Key Concepts in Psychoanalysis

Eslee Samberg, MD

Like many specialized fields, psychoanalysis has its own technical terms. The following are some of the most important of these terms, in that they help clarify how psychoanalysts think about their work. They also represent basic organizing principles about how the mind works. They were selected and described by Eslee Samberg, MD, co-editor with Elizabeth L. Auchincloss, MD of, Psychoanalytic Terms & Concepts (2012, Yale University Press.)

the dynamic unconscious

Much of mental life, both cognitive and emotional, occurs outside of a person’s conscious awareness. Some thoughts may require purposeful attention to bring them to mind. Psychoanalysts are especially interested in the dynamic unconscious, comprised of those thoughts and feelings that are actively kept out of consciousness by the action of defenses. Such thoughts and feelings would arouse anxiety or self-censure if they became conscious. Often organized as fantasies, they continue to exert powerful effects on a person’s behavior, attitudes, and experiences. These fantasies are vestiges of the past that describe wishful relationships of the self to others. The dynamic unconscious cannot be directly apprehended. Psychoanalysts derive their understanding of the dynamic unconscious through observation and inference facilitated by the method of free association and the focus on fantasies, dreams, and the transference.

conflict and compromise

All humans experience incompatible aims and wishes that cannot be easily reconciled. Intrapsychic conflict occurs when aims and wishes evoke anxiety and personal censure as childish, selfish, or morally transgressive. Such wishes are actively kept from conscious awareness by defensive processes but their influence remains active in less direct and obvious forms. The mind seeks a compromise between conflicting aims (wish and defense) and the demands of reality that facilitates maximal satisfaction. Intrapsychic conflict and compromise are universal features of mental life. When the intensity of conflict is great maladaptive compromises impede growth and development, inhibit professional ambitions, and interfere with establishing satisfying intimate relationships. Such conflicts derive from earlier stages of life but persist in disguised form; they are often externalized and a person then attributes the source of his problems to the outside world.

defense

Defense is the way the mind guards against painful emotional experience; it is an unconscious act that serves to maintain psychic equilibrium. Defenses may take many forms and people tend to utilize a specific array that contributes to the organization of their character. For example, defenses employed by the obsessional character tend to include intellectualization, reaction formation, doing and undoing; those employed by the hysteric tend to include repression and hyper-emotionality; and those employed by borderline personality organization tend to include denial and splitting. Defense against painful emotions inevitably evident within the psychoanalytic situation is called resistance.

Although Freud described specific defense mechanisms and others were added (most notably by Anna Freud), contemporary psychoanalysts understand that any thought, emotion, action, and symptom may be used defensively. When defenses fail to contain painful emotions such as anxiety or when defenses are employed too rigidly, the result is evident as symptoms, inhibitions and other forms of psychopathology.

transference

Transference is the patient’s constellation of conscious and unconscious thoughts and feelings about the psychoanalyst that derive from his earliest relationships with parents. Specific features of the psychoanalytic situation (frequency of sessions, use of the couch, free association method) are designed to evoke unconscious fantasies from childhood that have organized the intrapsychic relationship of self to important others. These fantasies are reanimated and directed towards the analyst in the here and now and serve to demonstrate to the patient how powerfully the past lives within the present.

While transference is a universal tendency, the patient’s opportunity within a psychoanalytic treatment to understand its sources provides the greatest leverage for therapeutic change. While the dominant influence in the patient’s transference is his intrapsychic life, the analyst’s personality and behavior may influence how the transference emerges. Some analysts regard the transference as accounting for all aspects of the relationship between patient and analyst. Other analysts find it useful to distinguish the transference from the “real relationship” and from the therapeutic alliance. The therapeutic alliance is the patient’s capacity to work cooperatively with the analyst even in the face of a negative transference.

free association

Free association is the psychoanalytic technique discovered by Sigmund Freud that laid the groundwork for psychoanalytic treatment. Free association is a mental process whereby the patient reveals his thoughts to the analyst without censorship or specific agenda. In normal human discourse an effort is made to provide one’s listener with organized, coherent and goal directed content. By relaxing such efforts, the patient’s discourse follows associative pathways that are linked by unconscious thoughts and emotions rather than conscious reason and logic, demonstrating the principle of psychic determinism. The analyst is able to make inferences about the patient’s unconscious mental life and to make connections that are not otherwise apparent. The patient’s methods of defense as well as wishful impulses are revealed. All patients invariably struggle with the effort to expose intimate sometimes shameful and guilt-ridden aspects of their inner life.