🔑 Key Definitions
Transference 🔄: Client transfers feelings from past relationships onto therapist (parental, negative, positive)
Countertransference 🔁: Therapist's emotional reactions to client - awareness essential, needs supervision
Unconscious 🌑: Repository of thoughts, feelings, memories outside awareness - drives behavior without conscious knowledge
🧠 Freud's Personality Structure
- Id ⚡: Primitive drives, pleasure principle
- Ego 🧠: Reality principle, mediator
- Superego 👼: Moral conscience, guilt
🛡️ 7 Defense Mechanisms
- 1. Denial - Refusing to accept reality
- 2. Repression - Pushing to unconscious
- 3. Projection - Attributing to others
- 4. Sublimation - Channeling into acceptable activities
- 5. Rationalization - Making excuses
- 6. Regression - Returning to earlier stage
- 7. Displacement - Redirecting to safer target
🎯 Treatment Goals
- Insight - Understanding unconscious motivations
- Making connections - Linking past to present
- Working through - Processing difficult emotions
- Behavior change - Through understanding
- Improved relationships - Healthier patterns
💡 Exam Tips
- TRANSFERENCE = client → therapist; COUNTERTRANSFERENCE = therapist → client
- 7 defense mechanisms: Denial, Repression, Projection, Sublimation, Rationalization, Regression, Displacement
- Good evidence for BPD; LESS evidence for ASPD effectiveness
- Mentalization-Based Treatment (MBT) = effective for BPD
- Forensic challenges: Involuntary treatment, manipulation, security, confidentiality limits
- Therapeutic ALLIANCE is KEY to success