Abnormal Psychology

120 CHAPTER 4

called dreams the “royal road to the

unconscious” (1900/1958) and pro-

posed that dreams have both:

•amanifest content, which is the con-

tent of the dream itself, as recounted

by the patient (such as a nightmare

that Leon might have about standing

in front of a group of people who are

laughing at him); and

•alatent content, which is the hid-

den, true meaning expressed by the

unconscious.

In dream analysis, the therapist

carefully examines the dream’s mani-

fest content in order to infer its latent

content. A psychodynamic therapist

might infer that Leon’s nightmare

expressed a reaction to his own ag-

gressive urges. In other words, in his

nightmare, Leon’s wish to hurt others

was transformed (via the process of

reaction formation—see Chapter 1)

into his being hurt by their laughter.

Using Resistance

At some point during psychodynamic therapy, patients are likely—overtly or covertly,

consciously or unconsciously—to hinder treatment; such behavior is referred to as

resistance. Patients may come late to therapy sessions (or forget to come at all)

or refuse to free associate, to discuss a dream, or to answer the therapist’s ques-

tions. Resistance is most likely to arise when disturbing or painful memories or

thoughts come into consciousness. Rather than viewing resistance as a problem,

the psychodynamic therapist views it as a natural part of treatment and uses it as

an opportunity to increase awareness and insight. The therapist interprets the resis-

tance as indicating the patient’s wish to avoid certain feelings or thoughts.

Using Transference

Another inevitable part of psychodynamic therapy and psychoanalysis istransference,

which occurs when patients interact with the therapist in the same manner that they

did with their parents or other important fi gures in their lives. In fact, transference

is an integral part of psychodynamic therapy, and the therapist encourages it by

nonjudgmentally asking the patient about his or her feelings toward the therapist

and encouraging the patient to explore and accept such feelings. As part of a cor-

rective emotional experience, patient and therapist talk about the patient’s feelings

toward the therapist, which serves to help the patient better understand his or her

transferred feelings and how they infl uence his or her behavior. According to psy-

chodynamic theory, as the patient becomes aware of such feelings, he or she is able

to accept them and have more choice about how—and whether—to express them.

Transference
The psychodynamic process by which
patients interact with the therapist in the
same manner that they did with their parents
or other important fi gures in their lives.

Psychoanalysts and psychodynamic thera-
pists interpret unconscious meaning from
patients’ slips of the tongue, referred to as
Freudian slips.

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CASE 4.1 • FROM THE OUTSIDE: A Patient’s Transference

A psychoanalyst describes a patient, Ms. B, and her transference:

Ms. B began her multiyear psychoanalysis when she was 29 years old, and felt she was

“stagnating in my own anger.” Ms. B was passed over for advancement and thought that she

might have to leave the [law] fi rm [where she’d worked for a number of years].

The eldest of fi ve sisters and two brothers, Ms. B came from a middle-class neighbor-

hood in New York City where her parents owned a “mom and pop candy store that everyone

called ‘Pop’s’ because my mother was always pregnant.” She describes her mother as