Psychotherapy Theory and Applications
PSY443
By Nadine Alhamzawi
Introduction to Psychoanalysis
SIGMUND FREUD
Freud started to realize that the success of therapy had more to do with the bond between the
patient and doctor than with the technique itself. This led him to focus more on that relationship,
which eventually led to his discovery of transference.
He stopped using hypnosis (the decision to give up on the hypnotic cathartic method was largely
based on Bernheim’s observation that the events recalled during hypnosis (in a hypnoid state)
could be re-evoked by patients in states of consciousness) after seeing that patients could
remember things just by being asked directly, without needing to be hypnotized.
Instead, he had patients lie down, focus on a symptom, and try to recall related memories. This
approach evolved into his famous free association method, where letting patients speak freely
was key, without interrupting their natural flow of thought.
● Unconscious Mind: The unconscious mind is a reservoir of thoughts, memories, and
desires inaccessible to conscious awareness. It significantly influences behaviour and
experiences.
● Defence Mechanisms: These are psychological strategies employed by the ego to protect
itself from anxiety arising from unacceptable thoughts or feelings. Examples include
repression, denial, and projection.
● Psychosexual Development: Freud proposed that personality develops through a series
of stages during childhood, where each stage focuses on pleasure from specific areas of
the body (oral, anal, phallic, latency, and genital).
● Transference: Transference refers to the projection of feelings and attitudes from one
person to another, often in a therapeutic relationship.
● Countertransference: Countertransference is the therapist's emotional reaction to the
patient.
● Free Association: A therapeutic technique where patients are encouraged to verbalise
thoughts as they come to mind, revealing unconscious processes.
Psychic Determinism
Psychic determinism is the idea that all thoughts, feelings, and behaviours are driven by the
unconscious mind and past experiences, especially from childhood. Freud believed nothing
happens by accident—everything has a hidden cause, even things that seem random at first.
,Instinct vs Drive
Instinct: is a natural biological urge that drives behavior, based on innate needs.
● Life instincts (Eros): which focus on survival and reproduction, and
● Death instincts (Thanatos): which are tied to aggression and self-destructive actions.
Drive: is the psychological side of an instinct, representing the internal state pushing a person to
meet their instinctual needs. Drives are shaped by social and environmental factors and can
change based on experience. Unlike instincts, drives don’t include physical responses but involve
inner tension (excitement) that motivates action. The ego controls how this inner tension leads to
behaviour, and while some actions are biologically driven, individual experiences can significantly
alter them.
Freud believed that drives are powered by psychic energy, which fuels mental and emotional
activities. He suggested that this energy is connected to our drives and can be directed toward
specific objects, people, or ideas. This focus of psychic energy is called a cathexis the amount of
energy invested in a mental representation of a person or thing. Essentially, cathexis is how much
emotional or mental energy we attach to something in our mind.
Freud’s development of drives in stages:
1. Oral Phase: In infancy, the mouth, lips, and tongue are the primary focus of pleasure and
sexual energy. For example, biting is a common way infants discharge aggressive
impulses. For instance, biting is a common way infants discharge aggressive impulses.
2. Anal Phase: During this stage, the anus becomes the main source of gratification. The
child experiences pleasure and discomfort from controlling bowel movements, with a
focus on expelling and retaining faeces.
3. Phallic Phase: By the ages 5-6, the genitals take on the central role in sexual
development. The penis becomes the primary object of interest for both boys and girls,
while the clitoris serves as the main site of sexual excitement for girls. This phase marks
the beginning of genital-focused sexual interest. Children may express aggression
through hands, teeth, and language. However, in their unconscious fantasies, the penis
may be symbolised as a weapon, such as arrows or guns, used to destroy enemies.
Fixation: refers to when the libidinal cathexis (emotional investment of psychic energy) remains
attached to early childhood objects or experiences into later life. For instance, a boy may stay
fixated on his mother.
While the focus of energy typically shifts as a child moves through developmental phases, some
of the earlier attachments or modes of gratification may linger, even unconsciously, into
adulthood, influencing later behaviours or fantasies.
, Theories of Mental/Psychic Apparatus
1-Topographical Model: This model divides the mind into three levels:
● Conscious (Cs): The thoughts and feelings we are aware of in the present.
● Preconscious (Pcs): Thoughts that aren’t immediately in our awareness but can be
brought into consciousness with some effort.
● Unconscious (Ucs): Deep-seated memories and desires that are repressed and not easily
accessible through conscious thought.
Freud explained that while the preconscious can be accessed with attention, the unconscious
remains hidden and cannot be made conscious by simply trying to focus on it.
2-Structural Model: Freud later developed this model, of the psyche into three parts (Id, Ego,
Superego)
Id:
Represents instinctual desires and drives, seeking immediate gratification.
The most basic and instinctual part of the mind, driven by raw desires and needs.
It operates on the pleasure principle, meaning it seeks immediate gratification without regard for
reality or social rules.
Present from birth, the id is responsible for fundamental urges like hunger, thirst, and sexual
desires, always pushing for satisfaction without concern for consequences or long-term planning.
Ego:
The realistic part mediates between the id’s demands and the outside world, aiming for rational
decisions.
The rational part of the mind acts as a mediator between the impulsive demands of the id and the
reality of the external world.
Operating on the reality principle, it seeks to fulfil the id's desires in realistic, socially acceptable
ways.
The ego handles decision-making, problem-solving, and managing the conflicts between the id's
urges and the moral standards of the superego, keeping behaviour balanced and appropriate.
The Differentiation of the Ego:
Refers to the process by which the ego develops distinct functions and abilities that allow it to
manage and mediate between the conflicting demands of the id, the superego, and the realities
of the external environment.
The ego plays a crucial role in how an individual interacts with their environment. For young
children, the environment primarily serves as a source of gratification for the urges and tensions
that arise from the id.
● Development of Identity: As the ego matures, it forms a clearer sense of self,
differentiating personal desires and impulses from those of others and societal
expectations.
PSY443
By Nadine Alhamzawi
Introduction to Psychoanalysis
SIGMUND FREUD
Freud started to realize that the success of therapy had more to do with the bond between the
patient and doctor than with the technique itself. This led him to focus more on that relationship,
which eventually led to his discovery of transference.
He stopped using hypnosis (the decision to give up on the hypnotic cathartic method was largely
based on Bernheim’s observation that the events recalled during hypnosis (in a hypnoid state)
could be re-evoked by patients in states of consciousness) after seeing that patients could
remember things just by being asked directly, without needing to be hypnotized.
Instead, he had patients lie down, focus on a symptom, and try to recall related memories. This
approach evolved into his famous free association method, where letting patients speak freely
was key, without interrupting their natural flow of thought.
● Unconscious Mind: The unconscious mind is a reservoir of thoughts, memories, and
desires inaccessible to conscious awareness. It significantly influences behaviour and
experiences.
● Defence Mechanisms: These are psychological strategies employed by the ego to protect
itself from anxiety arising from unacceptable thoughts or feelings. Examples include
repression, denial, and projection.
● Psychosexual Development: Freud proposed that personality develops through a series
of stages during childhood, where each stage focuses on pleasure from specific areas of
the body (oral, anal, phallic, latency, and genital).
● Transference: Transference refers to the projection of feelings and attitudes from one
person to another, often in a therapeutic relationship.
● Countertransference: Countertransference is the therapist's emotional reaction to the
patient.
● Free Association: A therapeutic technique where patients are encouraged to verbalise
thoughts as they come to mind, revealing unconscious processes.
Psychic Determinism
Psychic determinism is the idea that all thoughts, feelings, and behaviours are driven by the
unconscious mind and past experiences, especially from childhood. Freud believed nothing
happens by accident—everything has a hidden cause, even things that seem random at first.
,Instinct vs Drive
Instinct: is a natural biological urge that drives behavior, based on innate needs.
● Life instincts (Eros): which focus on survival and reproduction, and
● Death instincts (Thanatos): which are tied to aggression and self-destructive actions.
Drive: is the psychological side of an instinct, representing the internal state pushing a person to
meet their instinctual needs. Drives are shaped by social and environmental factors and can
change based on experience. Unlike instincts, drives don’t include physical responses but involve
inner tension (excitement) that motivates action. The ego controls how this inner tension leads to
behaviour, and while some actions are biologically driven, individual experiences can significantly
alter them.
Freud believed that drives are powered by psychic energy, which fuels mental and emotional
activities. He suggested that this energy is connected to our drives and can be directed toward
specific objects, people, or ideas. This focus of psychic energy is called a cathexis the amount of
energy invested in a mental representation of a person or thing. Essentially, cathexis is how much
emotional or mental energy we attach to something in our mind.
Freud’s development of drives in stages:
1. Oral Phase: In infancy, the mouth, lips, and tongue are the primary focus of pleasure and
sexual energy. For example, biting is a common way infants discharge aggressive
impulses. For instance, biting is a common way infants discharge aggressive impulses.
2. Anal Phase: During this stage, the anus becomes the main source of gratification. The
child experiences pleasure and discomfort from controlling bowel movements, with a
focus on expelling and retaining faeces.
3. Phallic Phase: By the ages 5-6, the genitals take on the central role in sexual
development. The penis becomes the primary object of interest for both boys and girls,
while the clitoris serves as the main site of sexual excitement for girls. This phase marks
the beginning of genital-focused sexual interest. Children may express aggression
through hands, teeth, and language. However, in their unconscious fantasies, the penis
may be symbolised as a weapon, such as arrows or guns, used to destroy enemies.
Fixation: refers to when the libidinal cathexis (emotional investment of psychic energy) remains
attached to early childhood objects or experiences into later life. For instance, a boy may stay
fixated on his mother.
While the focus of energy typically shifts as a child moves through developmental phases, some
of the earlier attachments or modes of gratification may linger, even unconsciously, into
adulthood, influencing later behaviours or fantasies.
, Theories of Mental/Psychic Apparatus
1-Topographical Model: This model divides the mind into three levels:
● Conscious (Cs): The thoughts and feelings we are aware of in the present.
● Preconscious (Pcs): Thoughts that aren’t immediately in our awareness but can be
brought into consciousness with some effort.
● Unconscious (Ucs): Deep-seated memories and desires that are repressed and not easily
accessible through conscious thought.
Freud explained that while the preconscious can be accessed with attention, the unconscious
remains hidden and cannot be made conscious by simply trying to focus on it.
2-Structural Model: Freud later developed this model, of the psyche into three parts (Id, Ego,
Superego)
Id:
Represents instinctual desires and drives, seeking immediate gratification.
The most basic and instinctual part of the mind, driven by raw desires and needs.
It operates on the pleasure principle, meaning it seeks immediate gratification without regard for
reality or social rules.
Present from birth, the id is responsible for fundamental urges like hunger, thirst, and sexual
desires, always pushing for satisfaction without concern for consequences or long-term planning.
Ego:
The realistic part mediates between the id’s demands and the outside world, aiming for rational
decisions.
The rational part of the mind acts as a mediator between the impulsive demands of the id and the
reality of the external world.
Operating on the reality principle, it seeks to fulfil the id's desires in realistic, socially acceptable
ways.
The ego handles decision-making, problem-solving, and managing the conflicts between the id's
urges and the moral standards of the superego, keeping behaviour balanced and appropriate.
The Differentiation of the Ego:
Refers to the process by which the ego develops distinct functions and abilities that allow it to
manage and mediate between the conflicting demands of the id, the superego, and the realities
of the external environment.
The ego plays a crucial role in how an individual interacts with their environment. For young
children, the environment primarily serves as a source of gratification for the urges and tensions
that arise from the id.
● Development of Identity: As the ego matures, it forms a clearer sense of self,
differentiating personal desires and impulses from those of others and societal
expectations.
