FOUR

What Is Psychoanalytic Psychotherapy?

"...Psychoanalytic psychotherapy is a process of loving, emotional engagement between human beings, which, as the royal road to emotional differentiation, integration, transformation, and growth, would seem to defy quantitative units of measure......this is a "healing art," not 'science' as currently defined. The definition of "science" will have to somehow expand and broaden, in order to encompass such intersubjective processes......these processes more resemble a music teacher working on a duet WITH her pupil, rather than a doctor in a white coat, working ON her patient..."

Peter Jay Stein, MD, MA, 2018

"...This is what psychoanalysis, and "psychoanalytic" psychotherapy have become: the process of helping someone to write, rewrite, reframe, review, and re-assess their life's story (their  life "narrative"), with more depth of understanding and compassion, eager to arrive at increasing one's emotional clarity, so that each moment becomes more intensely meaningful...which also requires that the psychotherapist must change..." 

Peter Jay Stein, MD, MA, 2017

DEVELOPMENTAL LINES - EGO FUNCTIONS - SELF CAPACITIES

(mastery of the following features of the Self are required for healthy development  and mastery of life's demands)

 

1) identity formation: 

    self-constancy - an integrated, cohesive, autonomous sense of self, with self awareness and continuity through time, of attitudes, feelings and memories, including the development of a well-balanced, moral self, conscience, or superego, that can distinguish right from wrong, fairness from injustice, knowing one's own rights, and respecting the rights of others. The Self exhibits an enduring and consistent pattern of memory organization and affect.

 

2) object constancy: 

    recognition of sameness and continuity of the Other through time, as a whole, integrated, separate person, a separate subjectivity.

 

3) self esteem - object esteem: 

    By what standards does one measure oneself and others? What qualities of Self  and Other embody value and worthiness? "Object-esteem" implies that one can appreciate the value and worth of another person, even if the other disappoints us (Gertrude Blanck, 1994).

 

4) reality testing, or sense of reality: 

    a) the ability to distinguish outside oneself (external reality) from inside oneself (internal fantasy);

    b) to distinguish boundaries between self and other;

    c) the degree of accuracy or alignment that one perceives of his/her relationship to the internal and external world, reflected subsequently in one's emotional reactions and behavior, i.e., one's adaptation to realistic demands.

    d) accepting the transitional nature of: biological existence, time, mortality, and death.

 

5) affect (emotional) regulation: 

    a) the development of a full range of affect;

    b) management of anxieties, moods, shame, guilt, inhibitions, and internal emotional conflict;

    c) regulating, modulating, controlling impulses and instincts, including anger and aggressivity, to delay or postpone action via trial action, i.e., reflective awareness and thought (thought as 'trial action': Freud, 1911), whereby one represents one's anticipated behavior in fantasy, before acting on it, and considers possible, alternative outcomes.

6) cognition/intellectual functioning/memory: 

    a) capacities to read, calculate, learn, and make inferences;

    b) secondary process thinking, i.e., understanding metaphor and symbolization, and, more specifically: "in psychoanalytic theory, the more sophisticated thought processes, based on logic, obeying the rules of causality, and consistent with external reality. 

Such processes are characteristic of mature conscious thought" 

(from http://medical-dictionary.thefreedictionary.com/secondary+process+thinking)

    c) planning, organiztion, goal-setting, goal achieving

 

7) language and speech acquisition and verbal skills: 

    a) semantic, symbolic communication. 

    b) understanding human, verbal, interactive contexts, utilizing receptive and expressive functions, in order to receive and convey appropriate meanings towards objects and circumstances.

 

8) social/interpersonal skills, and social judgement:

    a) to behave appropriately in different social contexts, and to anticipate the consequences of one's actions on oneself and others; 

    b) to understand interpersonal boundaries and their violations; 

    c) to seek connectedness to others, and the capacity to set realistic goals with others; 

    d) to exhibit empathy, mindfulness, and awareness of the feelings and intentions of others; 

    e) to express altruism, humor, love, compassion, and sustained committment towards others.

 

9) physiological/somatic/perceptual integrity: 

    a healthy state of the body, and its integrated organ systems

 

10) sexuality - 

    capacities for physical intimacy.