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정신분석기법과정신적 갈등
작성자  simonshin 작성일  2017.04.12 15:10 조회수 1132 추천 0
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 강의안: 분석의 목표와 기타 논제  
 

과목: 정신분석 기법과 정신적 갈등

주제: 분석의 목표와 기타 논제

교수: 신현근 박사

내용: 강의안

교재: Brenner, C. (1976). Goals of analysis, case selection, practical arrangements, and other topics. In Psychoanalytic technique and psychic conflict (pp. 167-201). New York: International Universities Press.

Goals of Analysis and Other Topics


1.      The goal of psychoanalysis in general is best defined as the maximum beneficial alteration of a patient’s psychic conflicts that can be achieved by analytic means.

2.      In individual cases, analytic goals are limited.

2.1.   Psychic conflicts can never disappear.

2.2.   Psychic conflicts can only change so that the resulting compromise formations are clinically normal rather than clinically pathological.

3.      Such changes must not be thought to be of only minor consequence.

3.1.   They are often of great importance and value to the patient.

3.2.   Their importance is all the grater because, when analysis is successful, its beneficial results are always widespread.

4.      A patient’s apparent lack of progress in analysis can be due to one or more than one of several causes.

4.1.   Only analytic scrutiny can help decide which is important in a particular case.

5.      An assessment of the degree to which it is possible by analytic means to achieve a beneficial alteration of a patient’s psychic conflicts plays a role in two aspects of analytic practice that seem at first glance to be unrelated, even antithetical, namely, in case selection and in termination.

6.      In selecting cases for analysis one tries to decide, on the basis of data that are necessarily limited and often inadequate, how likely it is that one can understand and beneficially alter a patient’s conflicts to a sufficient extent to justify the time, the effort, and the expense of analysis.

7.      In deciding when to terminate an analysis one tries to decide, on the basis of data that are much more plentiful and that one hopes are fully adequate in successful cases at least, whether the prospects for further beneficial alteration of a patient’s conflict speak in favor of interrupting or terminating analysis in the not too distant future.

8.      So-called forced termination is of doubtful value in analysis.

9.      So-called practical arrangements in analysis necessarily involve in the transference.

9.1.   They must be understood in this light and, when necessary, the patient’s reaction to them should be analyzed as a manifestation or part of the transference.

10.  Free Association

10.1.                    “Free association” is an undesirable term to apply to the psychoanalytic method for two reasons:

10.1.1.  Because patients in analysis often associate to designated, consciously perceived stimuli such as dreams, symptoms, etc.

10.1.2.  Because the cornerstone of the psychoanalytic technique, i.e., is that the patient’s associatiocons are never “free.”

10.1.2.1.        To the degree that a patient renounces conscious control over his thoughts they are determined by unconscious stimuli – by the unconscious influences that are active in his mind.

10.1.2.2.        To the extent that anyone renounces conscious control over his thoughts, to the degree that he ignores his customary conscious interests, unconscious stimuli take over and control his thoughts.

10.2.                    What we do hope to accomplish is something that we understand quite differently, something to which the term “free association” does not seem appropriate in its old sense.

10.2.1.  We create a situation, both physically and psychologically, that will keep extraneous and incidental stimuli to a minimum and we encourage patients to communicate their thoughts without editing them.

10.2.2.  Largely from what a patient then tells us we form a conjecture concerning the nature and origin of his psychic conflicts and of their relation to his current mental functioning: his feelings, thoughts, dreams, fantasies, symptoms, and so on.

10.2.3.  By means of interpretations based on our conjectures we alter the patient’s conflicts so that, among other things, he can tolerate less distorted derivatives of his infantile instinctual wishes.

11.  If his analysis is successful, a patient becomes freer – freer of anxiety, guilt, and depressive affects, of symptoms, inhibitions, and suffering – but his associations are always compromise formations.

11.1.                    They are never free of defenses, never free of restrictive and distorting influences of ego and superego functioning.

11.2.                    At the end of analysis, as at its beginning associations are compromises among id, ego, and superego.

12.  Psychic conflicts result in normal compromise formations as well as pathological ones.

12.1.                    It is, therefore, useful to have a holistic approach, one that includes an in interest in both normal and pathological compromise formations and that attempts to relate all of them to one another to the extent that such a relationship exists.

12.2.                    An analyst can accomplish the task of understanding a patient’s conflict most easily, most thoroughly and most expeditiously if it is second nature for him to see the patient’s mental life as a whole rather than as a conglomerate of fragments that are only loosely held together.

13.  The adage that the child lives on in the man, or adult, can be useful as a guideline to the best solution of many technical problems in psychoanalysis.

13.1.                    When a patient behaves toward his analyst in a way that is childishly demanding, childishly complaining, childishly unreasonable, childishly fantastic, or childishly anything else – angry, stubborn, tearful, or what not – one should be neither surprised nor critical.

13.2.                    That’s the way children are, as one discovers from having analyzed enough adults – paradoxical as it sounds to say so.


 
 
 
 
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