This Manual by Roberto Assagioli could be one of the more structured psychoanalytic work. It began with the delineation of the theory of psychosynthesis and then elaborated further with specific techniques that can be employed.
Psychosynthesis is another derivative from Freudian idea of the unconscious. Assagioli stipulated that the conflicting drives and inclinations hindered the growth of the Ego, and thus inciting the appearance of the psychopathology. His idea of psychoanalysis involves the dismantlement of the conflicting personality, the introjection of a new conception through therapy, and lastly the rebirth of an entirely new personality; thus the name of psychosynthesis.
Also central to his thoughts would be the idea of disidentification. In the midst of conflict, the Ego might project multiple identities that could be fraudulent and false; and thus the entire personality would be maladaptive. For an instance, the Ego could identify itself as a worker, and thus his entire life would be based on compulsivity. Or, on the other hand, the Ego could identify itself with its projection; the mask is now mistaken as the self itself. This is especially prominent in neurotic or borderline patients who have a very fragile sense of selfness, as soon as the illusion shattered, they fall into an abyss of despair. And so, Assagioli prescribed an exercise of disidentification that help to promote awareness to the patients that they are not their body, their feelings or their mental activities; in a way creating a “psychological distance”.
Assagioli’s conception of self and its therapeutic recommendations bordered on the risk of “psychologism”, that is interpreting psychic formulations as with biological processes. The progression from the mundane self to the higher self reminisce the genetic model of psychopathology. I appreciate the objective descriptions of active techniques prescribed; which is heavily on visualization. The rationale behind visualization would be the arising of gestalten, or psychic meanings from the exercises. Human generate meaning or understanding from psychic relations; just like we can create a face or shape out from the clouds or the wall imprintings. The exercises prescribed help to create new paths and avenues that can promote understanding of the patient’s condition.
Bu t the catch behind the many exercises prescribed, they heavily required both insight and enthusiasm from the patient’s part. We are currently stuck with a high-profile borderline patient with intense self harm ideations, very immune towards any kind of psychotherapy. Her splitting between the angelic professor with us, the evil cretin really did not help at all. And so, my team specialist agreed for me to conduct a disidentification therapy with the patient. Lo and behold, she has virtually zero ability of self-reflection, totally incapable of dissociating herself with the various identity she shackled herself with. After 45 minutes of exasperated trying, we ended the session, and even without immediate effect, the patient left the room with (I think) a grudgingly amazed from my persistence in trying.
Insight and participation from the patient is the determining factor of success in any kind of psychotherapy.