Psychoanalytic approach to human development. Psychoanalytic and humanistic approaches to personality

Walking- one of the most complex and at the same time common types of physical activity.

Cyclic walking movements trigger the lumbosacral centers spinal cord, regulate - the cerebral cortex, basal ganglia, brain stem structures and cerebellum. This regulation involves proprioceptive, vestibular and visual feedback afferentation.

Gait human being is a harmonious interaction of muscles, bones, eyes and inner ear. The coordination of movements is carried out by the brain and the central nervous system.

In case of disturbances in certain parts of the central nervous system, various movement disorders: shuffling gait, sudden jerking movements, or difficulty bending joints.

Abasia(Greek ἀ- prefix with the meaning of absence, non-, without- + βάσις - walking, gait) – also dysbasia– disturbance of gait (walking) or inability to walk due to gross gait disturbances.

1. In a broad sense, the term abasia means gait disturbances with lesions involving various levels of the system of organizing the motor act, and includes such types of gait disturbances as ataxic gait, hemiparetic, paraspastic, spastic-atactic, hypokinetic gait (with parkinsonism, progressive supranuclear paralysis and other diseases), apraxia of walking (frontal dysbasia), idiopathic senile dysbasia, peroneal gait, duck gait, walking with pronounced lordosis in the lumbar region, hyperkinetic gait, gait in diseases of the musculoskeletal system, dysbasia in mental retardation, dementia, psychogenic disorders, iatrogenic and drug dysbasia, gait disturbances in epilepsy and paroxysmal dyskinesia.

2. In neurology the term is often used astasia-abasia, with integrative sensorimotor disorders, more often in the elderly, associated with a violation of postural or locomotor synergies or postural reflexes, and often a variant of imbalance (astasia) is combined with a walking disorder (abasia). In particular, frontal dysbasia (gait apraxia) is distinguished when it is affected frontal lobes brain (as a result of stroke, dyscirculatory encephalopathy, normal pressure hydrocephalus), dysbasia in neurodegenerative diseases, senile dysbasia, as well as gait disturbances observed in hysteria (psychogenic dysbasia).

What diseases cause gait disturbances?

A certain role in the occurrence of gait disorders belongs to the eye and inner ear.

Older people with deteriorating vision develop gait disturbances.

A person with an inner ear infection may exhibit balance problems that lead to disturbances in their gait.

One of the common sources of gait disorders are functional disorders of the central nervous system. These may be conditions associated with taking sedatives, alcohol and drug abuse. Apparently, a certain role in the appearance of gait disorders plays poor nutrition, especially in older people. Vitamin B12 deficiency often causes numbness in the limbs and poor balance, leading to changes in gait. Finally, any disease or condition that affects nerves or muscles can cause gait disturbances.

One such condition is a pinched disc in the lower back. This condition is treatable.

More serious disorders that cause gait changes include amyotrophic lateral sclerosis (Lou Gehrig's disease), multiple sclerosis, muscular dystrophy, and Parkinson's disease.

Diabetes often causes loss of sensation in both legs. Many people with diabetes lose the ability to determine the position of their legs in relation to the floor. Therefore, they experience postural instability and gait disturbances.

Some diseases are accompanied by gait disturbances. If there are no neurological symptoms, the cause of the gait disorder is difficult to find out even for an experienced doctor.

Hemiplegic gait is observed with spastic hemiparesis. In severe cases, an altered position of the limbs is characteristic: the shoulder is adducted and turned inward, the elbow, wrist and fingers are bent, the leg is extended at the hip, knee and ankle joints. The step with the affected leg begins with abduction of the hip and movement in a circle, while the body deviates in the opposite direction (“the hand asks, the leg squints”).
With moderate spasticity, the position of the arm is normal, but its movements in time with walking are limited. The affected leg bends poorly and is turned outward.
Hemiplegic gait is a common residual disorder after stroke.

With a paraparetic gait, the patient moves both legs slowly and tensely, in a circle - the same as with hemiparesis. Many patients have legs that cross like scissors when walking.
Paraparetic gait is observed with spinal cord lesions and cerebral palsy.

Cock gait is caused by insufficient dorsiflexion of the foot. When stepping forward, the foot partially or completely hangs down, so the patient is forced to raise his leg higher - so that the toes do not touch the floor.
Unilateral disorder occurs with lumbosacral radiculopathy, neuropathy sciatic nerve or peroneal nerve; bilateral - for polyneuropathy and lumbosacral radiculopathy.

The duck gait is explained by the weakness of the proximal muscles of the legs and is usually observed with myopathies, less often with lesions of the neuromuscular junction or spinal amyotrophy.
Due to weakness of the hip flexors, the leg is lifted off the floor due to the tilt of the torso, the rotation of the pelvis promotes the movement of the leg forward. Weakness of the proximal leg muscles is usually bilateral, so the patient walks in a waddling manner.

With a parkinsonian (akinetic-rigid) gait, the patient is hunched over, his legs are bent, his arms are bent at the elbows and pressed to the body, and a pronation-supination rest tremor (with a frequency of 4-6 Hz) is often noticeable. Walking begins by leaning forward. Then follow mincing, shuffling steps - their speed steadily increases, as the body “overtakes” the legs. This is observed when moving both forward (propulsion) and backward (retropulsion). Having lost balance, the patient may fall (see "Extrapyramidal disorders").

Apraxic gait is observed with bilateral damage to the frontal lobe due to impairment of the ability to plan and execute a sequence of actions.

Apraxic gait resembles Parkinsonian gait - the same “supplicant pose” and mincing steps - however, upon detailed examination, significant differences are revealed. The patient easily performs the individual movements necessary for walking, both lying and standing. But when he is asked to go, he cannot budge for a long time. Having finally taken a few steps, the patient stops. After a few seconds, the attempt to walk is repeated.
Apraxic gait is often associated with dementia.

With choreoathetotic gait, the rhythm of walking is disrupted by sudden, violent movements. Due to chaotic movements in the hip joint, the gait looks “loose.”

With a cerebellar gait, the patient places his legs wide apart, the speed and length of steps change all the time.
When the medial zone of the cerebellum is damaged, a “drunk” gait and ataxia of the legs are observed. The patient maintains balance both with open and closed eyes, but loses it when the position changes. The gait may be fast, but it is not rhythmic. Often, when walking, the patient experiences uncertainty, but this goes away if he is at least slightly supported.
When the cerebellar hemispheres are damaged, gait disturbances are combined with locomotor ataxia and nystagmus.

The gait with sensory ataxia resembles a cerebellar gait - legs widely spaced, loss of balance when changing position.
The difference is that when the eyes are closed, the patient immediately loses balance and, if not supported, may fall (instability in the Romberg position).

Gait of vestibular ataxia. With vestibular ataxia, the patient always falls to one side - regardless of whether he is standing or walking. There is obvious asymmetrical nystagmus. Muscle strength and proprioceptive sensation are normal - in contrast to unilateral sensory ataxia and hemiparesis.

Gait during hysteria. Astasia - abasia - typical violation gait during hysteria. The patient has preserved coordinated movements of the legs, both lying and sitting, but he cannot stand or move without assistance. If the patient is distracted, he maintains his balance and takes several normal steps, but then defiantly falls - into the hands of the doctor or onto the bed.

Which doctors should I contact if gait disturbance occurs?

Neurologist
Traumatologist
Orthopedist
ENT

I’m sure you always pay attention to a beautiful figure and a beautiful gait. Have you ever wondered what exactly ensures our beautiful gait?

Central nervous system: cerebral cortex, extrapyramidal and pyramidal systems, brain stem, spinal cord, peripheral nerves, cerebellum, eyes, vestibular apparatus of the inner ear and of course the structures that govern all this - skeleton, bones, joints, muscles. Healthy listed structures, correct posture, smoothness and symmetry of movements ensure normal gait.

Gait is formed from childhood. Congenital dislocations hip joints or joint can subsequently lead to shortening of the limb and gait disturbance. Hereditary, degenerative, infectious diseases nervous system, manifested by muscle pathology, impaired tone (hypertonicity, hypotonicity, dystonia), paresis, hyperkinesis will also lead to gait disturbances - cerebral palsy, myopathies, myotonia, Friedreich's disease, Strumpel's disease, Huntington's chorea, polio.

Properly selected shoes will influence the formation of the correct gait. With tight shoes, the child will curl his toes, the formation of the arch of the foot will be disrupted, the joints may become deformed, resulting in arthrosis of the joints and gait disturbance. Flat feet and club feet interfere with gait. Incorrect long-term sitting at a desk will lead to curvature of the spine (scoliosis) and gait disturbance.

When walking correctly, the torso should lean slightly back. You need to keep your back straight chest– straightened, buttocks toned. With each step, your feet should be placed in one line, with your toes turned outward. Keep your head slightly elevated. Look straight ahead or slightly up.

Defeat peripheral nerves– fibular and tibial – will lead to gait disturbance. “Stepping” - when walking, the foot “slaps” because dorsal flexion (bending) is impossible and the foot hangs down. When walking, a patient with damage to the peroneal nerve tries to raise his leg higher (so as not to touch the floor with his toes), the foot hangs down, and when lowering his leg resting on the heel, the foot slaps on the floor. This type of gait is also called “rooster gait.” Affected peroneal nerve for compression-ischemic, traumatic, toxic neuropathies. Compression means that you have compressed a nerve and/or blood vessels and developed ischemia - circulatory failure. This is possible, for example, when sitting for a long time: “squatting” - repairs, gardening; in small buses on long trips. Sports activities, very sound sleep in an awkward position, tight bandages, plaster splints can cause circulatory problems in the nerves.

Damage to the tibial nerve makes it impossible to plantar flex the foot and toes and turn the foot inwards. In this case, the patient cannot stand on his heel, the arch of the foot deepens, and a “horse” foot is formed.

Atactic gait– the patient walks with his legs spread wide apart, leaning to the sides (usually towards the affected hemisphere), as if balancing on an unstable deck, the movements of the arms and legs are not coordinated. Turning the body is difficult. This is a "drunk walk". The appearance of an ataxic gait may indicate a disorder vestibular apparatus, about circulatory disorders in the vertebrobasilar basin of the brain, about problems in the cerebellum. Vascular diseases, intoxication, and brain tumors can manifest as an ataxic gait and even frequent falls.

Antalgic gait– with radicular pain syndromes of osteochondrosis, the patient walks, curving the spine (scoliosis appears), reducing the load on the diseased root and thereby the severity of pain. When there is pain in the joints, the patient spares them, adapting his gait to reduce the pain syndrome - lameness appears, and with coxarthrosis, a specific “duck” gait - the patient waddles from foot to foot like a duck.

With damage to the extrapyramidal systems, Parkinsonism develops akinetic-rigid syndrome– movements are constrained, muscle tone is increased, the coordination of movements is impaired, the patient walks, bent over, tilting his head forward, bending his arms at the elbow joints, in small steps, slowly “shuffling” along the floor. It is difficult for the patient to start moving, “disperse” and stop. When stopped, it continues for some time to move unsteadily forward or to the side.

With chorea it develops hyperkinetic-hypotonic syndrome with violent movements in the muscles of the trunk and limbs and periods muscle weakness(hypotension). The patient walks with a sort of “dancing” gait (Huntington’s chorea, St. Vitus’s dance).

When the pyramidal system is damaged when various diseases nervous system arise paresis and paralysis of the limbs. Thus, after a stroke with hemiparesis, a characteristic Wernicke–Mann position is formed: the paralyzed arm is brought to the body, bent in elbow joint and radiocarpal, fingers are bent, the paralyzed leg is maximally extended at the hip, knee, and ankle joints. When walking, the impression of an “elongated” leg is created. The patient, in order not to touch the floor with his toe, moves his foot in a semicircle - this gait is called “circumducing.” In milder cases, the patient limps, muscle tone in the affected limb is increased and therefore there is less flexion in the joints when walking.

In some diseases of the nervous system, it may develop lower paraparesis- weakness in both legs. For example, with multiple sclerosis, myelopathies, polyneuropathies (diabetic, alcoholic), Strumpel's disease. With these diseases, gait is also impaired.

Heavy gait– with swelling of the legs, varicose veins, poor circulation in the legs - a person stomps heavily, with difficulty lifting his burning legs.

Gait disturbances are always a symptom of some disease. Even a common cold and asthenia changes gait. A lack of vitamin B12 can cause numbness in the legs and affect gait.

Which doctor should I contact if I have gait problems?

If there is any disturbance in gait, you need to consult a doctor - a neurologist, traumatologist, therapist, otolaryngologist, ophthalmologist, angiosurgeon. It is necessary to be examined and treated for the underlying disease that caused the gait disturbance or to adjust the lifestyle, the habit of sitting cross-legged at a table, and to diversify a sedentary lifestyle with activities physical culture, visiting the pool, fitness classes, water aerobics, walks. Courses of multivitamins of group B and massage are useful.

Consultation with a doctor regarding gait disorders:

Question: how to sit at the computer correctly so as not to develop scoliosis of the spine?
Answer:

Unsteadiness of gait can be both a sign of problems with the musculoskeletal system and a symptom of pathologies in the central, peripheral nervous system, and blood vessels. This often affects older people. Therefore, when it appears, you must consult a doctor who will find out the cause of instability when walking.

Causes of unsteady gait

Walking is carried out thanks to the coordinated work of the muscles of the whole body. They are controlled by the nervous system by releasing special neurotransmitter substances such as acetylcholine. Normal for some diseases physical activity is disrupted and movements become erratic.

The main causes of unsteady gait:

1. Diseases of the musculoskeletal system: problems with muscles, joints, tendons, bones.
2. Pathologies of the spinal cord, brain, including the cerebellum, subcortical nuclei, extrapyramidal system and pyramidal tract.
3. Ischemic or hemorrhagic strokes.
4. Deficiency of vitamins B12, B1, folate.
5. Multiple sclerosis, myasthenia gravis.
6. Traumatic brain injuries: concussions, bruises.
7. Tumors of the brain or the eighth pair of cranial nerves.
8. Thrombarteritis obliterans, varicose veins.
9. Drug and alcohol intoxication.
10. Uncomfortable shoes and clothes.
11. Fainting.

There are many diseases in which the coordinated work of the leg muscles is disrupted.

It is useful to know how the main symptoms of cerebellar damage are related.

All about the consequences of defeat and: diagnosis and treatment of disorders.

Musculoskeletal problems

Diseases of the osteochondral system: arthritis, arthrosis, osteochondrosis, osteomyelitis can cause staggering when walking. With inflammation and degenerative changes in the knee and hip joints due to pain, a person is forced to reduce the load on the injured limb. Therefore, the movements become asymmetrical.

Unsteadiness of gait in osteochondrosis is caused by pinching of efferent and afferent fibers going to and from the legs. There may be a disturbance in their sensitivity or weakening of the muscles due to pinched nerves.

Muscle weakness may occur after the cast is removed from the fracture site. Since the affected limb did not participate in movement and the muscles on it atrophied, asymmetry and unsteadiness occur when walking.

Traumatic muscle paralysis, sprains and tendon ruptures are common causes of unsteady gait in both children and adults, as well as the elderly.

Brain pathologies

It is in the brain that there are centers that provide motor acts when walking. When their activity is disrupted, a person loses stability and his gait becomes unsteady.

Coordination of movements is regulated by the cerebellum, as well as the extrapyramidal and pyramid system. The cerebral cortex transmits impulses to the underlying sections along the pyramidal pathways.

Injuries to the base of the skull often damage the cerebellum. Ataxia is one of the causes of unsteadiness when walking. Along with this, a person after a TBI loses his sense of balance and nystagmus appears (involuntary movements of the eyeballs). Nausea and vomiting, sometimes a short-term unconsciousness, are also characteristic.

The cerebellum can be affected by genetic abnormalities, autoimmune processes, inflammation, and circulatory disorders.

Pathologies of the extrapyramidal system manifest themselves with chorea, hyperkinesis, and tremor. These diseases are included in the list of reasons why a person staggers when walking. Accumulation of copper in the subcortical nuclei during hepatolenticular degeneration (Konovalov's disease) gives similar symptoms.

Birth injuries, cerebral palsy

Cerebral palsy can result in both (or one) lower limbs being paralyzed or a specific muscle group being affected by spasm. Then the person also staggers when walking. Cerebral palsy is caused by intrauterine hypoxia or birth trauma.

Vitamin deficiency

Vitamin B12 is necessary for the proper functioning of the central nervous system and spinal cord. For diseases of the digestive tract, helminthic infestations, unbalanced diet its deficiency leads to a rooster's gait. Vitamin B1, folic acid also affects the functions of the central and peripheral nervous systems.

Acoustic neuroma

This is a tumor on the nerve that leads to disruption of the functioning of the vestibular apparatus. In addition, nausea and dizziness at rest may occur. Movements change and their coordination becomes disrupted, as the sense of the body in space is lost.

Multiple sclerosis, myasthenia gravis

– disruption of the conduction of nerve fibers, both motor and sensory, due to scar changes. In this case, spastic or flaccid paralysis of the limbs occurs, which leads to unsteadiness of the body.

Myasthenia – autoimmune disease, the cause of which is the production of antibodies against acetylcholine, a mediator that ensures muscle movement. A mild course of the disease leads to muscle weakness, rapid fatigue, and instability when walking.

Vascular problems

Vasculitis, diabetic artery damage, venous diseases lead to swelling and pain lower limbs, and as a result – an asymmetrical desynchronized gait.

All about: causes, symptoms, treatment.

A note about: causes of occurrence and treatment tactics.

It is important to understand what they are depending on the location of the lesion.

Diagnosis and treatment

MRI, CT, EEG are examination methods for identifying pathologies of the central nervous system. An examination by a neurologist or orthopedic surgeon is necessary. The treatment strategy for unsteady gait depends on its causes. This is done by a neuropathologist and surgeon. Treatment tactics:

1. In cerebral palsy, spastic paralysis of the legs is corrected by cutting the tendons of these muscles.
2. Multiple sclerosis and myasthenia gravis are treated with glucocorticoid hormones, immunosuppressants that suppress autoimmune reactions.
3. Flaccid paralysis is corrected with the help of cholinesterase inhibitors: Neostigmine, Kalimina.
4. B complex vitamins (Neuromultivit, Milgamma, Combilipen) are used to support the nervous system.
5. Treatment of osteochondrosis, arthrosis, and arthritis includes physical therapy. Patients take chondroprotectors (injections of Mucosat, Dona). Muscle relaxants and mineral complexes are prescribed.

Conclusion

How to treat unsteadiness of gait is decided by a neurologist or orthopedic surgeon. It all depends on the cause of the disorder in the motor function of the lower extremities. To clarify it, an examination by specialized specialists and instrumental examinations are necessary.

According to psychoanalysis, mental development occurs in the process of struggle between human desires and needs that are biological in origin and the restrictions imposed by society on their satisfaction. It is assumed that the outcome of this struggle is unclear not only at each specific stage of development, but also as a result of it. Depending on the more or less satisfactory passage of developmental stages, an adult experiences a greater or lesser level of mental maturity. At the same time, mental immaturity is manifested in a tendency to use ineffective defense mechanisms and to neuroses. According to S. Freud's theory, personality consists of three components: “It”, “I” and “Super-ego”. “It” is the most primitive component, the bearer of instincts and drives. Being unconscious, "It" obeys the pleasure principle."I" follows reality principle and takes into account the properties of the external world. The “super-ego” serves as the bearer of moral standards and plays the role of critic and censor.

According to S. Freud, a newborn child is a pure “It”, i.e. a set of immediate desires that require immediate satisfaction. At the first stage of psychosexual development, the center of the infant’s emotional life, its main erogenous zone, is the mouth - oral stage. But even with the best care, restrictions or delays in fulfilling the baby's wishes are inevitable. They lead to differentiation and selection of the object. Gradually from "It" under the influence external factors"I" is differentiated. This level of personality forces the child to obey external demands and learn to delay gratification, i.e. there is a transition to the principle of reality.

example

At the oral stage of libido fixation in a person, according to Freud, certain personality traits are formed: gluttony, greed, demandingness, dissatisfaction with everything offered. According to his ideas, already at the oral stage people are divided into optimists and pessimists.

In the second year of life, when teaching a child to be neat, the anus becomes the center of emotional life. On anal stage(lasting from one to three years) the prohibitions and demands of the external world gradually, as the child masters his excretory physiological functions, become internal, i.e. The “Super-I” instance begins to form. This authority contains authority, the influence of parents and other adults.

example

According to psychoanalysts, at this stage such character traits as accuracy, neatness, punctuality are formed; stubbornness, secrecy, aggressiveness; hoarding, thriftiness, tendency to collect.

Phallic stage(3–5 years) characterizes the highest level of childhood sexuality. The genitals become the leading erogenous zone. If the two previous stages were autoerotic, i.e. directed at the child himself, then now the libido becomes objective, directed at another person, primarily at the parent of the opposite sex.

S. Freud called the boy’s sexual attraction directed towards his mother and, in connection with this, ambivalent feelings towards his rival father Oedipus complex. A similar motivational-affective complex in girls is called Electra complex. The resolution of the Oedipus (Electra) complex occurs through identification with the parent of the same sex. By repressing this complex, the “Super-I” instance is completely differentiated.

Thus, according to Z. Freud, all three personal levels are formed in a person by the end of the phallic stage, i.e. by five or six years. This is what served as the basis for Freud’s famous saying: “The child is the father of the adult.” From this age, the “I” authority plays a vital role in organizing a person’s life. Acting on the basis of the reality principle, the “I” fights simultaneously against the destructive impulses of the “Id” and against the severity of the “Super-ego”. In such conditions, an alarm state appears as a signal of the presence of internal or external dangers. The “I”’s defense mechanisms against feelings of anxiety become sublimation And crowding out. At the same time, sublimation is considered by Freud as a positive mechanism that makes fruitful human activity possible, and repression is considered as a more negative one, capable of leading to neurosis.

example

From the point of view of psychoanalysis, the period of childhood up to five or six years is considered the most important in a person’s life. Fixations at the phallic stage contribute to the emergence of such personality traits as introspection, prudence, rational thinking, and later – exaggeration of the masculine principle.

• Latent stage(5–12 years old) got its name due to the fact that during this period there is a decrease in the child’s interest in gender issues, they fade into the background. At this time, the “I” completely controls the needs of the “It”. Being divorced from a sexual goal, libido energy is transferred to the assimilation of universal human experience, enshrined in science and culture, to the establishment of friendly relationships with peers and adults outside the family.
• Genital stage(12–18 years old) is characterized by the unification of all previous erogenous zones, an increase in the intensity of sexual desire and the adolescent’s desire for normal sexual communication. According to Freud, this is the final stage of psychosexual development, which should lead to the formation of mature sexuality and a mature balance between love and work. This stage (like all others) is highly dependent on the complete or partial resolution of the contradictions of the previous stages. At the genital stage, the “I” uses two new defense mechanisms: asceticism And intellectualization. Asceticism, through internal prohibitions, suppresses obsessive desires for sensual pleasure, while intellectualization reduces them to representation in the imagination, which also allows one to free oneself from them.

example

At the genital stage, mental homosexuality and narcissism can form. The first type of character is associated with same-sex preference, active activity and communication in same-sex groups, but not necessarily with sexual perversion. With narcissistic sexuality, the libido seems to turn from the outside world to the subject himself, and self-satisfaction and self-satisfaction begin to occupy the main place. Such characters direct their attention primarily to themselves, their actions and experiences.

§ 1. Mental development from the standpoint of classical psychoanalysis 3. Freud

The foundations of the psychoanalytic approach to understanding the development of the psyche in ontogenesis are laid 3. Freud(1856-1939)1. Mental development in psychoanalysis is identified with the process of complexity

understanding the sphere of drives, motives and feelings, with the development of personality, with the complication of its structures and functions. Freud identified three levels of the human psyche (according to the criterion of the fundamental possibility of awareness of mental processes) - consciousness, preconscious and unconscious. The center of his scientific interests was the unconscious level of the psyche - the receptacle of the instinctive needs of the body, drives, primarily sexual and aggressive. It is the unconscious that initially opposes society. Freud viewed personality development as an adaptation (adaptation) of the individual to the external social world, alien to him, but absolutely necessary. Human personality, according to Freud, includes three structural components - the Id, the Ego and the Super-Ego, which arise non-simultaneously. It (Id) is the primitive core of personality; it has an innate character, is in the unconscious and obeys the principle of pleasure. The id contains innate impulsive drives (the life instinct Eros and the death instinct Thanatos) and forms the energetic basis of mental development.

I (Ego) is a rational and, in principle, conscious part of the personality. It occurs as biological maturation occurs between 12 and 36 months of life and is guided by the principle of reality. The Ego’s task is to explain what is happening and structure a person’s behavior so that his instinctive demands are satisfied, and the restrictions of society and consciousness are not violated. With the assistance of the Ego, the conflict between the individual and society should weaken throughout life. The Super-I (Super-Ego) as a structural component of the personality is formed last, between 3 and 6 years of life. The super-ego represents conscience, the ego-ideal and strictly controls compliance with the norms accepted in a given society. Tendencies on the part of the Id and Super-Ego, as a rule, are of a conflicting nature, which gives rise to anxiety, nervousness, and tension in the individual. In response, the Ego creates and uses a series defense mechanisms such as repression, rationalization, sublimation, projection, regression, etc. However, while the child’s ego is still weak, not all conflicts can be resolved. Experiences become long-lasting, “fixed,” forming a certain type of character, i.e. The foundation of personality is laid by the experiences of early childhood. It should be noted, however, that Freud “did not specifically study the child’s psyche, but came to formulate the main provisions of his theory of personality development by analyzing the neurotic disorders of adult patients. Approaches to understanding child sexuality were outlined by Freud at the beginning of the 20th century in “Three Essays” on the theory of sexuality≫ (1905)1. He proceeded from the idea that a person is born with a certain amount sexual energy (libido), which moves in a strictly defined sequence across different areas of the body (mouth, anus, genitals). Freud outlined the order of development psychosexual stages as the body matures (biological development factor) and believed that the stages are universal and inherent in all people, regardless of their cultural level. Periodization age development 3. Freud is called the psychosexual theory of personality because the central line of his theory is related to sexual instinct broadly understood as receiving pleasure. The names of the stages of personal development (oral, anal, phallic, genital) indicate the main bodily (erogenous) zone, which is associated with the feeling of pleasure at this age.

Stages are a kind of steps on the path of development, and there is a danger of “getting stuck” at one stage or another, and then the components of childhood sexuality can become prerequisites for neurotic

symptoms in later life.

1. The oral stage lasts from birth to 18 months. The main source of pleasure at the initial stage of psychosexual development is connected with the satisfaction of the main organ -

genetic need and includes activities associated with breastfeeding: sucking, biting and swallowing. At the oral stage, attitudes towards other people are formed - attitudes of dependence, support or independence, trust. The mother awakens sexual desire in the child and teaches him to love. It is the optimal degree of satisfaction (stimulation) in the oral zone ( breastfeeding, sucking) lays the foundations for a healthy independent adult personality.

Extremes of maternal attitude in the first six months of life (excessive or, on the contrary, insufficient stimulation) distort personal development, fixation of the oral pass occurs

intensity. This means that an adult will use demonstrations of helplessness and gullibility as ways to adapt to the world around him, and will need constant approval of his actions from the outside. Too much parental affection speeds up puberty and makes the child “spoiled” and dependent.

In the second half of the first year of life, with teething, when the emphasis shifts to the actions of biting and chewing, oral-sadistic oral phase. Fixation on

The oral-sadistic phase leads to such adult personality traits as a love of controversy, a cynical consumer attitude towards others, and pessimism. The mouth area, according to Freud, remains an important erogenous zone throughout a person’s life. Attachment of libido to the oral zone sometimes it persists in an adult and makes itself felt residual oral behavior- gluttony, smoking, biting nails, chewing gum, etc.

2. The anal stage of personality development, associated with the emergence of the Ego, occurs between the ages of 1-1.5 and 3 years. Anal eroticism is associated, according to Freud, with pleasant sensations from the work of the intestines, from excretory functions, and with interest in one’s own feces.

At this stage, parents begin to teach the child to use the toilet, for the first time demanding that he give up instinctive pleasure. Method of toilet training, practical

forged by parents, determines the future forms of self-control and self-regulation of the child.

The correct educational approach is based on attention to the child’s condition and on encouraging children to have regular bowel movements. Emotional support for neatness as a manifestation

self-control has, according to Freud, a long-term positive effect in the development of neatness, personal health and even flexibility of thinking. With an unfavorable development option, parents behave excessively strict and demanding, achieve neatness as early as possible, focusing mainly on formal regime moments. In response to these inadequate demands, children develop a kind of protest tendencies in the form of “holding back” (constipation) or, on the contrary, “pushing out”. These fixed reactions, later spreading to other types of behavior, lead to the formation of a unique personality type: anal-retaining (stubborn, stingy, methodical) or anal-pushing (restless, impulsive, prone to destruction).

3. Phallic stage (3 years) - stage of psychosexual development with the participation of the genital zone itself. At the phallic stage of psychosexual development, the child is often considered

roars and examines his genitals, shows interest in issues related to the birth of children and sexual relations. Exactly at this age period in individual development

For every person, a certain historical conflict is reborn - the Oedipus complex. The boy discovers a desire to “possess” his mother and eliminate his father. Entering into unconscious rivalry with his father, the boy experiences fear of supposed cruel punishment on his part, fear of castration, in Freud's interpretation. The child's ambivalent feelings (love/hate for the father) that accompany the Oedipus complex are overcome between the ages of five and seven. The boy suppresses (represses from consciousness) his sexual desires towards his mother. Identification of oneself with the father (imitation of intonations, statements, actions, borrowing norms, rules, attitudes) contributes to the emergence of the Super-Ego, or conscience, the last component of the personality structure. In girls, Freud implies a similar dominant complex - the Electra complex. Resolution of the Electra complex also occurs by identifying oneself with the parent of the same sex - the mother and suppressing attraction to the father. The girl, by increasing her resemblance to her mother, gains symbolic “access” to her father.

4. Latent stage - sexual lull, from 6 years to 12 years, before the onset adolescence. The energy reserve is directed to non-sexual goals and activities - study, sports, cognition, friendship with peers, mainly of the same sex. Freud emphasized the importance of this break in human sexual development as a condition for the development of a higher human culture.

5. Genital stage (12-18 years) - a stage caused by biological maturation during puberty and completing psychosexual development. There is a surge of sexuality

new and aggressive impulses, the Oedipus complex is reborn at a new level Autoerotism disappears and is replaced by interest in another sexual object, a partner of the opposite sex. Normally, in youth there is a search for a place in society, a choice

marriage partner, creating a family. One of the most significant tasks of this stage is liberation

Genital character- this is the ideal type of personality from a psychoanalytic position, the level of personality maturity. Required quality genital character - the ability to heterosexual love without guilt or conflict experiences. The mature personality is characterized by Freud much more broadly: it is multifaceted, and it is characterized by activity in solving life problems and the ability to make efforts, the ability to work, the ability to delay gratification, responsibility in social and sexual relationships and concern for other people.

Thus, 3. Freud was interested in childhood as a period that preforms adult personality. Freud was convinced that all the most significant things in personality development happen before the age of five, and later a person is only “functioning”, trying to overcome early conflicts, so he did not identify any special stages of adulthood. At the same time, the childhood of an individual is preformed by events from the history of the development of the human race (this line is represented by the revival of the Oedipus complex, the analogy of the oral stage in the development of personality and the cannibal stage in the history of the human community, etc.). The most significant factors Personality formation in classical psychoanalysis is biological maturation and ways of communicating with parents. Failures to adapt to the demands of the environment in early childhood, traumatic experiences in childhood and fixation of libido predetermine deep conflicts and illnesses in the future.

The value of the psychoanalytic concept is that it is a dynamic concept of development, it shows a complex range of experiences, the unity mental life human, its irreducibility to individual functions and elements. Although these ideas are largely mythological, they nevertheless reveal the significance of childhood, the importance and longevity of parental influence. Communication with parents in early years, their influence on ways of solving typical age-related contradictions, conflicts and failures of adaptation affect later, manifesting themselves as characteristic problems already in an adult. Psychoanalysts insisted that negative childhood experience leads to infantilism, self-centeredness, increased aggressiveness of the individual, and such an adult will experience significant difficulties with his own child, in fulfilling the parental role. The most important aspect of the psychoanalytic approach can be considered the idea of ​​sensitive attention to the child, the desire to discern behind seemingly ordinary words and actions the issues that truly worry or confuse him. So, K.G. Jung, analyzing the “conflicts of a child’s soul,” critically remarks: “After all, children are usually not listened to at all, they are usually (at any age) looked after as if they were insane, as soon as the matter concerns something significant, but everything else comes down to training leading to automatic perfection≫(emphasis added - I.Sh.). This approach, according to Jung, is unacceptable: “We must take children as they really are, we must stop seeing in them only what we would like to see in them, and when raising them, we must comply not with dead rules, but with natural direction of development. Further development psychoanalytic direction in psychology is associated with the names of K. Jung, A. Adler, K. Horney, A. Freud, M. Klein, E. Erikson, B. Bettelheim, M. Mahler and others.

§ 2. Psychoanalysis of childhood. Attempts to organize analytical work with children from the standpoint of traditional psychoanalysis have encountered real difficulties: children do not express an interest in studying their past, there is no initiative to contact a psychoanalyst, and the level of verbal development is insufficient to express their experiences in words. At first, psychoanalysts mainly used observations and reports from parents as material for interpreting observations and reports.

Later, psychoanalytic methods were developed aimed specifically at children. Freud's followers in the field of child psychoanalysis, A. Freud and M. Klein, created their own, different

options for child psychotherapy.

A. Freud(1895-982) adhered to the traditional psychoanalytic position on the conflict of the child with the social world full of contradictions. Her works “Introduction to Child Psychoanalysis”

(1927), “Norm and Pathology in Childhood” (1966), etc. laid the foundations of child psychoanalysis. She emphasized that in order to understand the causes of behavioral difficulties, a psychologist must strive

penetrate not only into the unconscious layers of the child’s psyche, but also gain the most detailed knowledge about all three components of the personality (I, It, Super-I), about their relationships with the outside world, about the mechanisms of psychological defense and their role in personality development. A. Freud believed that in the psychoanalysis of children, firstly, one can and should use analytical methods common to adults on speech material: hypnosis, free associations, interpretation of dreams, symbols, parapraxia (slips of the tongue, forgetting), analysis of resistance and transference. Secondly, she also pointed to originality of the technique of analyzing children. The difficulties of using the method of free association, especially in young children, can be partially overcome by analyzing dreams, daydreams, daydreams, games and drawings, which will reveal the tendencies of the unconscious in an open and accessible form. A. Freud proposed new technical methods to help in the study of the self. One of them is the analysis of the transformations undergone by the child’s affects. In her opinion, the discrepancy between the expected (based on past experience) and demonstrated (instead of grief - a cheerful mood, instead of jealousy - excessive tenderness) emotional reaction of the child indicates that defense mechanisms are working, and thus it becomes possible to penetrate into the child’s self. Rich material on the formation of defense mechanisms at specific phases child development presents an analysis of animal phobias, characteristics of school and family behavior of children. Thus, A. Freud gave important children's game, believing that, being carried away by the game, the child will also become interested in the interpretations offered to him by the analyst regarding defense mechanisms and the unconscious emotions hiding behind them.

A psychoanalyst, according to A. Freud, to be successful in child therapy must have authority with the child, since the child’s Super-Ego is relatively weak and unable to cope with

liberated as a result of psychotherapy by impulses without outside help. Of particular importance is the nature of the child’s communication with an adult: “Whatever we start doing with the child,

whether we teach him arithmetic or geography, whether we educate him or subject him to analysis, we must first of all establish a certain emotional relationship between ourselves and the child.

bank. The more difficult the work that lies ahead of us, the stronger this connection should be,” emphasized A. Freud1. When organizing research and correctional work with difficult children (aggressive, anxious), the main efforts should be directed on the formation of attachment, libido development, rather than directly dealing with negative reactions. The influence of adults, which gives the child, on the one hand, hope for love, and on the other hand, makes him fear punishment, allows him to develop over the course of several years his own ability to control his inner instinctual life. At the same time, part of the achieved

marriage belongs to the forces of the child’s self, and the rest belongs to pressure external forces; the correlation of influences cannot be determined. When psychoanalyzing a child, A. Freud emphasizes, the external world has a much stronger influence on the mechanism of neurosis than in an adult. The child psychoanalyst must necessarily work to transform the environment. External world, he was raised

physical influences are a powerful ally of the child’s weak self in the fight against instinctive tendencies.

English psychoanalyst M. Klein(1882-960) developed her approach to the organization of psychoanalysis in early age. The main focus was spontaneous play activity of the child. M. Klein, unlike A. Freud, insisted on the possibility of direct access to the content of the child’s unconscious. She believed that action is more characteristic of a child than speech, and free play is the equivalent of the flow of associations of an adult; The stages of the game are analogues of the associative production of an adult.

Psychoanalysis with children, according to Klein, was based primarily on spontaneous children's play, which was helped to manifest itself by specially created conditions1. The therapist provides the child with a lot of small toys, ≪ the whole world in miniature” and gives him the opportunity to act freely for an hour. The most suitable for psychoanalytic play techniques are simple non-mechanical toys: wooden male and female figurines different sizes, animals, houses, hedges, trees, various vehicles, cubes, balls and sets of balls, plasticine, paper, scissors, a mild knife, pencils, crayons, paints, glue and rope. The variety, quantity, and miniature sizes of toys allow the child to widely express his fantasies and use his existing experience. conflict situations. The simplicity of toys and human figures ensures their easy inclusion in plots, fictional or prompted by the child’s real experience. The game room should also be equipped very simply, but provide maximum freedom of action. Play therapy requires a table, a few chairs, a small sofa, a few pillows, a washable floor, running water, and a chest of drawers. Game materials Each child is kept separately, locked in a specific box. This condition is intended to convince the child that his toys and playing with them will be known only to himself and the psychoanalyst. Observation of the child’s various reactions, the “flow of children’s play” (and especially manifestations of aggressiveness or compassion) becomes the main method of studying the structure of the child’s experiences. The undisturbed flow of the game corresponds to the free flow of associations; interruptions and inhibitions in games are equivalent to interruptions in free association. A break in the game is considered as protective effect on the part of the ego, comparable to resistance in free associations. The game can manifest a variety of emotional states: feelings of frustration and rejection, jealousy of family members and accompanying aggressiveness, feelings of love or hatred for a newborn, the pleasure of playing with a friend, confrontation with parents, feelings of anxiety, guilt and the desire to improve the situation.

Prior knowledge of the child's developmental history and presenting symptoms and impairments assists the therapist in interpreting the meaning of children's play. As a rule, the psychoanalyst tries

explain to the child the unconscious roots of his game, for which he has to use great ingenuity to help the child realize which of the real members of his family are represented by the figures used in the game. At the same time, the psychoanalyst does not insist that the interpretation accurately reflects the experienced psychic reality; it is rather a metaphorical explanation or an interpretative proposal put forward for testing. The child begins to understand that there is something unknown ("unconscious") in his own head and that the analyst is also participating in his game. M. Klein leads detailed description details of psychoanalytic gaming techniques using specific examples. Thus, at the request of her parents, M. Klein conducted psychotherapeutic treatment of a seven-year-old girl with normal intelligence, but with a negative attitude towards school and academic failure, with some neurotic disorders and poor contact with her mother. The girl did not want to draw or actively communicate in the therapist’s office. However, when she was given a set of toys, she began to act out the relationship that had excited her with her classmate. It was they who became the subject of interpretation by the psychoanalyst. Having heard the therapist's interpretation of her play, the girl began to trust him more. Gradually, during further treatment, her relationship with her mother and her school situation improved. Sometimes the child refuses to accept the therapist's interpretation and may even stop playing and throw away toys when told that his aggression is directed at his father or brother. Such reactions, in turn, also become the subject of interpretation by the psychoanalyst.

Changes in the nature of the child’s play can directly confirm the correctness of the proposed interpretation of the game. For example, a child finds a dirty figurine in a box with toys, which symbolized his younger brother in a previous game, and washes it in a basin from traces of his previous aggressive intentions. So, penetration into the depths of the unconscious, according to M. Klein, is possible using gaming techniques, through the analysis of the child’s anxiety and defense mechanisms. Regularly expressing interpretations of his behavior to the child patient helps him cope with emerging difficulties and conflicts. Some psychologists believe that the game itself is healing. So, D.V. Winnicott emphasizes the creative power of free play (play) in comparison with play according to the rules._