Notes to Psychotherapy

Abstract

full in drive* ----------------------------------------------------------------------------- ***Interpretation/Intervention*** see* in document* ---------------------------------------- The therapeutic effect in psychoanalysis is not the result of interpretation but psychic change is carried out by the affective content, the transference being the “key factor in analysis, with interpretation complementing it” (Andrade 2005: p. 682). Interpretations intend to broaden conscious awareness; they are for example effective when patients can verbalize experiences belonging to explicit memories. But interpretations may also influence unconscious processes such as dreaming, feeling, fantasying, thinking, and behaving. Conscious knowledge helps the patient to examine different procedures for changing his way of feeling, thinking, and behaving. The process of working through comprises unconscious modulations of self-relating and helps the patient to establish better relationships in his real life (Bleichmar 2004). Often it is not the content of the therapist’s verbal intervention the patient listens to, but the sound of the therapist’s voice, perceived as emotional expression. A professional musician in analysis tells: “I don’t remember what you (her analyst) said to me in the last session, but you appeared in my dream, in which you were a shepherd playing pastoral melodies for me.” She experienced the voice of her analyst as soothing and reassuring. According to Freud, “dreams are the royal road to the unconscious” (1900, 1900–1901), and it is true that they are probably the best tools for analytic work with early traumatized patients. The often overwhelming affects and emotions in dreams of experienced events which cannot be remembered, for which no words can be found by the patient, evoke in the intersubjective relationship and in the transference/countertransference emotions, thoughts, and images in the analyst. It is through the shared emotional investment between patient and therapist that these dreams find symbolic representation, meaning, and reconstruction in the analytic process and allow the patient to retrieve lost parts of his self and his livelihood. Britton (2002) considers the analytical process as effective if: - The patient’s relationship with his self has been enhanced and he has gained a better awareness of his relation to internal and external reality - The patient is capable of suffering, mourning, and recovering from loss - His paranoid and depressive anxiety has decreased while his faculty for (self) reflection has increased ----------------------------------------------------------------------------- **ABSTRACT** Neuroscience and psychoanalysis—regardless of their multiple differences—both deal with mind and brain. Today with a deeper neurobiological understanding of the brain, the dialogue between psychoanalysis and neuroscience has taken on a new dimension. In phylogeny and ontogeny, we witness that the unconscious mind precedes consciousness. The term unconscious refers to the unintentional nature of mental processes. Neuroscience uses the term nonconscious; nonconscious and unconscious have subtle distinctions depending on the research field of neuroscience and psychoanalysis. While there is no unified theory of consciousness, most current models provide, beyond the core of cognitive processes, room for intersubjectivity, affects, and feelings that all humans share in their embodied mind. What neuroscience cannot yet explain is the individual subjective experience. While advances in neuroscience had a significant impact on psychoanalysis with regard to theoretical concepts of the mind and the way in which psychoanalysts understand their patients, they are still of little relevance for the modus operandi in psychoanalytical therapy with a patient. The psychoanalytic process is based on an intersubjective relationship, involving the creation of a relational space in which latent development resources and resilience perspectives of a patient and mutual expectations of the patient and therapist are recorded. New functional possibilities and opportunities for more suitable integrations are explored and a more profound understanding of a commonly shared narrative is elaborated. The aim of the psychoanalytical process is directed towards working out new scope, open space and freedom, creation of alternatives, and more suitable forms of coping with life events. Psychoanalytical therapy for patients having experienced early childhood adversities is discussed. Narratives belong to the oldest tradition of mankind. In all cultures, there is a tendency to create stories about human diversity and to share tradition-based meanings: the soul of the people is reflected in their legends. Telling a story connects—by means of symbolism—memories, images, and scenes with the associated emotions and language. Narratives reveal un- and preconscious representations and phantasms of individual experiences. Telling a story also serves to ascribe meaning and significance to life events that interrupted the continuity of personal experiences. Narratives promote a grieving process and the working through of loss and psychological trauma.