Psychodynamic Theories of Behavior

1. Psychodynamic Theories of Behavior Robert Averbuch, MD Assistant Professor Department of Psychiatry Add pics of Freud from Web Review mini-notes from Mac for better understanding prior to lecturing Add subtitle: �Frued N� Friends�Add pics of Freud from Web Review mini-notes from Mac for better understanding prior to lecturing Add subtitle: �Frued N� Friends�

2. Who Was Freud?

3. Freud�s Theories, in Context Freud was originally trained as a Neurologist- biological approach to illness Treated mostly Hysteria (conversion disorders) Applied findings from abnormal patients to �normal� development Insert Hysteria MusicInsert Hysteria Music

4. Freud: A Sign of the Times? Time period: late 1800�s Victorian times: conservative, repressed society Prohibitions against sex

5. Key Contributions of Freud Psychic Determinism/ Dynamic Model Topographical Model of the Mind Unconscious, Preconscious, Conscious Stages of Psychosexual Development

6. Key Contributions of Freud Structural Model of the Mind ID, EGO, SuperEGO Defense Mechanisms Transference and Countertransference The Power of Catharsis

7. Behavior is Predetermined Freud sees people as passive; behaviors determined by interaction of external reality and internal drives Psychic Determinism: all behaviors driven by past experiences �There are no accidents�

8. Conflict and Behavior Instinctual Drives (libidinal: sexual, aggressive) instincts drive people Behaviors result from conflicts: Between instinctual (libidinal) drives and efforts to repress them from consciousness

9. Catharsis Inherent benefits come from releasing pent-up tension Some inherent value in the �talking cure�- being able to �unload�, or �get stuff off your mind�

10. Transference and Countertransference

11. Transference Aka �emotional baggage� UNCONSCIOUS misattribution of feelings, attitudes, and expectations from an important childhood relationship to a current one Add clip of someone in therapyAdd clip of someone in therapy

12. Countertransference Traditionally refers to the physician projecting their own feelings (�issues�, �emotional baggage�) onto their patient The corollary to �Transference�

13. Freud�s Topographic Model The �Landscape� of the Mind

14. Topographical Model Freud�s first model of psychopathology Division of the mind into three different layers of consciousness: Unconscious Preconscious Conscious

15. Unconscious Contains repressed thoughts and feelings Unconscious shows itself in: Dreams Hypnosis Parapraxes (Freudian slips) Driven by Primary Process Thinking

16. Primary Process Thinking Not cause-effect; illogical; fantasy Only concern is immediate gratification (drive satisfaction) Does not take reality into account Seen in dreams, during hypnosis, some forms of psychosis, young children, psychoanalytic psychotherapy

17. Freudian Slips (Parapraxes) A �slip of the tongue� Errors of speech or hearing that reveal one�s true but unconscious feelings ((show my drawing of �Freudian Slippers� at end of this section)) ((show my drawing of �Freudian Slippers� at end of this section))

18. Preconscious Accessible, but not immediately available Always running in the background/ behind the scenes

19. Conscious Fully and readily accessible Conscious mind does not have access to the unconscious Utilizes Secondary Process Thinking: Reality-based (takes external reality into consideration), logical, mature, time-oriented

20. Psychosexual Development

21. Psychosexual Development Children pass thru a series of age-dependent stages Each stage requires resolution of a particular conflict/task

22. Psychosexual Stages Failure to successfully navigate a stage�s particular conflict/ task is known as Fixation Leaving some energy in a stage Specific problems result from Fixation, depending on which stage is involved

23. Psychosexual Stages Freud's stages are based on clinical observations of his patients The Stages are: Oral Anal Phallic Latency Genital

24. Oral Stage Birth to 18 months Focus on the mouth and nursing Fixation results in difficulties with trust, attachment, commitment Fixation may also manifest as eating disorders, smoking, drinking problems

25. Anal Phase 18months- 2yrs Focus on the anus and potty training Failure to defecate on schedule may make parents sad/mad ((Show clip of Monica from Friends))((Show clip of Monica from Friends))

26. Anal Phase 18months- 2yrs Parental disappointment, in turn, makes baby angry and resentful towards caregivers, emotions which are defended against

27. Anal Phase Fixation may result in either: Anal retentiveness: perfectionism, obsessive-compulsive tendencies Anal expulsive: sloppy, messy, disorganized

28. Phallic (Oedipal) Phase Ages 3-6 Focus on the genitals Must successfully navigate the Oedipal Conflict ((Play �I touch myself�)) ((Play �I touch myself�))

29. Oedipal Conflict Boys want to marry mom and kill father, aka Oedipal Complex, but fear retaliation from father (castration anxiety); ultimately resolved thru identification with father

30. Oedipal Conflict Girls have penis envy, want to marry dad, aka �Electra Complex�; identify with mom to try to win dad�s love

31. Phallic (Oedipal) Phase: Ages 3-6 Resolution of the Oedipal Conflict results in formation of the Superego (the conscience- which proscribes incestual fantasies) Fixation results in attraction to unattainable partners

32. Latency Phase Ages 6-11 Sex drive is rerouted into socialization and skills development �Cooties� stage ((show pic of cooties)) ((show pic of cooties))

33. Latency Phase Ages 6-11 Don�t like opposite sex (has �cooties�) Fixation results in lack of initiative, low self esteem ((show pic of cooties)) ((show pic of cooties))

34. Genital Phase Ages 13- young adulthood Focus on adult sexual relationships

35. Structural Theory ID, EGO, and SuperEGO

36. The ID Home of instinctual Drives Completely unconscious Present at birth �I want it and I want it NOW!�

37. The Superego Internalized morals/values- sense of right and wrong aka Conscience Suppresses drives of ID (thru guilt and shame)

38. The Superego Mostly unconscious Develops with socialization, and thru identification with same-sex parent (resolution of the Oedipal Conflict)

39. The EGO Mediates between the ID, Superego, and reality Partly conscious ((Show Eggo Waffles picture)) or put picture of me((Show Eggo Waffles picture)) or put picture of me

40. Defense Mechanisms Keeping the unpleasant stuff out of mind

41. �Ego� Defense Mechanisms They serve to protect an individual from unpleasant thoughts or emotions Mostly unconscious

42. Defense Mechanisms Specific Examples

43. Mature/Healthy Defenses Altruism Anticipation Humor Sublimation Suppression

44. Sublimation Rerouting an unacceptable drive in a socially acceptable (often constructive) way A healthy, conscious defense Ex. Martial Arts

45. Suppression Deliberately (consciously) pushing anxiety-provoking material out of conscious awareness

46. Immature Defenses Acting Out Somatization Regression Denial Projection Splitting Displacement Reaction Formation Repression Magical Thinking Intellectualization Rationalization

47. Acting out Behaving in an attention-getting, often socially inappropriate manner to avoid dealing with unacceptable emotions or material

48. Somatization Unacceptable impulses or feelings converted into physical symptoms

49. Regression Return to earlier level of functioning (childlike behaviors) during stressful situations Ex. Kids regress after trauma

50. Denial Unconsciously discounting external reality

51. Projection Falsely attributing one�s own unacceptable impulses or feelings onto others Can manifest as paranoia

52. Magical Thinking The idea that one can control external events just by thinking a certain way, or by doing something that�s unrelated (superstitious behavior)

53. Splitting Selectively focusing on only part of a person Seeing people as either all-good or all-bad (Black and White thinking) Serves to relieve the uncertainty engendered by the fact that people have both bad and good qualities

54. Displacement Redirection of unacceptable feelings, impulses from their source onto a less threatening person or object Ex. Mad at your boss, so you go home and kick the dog Use Scrubs ClipUse Scrubs Clip

55. Reaction Formation Transforming an unacceptable impulse into a diametrically opposed thought, feeling, attitude, or behavior; denying unacceptable feelings and adopting opposite attitudes Ex. Person who loves pornography leads a movement to outlaw its sale in the neighborhood Review video tape of Skit on McElroy and defense mechanisms to see which ones we learned Use News clip on Fowley intern scandalReview video tape of Skit on McElroy and defense mechanisms to see which ones we learned Use News clip on Fowley intern scandal

56. Repression Keeping an idea or feeling out of conscious awareness The primary ego defense Freud postulated that other defenses are employed only when repression fails

57. Intellectualization Using higher cortical functions to avoid experiencing uncomfortable emotions; thinking without accompanying emotion

58. The End