Techniques in Psychoanalytic Therapy

Psychoanalytic therapy contains many different therapeutic techniques. These techniques are
intended to increase awareness and foster insight into the client's behavior. Four techniques will
be discussed in this lesson:

1. Free association
2. Dream analysis
3. Analysis of transference
4. Analysis of resistance

1. Free association is a practice in psychoanalytic therapy in which a client is asked to freely share
thoughts, random words, and anything else that comes to mind, regardless of how coherent or
appropriate the thoughts are. The process was originally developed by Sigmund Freud, who
claimed that it gave clients complete freedom to examine their thoughts without prompting or
intervention by the therapist. Freud claimed that the technique helped prevent three common issues
in therapy:
1. Transference the process of transferring feelings one has for one person to a different
person;
2. Projection the process of projecting ones own qualities onto someone else;
3. Resistance the practice of blocking out certain feelings or memories.

How Does Free Association Work?

In traditional free association, the client is encouraged to verbalize or write all thoughts that come
to mind. Free association is not a linear thought pattern. Rather, a person might produce an
incoherent stream of words such as dog, red, mother, and scoot, or may jump randomly from one
memory or emotion to another. The idea is that free association reveals associations and
connections that might otherwise go uncovered and that clients may uncover repressed memories
and emotions.

2. Dream analysis does not employ the dream itself to procure healing, but rather uses the clients
interpretation of the dream through a verbal description. One cannot accurately depict the nuances
and specifics of any dream. Therefore, the verbal description is the highest form of the true
depiction of the dream. Regardless of the trigger that led to the dream, the dream itself is a window
into ones psychological reasoning system. Sigmund Freud and Carl Jung both used dream analysis
in their work and wrote extensively on the subject.

Dream interpretation in the clinical sense involves three specific things:

1. The first requirement is a written text of the dream itself. To capture it in its most vibrant
state, therapists recommend that you write a dream down immediately upon waking. If you
cannot remember all of the aspects or details of your dream, the therapist will transcribe
what you remember as best as he can.
 2. The second important component to accurate dream analysis is to have a comprehensive
understanding of your own relationship to theimages in your dream. The psychological role
you play in your own dream, relative to the images your mind conjures up, is vital to proper
analysis. If something from your dream seems to be meaningless, you may discover, upon
further review, that the image elicited feelings or thoughts from childhood that directly
impact your present day struggles.
3. Lastly, you must work to discover the relationship that each of these associations shares.
In other words, try to see the bigger picture with respect to the associations in your dream
and how they relate to situations you are dealing with in the present moment. What
messages are these images trying to convey? Very often you can take an image from your
dream and identify your emotional reaction to it. And by reflecting on your past life and
times that you had the same emotional experience, you can relate those previous situations
to your current one and create any possible associations.

3. Transference

The patient is not satisfied with regarding the analyst in the light of reality as a helper and adviser
who, moreover, is remunerated for the trouble he takes and who would himself be content with
some such role as that of a guide on a difficult mountain climb. On the contrary, the patient sees
in him the return, the reincarnation, of some important figure out of his childhood or past, and
consequently transfers on to him feelings and reactions which undoubtedly applied to this
prototype. This fact of transference soon proves to be a factor of undreamt-of importance, on the
one hand an instrument of irreplaceable value and on the other hand a source of serious dangers.
This transference is ambivalent: it comprises positive (affectionate) as well as negative (hostile)
attitudes towards the analyst, who as a rule is put in the place of one or other of the patient's parents,
his father or mother. (Sigmund Freud: An Outline of Psychoanalysis - 1940.)

The Role of Transference in the Psychoanalytic Cure

So long as it is positive it serves us admirably. It alters the whole analytic situation; it pushes to
one side the patient's rational aim of becoming healthy and free from his ailments. Instead of it
there emerges the aim of pleasing the analyst and of winning his applause and love. It becomes the
true motive force of the patient's collaboration; his weak ego becomes strong; under its influence
he achieves things that would ordinarily be beyond his power; he leaves off his symptoms and
seems apparently to have recovered - merely for the sake of the analyst. The analyst may
shamefacedly admit to himself that he set out on a difficult undertaking without any suspicion of
the extraordinary powers that would be at his command.
Moreover, the relation of transference brings with it two further advantages. If the patient puts the
analyst in the place of his father (or mother), he is also giving him the power which his super-ego
exercises over his ego, since his parents were, as we know, the origin of his super-ego.
[] Another advantage of transference, too, is that in it the patient produces before us with plastic
clarity an important part of his life-story, of which he would otherwise have probably given us
only an insufficient account. He acts it before us, as it were, instead of reporting it to us. (Sigmund
Freud: An Outline of Psychoanalysis - 1940.) \

4. Resistance
It became evident that the work of uncovering what had been pathogenically forgotten had to
struggle against a constant and very intense resistance. The critical objections which the patient
raised in order to avoid communicating the ideas which occurred to him, and against which the
fundamental rule of psycho-analysis was directed, had themselves already been manifestations of
this resistance.

A consideration of the phenomena of resistance led to one of the corner-stones of the psycho-
analytic theory of the neuroses - the theory of repression. It was plausible to suppose that the same
forces which were now struggling against the pathogenic material being made conscious had at an
earlier time made the same efforts with success. (Sigmund Freud: An Outline of Psychoanalysis,
1940.)

As Constituent of the psychoanalysis theory

The theories of resistance and of repression, of the unconscious, of the aetiological significance of
sexual life and of the importance of infantile experiences - these form the principal constituents of
the theoretical structure of psycho-analysis. (Sigmund Freud: An Autobiographical Study, 1925.)

Strengths of Psychodynamic Approach

1. Uncovering Underlying Issues

One of the strengths of psychodynamic intervention for is its capacity to identify underlying issues
such as resentment and anger that may have their genesis in early childhood familial experiences.
Psychodynamic therapy helps client's identify the past as it interferes with healthy attitudes and
experiences of the present (Shedler, 2010). Ford (Transcript of Dr. Ford's analysis, 2006) discusses
the collaborative process of bringing to light somewhat unconscious feelings experienced by the
client, and indicates the similarity between this psychoanalytic technique and cognitive treatment.
Psychodynamic therapy "encourages exploration and discussion of the full range of a patient's
emotions" (Shedler, 2010, para.7). This helps the client begin to understand their internal emotions
that may be contradictory, troubling, or threatening. In this client's case, her acute depression may
come from such a range of underlying issues as well as the contemporary challenge of her
husband's illness. Psychodynamic intervention would help the client contend with new challenges
with a clearer understanding of underlying issues that may be clouding her ability to surmount
current challenges.

2. Focus on relationships and Interpersonal Experiences

Secondly, psychodynamic therapy "places heavy emphasis on patients' relationships and
interpersonal experience" (Shedler, 2010, para. 11). This would be especially important if some
of the client's difficulties were, at least in part, from her interpersonal relationship with her husband
and his inability to meet her emotional needs since his medical diagnosis. If this were the case, it
would benefit the client to identify and explore her attachment in her relationships, specifically the
one with her husband.
 Limitations of Psychodynamic Approach

1. Time Constraints
The first limitation (other than the first, above mentioned one) is the time necessary for successful
psychodynamic therapy. Even ruling out the immediacy in the client's need to relieve her acute
symptoms, the long-term application of this type of therapy would might not yield enough relief
in a reasonable amount of time (Scaturo, 2001). Although contemporary psychotherapy has altered
its limitation relating to time constraints, the relief for the client may come sooner from other, or
at least adjunct, therapies.

2. Psychodynamic Therapy as a Vacuum

A second limitation and criticism of psychotherapy is that the amelioration of many psychological
issues cannot be accomplished within the vacuum of psychodynamic therapy. In this client's case,
her most acute symptoms are directly related to her relationship with her husband. I imagine, at
some point, the need to include her husband in her therapy. This would necessitate a more family-
oriented medicine like family systems therapy (Scaturo, 2001). Although she has issues that are
clearly her own, I imagine the inclusion of her family (her husband) would present a more holistic
approach to her contemporary issues. The approach that includes her husband may, in fact, relieve
some of her most pressing issues.

Conclusion
This type of therapy does not suit someone with immediate needs as is evident in the client's
case, unless the more immediate needs are addressed first, or in concert with psychodynamic
therapy (Scaturo, 2001). Certainly, from initial observation, this client does not seem strong
enough to explore her emotions and relationships before addressing her severe depression and her
overall poor quality of life.
One last thought is that this client may have placed herself in a vacuum of sorts. Many
times, people with a broad support system do not deteriorate to the extent this client has. If she is
somewhat estranged from her husband (they don't seem to be communicating well at this point)
and she has no one else to talk to, she may simply find help in talking about her fears in a warm,
empathetic, positive client-centered therapy. Although modern psychoanalytic therapy no longer
uses the blank screen approach, any form of neutrality toward this client may not give her the
warmth, tenderness, and caring she seems to need at this critical time .