Freud’s Classical Psychoanalytic Theory, Case Study Example

Patient Overview

Wilma is eighteen years-old, an isolated and clearly introverted young woman. Referred for counseling by a concerned teacher, Wilma is as well chronically depressed, confused, lacking in ordinary social skills and harboring repressed resentments. She has yet to manifest suicidal urges but, given her age and her deeper submersion into alienated behaviors stemming from childhood influences which have not abated, it is likely that, without therapy, she will.

Regarding basic school interaction, Wilma has repeatedly exhibited an incomprehension as to how functioning within a normal societal situation typically occurs. Raised in a state of emotional flux by a conflicted and unstable mother, Wilma has never had a platform substantial enough from which to step into the world, even as a child, and this translated in her case to an agoraphobic state. She was often too frightened to go to school.

Most evident in a review of Wilma’s history is a complete absence of a male figure in her life, a circumstance rendered the more potentially damaging by the ‘mythic’ qualities attributed to her absent father by her mother, entirely of a derogatory nature. Wilma does have two older brothers, both of whom are seemingly well-adjusted and socially successful, which element serves to reinforce how the trauma of the lack of any father at all is radically different in the case of a daughter. Ultimately, Wilma described herself several years earlier as ’empty, lost and vacant’, among other despairing adjectives, and it appears she has not modified this self-image.

Analysis

No meaningful treatment of Wilma can be attempted without first addressing the enormous psycho-sexual burdens placed upon her from infancy on by her mother. The absence of a father figure within the home creates a vacuum in the id of the daughter because anger takes its place; the male absence is not compensated for, but warped, and Wilma’s deepest psychological recesses are in turmoil from infancy. Moreover, the rage directed at the father never known enhances the id ‘vacuum’ because it is essentially hearsay. From the start Wilma’s identity must be based on trusting a crime based on only a distraught mother’s evidence.

Clearly, her older brothers in no way compensated for the father image. Had one or both served to provide Wilma with a strong male template, it is likely that many of her conflicts would be less severe. It appears, however, that these boys took the path fairly typical in fragmented and dysfunctional homes and simply sought to save themselves, creating a world of ‘normalcy’ away from the home as boys can more easily do. Thus, Wilma’s psyche is completely left to fend for itself. No normal male or female healthy attention from any quarter is paid to her as a growing child. She then has no conception of the crucial dynamic of male and female relations, which is vital to the successful emotional and sexual maturing of a young girl.

Moreover, her mother further undermined even this perilous situation through a persistent abusing of the absent father. Not only is the greatest male influence never known, he is then invested with a sinister character and subsequently enormous power. It is probable that Wilma’s mother did not deliberately seek to emotionally disable her daughter; victimized herself, she perpetuated her own victimhood. She was emotionally incapable of caring for a daughter because she  was clearly damaged herself and in need of a validation she had to manufacture. Such mothers do not nurture or compensate; rather, they steadily attempt to mold their children into sympathetic ‘friends’, a support system on which they can rely. Some children, as Wilma’s brothers did, escape. Others, like Wilma, remain victimized, emotionally exploited, and caught in a maze too complex and of too lengthy a duration for their comprehension.

Ultimately, Wilma is psychologically unable to function on any meaningful level because she has been given no equipment whatsoever to do so. Her id occupies too forceful a place in her life because her life has never been exposed to much beyond those dark and unknown recesses, and her ego is too fragile and underdeveloped to begin to supply a balance. It has no core of rational expectation upon which to exist, principally because no allowances were made for normal maturation from the start. Her mother set her in a role as confidant and partner in commiseration, and her brothers removed themselves, creating not merely another male vacuum but a feeling of female unworthiness as well.

In a very real sense Wilma has been locked into a raw, formative stage from her earliest years, and intense difficulties in coping can only become more apparent as she moves through adolescence. Puberty triggered in her, not natural desires to expand and explore her sexuality and her sense of impending womanhood, but a further darkness. If men do not exist for her as anything but projected and harmful images, or real and seemingly good, functional beings who dismiss her, her psycho-sexual structure is collapsed before it is erected. Young women with similar histories frequently resort to an increased and self-inflicted victimization, allowing themselves to be exploited sexually because they can fathom no other road to understanding than that which enables such powerful figures to have absolute control.

Treatment and Psychoanalytic Theory

For Wilma to begin to comprehend and then relieve her issues, a classical and topographic, rather than structural, mode of therapy will yield the greatest chance of success. In Wilma’s case, the id, ego and super-ego are in no way distinct enough as properties to be treated.

Moreover, her own admitted sense of being ‘lost’ indicates a psyche largely unaware, on any level, of the forces that have shaped it. In time and with progress, a move to structural theory may be indicated, but only after therapy has first brought to the surface those dark areas fusing her internal psychological structure.

When examined in the eighth grade – typically the peak period of physical maturing into adulthood – Wilma described herself as ‘a bunch of molecules’. The extraordinary lack of personal identity expressed in the phrase goes to the void in Wilma’s unconscious; even the most insecure person is capable of seeing himself as such, even if only in terms of being a ‘failed’ person. Wilma has no such center at all, flawed or otherwise. She is not riddled with insecurity. Rather, there is no sense of self about which to feel insecure.

An initial probing into Wilma’s subconscious must be the starting point. She must be made to feel comfortable enough to recall whatever she can and, in her instance, dreams recollected will be invaluably useful. As even rudimentary expression of feelings and desires was not possible for her in an environment where such things were either warped or presented as disastrous – a conclusion the very young Wilma probably formed through sensing her mother’s frustration at having been abandoned, clearly the basis for her anger and abuse of Wilma’ father – it is only through dreams that her innate sense of the wrongness around her, and her place in it, could have been manifested.

It is a bitter irony but this process may not be especially painful to Wilma. Her experience of life thus far does not admit to a pattern of having sought escape from unpleasant realities in fictive or real denials. She is obedient and not unintelligent, nor in any way escapist. Her personal tragedy is that she has never not accepted the shadows in which she moves, so an inspection of her past in this regard will offer no greater pain to her.

As with any successful topographic therapy, layers will reveal and overlap, but it will likely be seen that the root of Wilma’s distress and sense of nothingness will lie in the father she did not know and, of greater importance, the figure of the man as established by her unhappy mother. Her bouts of teenage agoraphobia, for instance, were reflections of her deeper fear in meeting up with that unknown and awesomely powerful male, who cannot be confronted because he did not want her. It is crucial that these elements surface because, again, such women at Wilma’s age frequently fall into a mindless promiscuity, a means of allowing sexual activity to give some sense of borders, of basic reasoning, to what is otherwise unfathomable to them.

Once the subconscious is exposed to daylight, Wilma can begin to perceive a larger picture, one that she has been unable to yet see. To accomplish this, the Freudian psychoanalytic theory must be narrowed in focus and application. In broad terms, Freud’s theory takes the twin and foundational components of the conscious and unconscious mind and treats with both as an interrelated system of id, ego and superego. In this formula the id represents primal urges within the psyche – or the more blatant ‘unconscious’ – which operates in concert with the ego, the more rational and literally thoughtful element. Both are under the psychological sway of the superego, that component which brings the values, expectations and realities of the greater world at large into the equation.

In Wilma’s case, there is not so much an issue of a more typical conflict between the id and the ego as there is an id in a chaotic, unformed state unto itself. Wilma is all latency; virtually no personal or sexual development has been permitted to evolve within her, including desires normally present in the id in childhood. Her case classically represents how a Freudian focus on ‘biography’ is essential, to exclusively delve into, and consequently strip away, the barriers imposed from her early life which have locked her into so latent a state of being. Wilma has an id, to be sure; in Freudian terms, she could not exist without one. Yet she must be led to identify elements of it within herself, still largely unknown, before any progress can be made in how she both views herself as a whole person and interacts with the outside world.

Transference on some level is highly probable and desirable, in regard to psychoanalytic theory as concentrated upon her; Wilma will be in a sense rescued, and it is inevitable that a girl so long deprived of natural male affections will respond in an affectionate manner. This, along with potential Elektra complex issues, renders it most advisable that Wilma’s therapist be female, if only that Wilma be guided through the process by a woman with no possible agenda to exploit her, and gain as well the maternal role model she never knew. From this groundwork Wilma’s true therapy can begin and most likely result in success.