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The psychological treatments are all various methods of therapy, with varying degrees of success. The treatments are nearly always harmless, and the only thing that a patient has to lose is the cost of the treatment, unlike antipsychotic medications, which destroy brain cells and blanket the brain, causing a sedated state of being, and ECT, which destroys tons of brain cells, leaving irreparable damage. The main types of psychological treatments are:


Started by Freud, psychotherapy is a treatment of various mental disorders and complications in which the psychotherapist "talks to the unconscious." In discussing dreams that the patient had, or just talking about life or relationships, the therapist gets a glimpse of what's going on in the unconscious mind. Once this is identified, the therapist then nudges the patient to initiate and respond to conversations that indirectly, or directly, relate to what is REALLY bothering them. This process usually takes anywhere from a year to numerous years to complete, and is often put down for taking so long to fix seemingly simple problems.



While Freud treated the patient directly, Spotnitz established objects that the schizophrenic could relate to. An example would be if the patient seemed to mention his dog a few times during the session. The analyst would then continue talk of the dog, and if the patient was in a glum mood, the analyst would paint the dog as being sad. Once the patient understood the dogs problem, the analyst would treat the dog, always reading the patient, and would ask for patient input, too, on the dog's treatment. The patient would subconsciously recognize a parallel between him and the dog, and would mature through the therapy.
Initially, in the therapy, the model schizophrenic would be withdrawn and not too eager to talk. Instead, he would be quite indifferent about the analyst. "If you die, the hospital will just send another." "Why should I care about YOUR life?" (If too much rage, rather than indifference is immediately felt towards the analyst, then this hinders the therapy, along with too much love towards the therapist.) The Modern Psychoanalytic movement sees this indifference as a repression of rage, and that this rage, instead of being directed outward, is directed to the patient himself. The analyst's first job is to try to get a glimpse of this rage and try to point it out to an object. While the Modern Psychoanalytic movement doesn't necessarily endorse catharsis, this is a good method of initiating a connection between the patient and the analyst.

Freud developed the psychosexual stages of development:
Oral (0-1 yrs)
Anal (1-3)
Phallic (4-7)
Latency (7-12)
Genital 13+

Freud only really worked with patients that were over the age of 5, with the ability to speak coherently. If a 30 year old came to him at 2:00, and started feeling left out by the 1:00, say, that the 1:00 is getting him at a better time or is getting more out of him, then Freud could recognize this as being a projection of her and her older sister. Freud could then treat this feeling of neglect, and throughout the therapy, the patient would become better. Schizophrenia, also known as the Narcissistic Neurosis, is believed to have developed in the preverbal stages of development, when the feelings that the individual had were not conveyed in words. This makes standard psychotherapy difficult, because a direct association between those feelings and speech isn't there. The therapist must then skillfully talk to those emotions and feelings, without actually talking to them. This is by use of transference.

 


When the analyst makes a "connection" with the patient, this can be done through transference. Transference is basically when the patient takes his/her aggression, or other emotions felt by previous experiences, and directs it at the analyst, being closest persona. This transference has always been key to psychoanalysis, as it is key to the analysis of the schizophrenic patient. There are different stages of transference:
Negative Narcissistic Transference
Positive Narcissistic Transference
Negative Object Transference
Erotic Transference
Positive Transference

Freud dealt only with patients who were at the NOTranference stage, and nothing earlier. It is at this stage where speech is developed, and so the patient can go through a 'talking cure.' Freud's big thing was the Talking Cure. It's basically the patient sitting on the bench, and the analyst talking and directing the patient through his problems. This doesn't work with schizophrenia, because schizophrenia is believed to start in the first stage of transference. Since this is preverbal, it is harder to treat than the average neurotic.


Mirroring is the most widely used method of treating the narcissism. Initially in the therapy, an indifference is felt by the patient towards the analyst. To help that, the analyst will engage in conversation about the what a nice day it is, if he/she likes the colors of the curtains, and so on with trivial nonsense. This will continue until the patient makes some sort of emotional attachment towards the therapist, and we hit our first transference road-block. The patient will no longer feel indifferent towards the analyst, but will feel a contempt towards him. This is a good sign. This is an indication that the aggression that is turned towards the patient's self is now being redirected, to some degree to the analyst. This is the first, and most important, connection between the analyst and the patient. The therapist's job is now to work through the negative narcissistic transference, and this is done by mirroring the patient's mood. If the patient is cautious, the therapist is cautious, if the patient is outgoing, the therapist is more outgoing. This tends to show the patient that he is in the proper atmosphere, and he is understood, to some degree. He/She will most likely become angry about narcissistic situations, like lack of attention, abuse, etc. by the analyst. Once this passes, then the patient will talk about how his life was pretty good, and will usually be in a happy state during the session. The patient usually won't say something like, "Wow, do I love your company!" but will react more like a baby at the heels of his mother, perfectly content. He is standing near his mother and is happy, but he won't say, "Boy, mom, do I love your company." The company is there, and so is the positive feeling that is felt by the analyst. After overcoming this preverbal stage,(entering the erotic level of transference), we are now in Freud's realm of psychoanalysis. Now, the patient can be treated like a neurotic, and can become functional in society, depending on the patient and analyst. This is now the most widely accepted practice, as the Modern Psychoanalytic movement is the largest analytical movement in the US.


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