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Psychodynamic Theories

Psychodynamic Theories

Read the Case of Jim in Chapter 4

Each team member should discuss the case using the psychodynamic theory as a model.  Then use the psychodynamic theory to discuss how you would use it to assess the client.  

Post an initial response to this case analysis (approximately 350 words with at least 1 scholarly source).  

THE CASE OF JIM

RORSCHACH AND THEMATIC APPERCEPTION TEST (TAT) DATA

The Rorschach Inkblot Test and the Thematic Apperception Test (TAT) were administered to Jim by, a professional clinical psychologist. On the Rorschach, Jim gave relatively few responses–22 in all. This is surprising in view of other evidence of his intelligence and creative potential. It may be interesting to follow his responses to the first two cards and to consider the interpretations formulated by the psychologist, who also is a practicing psychoanalyst.

CARD 1

JIM        The first thing that comes to mind is a butterfly.

INTERPRETATION    Initially cautious and acts conventionally in a novel situation.

JIM        This reminds me of a frog. Not a whole frog, like a frog’s eyes. Really just reminds me of a frog.

interpretation     He becomes more circumspect, almost picky, and yet tends to overgeneralize while feeling inadequate about it.

JIM        Could be a bat. More spooky than the butterfly because there is no color. Dark and ominous.

INTERPRETATION    Phobic, worried, depressed, and pessimistic.

CARD 2

JIM        Could be two headless people with their arms touching. Looks like they are wearing heavy dresses. Could be one touching her hand against a mirror. If they’re women, their figures are not good. Look heavy.

INTERPRETATION    Alert to people. Concern or confusion about sexual role. Anal-compulsive features. Disparaging of women and hostile to them–headless and figures not good. Narcissism expressed in mirror image.

JIM        This looks like two faces facing each other. Masks, profiles–more masks than faces–not full, more of a façade, like one with a smile and one with a frown. He presents a façade, can smile or frown, but doesn’t feel genuine. Despite façade of poise, feels tense with people. Repeated several times that he was not imaginative. Is he worried about his productivity and importance?

A number of interesting responses occurred on other cards. On the third card Jim perceived women trying to lift weights. Here again was a suggestion of conflict about his sexual role and about a passive as opposed to an active orientation. On the following card he commented that “somehow they all have an Alfred Hitchcock look of spooky animals,” again suggesting a possible phobic quality to his behavior and a tendency to project dangers into the environment. His occasional references to symmetry and details suggested the use of compulsive defenses and intellectualization while experiencing threat. Disturbed and conflicted references to women come up in a number of places. On Card 7, he perceived two women from mythology who would be good if they were mythological but bad if they were fat. On the next to last card he perceived “some sort of a Count, Count Dracula. Eyes, ears, cape. Ready to grab, suck blood. Ready to go out and strangle some woman.” The reference to sucking blood suggested tendencies toward oral sadism, something that also appeared in another percept of vampires that suck blood. Jim followed the percept of Count Dracula with one of pink cotton candy. The tester interpreted this response as suggesting a yearning for nurturance and contact behind the oral sadism; that is, the subject uses oral aggressive tendencies (e.g., sarcasm, verbal attacks) to defend against more passive oral wishes (e.g., to be fed, to be taken care of, and to be dependent).

The examiner concluded that the Rorschach suggested a neurotic structure in which intellectualization, compulsivity, and hysterical operations (irrational fears, preoccupation with his body) are used to defend against anxiety. However, it was suggested that Jim continues to feel anxious and uncomfortable with others, particularly authority figures. The report from the Rorschach concluded: “He is conflicted about his sexual role. While he yearns for nurturance and contact from the motherly female, he feels very guilty about the cravings and his intense hostility toward women. He assumes a passive orientation, a continual role playing and, behind a facade of tact, he continues his rage, sorrow, and ambition.”

What kinds of stories did Jim tell on the TAT? Most striking about these stories were the sadness and hostility involved in all interpersonal relationships. In one story a boy is dominated by his mother, in another an insensitive gangster is capable of gross inhumanity, and in a third a husband is upset to learn that his wife is not a virgin. In particular, the relationships between men and women constantly involve one putting down the other. Consider this story.

    Looks like two older people. The woman is sincere, sensitive, and dependent on the man. There is something about the man’s expression that bespeaks of insensitivity–the way he looks at her, as if he conquered her. There is not the same compassion and security in her presence that she feels in his. In the end, the woman gets very hurt and is left to fend for herself. Normally I would think that they were married but in this case I don’t because two older people who are married would be happy with one another.

In this story we have a man being sadistic to a woman. We also see the use of the defensive mechanism of denial in Jim’s suggestion that these two people cannot be married since older married people are always happy with one another. In the story that followed the aforementioned one, there is again the theme of hostile mistreatment of a woman. In this story there is a more open expression of the sexual theme, along with evidence of some sexual role confusion.

    This picture brings up a gross thought. I think of Candy. The same guy who took advantage of Candy. He’s praying over her. Not the last rites, but he has convinced her that he is some powerful person and she’s looking for him to bestow his good graces upon her. His knee is on the bed, he’s unsuccessful, she’s naive. He goes to bed with her for mystical purposes. [Blushes] She goes on being naive and continues to be susceptible to that kind of thing. She has a very, very sweet compassionate look. Could it possibly be that this is supposed to be a guy wearing a tie? I’ll stick with the former.

The psychologist interpreting these stories observed that Jim appeared to be immature, naive, and characterized by a gross denial of all that is unpleasant or dirty, the latter for him including both sexuality and marital strife. The report continued: “He is vacillating between expressing sadistic urges and experiencing a sense of victimization. Probably he combines both, often in indirect expressions of hostility while feeling unjustly treated or accused. He is confused about what meaningful relationships two people can have. He is ambivalently idealistic and pessimistic about his own chances for a stable relationship.

Since he sees sex as dirty and as a mode for using or being used by his partner, he fears involvement. At the same time he craves attention, needs to be recognized, and is often preoccupied with sexual urges.”

Across the Rorschach and TAT, a number of themes emerge. One involves a lack of warmth in interpersonal relationships, including a disparaging and at times sadistic orientation toward women. In relation to women, Jim has a conflict between sexual preoccupation and the feeling that sex is dirty and involves hostility. The second theme involves experiencing tension and anxiety behind a facade of poise. A third theme involves conflict and confusion about his sexual identity. Although there is evidence of intelligence and creative potential, there also is evidence of rigidity and inhibition in relation to the unstructured nature of the projective tests. Compulsive defenses, intellectualization, and denial are only partially successful in helping him deal with his anxieties.

Comments on the Data

These data about Jim highlight the most attractive feature of projective tests. Their disguise enables one to penetrate the façade of someone’s personality (in psychoanalytic terms, his or her defenses) in order to view the person’s underlying needs, motives, or drives. Information presented in Jim’s autobiography (Chapter 2) did not indicate the psychological themes evident in his projective test responses. At the same time, the interpretations from the projective tests fit with and elaborate upon themes in his autobiography such as his hiding his tension behind a façade of poise and his conflicted relationship with women.

As we not only examine psychoanalytic theory but also look forward to other theories to come, an interesting point arises. It is difficult to see how other theories of personality could make as much use of this data about Jim as psychoanalytic theory can. The assessment practices associated with other theories are unlikely to reveal this sort of information. It is only on the Rorschach that we obtain content such as “women trying to lift weights,” “Count Dracula ready to grab, suck blood. Ready to go out and strangle some woman,” and “pink cotton candy.” The TAT is unique in revealing references to themes of sadness and hostility in interpersonal relationships. These responses allow for the psychodynamic interpretations. An important part of Jim’s personality functioning appears to involve a defense against sadistic urges. The references to sucking blood and to cotton candy, together with the rest of his responses, allow for the interpretation that he is partially fixated at the oral stage. In relation to this, it is interesting to observe that Jim has an ulcer, which involves the digestive tract, and that he had to drink milk (a treatment of choice at one time) to manage this condition.

As Freud’s fame grew, he attracted followers. As may be inevitable with any person of fame and the followers he or she attracts, some followed closely in his footsteps, whereas others rejected one or more aspects of his thinking and embarked in new directions–directions they may never have considered were it not for Freud, yet that he himself would not have taken. In the remainder of this chapter, we review this post-Freudian psychodynamic tradition.