability, consistent emotional closeness, and stability in relationships with chosen other human beings. (It is not suggested that one should trust everyone, for example). Concepts regarding internal representations (also sometimes termed, "introjects," "self and object representations," or "internalizations of self and other") although often attributed to Melanie Klein, were actually first mentioned by Sigmund Freud in his early concepts of drive theory (1905, Three Essays on the Theory of Sexuality). Freud's 1917 paper "Mourning and Melancholia", for example, hypothesized that unresolved grief was caused by the survivor's internalized image of the deceased becoming fused with that of the survivor, and then the survivor shifting unacceptable anger toward the deceased onto the now complex self image. Vamik Volkan, in "Linking Objects and Linking Phenomena," expanded on Freud's thoughts on this, describing the syndromes of "Established pathological mourning" vs. "reactive depression" based on similar dynamics. Melanie Klein's hypotheses regarding internalizations during the first year of life, leading to paranoid and depressive positions, were later challenged by Rene Spitz (e.g., The First Year of Life, 1965), who divided the first year of life into a coenesthetic phase of the first six months, and then a diacritic phase for the second six months. Margaret Mahler (Mahler, Fine, and Bergman (1975), "The Psychological Birth of the Human Infant") and her group, first in New York, then in Philadelphia, described distinct phases and subphases of child development leading to "separation-individuation" during the first three years of life, stressing the importance of constancy of parental figures, in the face of the child's destructive aggression, to the child's internalizations, stability of affect management, and ability to develop healthy autonomy. Later developers of the theory of self and object constancy as it affects adult psychiatric problems such as psychosis and borderline states have been John Frosch, Otto Kernberg, and Salman Akhtar. Peter Blos described (1960, in a book called "On Adolescence) how similar separation-individuation struggles occur during adolescence, of course with a different outcome from the first three years of life: the teen usually, eventually, leaves the parents' house (this varies with the culture). During adolescence, Erik Erikson (1950, 1960s) described the "identity crisis," that involves identity-diffusion anxiety. In order for an adult to be able to experience "Warm-ETHICS" (warmth, empathy, trust, holding environment (Winnicott), identity, closeness, and stability) in relationships (see Blackman (2003), 101 Defenses: How the Mind Shields Itself), the teenager must resolve the problems with identity and redevelop self and object constancy. [http://en.wikipedia.org/wiki/Psychoanalysis#Theories] |
| | >>Note: Structural Theory, which breaks the mind up into the id, the ego, and the superego. Actually, in German, the word for id is "es," which means "it." The word ego was coined by Freud's translators; Freud used the term, "ich" meaning "I" in English. Freud called the superego the "Uber-ich." The id was designated as the repository of sexual and aggressive wishes, which Freud called "drives." The ego was composed of those forces that opposed the drives -- defensive operations. The superego was Freud's term for the conscience -- values and ideals, shame and guilt. One problem Brenner (2006) later found with this theory (see above) was that Freud also suggested that forgotten thoughts ("the repressed") were also "located" in the id. However, Freud here realized that drives could be conscious or unconscious, and that consciousness vs. unconsciousness was a quality of any mental operation or any mental conflict. Forgetting things could be done on purpose, or not. People could be aware of guilt, or not aware. [http://en.wikipedia.org/wiki/Psychoanalysis#Theories] |
| | >>Note: Self psychology, which emphasizes the development of a stable sense of self through mutually empathic contacts with other humans, was developed originally by Heinz Kohut, and has been elucidated by the Ornsteins and Arnold Goldberg. Marian Tolpin explicated the need for "transmuting internalizations" (1971) during treatment, to correct what Kohut referred to as a disturbance in the "self-object" internalizations from parents. [http://en.wikipedia.org/wiki/Psychoanalysis#Theories] |
| | >>Note: Lacanian psychoanalysis, which integrates psychoanalysis with semiotics and Hegelian philosophy, is popular in France. Feminist theory of psychoanalysis, articulated mainly by Julia Kristeva, Luce Irigaray and Bracha Ettinger, is informed both by Freud, Lacan and the Object relations theory. [http://en.wikipedia.org/wiki/Psychoanalysis#Theories] |
| | >>Note: Analytical psychology, which has a more spiritual approach, founded by Carl Jung. |
| | Interpersonal psychoanalysis |
| | >>Note: Interpersonal psychoanalysis, which accents the nuances of interpersonal interactions, was first introduced by Harry Stack Sullivan, MD, and developed further by Frieda Fromm-Reichmann. It is the primary theory, still taught, at the William Alanson White Center. [http://en.wikipedia.org/wiki/Psychoanalysis#Theories] |
| | Relational psychoanalysis |
| | >>Note: Relational psychoanalysis, which combines interpersonal psychoanalysis with object-relations theory as critical for mental health, was introduced by Stephen Mitchell. Relational psychoanalysis emphasizes how the individual's personality is shaped by both real and imagined relationships with others, and how these relationship patterns are re-enacted in the interactions between analyst and patient. Fonagy and Target, in London, have propounded their view of the necessity of helping certain detached, isolated patients, develop the capacity for "mentalization" associated with thinking about relationships and themselves. [http://en.wikipedia.org/wiki/Psychoanalysis#Theories] |
| | >>Note: Modern psychoanalysis, a body of theoretical and clinical knowledge developed by Hyman Spotnitz and his colleagues, extended Freud's theories so as to make them applicable to the full spectrum of emotional disorders. Modern psychoanalytic interventions are primarily intended to provide an emotional-maturational communication to the patient, rather than to promote intellectual insight. [http://en.wikipedia.org/wiki/Psychoanalysis#Theories] |
| | Psychopathology (mental disturbances) |
| | >>Note: The various psychoses involve deficits in the autonomous ego functions of integration (organization) of thought, in abstraction ability, in relationship to reality and in reality testing. In depressions with psychotic features, the self-preservation function may also be damaged (sometimes by overwhelming depressive affect). Because of the integrative deficits (often causing what general psychiatrists call "loose associations," "blocking," "flight of ideas," "verbigeration," and "thought withdrawal"), the development of self and object representations is also impaired. Clinically, therefore, psychotic individuals manifest limitations in warmth, empathy, trust, identity, closeness and/or stability in relationships (due to problems with self-object fusion anxiety) as well. In patients whose autonomous ego functions are more intact, but who still show problems with object relations, the diagnosis often falls into the category known as "borderline." Borderline patients also show deficits, often in controlling impulses, affects, or fantasies -- but their ability to test reality remains more or less intact. Those adults who do not experience guilt and shame, and who indulge in criminal behavior, are usually diagnosed as psychopaths, or, using DSM-IV-TR, antisocial personality disorder. Panic, phobias, conversions, obsessions, compulsions and depressions (analysts call these "neurotic symptoms") are not usually caused by deficits in functions. Instead, they are caused by intrapsychic conflicts. The conflicts are generally among sexual and hostile-aggressive wishes, guilt and shame, and reality factors. The conflicts may be conscious or unconscious, but create anxiety, depressive affect, and anger. Finally, the various elements are managed by defensive operations -- essentially shut-off brain mechanisms that make people unaware of that element of conflict. "Repression" is the term given to the mechanism that shuts thoughts out of consciousness. "Isolation of affect" is the term used for the mechanism that shuts sensations out of consciousness. Neurotic symptoms may occur with or without deficits in ego functions, object relations, and ego strengths. Therefore, it is not uncommon to encounter obsessive-compulsive schizophrenics, panic patients who also suffer with borderline personality disorder, etc. [http://en.wikipedia.org/wiki/Psychoanalysis#Psychopathology_.28mental_disturbances.29] |
| | Indications and contraindications for analytic treatment |
| | >>Note: Using the various analytic theories to assess mental problems, several particular constellations of problems are particularly suited for analytic techniques (see below) whereas other problems respond better to medicines and different interpersonal interventions. To be treated with psychoanalysis, whatever the presenting problem, the person requesting help must demonstrate: 1. good capacity to organize thought (integrative function). 2. good abstraction ability. 3. reasonable ability to observe self and others. 4. some capacity for trust and empathy. 5. some ability to control emotion and urges, and |
| | 6. good contact with reality (excludes most psychotic patients). 6. some guilt and shame (excludes most criminals). 7. reasonable self-preservation ability (excludes severely suicidal patients). If any of the above are faulty, then modifications of techniques, or completely different treatment approaches, must be instituted. The more there are deficits of serious magnitude in any of the above mental operations (1-8), the more psychoanalysis as treatment is contraindicated, and the more medication and supportive approaches are indicated. In non-psychotic first-degree criminals, any treatment is often contraindicated. The problems treatable with analysis include: phobias, conversions, compulsions, obsessions, anxiety attacks, depressions, sexual dysfunctions, a wide variety of relationship problems (dating and marital strife, e.g.), and a wide variety of character problems (e.g., painful shyness, meanness, obnoxiousness, workaholism, hyperseductiveness, hyperemotionality, hyperfastidiousness). The fact that many of such patients also demonstrate deficits in numbers 1-8 above makes diagnosis and treatment selection difficult. [http://en.wikipedia.org/wiki/Psychoanalysis#Indications_and_contraindications_for_analytic_treatment] |
| | >>Note: The basic method of psychoanalysis is interpretation of the analysand's unconscious conflicts that are interfering with current-day functioning -- conflicts that are causing painful symptoms such as phobias, anxiety, depression, and compulsions. Strachey (1936) stressed that figuring out ways the patient distorted perceptions about the analyst led to understanding what may have been forgotten (also see Freud's paper "Repeating, Remembering, and Working Through"). In particular, unconscious hostile feelings toward the analyst could be found in symbolic, negative reactions to what Robert Langs later called the "frame" of the therapy -- the setup that included times of the sessions, payment of fees, and necessity of talking. In patients who made mistakes, forgot, or showed other peculiarities regarding time, fees, and talking, the analyst can usually find various unconscious "resistances" to the flow of thoughts (sometimes called free association). When the patient reclines on a couch with the analyst out of view, the patient tends to remember more, experience more resistance and transference, and be able to reorganize thoughts after the development of insight -- through the interpretive work of the analyst. Although fantasy life can be understood through the examination of dreams, masturbation fantasies (cf. Marcus, I. and Francis, J. (1975), Masturbation from Infancy to Senescence) are also important. The analyst is interested in how the patient reacts to and avoids such fantasies (cf. Paul Gray (1995), The Ego and the Analysis of Defense). Various memories of early life are generally distorted -- Freud called them "screen memories" -- and in any case, very early experiences (before age two) -- can not be remembered (See the child studies of Eleanor Galenson on "evocative memory"). [http://en.wikipedia.org/wiki/Psychoanalysis#Technique] |
| | >>Note: Psychoanalytic training in the United States, in most locations, involves three facets: 1. Personal analytic treatment for the trainee, conducted confidentially, with no report to the Education Committee of the Analytic Training Institute. 2. Approximately 600 hours of class instruction, with a standard curriculum, over a four-year period. Classes are often a few hours per week, or for a full day or two every other weekend during the academic year; this varies with the institute. 3. Supervision once per week, with a senior analyst, on each analytic treatment case the trainee has. The minimum number of cases varies between institutes, often two to four cases. Male and female cases are required. Supervision must go on for at least a few years on one or more cases. Supervision is done in the supervisor's office, where the trainee presents material from the analytic work that week, examines the unconscious conflicts with the supervisor, and learns, discusses, and is advised about technique. Psychoanalytic Training Centers in the United States have been accredited by special committees of the American Psychoanalytic Association or the International Psychoanalytical Association. Because of theoretical differences, other institutes have arisen, as well, which belong to other organizations such as the American Academy of Psychoanalysis and Dynamic Psychotherapy, and the National Association for the Advancement of Psychoanalysis. At most psychoanalytic institutes in the United States, qualifications for entry include a terminal degree in a mental health field, such as Ph.D., C.S.W., or M.D. A few institutes restrict applicants to those already holding an M.D. or Ph.D., and one institute in Southern California confers a Ph.D. or Psy.D. in psychoanalysis upon graduation, which involves completion of the necessary requirements for the state boards that confer that doctoral degree. In many institutes in Europe and Latin America, the admission for training does not necessarily require a license-bearing preliminary degree. [http://en.wikipedia.org/wiki/Psychoanalysis#Training] |
| | Efficacy and empirical research |
| | >>Note: Over a hundred years of case reports and studies in the journal Modern Psychoanalysis, the Psychoanalytic Quarterly, the International Journal of Psychoanalysis and the Journal of the American Psychoanalytic Association demonstrate the efficacy of analysis in cases of neurosis and character or personality problems. Psychoanalysis modified by object relations techniques has been shown to be effective in many cases of ingrained problems of intimacy and relationship (cf. the many books of Otto Kernberg). As a therapeutic treatment, psychoanalytic techniques may be useful in a one-session consultation (see Blackman, J. (1994), Psychodynamic Technique during Ungent Consultation Interviews, Journal Psychotherapy Practice & Research). Psychoanalytic treatment, in other situations, may run from about a year to many years, depending on the severity and complexity of the pathology. |
| | Cost and length of treatment |
| | >>Note: The cost of psychoanalytic treatment ranges widely from city to city. Low-fee analysis is often available in a psychoanalytic training clinic and graduate schools. Otherwise, the fee set by each analyst varies with the analyst's training and experience. Since, in most locations in the United States, unlike in Ontario and Germany, classical analysis (which usually requires sessions three to five times per week) is not covered by health insurance, many analysts may negotiate their fees with patients whom they feel they can help, but who have financial difficulties. The various modifications of analysis, which include dynamic therapy, brief therapies, and certain types of group therapy (cf. Slavson, S. R., A Textbook in Analytic Group Therapy), are carried out on a less frequent basis - usually once, twice, or three times a week - and usually the patient sits facing the therapist. Many studies have also been done on briefer "dynamic" treatments; these are more expedient to measure, and shed light on the therapeutic process to some extent. Brief Relational Therapy (BRT), Brief Psychodynamic Therapy (BPT), and Time-Limited Dynamic Therapy (TLDP) limit treatment to 20-30 sessions. On average, classical analysis may last 5.7 years, but for phobias and depressions uncomplicated by ego deficits or object relations deficits, analysis may run just a year or two. Longer analyses are indicated for those with more serious disturbances in object relations, more symptoms, and more ingrained character pathology (such as obnoxiousness, severe passivity, or heinous procrastination). [http://en.wikipedia.org/wiki/Psychoanalysis#Cost_and_length_of_treatment] |
| | Curiosities, archaic ideas, and controversy |
| | >>Note: Freud revisited the Oedipal territory in the final essay of Totem and Taboo. There, he combined one of Charles Darwin's more speculative theories about the arrangements of early human societies (a single alpha-male surrounded by a harem of females, similar to the arrangement of gorilla groupings) with the theory of the sacrifice ritual taken from William Robertson Smith. Smith believed he had located the origins of totemism in a singular event, whereby a band of prehistoric brothers expelled from the alpha-male group returned to kill their father, whom they both feared and respected. In this respect, Freud located the beginnings of the Oedipus complex at the origins of human society, and postulated that all religion was in effect an extended and collective solution to the problem of guilt and ambivalence relating to the killing of the father figure (which Freud saw as the true original sin). In 1920, after the carnage of World War I, and after studying severe depressions and masochistic states, Freud became concerned with what today Parens has called "destructive aggression." He began to formulate that there were wishes that drove human beings that were not sexual, but aggressive. The concepts of a libidinal and an aggressive drive are still used clinically by a large number of practicing analysts, but there is today some dispute (and research into) the origins of either sexual or destructive fantasies and/or behavior. Freud attempted, in "Beyond the Pleasure Principle" (1920), to theorize that there might be cellular origins to destructiveness, an idea that may be supported by current research into telomeres and cell death. Most North American analysts, however, have not been persuaded by Freud's arguments that there is a "Death Drive" underlying aggression. However, analysts in England (the Melanie Klein group) and South America utilize this concept. |
| | >>Note: Psychoanalysis can be adapted to different cultures, as long as the therapist or counseling understands the client’s culture. For example, Tori and Blimes found that defense mechanisms were valid in a normative sample of 2,624 Thais. The use of certain defense mechanisms was related to cultural values. For example Thais value calmness and collectiveness (because of Buddhist beliefs), so they were low on regressive emotionality. Psychoanalysis also applies because Freud used techniques that allowed him to get the subjective perceptions of his patients. He takes an objective approach by not facing his clients during his talk therapy sessions. He met with his patients where ever they were, such as when he used free association—where clients would say whatever came to mind without self-censorship. His treatments had little to no structure for most cultures, especially Asian cultures. Therefore, it is more likely that Freudian constructs will be used in structured therapy (Thompson, et al., 2004). In addition, Corey postulates that it will be necessary for a therapist to help clients develop a cultural identity as well as an ego identity. Since Freud has been criticized for not accounting for external/societal forces, it seems logical that therapists or counselors using his premises will work with the family more. |
| | Play therapy, art therapy, and other therapies |
| | >>Note: Psychoanalytic constructs have been adapted and modified for use with children. Play therapy, art therapy, and storytelling, have been the beneficiaries of these modifications. Throughout her career, from the 1920s through the 1970s, Anna Freud (Sigmund Freud's daughter) adapted psychoanalysis for children through play. This is still used today for children, especially those who are preadolescent (see Leon Hoffman, New York Psychoanalytic Institute Center for Children). Using toys and games, children are able to demonstrate, symbolically, their fears, fantasies, and defenses; although not identical, this technique, in children, is analogous to the aim of free association in adults. Psychoanalytic play therapy allows the child and analyst to understand children's conflicts, particularly defenses such as disobedience and withdrawal, that have been guarding against various unpleasant feelings and hostile wishes. Psychoanalytic constructs fit with constructs of other more structured therapies, and Firestone (2002) thinks psychotherapy should have more depth and involve both psychodynamic and cognitive-behavioral approaches. For example, Corey states that Albert Ellis, the founder of Rational Emotive Behavioral Therapy (REBT), would allow his clients to experience depression over a loss, since such an emotion would be rational—often people will be irrational and deny their feelings. In art therapy, the counselor may have a child draw a portrait and then tell a story about the portrait. The counselor watches for recurring themes — regardless of whether it is with art or toys. [http://en.wikipedia.org/wiki/Psychoanalysis#Play_therapy.2C_art_therapy.2C_and_other_therapies] |
| | >>Note: Play therapy is generally employed with children ages 3 to 11, play provides a way for children to express their experiences and feelings through a natural, self-guided, self-healing process. As children’s experiences and knowledges are often communicated through play, it becomes an important vehicle for them to know and accept themselves and others. Play Therapy is the systematic use of a theoretical model to establish an interpersonal process wherein play therapists use the therapeutic powers of play to help clients prevent or resolve psychosocial challenges and achieve optimal growth and development. A working definition might be a form of counseling or psychotherapy that therapeutically engages the power of play to communicate with and help people, especially children, to engender optimal integration and individuation. Play Therapy is often used as tool of diagnosis. A play therapist observes a client playing with toys (play-houses, pets, dolls, etc) to determine the cause of the disturbed behaviour. The objects and patterns of play, as well as the willingness to interact with the therapist can be used to understand the underlying rationale for behavior both inside and outside the session. According to the psychodynamic view, people (especially children) will engage in play behaviour in order to work through their interior obfuscations and anxieties. In this way play therapy can be used as a self-help mechanism, as long as children are allowed time for 'free play' or 'unstructured play'. From a developmental point of view, play has been determined to be an essential component of healthy child development. Play has been directly linked to cognitive development. One approach to treatment, is for play therapists use a type of systematic desensitization or relearning therapy to change the disturbing behaviour, either systematically or in less formal social settings. These processes are normally used with children, but are also applied with other pre-verbal, non-verbal, or verbally-impaired persons, such as slow-learners, brain-injured or drug-affected persons. Mature adults usually need much "group permission" before indulging in the relaxed spontaneity of play therapy, so a very skilled group worker is needed to deal with such guarded individuals. Many mature adults find that "child's play" is so difficult and taboo, that most experienced group workers need specially tailored "play" strategies to reach them. Competent adult-group workers will use these play strategies to enable more unguarded spontaneity to develop in the non-childish student. [http://en.wikipedia.org/wiki/Play_therapy] |
| | >>Note: Art therapy is a form of expressive therapy that uses art materials, such as paints, chalk and markers. Art therapy combines traditional psychotherapeutic theories and techniques with an understanding of the psychological aspects of the creative process, especially the affective properties of the different art materials. As a mental health profession, art therapy is employed in many clinical settings with diverse populations. Art therapy can be found in non-clinical settings as well, such as in art studios and in workshops that focus on creativity development. Art therapists work with children, adolescents, and adults and provide services to individuals, couples, families, groups, and communities. According to the American Art Therapy Association, art therapy is based on the belief that the creative process of art is both healing and life-enhancing. Art therapists use the creative process and the issues that come up during art therapy to help their clients increase insight and judgment, cope better with stress, work through traumatic experiences, increase cognitive abilities, have better relationships with family and friends, and to just be able to enjoy the life-affirming pleasures of the creative experience. The term art therapist is reserved for those that are professionals trained in both art and therapy and hold a master's degree in art therapy or a related field. [http://en.wikipedia.org/wiki/Art_therapy] |
| | >>Note: Storytelling is the ancient art of conveying events in words, images, and sounds, often by improvisation or embellishment. Stories have probably been shared in every culture and in every land as a means of entertainment, education, preservation of culture and to instill knowledge and values/morals. Crucial elements of storytelling include plot and characters, as well as the narrative point of view. Stories are frequently used to teach, explain, and/or entertain. Less frequently, but occasionally with major consequences, they have been used to mislead. There can be much truth in a story of fiction, and much falsehood in a story that uses facts. Storytelling has existed as long as humanity has had language. It's the world of myth, of history, of the imagination...it explains life. Every culture has its stories, legends, and every culture has its storytellers, often revered figures with the magic of the tale in their voices and minds. The appearance of technology has changed the tools available to storytellers. The earliest forms of storytelling are thought to have been primarily oral combined with gestures and expressions. Rudimentary drawings such as can be seen in the artwork scratched onto the walls of caves may also have been early forms of storytelling. Ephemeral media such as sand, leaves, and the carved trunks of living trees have also been used to record stories in pictures or with writing. With the advent of writing and the use of stable, portable media stories were recorded, transcribed and shared over wide regions of the world. Stories have been carved, scratched, painted, printed, or inked onto wood or bamboo, ivory and other bones, pottery, clay tablets, stone, palm-leaf books, skins (parchment), bark cloth, paper, silk, canvas and other textiles, recorded on film and stored electronically in digital form. Complex forms of tattooing may also represent stories, with information about genealogy, affiliation and social status. Traditionally, oral stories were passed from generation to generation, and survived solely by memory. With written media, this has become less important. Conversely, in modern times, the vast entertainment industry is built upon a foundation of sophisticated multimedia storytelling. [http://en.wikipedia.org/wiki/Storytelling] |
| | Challenges to scientific validity |
| | Psychoanalytic and Psychodynamic at the Open Directory Project |
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