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Psychoanalytic Therapy for Peter

Discuss about the Mutual Obligations, Counseling Stages and Principles.

Psychoanalytic therapy is a type of mental treatment that is based on the theories laid down by Sigmund Freud. The therapy works to explore the influence of the unconscious mind on the behaviors and thoughts for offering insight for providing therapy resolution to the patient. The early childhood experiences are taken into consideration to investigate if those experiences have an influence on the life of the individual and have contributory effects to the present concerns (Peterfreund, 2016). This is a long term choice of therapy continuing even for years which depends on the exploration of the concern. Deep-seated changes are made on the emotional and personality development as the psychological challenges are assumed to be rooted on to the unconscious mind. This essay will discuss the case of Peter who is experiencing serious and frequent inter-personal conflicts at home and work. Mental health professionals have been unable to resolve his issue and therefore, he will be provided with the psychoanalytic therapy and the benefits from the associated modalities will be assessed.

The psychoanalytic therapy for Peter will identify the problem areas that have resulted in his interpersonal conflict. The therapy will help him to overcome the hardships that have resulted as a reaction to his past relationships and obstacles (Hall, 2013). It is a common fact that the interpersonal conflicts have resulted from the emotions that were repressed due to the difficult situations. The environment of Peter is held responsible for shaping him into someone as a result of internal conflict. The conflict gets hidden behind his present self that comes out as a negative effect of his experience of the world around him.

The treatment process in psychoanalytic therapy has been divided into three stages namely early, middle and late stages. The early or initiation stage will initiate the treatment for Peter where the therapist will get to know him. The danger situations, defensive maneuvers and characterological style that rule his behavior will be learned by the therapist. In this stage, therapeutic alliance is solidified and a rapport is established and Peter will be made aware of the therapy rules that include responsibilities of the therapist and the patient, reporting of dreams and free association (Dreher & Sandler, 2013). The initial resistances offered by Peter to the process of treatment will be noted and will be either explored immediately or stored for any future reference. Accordingly, the early transferential responses that are exhibited by the patient will also be stored and noted for using at a futuristic stage when the past experiences of the patient have been better understood and explain the present transferential responses (Sanville, 2013). The therapist learns in detail the issues of interpersonal conflicts faced by Peter at home and work for determination of the suitability of the therapy and agreements are made on the mutual obligations, counseling stages and principles. The cause and symptoms are then gradually understood by the therapist.

Stages of Psychoanalytic Therapy

The middle stage marks the pronouncement of the treatment resistance and transference response which becomes a crucial part of the treatment process. Solidification of the working alliance can help Peter to experience the real thoughts and feelings in the present with the observation of the repetitious nature of the previous responses from the past. This stage of the treatment marks the acting through the conflicts which note the past patterns that have been repeated in the present life of Peter including them, whom he meets outside the office of the therapist and the therapist himself (Huber et al., 2013). Here, the memories of Peter are recalled which were distorted previously by the fears and wishes start to become increasingly clear. This will cause Peter to experience the wider choices present in his life as the distortions of the past will not distort his present abilities of decision making. This stage is also known as the transference and consolidation stage wherein Peter will transfer his feelings of the past life to the therapist and this will benefit the therapist to better understand his childhood experiences. Here, the therapist will reveal the relationship between the disease and the inner conscious desires or conflicts and provide explanations. This will cause Peter to comprehend and realize and in reaction to this, he might provide continuous resistance that will eventually have good effects to the treatment.

The late phase is the termination phase which comprises the final part where the consolidation of the changes occurs with the solidification of the new behaviors. Understanding of the old patterns in the context of Peter's old and memories are made available which have been previously repressed. Interpersonal conflicts, maladaptive behavioral conflicts and conflicts with the therapist in the therapeutic situation are all resolved in this final stage (Summers, 2013). This is the resolution stage where the unconscious desires or conflicts of Peter will be consolidated and the end of treatment time will be declared. Transference might be repeated repeatedly and eventually Peter will become able to resolve his transference by himself. This will mark the end of the therapy.


Critiquing the psychoanalytic approach, it can be stated that the psychoanalytic approach is a great contribution by Sigmund Freud that applied the principles of cause and effect in the human behavior. Critiques have observed this approach as a scientific construct rather than considering it as an empirical system that is observable. Constructs are necessary and convenient in dealing with the subject matters that are complicated and the explanatory scheme of Freud followed a traditional trait that looked into the cause of the behavior exhibited by an individual (Summers, 2013). This is psychoanalytic approach is all about as it constitutes a provocative and dramatic picture of psychotherapy, mental illness and personality of the individuals, suffering from external or internal conflicts and trying to survive the aggressive urges. Freud believed that human beings are not rational actors and rather they are driven by the instinctual, primitive and unconscious desires. It is a significant method that is being actively used in the field of psychiatry, however, several objections have been surfaced because of its lack of theoretical rigor and methodological rigidity (Vanolo, 2014). It has been pointed out by the modern psychologists that the psychoanalytic approach is excessively relied on the data ambiguities that include free associations and dreams. This Freudian theory fails to initiate the treatment standards and seems weak without empirical evidence.

Critiquing the Psychoanalytic Approach

There have been several changes that have occurred over the time in traditional psychoanalysis as the patients now prefer a more interactive counseling experience that is carried out with the therapist. More emphasis is laid on the present problems rather than focusing on the early childhood memories. Since the concepts of psychoanalytical approach are subjective, its scientific testing is difficult (Elliott, 2015). This constitutes the situation of scientifically studying the tripartite personality or the unconscious mind. Therefore, the argument can be raised that empirical investigation of its theories and the psychodynamic perspective is unfalsifiable. A series of hypotheses are involved in the psychodynamic approach where few of them are tested easily compared to others which need more supporting evidence. Although the applied theories are not tested easily, it necessarily does not mean that it lacks strong explanatory powers. Another argument can be put forward in this regard that maximum evidence of the psychoanalytic approach has been derived from the case studies of Freud where a single person have been studied in detail which includes the middle-aged women belonging to Vienna (Vinnars, Frydman Dixon & Barber, 2013). This aspect makes the generalization of the approach difficult on a wider population.

This case study method also raises the issue of bias by the researchers where the case history of the patients is distorted to fit into the theory. The idea has also been identified as too deterministic and leaves little room for free will (Aron, 2013). However, there are few positive aspects of the psychoanalytic approach which explains behavior as it is a complete personality theory. The early childhood experiences and the unconscious mind activity are also emphasized along with the dynamic nature of the behavior. This approach can be of immense use in the psychological treatment of the mental disorders.


There are several modalities that can address or overcome the limitations of the psychoanalytic approach. These are the behavior, cognitive, humanistic and holistic therapy that acts as guidelines for the psychologists for understanding their patients and the associated problems and help them to develop the solutions (Levi et al., 2015). The behavior therapy focuses on the role of the learning in the development of abnormal and normal behaviors. The cognitive therapy emphasizes on the process of thinking of the individuals rather than their actions. The humanistic therapy emphasizes on the capacity of the people for making rational choices and helps them to develop their potential to the maximum extent (Piazza-Bonin et al., 2016). Holistic or Integrative therapy helps the therapists to customize their treatment according to the individual needs of the patients and is not restricted to a single policy.

Limitations of Psychoanalytic Therapy

Considering the interpersonal conflict of Peter, it can be stated that the modality of cognitive behavioral therapy is the best-suited modality for overcoming the limitations of psychoanalytic therapy, as discussed in the critique of the approach. This therapy is recognized as a psychosocial intervention which is a model of evidence-based practice often used for the treatment of mental disorders (Leichsenring et al., 2013). This therapy is focused on the strategies of personal coping and targets on solving the current problems by changing the undesirable cognitive patterns. It is a combination of cognitive and behavioral psychology. Since Peter is having serious problems of interpersonal conflict at work and home, the problem needs immediate intervention. As the psychoanalytic therapy requires longer term commitment, it might not provide him immediate relief and therefore, is a limitation of the applied therapy that can be overcome by a more structured modality of cognitive behavioral therapy. Peter has also sought help from different mental health professionals but was of no use and this suggests that he has already made large investments for his treatment. The psychoanalytic approach will further add up to the burden of treatment expenses due to the length of the therapy which can be avoided with cognitive behavioral therapy as it is more affordable since it is shorter in duration. The psychoanalytic approach discusses the personal or childhood history which might be disturbing for Peter whereas cognitive behavioral therapy is more focused on the present rather than investigating the past.

With the psychoanalytic approach, the treatment of Peter was based on the theoretical construct of the unconscious mind that was very difficult to prove, however, with the model of cognitive behavioral therapy, strong scientific support can be provided due to its evident effectiveness in several issues (Olatunji et al., 2013). The psychoanalytic approach requires interpretation by the therapist and therefore it lacks objectivity, however, the cognitive behavioral therapy is very much empowering as it follows the process of practical teaching techniques supported by homework which can be applied even after the conclusion of the therapy.


Interpersonal conflicts of Peter can be reduced with cognitive behavioral therapy by strictly avoiding the discussion of topics which can provoke conflict. Peter should refrain from getting into arguments that can evoke anger until his therapy completes. If his daily life activities distract him from the important therapy tasks, the efficacy of the therapy might get compromised (Cahn, 2013). Interpersonal conflict is a type of stressor that can be controlled by cognitive behavioral therapy. Therefore, social support has to be provided to Peter during the course of the treatment for reducing or eliminating his interpersonal conflicts.

Alternative Modalities to Psychoanalytic Therapy

Psychoanalytic therapy focuses on the interactions of the individual in his past so that the therapist can identify it with their present mental status. Peter is suffering from serious interpersonal conflicts which might have connections with his past. Psychoanalytic therapy will outline his thought components and how they affect his relationship with himself and others. Patterns and tendencies in the behavior of Peter will allow the therapist to recognize the reason for his interpersonal conflicts and will assess the damaging perceptions. This therapy will help Peter to act accordingly and make healthy decisions without going through the phase of anxiety as depression and anxiety often result from the interactions of the past.

References

Aron, L. (2013). A meeting of minds: Mutuality in psychoanalysis (Vol. 4). Routledge.

Cahn, D. D. (2013). Conflict in personal relationships. Routledge.

Dreher, A. U., & Sandler, J. (2013). What do psychoanalysts want?: the problem of aims in psychoanalytic therapy (Vol. 24). Routledge.

Elliott, A. (2015). Psychoanalytic theory: An introduction. Palgrave MacMillan.

Hall, H. K. (Ed.). (2013). Psychoanalytic therapy and behavior therapy: is integration possible?. Springer Science & Business Media.

Huber, D., Henrich, G., Clarkin, J., & Klug, G. (2013). Psychoanalytic versus psychodynamic therapy for depression: a three-year follow-up study. Psychiatry: Interpersonal & Biological Processes, 76(2), 132-149.

Leichsenring, F., Salzer, S., Beutel, M. E., Herpertz, S., Hiller, W., Hoyer, J., ... & Ritter, V. (2013). Psychodynamic therapy and cognitive-behavioral therapy in social anxiety disorder: a multicenter randomized controlled trial. American Journal of Psychiatry.

Levi, O., Bar?Haim, Y., Kreiss, Y., & Fruchter, E. (2015). Cognitive–Behavioural Therapy and Psychodynamic Psychotherapy in the Treatment of Combat?Related Post?Traumatic Stress Disorder: A Comparative Effectiveness Study. Clinical psychology & psychotherapy.

Olatunji, B. O., Davis, M. L., Powers, M. B., & Smits, J. A. (2013). Cognitive-behavioral therapy for obsessive-compulsive disorder: a meta-analysis of treatment outcome and moderators. Journal of psychiatric research, 47(1), 33-41.

Peterfreund, E. (2016). The process of psychoanalytic therapy: Models and strategies.

Piazza-Bonin, E., Neimeyer, R. A., Alves, D., & Smigelsky, M. (2016). Innovative Moments in Humanistic Therapy II: Analysis of Change Processes Across the Course of Three Cases of Grief Therapy. Journal of Constructivist Psychology, 29(3), 298-317.

Sanville, J. B. (2013). The playground of psychoanalytic therapy. Routledge.

Summers, F. (2013). Self creation: Psychoanalytic therapy and the art of the possible. Routledge.

Summers, F. (2013). Transcending the self: An object relations model of psychoanalytic therapy. Routledge.

Vanolo, A. (2014). Locating the couch: an autobiographical analysis of the multiple spatialities of psychoanalytic therapy. Social & Cultural Geography, 15(4), 368-384.

Vinnars, B., Frydman Dixon, S., & Barber, J. P. (2013). Pragmatic Psychodynamic Psychotherapy—Bridging Contemporary Psychoanalytic Clinical Practice and Evidence-Based Psychodynamic Practice. Psychoanalytic Inquiry, 33(6), 567-583.

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