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현대정신분석의개입기법
작성자  simonshin 작성일  2017.01.07 19:59 조회수 965 추천 0
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 현대정신분석 소개  
첨부파일 : f1_20170107200008.pdf
 

과목: 현대정신분석의 개입 기법

주제: 현대정신분석 소개

강사: 신현근 박사

내용: 강의안

교재: Spotnitz, H. (2004). Modern Psychoanalysis of the Schizophrenic Patient: Theory of the Technique (2nd ed.). New York: YBK Publishers.

 Introduction on Modern Psychoanalysis

 

1.       Definition

1.1.    “Modern psychoanalysis” as a specific operational theory is a unitary approach that has evolved out of the experience of Hyman Spotnitz and that of his colleagues who focus on meeting the therapeutic needs of persons suffering from the schizophrenia and other severe preoedipal disorders.

 

2.       Freud’s perspectives on cure and schizophrenia

2.1.    The broad general principles for reversing the schizophrenic reaction were discovered by Freud.

2.2.    However, scientific errors of historic significance obscured Freud’s discovery, and his early clinical experience convinced him, as he stated in 1913, that the disorder was psychologically irreversible.

2.3.    Rejection of the schizophrenic individual as an unsuitable candidate for psychoanalysis reflects the continuing influence of the Freud’s warning (1913).

2.4.    Eradication of the cause of illness, thereby producing basic change in the dynamics of personality was what Freud meant by the word “cure”.  The “cure” was the promise that Freud withheld from schizophrenic individuals.

2.5.    The belief that schizophrenics were incurable – now attributed by many to the feeling of incurability they characteristically induce in the analyst - was shared by Eugen Bleuler, who coined the name “schizophrenia.”

 

3.       Goal of modern psychoanalysis

3.1.    The goal of modern psychoanalysis is to discover the forces that have driven a patient into emotional illness and to help the patient manage those forces so as to achieve emotional health and maturity.

3.2.    Modern psychoanalysts have come to think of cure as the development of a mature personality capable of thinking and feeling everything.

 

4.       Operational theory of modern psychoanalysis

4.1.    The operational theory is empirically applied to take account of the initial unresponsiveness of the preverbal personality to interpretative procedures and to the oscillating transference states.

4.2.    Post-Freudian findings on the role of aggressive forces in the early development of the mind are reflected in the theory.

4.3.    Safeguards against chaotic regression figure prominently in the clinical approach of the modern psychoanalysts: the therapeutic alliance is permitted to evolve at a pace the patient is able to tolerate.  .

5.        Spotnitz’s Conceptualization of Schizophrenia

5.1.    Three factors are primary for the psychoanalytic understanding of schizophrenia: aggression, object protection, and sacrifice of the self.

5.2.    These are the elements that combine to produce the schizophrenic nucleus of the personality.

5.3.    The operational concept follows: Schizophrenia is an organized mental situation, an intricately structured but psychically unsuccessful defense against destructive behavior.

5.4.    Both aggressive and libidinal impulses figure in this organized situation; aggressive urges provide the explosive force while libidinal urges play an inhibiting role.

5.5.    The operation of the defense protects the object from the release of volcanic aggression (narcissistic rage) but entails (or threatens) the disruption of the psychic apparatus.

5.6.    Obliteration of the object field of the mind and fragmentation of the ego are among the secondary consequences of the defense.

5.7.    The psychological murder of the object and psychological suicide are ways of fighting against the lifting of the barriers of actual murder and suicide.

 

6.       Therapeutic Approach

6.1.    Analytic Approach

6.1.1.Modern psychoanalysis does not use psychotherapy but works with transference resistance.

6.2.    Empirical Approach

6.2.1.Modern psychoanalysis is empirically applied to take account of the initial unresponsiveness of the preverbal personality to interpretive procedures and to the patient’s oscillating transference state.

6.2.2.From patient to patient, regardless of the nature of the disorder, the types of interventions employed are empirically determined by the individual responsiveness.

6.2.3.Post-Freudian findings on the role of aggressive forces in the early development of the mind are reflected in the theory.

6.3.    Patient Oriented Approach

6.3.1.The therapeutic alliance is evolved at a pace the patient is permitted to evolve at a pace patient is able to tolerate.

6.3.2.Safeguards against chaotic regression figure prominently in the clinical approach of the modern psychoanalysis.

6.3.3.Open and Pragmatic Approach

6.3.3.1.              Modern psychoanalysis accepts and works with pragmatic concept.

6.3.3.2.              It does not limit itself to psychological treatment alone.

6.3.3.3.              However, although the analyst cooperates with physicians who use physical and chemical methods with patients, he relies only on psychological communication to resolve transference resistances that interfere with mature, and healthy functioning. 

 

7.       Therapeutic Framework

7.1.    Basic Framework

7.1.1.Modern psychoanalysis begins where Freud left off, in the sense that it adheres to the basic Freudian framework of recognizing and investigating transference and resistance phenomena.

7.1.2.The modern analyst’s strategy is to create a transference situation by having the patient communicate verbally from the couch.

7.1.3.Cure is then effected through analysis and resolution of transference resistances – blocks to the expression of repressed feeling.

7.2.    Amplification of the Theory

7.2.1.Modern psychoanalysis amplifies the basic theory of psychoanalytic technique by adopting the extensive range of interventions – ego-reinforcing, emotional, and symbolic.

 

8.       Application

8.1.    Schizophrenia

8.1.1.The clinical procedures, working concepts, and interventions of modern psychoanalysis were formulated specifically for the treatment of the individuals suffering from schizophrenia.

8.2.    Extension

8.2.1.Working with aggression, modern psychoanalysts have concentrated on the cure of psychologically reversible illness, such as psychosomatic disorders, organic disorders with a psychological component, psychosis, neurosis, and character disorders.

 

9.       Methodological Area

9.1.    All psychological methods are included in modern psychoanalysis: for example, group therapy; individual sessions that range in number from one per year to as many as six per week; and treatment of one patient by several therapists or treatment of several patients by one therapist.

9.2.    Dynamic methods are used singly or in combination with other methods as long as they help resolve transference resistance, i.e., produce a mature personality.

9.3.    The methodological area is still open to research, and no one knows as yet what the limits to modern psychoanalysis will be.

 

10.   Essential Elements in Analytic Cure

10.1.                     An object capable of proving a setting conducive to emotional reactiveness and right kind of retraining.

10.2.                     Reasonably favorable life situation: If the environmental realities are too unfavorable and personal demands too great, it may be impossible to treat that patient successfully in office practice.

10.3.                     Real desire for analytic cure

In those who do not initially experience a strong urge to work for change and improvement or who do not develop it through changing circumstances of life, the desire for personal maturation needs to be created as an aspect of the treatment relationship


11.   Patients role as guide

11.1.                     Central to the development of modern psychoanalysis are patients who have worked with modern psychoanalysts.

11.2.                     When the analysts use his patients as his guide, his treatment plan itself produces growth.

 

 
 
 
 
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