Introductory Lectures on Neuropsychoanalysis: Lecture Five Part 4 " How to Treat the Mind" Defense Analysis

DEFENSE ANALYSIS .............In earlier lectures I have spoken about the role of interpretation in neuropsychoanalytic treatment. I explained the part played by both transference and extratransference interpretations. But we cannot always begin with these type of interpretations. Why is this the case? Because of DEFENSE. Part of the way our minds operate is we defend ourselves from unpleasant feelings in order not to feel them. To feel the feelings would make us too uncomfortable. So we defend ourselves from the discomfort. When patients come to treatment because their defenses have failed them (which is most often the case), they will be feeling their unpleasant feelings. But when their feelings are adequately defended against, these defenses must be interpreted before transference and extratransference interpretations are attempted. Only after interpreting these defenses can we move to transference and extratransference interpretations of the unworkable, repressed, childhood prediction. For example, let's say when you were a young child your Father would scold you harshly everytime you asked him to PLAY with you. And you wanted to destroy him, kill him, or somehow remove him from the home. But he was bigger and stronger than you, and you could not get rid of him. You felt RAGE toward him as an unwanted obstacle getting in the way of your meeting your PLAY needs. You were also afraid, however , if you expressed your RAGE roward him for being in your way, he would harshly punish you. So you had a conflict that needed resolving. But your little ego was not mature enough to come up with a good solution/prediction to the conflict. So you came up with the best prediction you could at the time which was, " I cannot remove him and get my PLAY needs met, so I will comply with him and forgo meeting those needs." This was not a workable prediction because the obstacle who stood in the way of your getting your need met was still there. But it was the best solution you could come up with at the time. So to get rid of the anxiety of an insoluable conflict/inadequate prediction, your ego repressed it into your unconscious ( This is primary repression in Freud.) But because the prediction did not work ie, the frustrating obstacle was not removed, you were still left with the feeling of RAGE ( due to prediction error.) Now your ego had to call on the other defense mechanisms to defend you against the feeling of RAGE (Freud referred to these other defenses as secondary or after pressure defenses.) These defenses would be either the more realistic neurotic defenses such as reaction formation and isolation of affect, or the less realistic narcissistic/bordeline/psychotic level defenses such as introjection, projection and disavowel. Your ego at this time chose the neurotic level defense mechanism of reaction formation. The reaction formation caused you not to feel RAGE but to feel it's opposite, love. But, here is the most important part--your RAGE feeling did not really go away. It was still there-- just defended against. Now as an adult your rage is so well defended against that you find yourself unable to express RAGE at all--even when you need to. This greatly limits your life. So in order to "undefend" your childhood RAGE you need a neuropsychoanalytic analyst/therapist to help you interpret the reaction formation defense against it-- to dismantle it, so you can feel the RAGE, learn where it came from, understand the unworkable prediction that led to it, and eventually change to a new prediction that will eliminate the need for it. The eventual new prediction will allow you to remove obstacles like your Father from your life. It will say," Instead of destroying persons like my Father who get in the way of my PLAY need, I will assert myself with them and demand they stop. If they refuse, I will end my relationship with them." And since the new prediction works, and you have successfully removed the obstacle in your way, you no longer feel the RAGE. There is no longer any need for the RAGE, and therefore it does now indeed go away. And since there is now no RAGE, there is no need for the reaction formation defense against it. ....... In Modern Freudian psychoanalytic treatment this process is called Defense Analysis. As shown above, we follow a similar process in neuropsychoanalytic treatment. The difference comes in understanding the relationship of primary repression to the secondary after pressure defenses. ) Neuropsychoanalysis believes primary repression represses the unworkable childhood prediction. The other after pressure defense mechanisms then defend against the resultant unpleasant feeling. It is these after pressure defenses that the neuropsychoanalytic clinician must interpret first, before being able to interpret the repressed prediction that has caused the unpleasant feeling. The repressed prediction itself then is best interpreted through transference and extratransference interpretations. The interpreted repressed, unworkable old prediction is then eventually replaced with the new workable prediction. But replacing the old prediction with the new one requires what psychoanalytic treatment calls " Working Through."