With the help of free association, dream analysis, and projective techniques, the psychoanalyst gradually comes to understand the unconscious source of the patient' s problems. The patient must also come to understand the unconscious dynamics of his or her situation. Toward this end, the psychoanalyst of fers the patient interpretations of the psychodynamic causes of the problems. The patient is led to view problematic thoughts, dreams, behaviors, symptoms, or feelings as all having unconscious roots and as expressions of unconscious conflicts or repressed u ges. The psychoanalyst might say, "Could it be that the reason you feel so sleepy when you go out with your boyfriend is that you are afraid of being sexually attractive to him?" The patient is confronted with an explanation of something she has been keeping from herself. Through many interpretations, the patient is gradually led to an understanding of the unconscious source of her problems. This is the beginning of insight. Insight, in psychoanalysis, is more than a simple cognitive understanding of the intrapsychic basis of one' s troubles, though this certainly is a part of insight. Insight refers to an intense emotional experience that accompanies the release of repressed material. When this material is reintegrated into conscious awareness, and the person experiences the emotions associated with that previously repressed material, then we say that some degree of insight has been achieved.
As you might imagine, none of this is easy . The patient, or at least the patient' s ego, has expended much energy to repress the root of the problem in order to keep anxiety at bay. As the therapist pokes at the unconscious material through free association and dream analysis, and begins to of fer interpretations, the patient typically feels threatened. The forces that have worked to repress the disturbing impulse or trauma now work to resist the psychoanalytic process, in a stage of psychoanalysis called resistance. As the patient' s defenses are threatened by the probing psychoanalyst, the patient may unconsciously set up obstacles to progress. The patient may come up with all sorts of clever ways to misdirect or derail the psychoanalyst. The patient may for get appointments, not pay the analyst' s bill, or go very late to a session. Sometimes during a session, a patient in resistance might spend a great deal of time on trivial matters, thereby avoiding important issues. A patient might waste lots of time recalling the names of and other details about every classmate he or she knew in grade school, a process that could take weeks of session time. Or a patient who is being pressed by the analyst and confronted with interpretations might become angry and insult the analyst.
When an analyst detects a patient' s resistance, it is usually a welcome sign that progress is being made. Resistance signifies that important unconscious material i coming to the fore. The resistance itself then becomes an integral part of the interpretations the analyst of fers to the patient. For example, the analyst might say , "Perhaps you are insulting me because you want to avoid discussing the various ways in which you have been trying to make yourself sexually unattractive to men. Let' s talk some more about what you are trying to avoid by starting an ar gument with me."
Another important step in most analyses is called transference. In this stage, the patient begins reacting to the analyst as if he or she were an important figure fro the patient's own life. The patient displaces past or present feelings toward someone from his or her own life onto the analyst. For example, a patient might feel and act toward his analyst the way he felt or acted toward his father . The feelings that the patient transfers onto the analyst can be either positive or negative. For example, a patient may express her admiration for the analyst' s powerful intellect and keen mind and offer the sort of adoration that a child is likely to have toward a parent. Old conflicts and old reactions then are played out during the therapy sessions
The idea behind transference is that the interpersonal problems between a patient and the important people in his or her life will be reenacted in the therapy session with the analyst. Freud called this the "repetition compulsion," whereby the person reenacts his or her interpersonal problems with new people, including the psychoanalyst. Transference may be one source of clues about the person' s unconscious conflicts, and it provides the analyst with opportunities for o fering interpretations about the patient's behavior.
Transference can occur in everyday life as well as in psychoanalysis. The nature of our everyday interactions with others can be influenced by past relationship patterns. For example, a student might work hard on a paper to please a favorite professor. Earning less than a perfect grade on that paper—say, a B+—might cause distress, a tearful scene with the professor, or a temper tantrum. The surprised professor might wonder what this person is really reacting to. Perhaps the student is replaying a childhood pattern of reacting immaturely whenever he or she disappoints a person from whom he or she desperately seeks approval, such as a demanding parent.
Think of a time when you or someone you know overreacted to an event. Once you have identified such a situation, can you think of any similarities it has to past situations, particularly from childhood? Are there any reasons to suppose that you or someone you know who is overreacting is repeating a conflict from the past?
Movies and other modern media often portray psychoanalysis as resulting in a flas of insight, in which the patient is suddenly and forever cured. Real life is not so simple. A thorough psychoanalysis can take years, sometimes a decade or longer. The analyst provides interpretation after interpretation, illustrating to the patient the unconscious source of his or her problems. Along the way, the patient may exhibit resistance. Transference also typically becomes an issue for interpretation. Through long and laborious work by both patient and analyst, the patient gradually gains insight. The successfully analyzed patient then has available the psychic energy that his or her ego has formerly been expending in repressing conflicts. This energy may be directed into those twin pursuits Freud said were the hallmarks of adult personality development—to love and to work.
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