Karin, Demetris, DAndra, Walter

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Shift from individualism of Freudian theory to relationship oriented object relations theory and self psychology Dissatisfaction with cybernetic model Truths were found in systematic interactions, but self awareness was key to unlocking the inner conflict and confusion of an individual Psychoanalytic therapist probe beneath family dialogue by exploring individual family members fears and longings

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An important feature of psychoanalytic view is that family are a group of interlocking, intra psychic system Psychoanalytic treatment involves uncovering and interpreting unconscious impulses and defenses against them. Family interactions should be analyzed and to know where to look and discover basic wants and fears that keep individuals from interacting in a mature way Nature of interactions are partly dictated by psychic organization of unsuspected depth and complexity

Freudian Driven Psychology Sexual and aggressive drives lead to acting on impulses

This results in conflict that drive behaviors and lead to punishment Expression of Anxiety or Depression is punishing due to unconscious past experiences and associations Balances of conflict can be associated by strengthening the defenses against impulses or relaxing defense to permit gratification

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Every Human longs to be appreciated Parents who demonstrate appreciation have children who internalize acceptance and form strong self confident personalities. They are able to stand alone and love Flat, unresponsive or withdrawn parents have children who crave appreciation. They are unhappy, cheated out of loving affirmation, and will live life craving attention he was denied

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Psychoanalysis + Family Therapy=The study of individuals and their deepest motives combined with the study of social relationships Childhood experiences are key to later problems in relationships People relate to others on the basis of expectations formed by early experience Internal Objects-mental images of self and others are built up from experience and expectations

Fairbairn redefined Freuds concept of splitting into a 3 part ego division resulting ina central,rejecting and exciting ego

External object is experienced by 1) An ideal object which leads to satisfaction 2) A rejecting object which leads to anger 3) An exciting object which leads to longing If splitting isnt resolved, object relations retain either an all good or all bad quality

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Attachment is considered a basic need in all creatures (Spitz and Bowlby). Analectic depression results from a denial of such an attachment resulting in a turning away from the world and withdrawal into apathy Denial of such a need results in enmeshed and disengaged relationships Separation-individuation a gradual process of separation from the mother which, successfully done, will produce a well differentiated self (Marget Mahler)
Failure of separation process results in overly intense emotional attachments which may be seen during lifes transitions (school, adolescence)

A mother who does not meet a childs need for tenderness may dissociate to escape anxiety when exposed to pain or frustration that would be intolerable This creates responses to future interpersonal situation. These self dynamism are: Good me, bad me and not me An individuals capacity for dealing with conflict and failure is related to the depth of maturity of the internal world of object relations Trust in self is based on the goodness of others and confirmation of love form internalized good objects

An average expectable environment featuring good enough mothering is adequate in order to thrive Early attachment between mother and child are critical aspect of healthy development An infant needs emerging and identification with the mother as a foundation for growth Infants become less dependent on mothers and may adopt a transitional object

Phases of development
Initial Autistic phase and Symbiotic phase Separation individuation period- allows the child to know the mother is constantly there as in peek a boo phase Earliest introjections occur in process of separation from mother-successfully done ensures child is an independent being Process is subverted if infant clings and separation is anxiety driven/provoking A child with a history of good object relations can tolerate closeness and separation

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Self Psychology-secure attachments developed through 1) mirroring( I see how you feel) 2) idealization -parents are terrific and I am part of them)

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Grandiosity gives way to self esteem; idealization of parents becomes the basis for personal values Not subdued grandiose self can result in Narcisstic personality disorder(NPD) Lasch describes NPD as lonely craves attention and is easily angered who craves to be a hero since this does not occur rage takes place (result of the narcisstic wound) Freud said this a disruption of self preserving instinct

Daniel Stern claimed child development is not a gradual process of separation and individuation Infants differentiate from birth through increasing complex modes of relatedness From Attunement to empathy these are life long needs Individual personalities make up families

These interlocking fantasy have been referred to as: mutual projective identification, neurotic complementary, marital collusion, mutual adaption, conscious and unconscious contracts. Boszormentyi-Nagy Contributions of psychodynamic family therapist is the concept of contextual therapy which emphasizes the ethical dimension of family development.

Poorly differentiated children face a crisis in adolescence when developmental pressures for independence conflict with infantile attachments
When they marry they may seek constant approval or automatically reject any influence or both Over evaluation of a loved object leads us to make poor judgments based on idealization Your own identity glows in the radiance of a companion

False Self-Children suppress feeling s that lead to rejection which may lead to schizoid behavior Prior to marriage powerful dependency needs, narcissim and unruly impulsive come to light Projective identification is a mutual way in which interactions between two people can activate latent elements in each others personality

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In Marriage:
Our own needs and feelings are hidden to win approval Marriage is a balance of rights and responsibilities Projective identification is a mutual way in which interactions between two people can activate latent elements in each others personality Marriage is a transaction between hidden internalized objects Maritial studies looked at marital bonds due to unconscious fantasy-

Martial Contracts have unconscious factors and 3 levels of awareness (Sager)

1) Verbalized, not always heard 2) Conscious not verbalized due to feaar of anger or disapproval 3) Unconscious Partners become angry if the other does not live up to the terms

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Children represent a more devoted love object than the spouse, someone to succeed when parents failed, or a peace offering to grandparents Delineations(Zinner and Shapiro) occur when parental actions communicate parental fantasy to their children Pathological delineations are based on parents defensive needs than on realistic perceptions of children-children are labeled as bad, brilliant,etc regardless of the truth

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Children identified as patients project identification to cement attachments, assuage unconscious guilt, or preserve their parents shaky marriage Family myths serve the same function in families by simplifying and distorting reality Families experience fixation and regression. When under stress they become stuck in dysfunctional patterns and regress to earlier levels of development Invisible loyalties are unconscious commitments children take on to help families to the detriment of their own well being which result in pathological reactions

Relationship problems occur because children distort their perceptions by attributing the qualities of one person to someone else. This is referred to as:
x x x x x x x x Transference (Freud) Scapegoating Trading of Disassociations Merging Irrational role assignments Delineations Symbiosis Family projection Process

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To free families members of unconscious constraints so that they are able to interact with one another as healthy individuals Provide long term therapy, however, many times crisis resolution with symptom reduction is key as seen in family therapy. Separation-individuation or differentiation (similar to Bowens concept) To help families convene and learn to let go of one another in a way that allows individuals to be independent as well as related To help family members overcome irrational unproductive guilt and to claim their entitlements

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Insight is necessary but not sufficient Insights have to be worked through to the point where new ways of interacting emerge. The therapist has to interrupt to get couples to get in touch with what they are feeling and avoiding

Listening ` Empathy ` Interpretations-clarifies hidden aspect of experience ` Analytic Neutrality-understanding without worrying on solving problems. Anxious involvement is suspended with outcomes
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Couple therapy organizes exploration along 4 channels 1. Internal experience 2. History of experience 3. How partner triggers the experience 4. How context of session and therapist input might contribute to whats going on

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2. 3.

Sessions begin by inviting family members to discuss concerns, thought and feelings. Have familys decide what to discuss Interpretations are made about how family members continue to re enact the past and distorted images from childhood

1. 2. 3.

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Projective identification may occur when feelings are communicated and provoked by subtle symbols. To work through this a therapist must: Interrupt squabbling which may be masking true feelings Explore how each individual is feeling Projecting partner is told to listen, not communicate or comment Once finished, the projector is to feedback what she understood the partner to be saying in an empathetic manner.

Couple comes for counseling. Presenting problem is that husband was caught text messaging an old girlfriend Happy Birthday-Juan. Wife has been jealous and insecure, and now she knows without a doubt that he is, or will soon, cheat on her. He angrily claims that he has been loyal, but that she is always controlling him, and hes not free to show respect and friendship toward men or women he has known. He insists on having more freedom, while she insists that he cut off his relationships with old girlfriends and men who are bad influences.

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Couple comes for counseling. They have been married for six years, and have three young children. Mom works and juggles parenting duties with a bank job. Dad is a coach, and is away at night a lot during football and basketball season. Kids are doing well at school, but parents have begun arguing over little things. Every time they talk, they get into an argument, and lately have been using a lot of foul language. He thinks she needs to quit work because she doesnt have any time for him, and she thinks he needs to spend more time at home with the kids.

What is hidden in family dialogues is not consciously withheld but repressed into unconsciousness Insight and understanding is urged in order to consider what families are going to do about problems they discuss Families are urged to develop a balance of fairness

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Psychoanalysis have been criticized for absolving people for responsibility of their actions Resistance to empirical standards for Psychoanalytical therapy-difficult to measure Symptom reductions is not the goal but the presence or absence of unconscious conflict