Chapter 5

Psychoanalytic Counseling
A moment’s insight is sometimes worth a life’s
experience.

Oliver Wendell Holmes

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Chapter Objectives
After reading this chapter, you should be able to:
• Outline the development of psychoanalysis and Sigmund
Freud
• Explain the theory of psychoanalysis including its core
concepts
• Discuss the counseling relationship and goals in
psychoanalysis
• Describe assessment, process, and techniques in
psychoanalysis
• Demonstrate some therapeutic techniques
• Clarify the effectiveness of psychoanalysis
• Discuss psychoanalytic play therapy
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 Sigmund Freud
(1856-1939)
• Lived in Vienna for 80 years
• Noticed patients’ physical symptoms
seemed to have mental base
• He began to get the idea that most of the
forces at work were unconscious
• From this came the foundations for a theory
of personality

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 Sigmund Freud
• Developed his model of people over five
decades of observing and writing
• Major principles were based on the clinical
study of individual patients undergoing
treatment for their problems
• The father of psychoanalysis and the
grandfather of child psychoanalysis

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 Nature of People
• Psychic determinism and unconscious mental
processes
• People basically evil and victims of instincts that
must be balanced
• To achieve balance people need a deep
understanding of the forces that motivate them
• Psychic energy systems are the id, ego, superego
• Behavior determined by energy, unconscious
motives and by instinctual and biological drives

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 Basis
• Psychic determinism implies mental life is a
continuous logical manifestation of cause-related
relationships
• Unconscious mental processes are the causative
factors that are unknown, below conscious level
• Thus people often do not understand feelings or
actions
• Basis for much of what is involved in
psychoanalysis

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 Terms
• Unconscious
• Conscious
• Preconscious
• Subconscious
• Collective unconscious

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CONSCIOUSNESS
PRECONSCIOUS

THE PERSONAL
UNCONSCIOUS

SUBCONSCIOUS

THE COLLECTIVE
UNCONSCIOUS
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 Theory Concepts
Structural Developmental
o Id o Defense
o Ego mechanisms
o Superego o Psychosexual stages

Dynamic
o Instinct
o Cathexis
o Anticathexis
o Anxiety

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 Structural Concepts
• Id: basic instinctual drives and seeks
pleasure.
• Ego: attempts to balance the desires
of the id and the reality of the external
world.
• Superego: personal moral standard

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 Dynamic Concepts
• Instinct: inborn psychological representation
• Cathexis: directing energy toward an object
that will satisfy a need.
• Anticathexis: ego’s restraint of the id’s
impulses.
• Anxiety: conscious state that reflects the
presence of an emotional experience by
external or internal nervous energy.
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 Developmental Concepts
• Defense mechanisms: operations of the
mind that aim to ward off anxiety and
depression; unconscious distortions of reality
that reduce painful affect and conflict through
automatic, habitual responses
• Psychosexual Stages: succession of
stages characterized by dominant mode of
achieving libidinal pleasure and by specific
developmental tasks
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 ENERGY SYSTEM
LIBIDO
Involuntary
Involuntary bodily
bodily processes:
processes:
Breathing, digestion,
Breathing, digestion, circulation
circulation
 Defense Mechanisms
• Identification • Intellectualization
• Displacement • Regression
• Repression and • Fixation
suppression • Undoing
• Projection • Acting out
• Reaction formation • Compensation
• Rationalization • Sublimation
• Denial
• Fantasy
• Withdrawal

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 Psychosexual Stages
ORAL STAGE: Birth to 1 1/2 Years
o Adjust to the weaning process and learn to chew food

ANAL STAGE: 1 1/2 to 3 Years

o Regulation of natural functions

PHALLIC STAGE: 3 to 6 Years

o Oedipus/Electra complex
o Sexual desires and attitudes take shape

LATENCY STAGE: 6 to 11 Years

o Developmental skills and activities

GENITAL STAGE: Adolescence

o Developing heterosexual relationships
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DEPENDENCY

AUTONOMY

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When Analyzing Children
• Develop a warm, friendly relationship
• Accept the child
• Create an atmosphere of permissiveness in the
relationship
• Recognize the child’s feelings and reflect them
• Respect the child’s ability to solve problems
• Allow the child to lead and follow that lead
• Do not hurry
• Use only necessary limits (Merydith, 2007, p. 112).

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Process: Beginning
• Opening phase
o reasons for seeking treatment
o triggers to current problems
o degree of distress of the client

• The elements of treatment

o building the therapeutic relationship
o exploring the client’s concerns

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Process: Middle Phase
• Working through
o themes revisited and explored
o increase understanding of the forces, past patterns,
and inner conflicts that are causing the client’s
problems.

• The elements of treatment

o analysis of transference
o examination of other relationships

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Process: Final Phase
• Ending
o goals have been reached
o transference is resolved
o separation is the next step

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 Psychoanalytic Counseling
and Self-Esteem
Simon’s six conditions for nurturing and
maintaining self esteem and mental health:
• Belonging
• Child Advocacy
• Risk Management
• Empowerment
• Uniqueness
• Productivity

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 Counseling Methods
CATHARSIS:
o Process of remembering, verbalizing, and emotionally reliving
an early childhood event in order to eliminate the symptoms
that had been caused by the event.
FREE ASSOCIATION:
o The process in which unconscious thoughts are brought to the
conscious mind by vocalizing whatever thoughts or feelings
come to mind.
INTERPRETATION:
o DREAMS - express wish fulfillment
o PARAPRAXIA - “Freudian Slips”
o HUMOR - Jokes, puns, satire are all acceptable means for
unconscious urges to gain access to the conscious.

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 Counseling Methods
ANALYSIS of TRANSFERENCE
o Client views the counselor as someone else

ANALYSIS of RESISTANCE
o Client resists the attempts of the counselor to help

ANALYSIS of INCOMPLETE SENTENCES

o Projective techniques to understand the client

BIBLIOCOUNSELING:
o Reading and discussing books about situations similar to
clients’ issues

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 Counseling Methods
STORYTELLING:
o Client tells a story and the counselor retells
the story with better responses/alternatives

PSYCHOANALYTIC PLAY THERAPY

o Toys and games assist the counselor with
putting the child at ease, creating an
alliance, and discovering clues about the
client’s inner life.

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Psychoanalytic Play Therapy
Fundamental goal: the child’s insight into self
• aim is moving past the current pain in
order to accept one’s self and develop
security, adaptability, and self-accepting
ways

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Psychoanalytic Play Therapy
More specific goals:
• decreasing suffering,
• recovering from trauma,
• adjusting to life,
• following a medical treatment plan,
• eliminating fears,
• advancing academically,
• managing anger, and accepting disabilities.

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 Object Relations Theory
• Early family relationships affect
relationships outside the family.

• Family relationships that model appropriate

and healthy models for future relationship
development are the best assistance
children can have in learning to build
relationships outside the family.

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 Evaluation of Psychoanalytic
Counseling
• Research on psychoanalysis with children
and adolescents is also sparse.
• Muratori, Picchi, Bruni, Patarnello, and
Romagnoli (2003) treated 58 young children
with psychoanalysis for 11 sessions.
• The results indicate support for
psychoanalysis as a treatment for anxiety
and depression in children (Shapiro,
Friedberg, & Bardenstein, 2006).
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