Notes - week 2 Flashcards
(22 cards)
Aims of therapy
- Remove repressions produced during the patient’s early development and “replace them with reactions more in keeping
with a state of psychological maturity” - Fill in gaps in memory
- Change can only occur when conscious thought processes
have penetrated as far as this place and have overcome the
repressive resistances there - The point is to be adapted to the world
- Analysis confers self-knowledge and self-control
formulations of the exact process
of healing
- consciously transmitting to the patient what he has repressed does in fact have some effect - At
first it will arouse resistances, and then, once these have been overcome, it will provoke a thought process that in due course, finally produces its anticipated influence upon the unconscious memory
Abreaction
The liberation by revival and expression of the emotion associated
with forgotten or repressed ideas of the event that first caused it
- Psychoanalysis is not supposed to use ‘abreaction’ in the same way suggestion does - Freud thinks that the form of remembering that psychoanalysis can help with lends itself to ‘abreaction’
He suggests hypnotism allowed the patient to return to exactly
the original state they were in when traumatized and that this makes possible a healing energy release (‘abreaction’)
Abreaction and suggestion/hypnosis
Remembering’ took a very
simple form in these hypnotic treatments. The patient reverted to an earlier situation, which he appeared to never confuse with the present one, conveyed the psychic processes of that earlier situation insofar as they remained normal, and in addition conveyed whatever resulted from translating the unconscious processes of that time into conscious ones
What is / is not therapeutically helpful
- Repeating/acting out is not therapeutically helpful…(things that have been forgotten/repressed are acted out)
- Only remembering can help a person eliminate repressions and
transform/heal - ‘Remembering’ and ‘Working-Through’ are intimately related
Working through
- Freud formulates ‘working-through’ more vaguely than he formulates
remembering…The term points to some process the patient undertakes once their resistances have been revealed to them by the therapist…It involves developing a familiarity with/acknowledgement of the resistances, working through them, & in this way becoming able to
remember - Working-through is supposed to distinguish psychoanalysis from
suggestion, and yet Freud tells us it’s basically like ‘abreacting
Things that are repeated/acted out:
- everything deriving from the repressed element within himself
that has already established itself in his manifest personality—
his inhibitions and unproductive attitudes, his pathological
characteristics. Indeed, he also repeats all his symptoms during
the course of the treatment - transference is a part of what helps working through
transference
- It involves transposing a forgotten past onto the present therapeutic situation and onto other situations in the patient’s life (transference does exceed the therapeutic context)
- What is specifically transposed: relationships that maintained between the patient and others in the originally traumatizing context [the situations/contexts in which the pathologies they’re now navigating were originally forged]; these are reproduced between the patient
and analyst: their relationship just becomes a translation of an earlier one the patient was locked into…
Other elements of original, traumatic contexts are transposed onto the present as well
Why you shouldn’t make important, life-altering decisions while in therapy…The repetitions that start happening (as unconscious material starts to come out of hiding) can damage your life
Isn’t transference ‘acting out’
If transference is a form of ‘acting out’ (as opposed to remembering),
then how is it supposed to be therapeutically helpful, as Freud says it is…
“We soon realize that the transference is itself merely an instance of repetition
not all transference is therapeutically helpful…If the transference
is ‘good’ it can lead to remembering…If it’s ‘bad’ it leads to
resistance/acting out
- The key to effective therapy involves using the transference (somehow) to convert the impulse to act out into remembering
Controlling the transference
- How much control does the analyst have? Note all of the ways in
which Freud flags the analyst’s lack of control: They are just getting a complex process underway; the process itself will do its thing - We render the compulsion [to repeat] harmless, indeed beneficial, by allowing it some sovereignty, by giving it its head within a specific domain. We offer it transference as a playground in which it has license to express itself with almost total freedom, coupled with an obligation to reveal to us everything in the way of pathogenic drives that have hidden themselves away in the
patient’s psyche
transference neurosis
- We can routinely succeed in giving all the symptoms of the [patient’s]
illness a new meaning in terms of transference; in replacing his ordinary neurosis with a transference neurosis - Transference thus creates an intermediate realm between sickness and healthy life by means of which the transition from one to the other is accomplished
- it constitutes an artificial illness that is in all respects amenable to treatment
- The repetition reactions exhibited in
transference then lead along familiar paths to the reawakening of memories, which surface without any apparent difficulty once the patient’s resistances have been overcome
What kind of material does [the patient] make available to us that we can use to put [them] on the path to recovering [their] lost memories? (During transference)
- fragments of those memories in [their] dreams
- the thoughts that occur to [them] when [they] give [themselves] over to free-association, from which we can discover allusions to the repressed experiences and derivatives of the repressed emotional impulses, as well as to [their] emotions attached to what has been repressed
- We have found the transference relationship established with the analyst particularly conducive to the recurrence of such emotional connections
Importance placed on memory,
consciousness, reflection
- Not all reflection/forms of consciousness are good…
- Remember everything Freud says in the essays we read for last week about not letting patients read about psychoanalysis before beginning treatment, or even prepare what they are going to say in therapy in advance…
- Some forms of ‘intellectualization’/reflection will just operate as forms of resistance, or help resistance out
Positive vs negative transference
-There are different kinds: positive (transfer of affectionate feelings; the patient inserts the therapist “into a series of imagos of people from whom [they] have been
accustomed to receive affection” [WA, 59]) and negative (transfer of hostile
feelings; other examples: relation driven by a guilty conscience or a masochistic need to suffer)
-The negative transferences are not therapeutically helpful; the positive ones are not ALWAYS therapeutically helpful: if they are translations of repressed erotic attachments they might not be helpful, but compare this statement from “The Dynamics of Transference” to Freud’s claims in “Observations on Love in Transference…”
-Sometimes a positive and negative transference can co-occur (the transference can be ambivalent)
-Sometimes the way it operates to be therapeutically helpful makes it hard to distinguish from suggestion (cf. WA, 63)
-It’s supposed to help the patient overcome resistances by effecting the ‘emotive dynamic’ psychoanalysis supplies the patient with (WA, 62)
-It might be a great form of resistance because it turns the analyst into the person the patient might have negative feelings toward (some person from the original context in which the patient developed their pathology)…Because the analyst in some sense IS that person, the patient is more reluctant to confess
their feelings about the person to the analyst…
-Note that Freud proposes this idea but admits he’s not sure it’s
the best explanation of why transference operates as
resistance
Contrast between Freud’s early sketch of therapy and his later one in “Analysis Terminable and Interminable
-Is it ever time to end therapy? Does therapy ever result in a
permanent cure? In “On the Dynamics of Transference” (see last
paragraph), he does make it sound like a permanent cure is
possible…
-How could a cure be permanent if the marks left on the psyche
by a person’s early traumatic experiences are indelible?
the archeology metaphor
The analyst’s “work of construction or, if you prefer, of reconstruction, corresponds extensively to that of the archaeologist who excavates a ruined and buried settlement or
an ancient building.
It is in fact identical to it, except that the analyst works under better conditions, and has more material to
help him, because he is dealing with something living, not a ruined object…But as the archaeologist builds up a picture of the shell of a building from remaining masonry, establishes the number and position of columns from depressions in the ground, and reconstructs the former decorations and pictures on the walls
from remains found in the rubble, the analyst proceeds in exactly
the same way
- when he draws his conclusions from fragments of memory and
associations, and from comments volunteered by the analysand. Both
are granted the right to reconstruct by piecing together and completing
the existing remains
Moreover, we must consider that an excavation involves objects that have been destroyed, and that large and important fragments of these objects have quite certainly been lost, through mechanical force, fire and looting. No amount of effort can succeed in locating them in order to reunite them with the surviving remains
- As is well known, we have reason to doubt whether any psychological formation ever suffers really complete destruction.
Objects excavated vs. objects
constructed
It’s interesting that Freud admits psychoanalytic interpretations are
‘constructions’ and yet also insists that the psychic phenomena the
constructions are interpretations OF are like ancient cities: they are
object-like and have an endurance that not even ancient cities have…
Why not just think the constructions are mere constructions (fanciful
interpretations/made up/things that don’t map onto anything real)?
Freud admits that we never have direct access to unconscious
phenomena/the origins of pathology: we only ever have translations of these things that mediate our relation to them (“On the basis of the signs it has left behind, [the analyst] has to guess at what has been forgotten”
- this last point has to do with repetition
- People like Derrida would think of the ‘translations’ of unconscious phenomena that Freud has in mind (symptoms, behaviours, the transference, etc., etc.) as ‘supplements’ that actively constitute the thing they are supposed to translate… If you have a traumatic past but then write an award-winning
novel as a result of having had it and, after winning this award, stop regretting this past and instead find yourself grateful for it, there’s a sense in which the new present you find yourself in has re-constituted the past…It has supplemented it/makes it what it is
objection that was levelled
at psychoanalysis even at his time:
It seems like there’s no way for the patient to disagree with
the analyst’s interpretation of the source of their problems
if they vehemently deny the truth of the interpretation (or say NO to
the interpretation), they become legible, within a psychoanalytic
framework anyway—because this framework works with a conception of ‘resistance’ to therapy—as simply resisting the truth so they can avoid making any therapeutic advances
The therapist can supposedly know they’re getting close to the truth with
their interpretation if the patient reacts violently against it (the more violently they object to it, the more likely it is to be true, the thinking runs)…In “Constructions in Analysis,” Freud says something a bit different: he says, if the therapist gets it wrong, the patient doesn’t react or change, but if the therapist is right, the patient reacts with a worsening of his symptoms/the patient’s well-being plummets
-The aforementioned objection does make psychoanalysis look violent,
makes it seem as if the patient is locked into a power-relationship with their analyst and is subordinated to their ‘take’ (there’s no room for autonomy in the form of disagreement)
-Freud argues that the objection distorts what therapy actually entails and is supposed to entail
- The therapist has to be highly tuned into the patient and into context while determining the meanings of ‘Yes’ and ‘No
Freud’s argument on suggestion
The danger of leading the patient astray by the power of
suggestion, by ‘talking him into’ something you yourself believe in,
but which he would be wrong to accept, has surely been grossly
exaggerated. For some mishap like this to befall him, the analyst
must have behaved very incorrectly; above all he would have
cause to reproach himself for not letting the patient have his say.
Without vainglory, I can state that such an abuse of ‘suggestion’
has never once occurred throughout my career
Freuds response to the objection
-Wrong/distorting interpretations are harmless…The patient won’t
react to these (says neither yes or no)…There may be a delayed
response (which indicates the interpretation was not wrong), but if
there isn’t then the interpretation was just a harmless misguided one
We don’t take ‘no’ at face-value…but we also don’t take ‘yes’ (agreement with what the analyst is suggesting) at face value! (Saying ‘yes’ can be a way of resisting therapy. If the patient says yes but then also produces new memories that help the construction
develop, or in other ways indirectly confirm the construction, we can
trust it
- -‘No’ doesn’t tell us for certain that our interpretation is right…It
might (it’s compatible with the interpretation being right), but it
also might not…Sometimes people say no because they’ve just been
given a fragment of the whole truth and the truth will only strike them
as true if they get the whole truth…Something which can only occur once the entire course of therapy has been undergone - There are indirect confirmations of the truth of an interpretation:
the patient might respond to an interpretation “with an association that contains something similar or analogous to the contents of the
construction”
Statements that contradict a suggestion on the part of an
analyst might also be indirectly confirming: Analyst: “Perhaps
when you say Jauner, you mean Gauner, which means ‘audacious crook’ or ‘cunning devil’”…Analysand: “That seems a little too daring to me”
the discussion about ‘delusions’ at
the end of “Constructs in Analysis”
-Delusions, like dreams, are translations of the source of pathology…(They are distorting translations; the distortions they effect are part of ‘resistance’)
- “Perhaps the delusions in which we regularly find these hallucinations
embedded are not so independent of the upsurge of the unconscious and
the return of the repressed as we commonly assume. In the mechanism of a delusion we generally pick out just two factors; the turning away from the real world and its motives, on the one hand, and on the other the influence of wish-fulfillment on the contents of delusion” (“Constructions in Analysis,”
WA, 220)
-Interesting to think delusions would be amenable to psychoanalytic
treatment…(Treating psychotic disorders with psychoanalysis is not a
possibility people entertained or generally entertain currently
Delusions as constructions
- “The delusions of the sick seem to
me equivalent to the constructions that we build up in analytic treatment. They are attempts at explanation and recuperation,
which, admittedly, under the conditions of psychosis, can only
lead to our replacing the piece of reality which is being denied in
the present, by another piece that the patient has already
similarly denied in his early years”