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Classical psychoanalysis is the most challenging of all the psychotherapies in terms of time, cost and effort. It is usually conducted with the patient lying on a couch and with the analyst seated out of his/her sight, to hear what the patient has to say. The treatment sessions last about 50 minutes and are normally held four or five times a week for at least three years. The primary technique used in psychoanalysis, as well as in other dynamic psychotherapies, which consists in permitting the unconscious material to enter the consciousness of the patient, is called "free association."
According to Freud, the patient "is to tell us not only what he can say intentionally and willingly, what will give him relief like a confession, but everything else as well that his self observation yields him, everything that comes into his head, even if it is disagreeable for him to say, even if it seems to him unimportant or actually nonsensical. The difficulty of the procedure stands in the fact that for a person to speak his/her inner thoughts is a departure from years of trying to conceal them to others. Free association also present difficulties because the patients find it hard to remember repressed feelings or experiences, which are related to intense and conflicting emotions never resolved.
Attentive listening and empathy from the therapist allows the patient to express thoughts and feelings which will later allow for the discovery of underlying emotional conflicts. During treatment, the patient will try to "blame" someone for the distress he/she feels, and this person if often the psychoanalyst. This is how patients often arrive to having all sorts of feelings, ranging from love to hate and from rivalry to rejection toward the psychoanalyst. This process, the projection onto the psychoanalyst of behaviors and feelings that have originated in earlier relationships is referred to as "transference." The manner in which the analyst handles the transference is crucial to the success of the psychoanalysis. The general conception is that the patient discovers the nature of his/her unconscious feelings and then becomes able to acknowledge them. The therapist directs the patient's attention to important aspects, of which he/she seems unaware, usually relating to links between the past and present, the emotional responses to the therapist and the important people in the patient life. These feelings are then regarded in a much more dispassionate way and from a tolerant perspective, as the patient feels liberated from their influence in future behavior.
The patient gradually learns to trust the therapist and becomes increasingly able to talk candidly and sincerely about his/her most intimate feelings and thoughts. Individual dynamic psychotherapy is also similar to psychoanalysis but involves a less formal environment, as the therapist and the patient are seated, so eye contact may be achieved.
It is certain that, in these conditions, that the relationship between the therapist and the patient is very close. Psychoanalysis allows the therapist to go very deep into the soul of the person he/she is treating. Therefore, the social and ethical aspect strongly influences the bond between the two. Used in social work, psychoanalysis may present a series of contradictions and may even prove harmful to the final purpose of helping people, in some cases.
2-How theory fits with the Life Model Schema: life transitions, environmental stressors, interpersonal obstacles. If it does not fit schema, explain where incongruities exist.
Psychoanalysis has dealt with issues such as life transitions, environmental stressors and interpersonal obstacles for a very long period of time. Although its specific methods are not always similar to those of affiliated sciences, such as psychology or psychiatry, when it comes to social work, psychoanalysis may prove extremely useful in treating those illnesses that are unapproachable for the other psycho-sciences, due to their nature.
Psychoanalysis, at least in its Freudian form, concentrates on the individual and the early development stages, without considering environmental factors as much as psychology, for instance. Interpersonal obstacles are attributed to a lack of adaptation to social norms, produced by internal factors in the individual, and not by the inadequacy of social factors.
However, these elements are not totally alien to psychoanalysis. Modern research has taken into consideration all the conditions that may influence the mental health of the patient, while concentrating on the inner self of the individual. This is why it is now used on a large scale in social work - it provides a unique insight to a person's soul. Therefore, any incongruities that may appear should be overseen and integrated into the larger goal of helping people.
3- Discuss compatibility of theory with social work values, ethics and skills; as well as the theory's relation to a strengths perspective in social work.
Normal behavior means acceptance of certain more or less specific ethical values which influence, direct and motivate behavior. (Papanek, 1991). Adults are often confronted with important choices regarding various situations, and the decision they take is determined by the consequences of this decision. If such decisions involve other persons, it is imperative to assess the ethical issues at hand in order to avoid harming others or even oneself.
The system of ethical values existing in each individual cannot simply be taken from society, since the provided frame of reference must be adapted according to the needs and desires of every individual. Therefore, many psychotherapists are afraid to indoctrinate, influence or judge the patient in accordance with their own system of values, as an effect thereof would be depriving the patient of independence or self-realization.
Psychotherapy may be viewd as "adjustment therapy," the term "adjustment" referring to any type of values which the therapist manages to identify. The approach also depends on the convictions of the therapist. One might have as a goal the patient's adjustment to accepted social values, while another might believe that mental health includes a slight form of rebellion against society.
Whether he/she wants it or not, the therapist exerts in the vast majority of cases a formidable influence on the patient, by using both verbal and non-verbal communication. It would seem that every patient becomes after a more or less short period of time a "therapist addict." As I have mentioned above, as an effect of the transference process, the patient desires to be accepted by the therapist and, as a consequence, he/she will be influenced in the performed actions by what the therapist views as acceptable behavior.
The therapist should have firm convictions regarding the patient's right to own values and respect for the differences between them. The patient may have religious values or ethical values different from those of the therapist. Another area in which differences are hard to avoid is the one of family setting and sexual morality. However, the therapist must remain objective, must think rationally and "must accept and respect the patient's integrity and values, if these are genuinely held and directed toward social feeling."
General directives of behavior build a frame of reference for each individual, who has thereby the chance to complement his/her own set of ethical values, according to the expectations of each person. Psychotherapy, whether in the form of individual or group therapy, is faced with the problem of directing the patient toward mental health by inducing a social feeling and the corresponding ethical values. The therapist must strongly believe that social interest is worthwhile and natural and that his/her tolerance of the patient's set of values, as long as they remain generally acceptable, helps the patient recover more rapidly. The patient, who has in the beginning a shaky set of values, becomes healthier and integrated into society.
The assumption the strengths perspective makes is that humans have the general capacity for growth and change, which corresponds to humanist approaches to social work. This "life force," as some authors have names it (Weick, 1992 cited by Early, GlenMaye), or "the human power," as have others, (Smalley, 1967 cited by Early, GlenMaye), is the drive that constantly transforms and heals. Since the individual has the capacity to grow, change, and adapt, it may be inferred that, since families share many of the qualities of individuals, they have the same characteristics.
As a consequence, both families and individuals have a wide range of capabilities, abilities, and strengths. Each individual has some degree of experiences, characteristics, and roles, which contribute to the personality of that particular individual. (Saleebey, 1997a; Weick, Rapp, Sullivan, & Kisthardt, 1989, sources cited by Early, GlenMaye). Correspondingly, "Families have traditions, rituals, and the combined capabilities of family members. Families also share the strengths of other systems in which they are embedded, such as extended family and neighborhood.
From an empowerment perspective this means that families already are competent or they have the capacity to become competent (Dunst, Trivette, & Deal, 1994, sources cited by Early, GlenMaye). The strengths approach attempts to understand clients in terms of their strengths. This involves systematically examining survival skills, abilities, knowledge, resources, and desires that can be used in some way to help…[continue]
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