Monday, January 11, 2010

Psychodynamic theories of anxiety


Sigmund Freud is the forerunner of this school of thought. He defined anxiety as: “a specific state of unpleasure accompanied by motor discharge along definite pathways.”
Freud postulated that human anxiety is initiated during birth process, when an infant is expelled from the safe, warm uterine environment into a potentially dangerous one. This anxiety signal is reproduced in a modified form, whenever danger recurs, throughout the life.
Defense mechanisms:
According to this theory, anxiety is an indication that something is disturbing the internal psychological equilibrium. It is a signal to the ego that an unacceptable drive is pressing for conscious representation and discharge. This is called signal anxiety. This signal anxiety arouses the ego to take defensive action to cope up rationally against the pressures from within.
These defenses serve as disguises through which people hide their motives and conflicts from themselves as well as from others. Defenses are used to reduce anxiety arising from ego’s fear of being completely overwhelmed or destroyed by the power of instincts. Thus the role of defenses is to preserve the psychological organization and stability of the individual.
The most important & basic defense is Repression. Ideally, the use of repression alone should result in restoration of the psychological equilibrium. Repression reduces anxiety by keeping anxiety-laden thoughts and impulses out of person’s consciousness. It is often described as motivated forgetting. It is directed at both, external dangers, such as fear arousing events and internal dangers such as wishes, impulses and emotions that arouse guilt.
If the defenses are successful, the anxiety is dispelled or safely contained. When repression fails, other secondary defense mechanisms are called into play. These include denial, displacement, regression and others. Through these defense mechanisms the drives achieve a partial expression. This expression is disguised in the symptoms of hysteria, phobic disorder or obsessive-compulsive disorder depending on the defense that predominates.
If repression fails to function adequately and secondary defense mechanisms are not called into play, anxiety is found only as a symptom. When it rises above the low intensity, characteristic of its function as a signal, it may emerge with the fury of a panic attack.

Developmental stages

Freud believed that people normally progress through the five stages of psychosexual development. Problems at any stage may retard or arrest development and have long term effect on the life of the person.
Oral stage:
This is observed during first year of life. The newborn is completely dependent on others for fulfillment of all his needs. During this stage,

the body pleasure is centered on the mouth. The baby gets satisfaction from sucking, eating and biting in the course of feeding.
Anal stage:
It is found in the second year of life. It is characterised by a shift in body pleasure to the anus. It is reflected by concern with retention and expulsion of faeces.
Freud felt that during this stage of toilet training, a child has the first experience with externally imposed control. The pattern of toilet training may influence the personal qualities and conflicts experienced by the person in his life. Thus, if a person is subjected to very harsh, repressive type of training during this period, it may make the person obsessed with cleanliness during the adult phase.
Phallic stage:
In this stage the child observes the differences between male and female and experiences what Freud called as Oedipus complex. This occurs at about five years of age. Freud proposed that children develop a desire for opposite sex parent and a wish to displace the same sex parent. This type of attraction leads to serious conflict, which he termed as Oedipus and Electra complex in boys and girls respectively. These two complexes were named after two Greek characters. Oedipus unknowingly killed his father and then married his mother and Electra induced her brother to kill their mother.

Latency stage:
This stage follows phallic stage and in this stage there is very little explicit or overt concern with sexuality. The child represses his or her memories of infantile sexuality and forbidden sexual activity.
Genital stage:
During this stage the person attains maturity in psychosexual development. The person becomes capable for genuine love for other people and can achieve adult sexual satisfaction. He or she may relate to others in a heterosexual fashion.
The Structure of Personality

It refers to a person’s unique and relatively stable qualities that characterise behaviour patterns across different situations and over a period of time.
The personality consists of three dynamic structures i.e. Id, Ego and Superego. They are used as strong psychological forces and not physical locations in brain.
Id: Desire:
This part of personality deals with immediate gratification of primitive needs, sexual desires and aggressive impulses. It is totally unconscious and follows the pleasure principle. Thus, Id seeks the discharge of tension arising out of biological drives. Its main concern
is ‘need gratification’ in any manner. An infant’s mind is conceived as all Id.

Ego: Reason:
It develops out of Id. It works on ‘reality principle’. It tries to maximise pleasure and minimise pain. The ego emerges in childhood and is the personality which moderates the desires of Id.

Super Ego: Conscience:
It deals with the ideals. It represents the societal demands and ideals. If a person falls short of societal norms & ideals, then superego creates the feelings of guilt and punishes the person. It provides judgements on what behaviours are ‘acceptable’ and which are ‘bad’.
Categories of anxiety
Freud broke down his concept of anxiety into three types: Reality, Moral and Neurotic anxiety.
All three are involved with the ego’s response to actual, or potential, helplessness when threatened with overwhelming psychic danger. The function of ego is of mediation between instinctual demands to ensure that some gratification is achieved, while still preserving its own integrity. If such an outcome becomes impossible, pathological anxiety results.
The reality anxiety is due to real external threat. In this the ego’s aim is to expedite the gratification of instincts without making the organism vulnerable to anger, e.g. ‘I must have / do this, but I must avoid having physical harm in the process’. If the ego is uncertain how to achieve this aim, fear related anxiety results.
The moral anxiety is due to id-superego conflict. In this the ego’s aim is to preserve its sense of its own goodness while at the same time placating the instincts, e.g. ‘If I am good and worthy, I cannot allow myself to have / do this’. Shame / guilt related anxiety results if ego fails to meet the moral demands of the superego.
The neurotic anxiety is due to id- ego conflict. In this the ego’s aim is to protect its own identity and structure while an uncharacteristic and powerful instinctual drive threatens to overwhelm it, e.g. ‘I long to have / do this, but I cannot allow myself to perceive that I am the one who has/ does this’. Neurotic anxiety results when ego cannot satisfy these conflicting aims.

Freud writes that, “In some cases the characteristics of reality anxiety and neurotic anxiety are mingled. The danger is known and real but the anxiety in regard to it is over-great, greater than seems proper to us.”

While differentiating neurosis from psychosis, he says that for neurosis the decisive factor would be the predominance of the influence of reality, whereas for psychosis, a loss of reality would necessarily be present.

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