Psychoanalytic Etiology

Question 1

Freud’s Drive Conflict Model

Answer 1

(Freud 1926)
The psychosexual stages progress in order and development is susceptible to over- or under-gratification leading to fixation

Question 2

Freud’s view of depression

Answer 2

(Freud 1917) Mourning and Melancholia

• Depressed people suffered a symbolic loss (as opposed to the loss of a loved person in mourning)
• There is a disturbance in self-regard, anger turned inward leads to self-deprecation and loss of self-esteemd
• Caused by over/undergratification at oral stage

Question 3

Freud’s view of mania

Answer 3

(Freud 1917) Mourning and Melancholia
-When the ego recovers from the loss of the object, all the anticathexis drawn into the ego during melancholia is freed and becomes mania

Question 4

Freud’s view of anxiety

Answer 4

(Freud 1926)

• Anxiety is a signal of danger
• There are realistic, moral, and neurotic types
• Neurotic anxiety is the fear of punishment or annihilation, anticipation of danger based on past experience
• loss of the object (oral), loss of the object’s love (anal), body integrity/castration (phallic), and punishment from the superego (genital)
• Anxiety comes from pathological compromise formation

Question 5

Freud’s view of schizophrenia

Answer 5

(Freud 1924)

• No ego defenses have developed and therefor there is no differentiation between self and world
• id fantasies are mistaken for reality

Question 6

Anna Freud’s view of depression

Answer 6

(A. Freud, 1936)
-hate turned toward the self, because if the bad is outside, there is no hope of controlling it, but if the bad is inside, it’s safer
-focus on interpreting defenses rather than id impulses
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Question 7

Fairbairn’s view of repetition compulsion

Answer 7

(Fairbairn 1941)

• Repetition compulsion is a person’s attempt to re-master past relationships that went poorly, or because they are recreating relationships with the same type of internalized objects they had before.
• 3 objects: gratifying, enticing, and rejecting

Question 8

Fairbairn’s view of depression

Answer 8

(Fairbairn 1941)
A lack of internalization of positive objects causes child to use fantasized internal objects, dooming them to repeat the past and they believe the love object’s absence was their fault (too needy or hateful)

Question 9

Fairbairn’s view of anxiety

Answer 9

(Fairbairn 1941)

Dangerous object ties threaten to break through, or internalized wrathful/punitive objects

Question 10

Winnicott’s view of depression

Answer 10

(Winnicott 1949)
-Failures of good enough mothering and empathy causes a false self which appeases others and feels bad about pleasing self

Question 11

Winnicott’s view of anxiety

Answer 11

(Winnicott 1949)
-Failures of good enough mothering nurturing causes false self which views spontaneity as scary, patient anxiously seeks missing empathy

Question 12

Kohut’s view of depression

Answer 12

(Kohut 1971)
Lack of mirroring and transmuting internalization of it causes low self-esteem, poor self-soothing, fragmentation of self

Question 13

Kohut’s view of anxiety

Answer 13

(Kohut 1971)

Anxiety is an expression of fear of the disintegration of the self

Question 14

Psychodynamic conceptualization

Depression

Answer 14

(Blatt, 1974)
patient feels helpless, weak, and
fears abandonment— results from disruption of relationship with a primary caregiver anaclintic

introjective:introjective depression, in which the patient feels
worthless, guilty, and fears loss of approval, unrelenting self-criticism

Question 15

Defense Mechanisms OCD

Answer 15

• intellectualization and isolation (warding off the affects associated with the unacceptable ideas and impulses),
• undoing (carrying out compulsions to neutralize the offending ideas and impulses)
• reaction formation (adopting character traits exactly opposite of the feared impulses).

The imperfect success of these defenses gave rise to OCD symptoms: anxiety; preoccupation with dirt or germs or moral questions; and, fears of acting on unacceptable impulses.

Question 16

OCD symtpoms role –classical

Answer 16

remove ego from danger

Question 17

PTSD: analytic–classic–Freud

Answer 17

Freud, 1914

Trauma alters the foundations of the persons life. Impairs ability to live in the present–try to reconcile past trauma and its impact on present and future

Overwhelm capacity to cope and renders the person helpless

Question 18

PTSD contemporary–think ego

Answer 18

(Kaplan & Sadock, 1998)

Truama reactivates a childhood trauma or a psychic conflict of the past

The ego relives trauma and tries to master and reduce anxiety

Question 19

Freud: OCD

Answer 19

(Freud, 1926)

Obsessional Neurosis two categories:

They are either prohibitions, precautions, and expiations (reparation for guilt) or

They are substitutive satisfactions which often appear in symbolic disguise.

• impulses will get out of control–undo or conteract impulses toward destructiveness greed, and messiness

Question 20

PTSD: contemporary: self psych

Answer 20

Kernberg 1975

Splitting–cant integrate the good and bad. You can’t integrate the part of you that experienced the trauma. So you experience anxiety.

Lack of role model for that integration which makes the task more difficult

Question 21

PTSD contemporary

Lansky, 2000

Answer 21

shame as part of PTSD

Trauma shatters social order

Question 22

OCD Contemporary

Answer 22

Salzman, 1980

obsessive pattern is a way for preventing any thought that could produce shame, , or a feeling of deficiency or weakness

there is a need to control internal and external

anger and dependency are unacceptable
as children they had difficulty expressing agression