Jolean R. Logan
GC653-70
Dr. Mohdzain
Presentation #1
Psychoanalytic Treatment of Ruth
The psychoanalytic approach focuses on the
unconscious dynamics of Ruth’s behavior.
Considerable attention is given to material that she has repressed, such
as her current feelings of guilt and shame regarding her sexual feelings. In the past, and under her father’s control,
Ruth had to closely monitor her sexual impulses. As a result, she has introjected many of her father’s rigid views
of sexuality into her own family as an adult.
Ruth has also developed a strong superego by making the parental
standards of her parents her own. As a
result, Ruth, up until recently, has centered her life around the roles of
mother and wife. Recently, Ruth has
realized that these aspirations are unrealistic, and has begun examining her
own dissatisfaction with her life in general.
Ruth is aware that she has lived a very structured and disciplined life,
that she has largely functioned in the roles of mother and wife, and she worries
that her children and marriage will be adversely affected if she becomes
professionally involved outside of the home.
Ruth has internalized this guilt and anxiety, which eventually became
depression. As a result of this
depression, Ruth has become overweight.
All of these factors have led Ruth to seek individual therapy.
The guilt and shame that Ruth has
experiences in her life regarding issues of sexuality can be attributed back to
a critical incident which occurred at the age of six. Ruth’s father caught her and a boy “playing doctor”, and her
father did not talk to Ruth for several weeks.
The guilt and shame that Ruth experienced from that episode has remained
with her all of these years. This event
could be related to Erickson’s Psychosocial stage of Preschool Age: Initiative
versus guilt. Ruth was not given the
freedom to select activities that were personally meaningful to her at this
point, so she has not been able to develop a positive view of herself and to
successfully follow through with her projects without feelings of guilt, such
as with her schooling and desire to become a professional outside of her home
and family. Instead, Ruth has allowed
her husband and children to determine, although in an indirect way, the course
of her life. As applied to Freud’s
Psychosexual Phallic Stage, Ruth might be interpreted to have and Electra
complex for her father, which involves her intense strivings for her father’s
love and approval. According to this
view, the manner in which Ruth’s father responded to this incident when she was
six years old has contributed to the sexual attitudes and feelings that she has
developed. In addition, Ruth’s
childhood can be applied to the Stages of Development in Object-Relations
Theory. With this theory, it is proposed
that Ruth searched for relationships that match patterns established by her
earlier experiences with her mother and father. Ruth has indicated that her mother was relatively affectionate,
and that she could never do enough to please her mother. Her family was highly dependent upon and
detached from each other. As a result,
Ruth sought out a life and husband who could provide her the same patterns in
her own marriage and family.
The therapeutic process to be used with
Ruth is as follows. Two main goals of
Freudian psychoanalytic therapy are to make the unconscious conscious and to
strengthen the ego so that behavior is based more on reality and less on
instinctual cravings or irrational guilt.
As a result, successful analysis of Ruth will involve a significant
modification of her personality and character structure. Treatment will focus on restructuring,
discussing, interpreting, and analyzing her childhood experiences. The therapist will assume an anonymous
stance in therapy, in an attempt to foster a transference relationship with
Ruth of her father onto the therapist, in which she will project feelings
toward her father onto the therapist.
Ruth will be assisted in achieving self-awareness and more effective
personal relationships, and in dealing with her anxiety in a realistic
manner. Ruth will be taught the
meanings of therapeutic processes so that she can achieve insight into her
problems, increase her awareness of ways in which to change, and this gain more
control over her life. The estimated
length of therapy for Ruth is several times weekly for three to five
years. Ruth will be instructed to free
associate after some initial sessions.
Ruth will be ready to terminate her sessions when it is agreed that she
has resolved those symptoms and conflicts that were able to be resolved, when
she has clarified and accepted her remaining emotional problems, has understood
the historical roots of her difficulties, and can integrate her awareness of
past problems with her present relationships, especially with her husband and
children. In order to produce change,
the transference relationship that Ruth has for her therapist must be worked
through, and any countertransference issues also examined.
The techniques of psychoanalytic therapy as
applied to Ruth are aimed at increasing awareness, fostering insight into her
behavior, and understanding the meaning of her symptoms. The analytic framework will be maintained
with Ruth by the therapist remaining relatively anonymous, the setting of
sessions at regular and consistent times, and the ending of sessions at
designated times. Free association will
also be used, in which Ruth will be encouraged to say whatever it is that comes
to her mind. This technique will be
used in order to open the door to her unconscious. Interpretation is also a technique likely to be use with Ruth,
and this goes along with free association.
Interpretation of Ruth’s free associations, resistances, and the
therapeutic relationship will allow the ego to bring in this new material and
serves to uncover remaining unconscious material. Dream analysis might also be used with this client as another
avenue with which to explore her unconscious and to give her some needed
insight into her problems. Both the
latent and manifest content of her dreams is to be explored. Finally, Ruth’s resistance and transference
toward the therapist will be analyzed and interpreted.