Introduction to psychoanalysis
This film outlines the main discoveries and findings of psychoanalysis, founded by Sigmund Freud, about the structure and functioning of the psyche, and about the nature of mental illness and of psychological disturbances in general.
It’s presented by Otto Kernberg, possibly the most well-know psychoanalyst alive, who has often come to teach psychoanalysis in Madrid. He is a professor of psychiatry at Cornell University Medical School, Training Analyst at Columbia University Centre for Psychoanalytic Training and Research, and also the director of the Institute for the Study of Personality Disorders at Cornell University.
This film is divided into the following five main points, which are briefly summarized here below.
Three clinical cases to understand basic concepts of psychoanalysis:
- Depressive –– young woman who had problems in her relationships with men, deeply worried about people being critical of her, suffered from chronic sense of insecurity.
- Obsessive-compulsive –– young man, excessively friendly, perfectionistic, tense with people in authority, tended to submit to them and then exploded when he felt dominated,
- Oedipal constellation –– young man who loved his girlfriend very much, but he was unable to function sexually with her, he had serious sexual inhibitions that he did not have with women with whom he had casual sex.
The dynamic nature of the mind:
- In the first case, the main defence mechanism is projection –– attributing to others her own feelings.
- In the second case, the main defence mechanism is reaction formation –– development of behaviour opposite to what one feels.
- In the third case, the main defence mechanism is repression of sexual feelings towards who he loves and splitting –– separating sexual feelings from love.
Defence mechanisms don’t solve the problem but contribute to further creating distorted and inhibited behaviour, symptoms.
Freud proposed the existence of dynamic unconscious in which primitive impulses continue to be active. He classified them into drives: libido and aggression, life drive and death drive.
Freud saw a fight between these principles going on eternally in the unconscious in which there is no sense of time, contradiction, logic, space, and conflicts can be displaced from one issue to another. This is called primary process as opposed to logical secondary process.
Brain and the mind:
What’s known from neurobiological research and how does that fit with psychoanalytical theories?
The brain is organ with two big systems, the cortex, the limbic system.
The cortex is relatively thin layer, extremely complex and rich, whose function is to provide our cognitive conscious intelligent perception and understanding of external and internal reality. It’s fundamentally rational.
The limbic system activates affects, the fundamental motivational systems. Good or bad feelings tell us what to look for and avoid because of how they feel. Affects get activated on the basis of deeper systems of the brain, particularly the hypothalamus that communicates deep bodily needs.
Structural development of the mind: forms of mental disorders
From an object relations / Kleinian (schools of psychoanalysis) point of view.
When the baby is hungry it is overwhelmed by negative affects, hunger, rage, anxiety, and panic. In this state the baby hates the mother and experiences her as bad. Moments later, when it is fed by the mother, it experiences intensely positive, almost orgasmic affects. In this state the baby loves the mother and experiences her as good.
This develops two sets of separate and different experiences of oneself that are stored as representations in the brain. Angry-self representation interacting with bad mother, and happy-self representation interacting with good mother. These memories are stored differently in the hippocampus.
Gradually, as good experiences predominate over bad experiences, when love predominates over hate, the baby becomes able to tolerate bad moments, they become less impressive. An integration takes place in the cortex and the baby is able to bring together the good and bad representations of self and other. Gradually an integrated representation of the self and of the objet build up. This is normal identity.
If bad experiences are so dominant then the integration is not possible, the negative segment builds up so much it cannot be tolerated and a permanent split is maintained in the personality. The world is split into an idealized one and a persecutory one. Several different serious outcomes are borderline personality, paranoid personality, narcissistic personality, psychopathic personality.
Treatment and research
What are the indications for psychoanalysis and psychoanalytical psychotherapies?
- Chronic depressions
- Chronic anxiety states
- Sexual inhibition and difficulties in intimacy and love
- Conversion symptoms that are physical symptoms based on unconscious symbolic meaning
- Personality disorders
What are basic features of psychoanalytic treatment?
- Free association, free-floating attention
- Analysis of transference
- Analysis of countertransference
He finishes discussing how extensive empirical research is currently testing the effectiveness of psychoanalysis and psychoanalytic psychotherapy.