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Psychoanalytic Theory

Psychoanalytic Theory

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Psychoanalytic Theory

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  1. Psychoanalytic Theory Interpretation of Dreams Models of Psyche

  2. Interpretation of Dreams1900

  3. Dream of Irma’s Injection One day I had a visit from a junior colleague, who had been staying with my patient, Irma, and her family at their country resort. I asked him how he had found her, and he answered, “She’s better, but not quite well.” I was conscious that my friend Otto’s words, or the tone in which he spoke them, annoyed me. I fancied I detected a reproof in them, such as to the effect that I had promised the patient too much...

  4. Dream of Irma’s Injection That same evening, I wrote out Irma’s case history, with the idea of giving it to Dr. M, a common friend, in order to justify myself. That night I had the following dream, which I noted down immediately upon waking.

  5. Dream of Irma’s Injection Freud dreamed he was at a formal party in a long reception hall, and his patient Irma was there. He criticized her for not accepting his interpretations, and said,“If you still get pains, it’s really only your fault.”She said she was suffering greatly, and Freud noticed that she didn’t look well. He became alarmed that he had missed a physical illness, and began examining her throat. Then he called over his friend Dr. M to examine her as well.

  6. Dream of Irma’s Injection By this point, Freud’s colleague Otto was standing next to them, and after declaring the Irma had an infection that eventually would pass, Dr. M. observed that“my friend Otto had given her an injection of propyl, propyls, propionic acid, trimethylamin (and I saw before me the formula for this printed in heavy type)... Injections of that sort ought not to be made so thoughtlessly....”

  7. Dream of Irma’s Injection Freud reports his free associations to the dream, image by image. These led to his own doubts about his medical competence and newly-propounded psychoanalytic theories. Other associations led to thoughts about supporters of his work, and others to thoughts of getting back at his detractors. He discovered that “trimethylamin”“was an allusion not only to the immensely powerful factor of sexuality, but also to the person whose agreement I recalled with satisfaction whenever I felt isolated in my opinions.”

  8. Dream of Irma’s Injection Freud concluded that : “The dream fulfilled certain wishes which were started in me by the events of the previous evening. The conclusion of the dream… was that I was not responsible for the persistence of Irma’s pains, but that Otto was. Otto had in fact annoyed me by his remarks about Irma’s incomplete cure, and the dream gave me my revenge by throwing the reproach back on to him.

  9. Dream of Irma’s Injection “The dream acquitted me of the responsibility for Irma’s condition by showing that it was due to other factors... The dream represented a particular state of affairs as I should have wished it to be. Thus its content was the fulfillment of a wish....”

  10. Interpretation of Dreams • Day Residue • Wish-fulfillment • Regression from secondary process verbal to primary process pictoralthinking • Disguise and distortion of the wish • Free association to images

  11. Theory of Dreams Manifest Content distortion daycensor residue anxiety Latent Content ( wish )

  12. Example Dream Last Saturday night, Tom went to a night club with a couple of his friends, and met another friend named Horace there, who was out with his girlfriend Terry. Tom really took a liking to Terry, and thought she maybe liked him, but he didn’t even talk with her very much because he was afraid Horace might notice his attraction to her and be angry. He went home alone and lonely, and that night had a dream:

  13. Example Dream He and Terry were horseback riding through the countryside on a beautiful autumn day. They stopped and spread out a blanket and picnic lunch under a tree, and were just about to kiss when to his horror, Tom noticed that Terry’s horse had wandered onto a road, and a large truck was bearing down on him.

  14. Example Dream Tom leaped up, raced down to the road, grabbed the horse’s reins, and led it off the road to safety just as the truck roared by. When he looked back, Terry and the picnic were gone, and he found himself coughing in the thick smoky exhaust and dust left by the truck. Then he woke up in a start.

  15. Interpretation • Day Residue: Tom met & liked Terry • Manifest: Tom saves Terry’s horse • Symbol: horse = Horace • Latent wish: get rid of Horace get Terry • Defense: reaction formation

  16. Deeper Interpretation? • Oedipal triangle? • Horse = Horace = father? • Terry = mother?

  17. Dora

  18. Cast of Characters Mother Father Herr K Frau K Dora ?

  19. Dora • Not a very interesting case • Writing it to support his theory of dream interpretation

  20. Dora “If it is true that the causes of hysterical disorders are to be found in the intimacies of the patients’ psycho-sexual life, and that hysterical symptoms are the expression of their most secret and repressed wishes, then the complete exposition of a case of hysteria is bound to involve the revelation of the intimacies and the betrayal of those secrets.” (p. 22)

  21. Dora • Treatment lasted only 3 months • Analysis focused on 2 dreams “The case has opened smoothly to my collection of picklocks” ( letter to friend )

  22. Dora • Age 12: migraines & coughing • Age 18: coughing loss of voice suicide note fainting (after argument with her father over his affair with Frau K)

  23. Dora “When she was feeling most embittered she used to be overcome by the idea that she had been handed over to Herr K. as the price of his tolerating the relations between her father and his wife; and her rage at her father’s making such a use of her was visible behind her affection for him.” (p. 50)

  24. Dora • Herr K’s “proposal” at lake (she’s 16): “The experience with Herr K – his making love to her and the insult to her honour which was involved – seems to provide in Dora’s case the psychic trauma which Breuer and I declared long ago to be the indispensable prerequisite for the production of a hysterical disorder.” (p. 42)

  25. Dora • Seduction incident at 14 (actually 13): Herr K called her to his office, and there “suddenly clasped the girl to him and pressed a kiss upon her lips. This was surely just the situation to call up a distinct feeling of sexual excitement in a girl of fourteen who had never before been approached. But Dora had at that moment a violent feeling of disgust, tore herself free from the man, and hurried past him to the staircase and from there to the street door.” (p. 43)

  26. Dora “In this scene -- second in order of mention, but first in order of time -- the behavior of this child of 14 [actually 13] was already entirely and completely hysterical. I should without question consider a person hysterical in whom an occasion for sexual excitement elicited feelings that were preponderantly or exclusively unpleasurable...”(p. 44)

  27. Dora • Conversion Hysteria “Instead of the genital sensation which would certainly have been felt by a healthy girl in such circumstances, Dora was overcome by the unpleasurable feeling which is proper to the tract of mucous membrane at the entrance to the alimentary canal -- that is, by disgust.”(p. 44)

  28. Dora “I have formed in my own mind the following reconstruction of the scene. I believe that during the man’s passionate embrace she felt not merely his kiss upon her lips, but also the pressure of his erect member against her body.”(p. 45)

  29. Dora “This perception was revolting to her; it was dismissed from her memory, repressed, and replaced by the innocent sensation of pressure upon her thorax, which in turn derived an excessive intensity from its repressed source. Once more, therefore, we find a displacement from the lower part of the body to the upper....” (p. 45)

  30. Dora Freud became convinced Dora’s cough represents defense against wish-fulfilling image of fellatio. He reports that when Dora accepted his interpretation, her cough disappeared.

  31. Dora “...she had all these years been in love with Herr K. When I informed her of this conclusion, she did not assent to it.”( p. 53)

  32. Theory of Dreams Manifest Content distortion daycensor residue anxiety Latent Content ( wish )

  33. Dora: First Dream “A house was on fire. My father was standing beside my bed and woke me up. I dressed myself quickly. Mother wanted to stop and save her jewel-case; but Father said: ‘I refuse to let myself and my two children be burnt for the sake of your jewel-case.’ We hurried downstairs, and as soon as I was outside I woke up.” (p. 81)

  34. Dora: First Dream • Herr K had given her an expensive jewel case • “jewel case” slang for “genitals” • Freud explains “jewel case” symbolizes her threatened virginity • Dora: “I knew you’d say that!”(p. 87)

  35. Dora: First Dream “The meaning of your dream is now becoming even clearer. You said to yourself: ‘This man is persecuting me; he wants to force his way into my room. My jewel case is in danger, and if anything happens it will be Father’s fault.’ For that reason in the dream you chose a situation which expresses the opposite -- a danger from which your father is saving you.” (p. 87)

  36. Dora: First Dream • The dream means:“I must fly from this house, for I see that my virginity is threatened here; I shall go away with my father, and I shall take precautions not to be surprised while I am dressing in the morning.” (p. 104) • Further:“You were ready to give your father what your mother withheld from him...”

  37. Freud: Oedipal Interpretation • Unconscious identification with Frau K, who’s sleeping with her father • Conscious wish to get father from Frau K • Repressed sexual attraction to Herr K = displacement from father

  38. Only a cigar?

  39. Dora: Second Dream Her father dies. She has stuck-in-mud feeling trying to get to the railroad station to get home. She finds herself in a wood with a man who she asks for directions, and he tells her “it’s two hours more.” (p. 114)

  40. Dora: Second Dream Dora’s association to the man’s “two hours more” leads to a recollection of staring for two hours at a picture of the Madonna with child.

  41. Dora: Second Dream • Freud: the encounter with the man in the woods represents the scene of Herr K’s attempted seduction. • Staring at Madonna with child represents her readiness to give up her Oedipal attachment to her father, and move on to becoming some man’s wife and having a baby.

  42. Dora • Apparently “hysterical” appendicitis occurred 9 months after Herr K’s advances at the lake • Freud infers this = hysterical childbirth • Confirms interpretation of unconscious fantasy / desire for Herr K • Dora “disputes no longer” her love for Herr K (p. 113)

  43. Dora: termination • Dora confronts adults about their duplicity • Breaks off treatment

  44. Freud on Dora (1914) “What a measure of self-complacency and thoughtlessness must be possessed by anyone who can, on the shortest acquaintance, inform a stranger who is entirely ignorant of all the tenets of analysis that he is attached to his mother by incestuous ties....

  45. Freud on Dora (1914) “Behavior of this sort will completely discredit oneself and the treatment in the patient’s eyes, and will arouse the most violent opposition in him, whether one’s guess is true or not... As a rule the therapeutic effect will be nil; but the deterring of the patient from analysis will be final.”

  46. “Rat Man” Case • Gotten “stalled” in life: • Couldn’t finish college • Couldn’t decide whether or who to marry • Couldn’t decide profession • Compulsive ideas: • to cut throat with razor • Obsessive ideas: • Rituals to protect father and girlfriend

  47. “Rat Man” Case When I was 6 years old I already suffered from erections… and at that same time I used to have the morbid idea that my parents knew my thoughts… There were girls who pleased me very much, and I had a very strong wish to see them naked. But in wishing this I had an uncanny feeling, as thought something must happen if I thought such things – for instance, that my father might die – and as thought I must do all sorts of things to prevent it.

  48. “Rat Man” Case • In army, an officer “fond of cruelty” told of rat torture • Horrified & revolted, but began to have sudden thoughts of father & girlfriend subjected to the torture (especially after masturbating) • Would make vow to do something to protect them

  49. “Rat Man” Case • Therapy effected through transference • Acted out conflicts with Freud as authority figure (“captain,” father) • Abreacted emotions of rage & shame at Freud • No complete recovery of traumatic memories • Gained insight into ucs. wishes & fears

  50. “Rat Man” Case • Obsessive-Compulsive Neurosis [ no dissociation or “conversion” ] • Undoing: acting-out  repentance / reparation • Reaction formation: rituals to save loved person from harm, but images of harm fulfill ucs. wish