The early days of therapeutic practice with mental imagery: the psychodynamic school
Freud and psychoanalysis
As discussed in the previous chapter, Freud (Jones, 1951) was developing his theories during the last decades of the 19 th century when there was widespread enthusiastic experimentation with a range of methods that appeared to allow access to nonconscious parts of the mind. Charcot (1825-1893) and Janet’s (1842-1910) pioneering work influenced Freud’s early experiments where he sought to use hypnosis to help his patients relive traumatic events. In 1892, Freud (Breuer and Freud, 1955) dispensed with hypnosis and used a technique of pressing his hand on the patient’s forehead to stimulate imagery and then interpreting the arising images and fantasies. Later on, he ceased to encourage this active generation of imagery and instead began to rely on other methods such as free association that he believed offered a better means for allowing a free flow of unconscious contents to arise in the patient. From then on, his work with mental imagery became restricted to interpreting his patients’ dreams and spontaneous fantasies (Freud, 1900).
This shift away from the initial active use of mental imagery can be explained by Freud’s developing formulation of psychoanalytic practices and his view of the defensive nature of the unconscious. In terms of the former, Freud believed that methods for actively generating mental images would conceal the patient’s transference and defences. Verbal methods for accessing uncensored unconscious material were viewed as less problematic in this regard. In terms of the latter, Freud believed that the unconscious is a receptacle for all the material and experiences that the conscious mind, particularly during childhood development, could not assimilate and this material is generally negative or culturally unacceptable. Consequently, the unconscious both discloses information through dream images and fantasies but also uses these images to ward off the re-experiencing of repressed material. In other words, images should not be taken at face value. The manifest image is viewed as the product of processes of symbolization, condensation and displacement. Interpretative strategies are required to explore its multiple latent meanings. Images were increasingly viewed by Freud as a manifestation of the patient’s resistance.
In summary, once the fundamental principles of the practice of psychoanalysis had been firmly established this included a particular therapeutic use of mental images limited mainly to dream imagery and fantasy. This classic approach is characterised by understanding the patient’s imagery as screen memories, i.e. what a screen conceals. The emphasis is on latent content and what the mental image conceals rather than the manifest content and what it might reveal. No one can doubt the greatness of Freud’s legacy with regard to mental imagery: his revolutionary psychoanalytical method effectively re-established mental images as important therapeutic tools. However, his interpretative framework is stamped with ‘the hermeneutics of suspicion’ (Ricoeur, 1970) - a byproduct of which is an enduring perception in popular culture that dream images are invariably disguised communications about sex.
During the 1970s, a more active engagement with patients’ mental images did resurface within this school and this was prompted by a combination of factors. Psychoanalytic approaches are not immune to cultural shifts and, as discussed in the previous chapter, during that decade there was a widespread resurgence of interest in the study of mental imagery. But, perhaps more significantly, revisions of the psychoanalytic school had taken place during the previous decades, in particular, object relations and self-structure approaches, that were less concerned with drive theory. These developments paved the way for exploring more active use of mental images. A good example of these new approaches is Silverman’s (1987) ‘imploding psychodynamic themes’ technique where the patient is actively encouraged by the analyst to conjure up affect-laden imagery. Silverman makes the case that this active technique is more likely to facilitate the patient’s process of working through inner conflict than the traditional approach of interpreting spontaneous fantasies.
Yet, despite openness to a more active role of the analyst, it is fair to say that in general, mental images do not appear to represent a significant focus of interest in current psychoanalytic theorising and contemporary psychoanalytically informed relational practice.