Psychoanalytic clinical theories focus on three different assumptions that overlap to a certain extent depending on individual history (OPD Task Force, 2008): Psychopathology (a) manifests itself as an expression of unconscious conflict between different wishes and needs as well as expectations from the social environment, (b) is an expression of an impairment of personality functioning, and (c) evolves in dysfunctional relationships. Bearing in mind biological protective and risk factors (e.g. Hill, 2002), mental disorders are mainly seen as manifestations of early problems arising from childhood experiences. Thus, psychoanalytic theories tend to deal with the question of how early experiences can have an impact on adult functioning. For example, Benjamin (2003) has stated that representations of past interactions get “copied” into present interactions by three different processes: identification (behaving like a significant other), recapitulation (behaving as being in control of the other), and introjection (treating the self the same way the other did). Psychoanalytic thinking aims to understand each patient individually, starting with the etiology of problems and progressing to the specific psychogenesis of symptoms, that is, how a person copes specifically with aversive experiences and current life situations. In that sense, any psychopathology is regarded as an adaptation to inner and attachment-related problems associated with impaired functioning or dynamic defenses against unbearable mental states. Later in life, these “solutions” may become rigid, may not fit well with the demands of current situations, and may cause suffering both for the individual and for others around him/her. This basic assumption leads to a quite unique stance in psychoanalytic theory, in which symptoms – even the most cruel or irrational behavior – are considered to be meaningful in terms of assuming a vital function of regulating the self or interpersonal relationships. The hidden (or, rather, not superficially obvious) meaning of symptoms can be understood in terms of the individual’s personal history, unconscious conflict, or structural impairment incurred in the course of psychological adaptation to environmental demands which the individual aims to cope with within the limits of his/her constitutional capacities and social resources
