Sigmund Freud:Theories In Action
- 1 Theories In Action
Theories In Action
Freud's laboratory did not consist of various apparatus like beakers, scales, or microscopes. Instead, his lab consisted of essentially one piece of furniture: the couch. Most who told their stories on his couch did so as if they were speaking to themselves, since Freud traditionally sat at the head of the couch, out of sight. Some say this therapeutic remoteness was necessary for objectivity; others claim it is evidence of his lack of warmth. Freud admitted to having less interest in treating patients and more passion for understanding the workings of the human personality. His patients were simply his subjects or the means by which to gather the data toward that end.
Despite the many critics Freud has garnered in the last several decades, he did create a number of important techniques that were repeatedly used with his patients and that were adopted by large numbers of followers in subsequent years. Traditional psychoanalysts still use some of these techniques in treatment, much in the same way Freud attempted them. Many others use modified versions that faintly resemble Freud's original work. The fact remains, however, that the discipline of psychology owes a large debt to this pioneer for how he challenged and contributed to our treatment of mental disorders.
The techniques of psychoanalytic therapy are designed to increase awareness, foster insights into the patient's behavior, and shed light on the meaning of one's symptoms. Following are some of the most important techniques that are associated with psychoanalysis.
Free association plays a central role in analytic treatment. In using free association, patients are encouraged to say whatever comes to mind, regardless of how painful or irrelevant it may seem. The aim of this unchecked verbalization is to open the door of the unconscious so that thoughts, wishes, fantasies, conflicts, and motivations held in the unconscious mind can flow into consciousness without censorship. Free association often leads the patient to remember past experiences that may have been repressed and can result in an intense expression of emotion, called catharsis.
During the free-association process, the therapist's task is to identify the repressed material that is locked in the unconscious. If there is any disruption in the flow, this usually indicates the presence of anxiety, which the therapist attempts to identify and interpret.
Dream analysis is also an important procedure for uncovering unconscious material and giving the patient insight into areas of unresolved problems. During sleep, defenses are lowered and repressed feelings surface. Freud called dreams the "royal road to consciousness," because in them unconscious wishes, needs, and fears are expressed. Some motivations and fears are so unacceptable to the person that they are expressed in disguised or symbolic form through dreams rather than being directly revealed in some other way.
Dreams have two levels of content: latent content and manifest content. Latent content consists of hidden, symbolic, and unconscious motives, wishes, and fears. But latent content, if revealed directly, can be very painful for the person to experience. So to make it less threatening, it transforms into what is called manifest content, which is the dream as it appears to the dreamer. This manifest content is often disguised in symbols. The therapist's task in dream analysis is to identify the symbols in dreams and provide guidance to the patient as to the dream's meaning.
As part of dream analysis, the therapist may ask the patient to free associate some aspect of the manifest content to help him or her understand latent meanings. As the meaning of the dreams are recognized, it helps the patient unlock the repression that has kept the material hidden and allows the patient new potential to deal effectively with the material.
Analysis and interpretation of transference
Transference is the unconscious shifting of feelings from someone in the patient's personal life to the therapist. Transference allows the patient to understand and resolve previously "unfinished business" from past relationships. As therapy progresses, childhood feelings and conflicts begin to surface from the unconscious. A patient may unconsciously transfer feelings of love, sexuality, hostility, or any number of other emotions onto the therapist during the process of therapy. If the therapy is to produce real change, the transference relationship must be worked through.
The transference situation is considered valuable because it allows the patient an opportunity to re-experience a variety of feelings that would not otherwise be accessible to them. By using the therapist as a safe or neutral object to express these wishes, beliefs, and desires, patients are able to change some of their long-standing patterns of behavior.
The analysis of transference is an important technique in psychoanalytic therapy because it allows the patient to achieve present-moment insight into past relational issues. As the therapist interprets the transference process for the patient, he or she can work with the insights to make changes in desired areas.
Analysis and interpretation of resistance
Resistance in a psychoanalytic context is anything that works against the progress of therapy and prevents the patient from accessing unconscious material. Resistance then is any idea, attitude, feeling, or action that gets in the way of potential change. During free association, a patient may show an unwillingness to relate to certain thoughts or experiences. Freud views resistance as an unconscious process that people use to protect themselves against intolerable anxiety and pain that might result if they became aware of the repressed feelings.
In therapy, resistance blocks both the patient and therapist from gaining insight into the processes of the unconscious. The analytic therapist's role is to point out resistance when it is observed in hopes that the patient will acknowledge the block and deal with the conflict.
Resistance in psychoanalytic therapy is not something to be rid of, but something that must be dealt with. The anxiety that causes the resistance will not lessen unless the resistance is faced. Having said this, it is important that the analytic therapist respects the resistances of clients and assists them in working therapeutically with their defenses. When handled properly, resistance can be one of the most valuable tools in understanding the patient.
It appears that the current status of psychoanalytic theory is going through an identity crisis of its own and has been since the mid-1980s. Some in the psychoanalytic community believe that the theory and practice of psychoanalysis are declining due to several key factors.
Terms long used in psychoanalysis are familiar to many but remain vague and imprecise. This makes continuity of use across the professional landscape difficult and open to various interpretations, some of which may be contradictory. Second, many terms in psychoanalytic theory refer to abstractions, such as drives or instincts, yet are often treated as if they refer to substantial entities. Yet, without more concrete ways of describing these abstractions, some fear that psychoanalysis will never be subjected to the rigorous empirical testing that would enhance its credibility in a therapeutic environment that increasingly values measurable therapeutic outcomes. Another problem within psychoanalytic theory surrounds the multiple layering of concepts and terms, often making it redundant and more complicated than it needs to be.
On the issue of empirical testing, those in the psychoanalytic community differ widely. Some believe that the theories are not empirically verifiable, while others believe they already have been extensively tested. Proponents cite two important facts. First, they claim that a large body of experimental evidence already exists on psychoanalytic ideas, some confirming the theory and others not. Second, while psychoanalysis does not seek to validate their concepts using empirical methods, it does use a holistic method of viewing the entire person as a single organism. This procedure is widely used with validity in both the social sciences and the "hard" sciences. Recognizing the holistic nature of psychoanalytic ideas and therapy suggests that some kinds of interpretation are more valid than others. In the minds of some psychoanalysts, the use of a holistic method nullifies the debate about whether psychoanalysis is a science or merely a means of interpretation.
Some general propositions have been set forth that most of today's practitioners would agree form core foundational ideas of modern psychoanalysis:
- Humans have many thoughts, emotions, and motives that are unconscious. Neurological studies supply ample evidence that unconscious processes of cognition exist. Defense mechanisms like repression and denial against emotions that are unpleasant are well documented as real responses.
- Personality patterns form in childhood and shape later relationships. Observational and longitudinal studies have shown that adult personality traits have parallels that begin in childhood.
- Mental representations of the self, others, and relationships guide our social patterns. Considerable research on attachment behaviors both in animals and humans confirm this.
- Personality development is more than simply working through sexual conflict (Freud's theory). It also involves learning to move from dependency to interdependency.
Not all of the research on Freud's ideas supports psychoanalytic theory. Studies on personality development do not confirm the suggestion that personality is formed by age five and changes little after that, as Freud thought. Most psychologists accept that personality continues to develop over time and can change dramatically after childhood. Contemporary research on instincts as the driving force of personality shows that Freud's conception of these ideas is no longer a useful model for human motivation. But the most important finding is that some psychoanalytic concepts can be reduced to propositions testable by the methods of science. Chronology
1856: Sigismund Freud is born (changes his name to Sigmund at age 22).
1873: Receives a summa cum laude award on graduation from the Gymnasium. He is already able to read in several languages.
1877: Joins Brücke's laboratory.
1880: A year of military service. Breuer provides treatment to Bertha Pappenheim (Anna O.).
1881: Awarded a delayed doctor's degree in medicine.
1882: Meets Martha Bernays and becomes secretly engaged to her.
1884: Discovers the analgesic properties of cocaine.
1886: Starts private practice. Marries Martha in September.
1887: Starts using hypnosis. The birth of daughter Mathilda.
1889: Birth of son Martin.
1891: Birth of son Olivier.
1892: Birth of son Ernst.
1893: Birth of daughter Sophie.
1895: Birth of daughter Anna.
1896: Freud for the first time uses the term "psychoanalysis." Death of Jacob Freud.
1897: Postulates Oedipus complex.
1899: The Interpretation of Dreams is published on November 4.
1902: Begins the Wednesday Psychological Society meetings at his home.
1906: C. G. Jung starts his correspondence with Sigmund Freud.
1909: Publication of Analysis of a Phobia in a Five-Year-Old Boy (Little Hans).
1911: Adler's resignation.
1913: Break from Jung. Publication of Totem and Taboo.
1920: Publishes Beyond the Pleasure Principle.
1921: Publishes Group Psychology and the Analysis of the Ego.
1923: Diagnosed with cancer of the jaw. Publication of The Ego and the Id.
1930: Freud's mother dies.
1933: Sigmund Freud has a letter exchange with Albert Einstein on the topic Why the War? The Nazis publicly burn Freud's work in Berlin.
1938: March 13th: Austria's annexation (Anschluss). Freud's house and the headquarters of the Vienna Association of Psychoanalysis are searched. Anna Freud is arrested and interrogated by the Gestapo. In June, Freud and his family emigrate to Great Britain.
1939: September 23rd, Freud's death. Moses and Monotheism is published.
Each of Freud's five major case histories was written for colleagues and was intended as an explanation of the meaning of the patient's symptoms along with his observations and analysis. All of his case histories are relevant to the development of his theory and practice of psychoanalysis, but three are of particular importance because they demonstrate how his theory Biography:
Anna Freud, in addition to being the youngest daughter of Sigmund Freud, was a pivotal figure in the field of child psychoanalysis and development. She was born in Vienna, Austria, and educated at private schools in Vienna. From the beginning Anna did not form a close bond with her mother, but she did feel especially close to her father while growing up. She received much affirmation from the elder Freud, and he routinely expressed his approval of her intellectual interests and pursuits.
As a student she was bored and restless with formal education and openly complained about attending school. She claims to have learned less in her formal education than from guests that her father had at their home. This is where she supposedly learned several languages such as Hebrew, German, English, French, and Italian. At age of 19, Anna began two years of study to become a teacher, and in the summer of 1915 she successfully passed her teacher's examination.
When Anna Freud was 23 years old, she underwent psychoanalysis with her father as analyst, which was unusual, even at that time. This analysis continued for several years, and Anna seemed to form a dependence on her father from which she never broke free until his later years. In 1923, when her father had the first of many operations on his jaw to remove cancer growths, Anna felt it was her duty to care for him because he was ill. She remained his constant companion and primary caregiver until his death many years later.
Shortly after this, in 1924, Anna Freud began taking more responsibility over her father's professional career and performing active service in the psychoanalytic community. That same year she became a member of the Committee of her father's closest advisors. In 1925, she was on the executive board of the Vienna Psychoanalytic Institute and started work as a training analyst. In addition, she also took over all the aspects of production of the Verlag, a psychoanalytic publication similar to a journal that her father created.
Anna Freud's long-time interest had been children. Though she never married nor had her own, she devoted her professional career, first a teacher and then as a psychoanalyst, to working with children. She was undoubtedly influenced profoundly by her father's psychoanalytic theories. She used these theories as a framework to understand the experiences of children and the stages of their normal psychological development.
In 1927 Freud and two of her closest friends, Eva Rosenfeld and Dorothy Burlingham, organized a nursery school for local children. Within this school Freud and her colleagues (the most famous of which was Erik Erikson) taught alternate teaching methods while taking careful notes of the process. Anna would increasingly use her work with children as a means to study the developing ego of children. She eventually published, The Ego and the Mechanisms of Defense in 1936 in honor of her father's 80th birthday.
World War II brought dramatic changes in the structure of the psychoanalytic movement. After the Nazis took control of Austria in 1938, Anna and her father emigrated to London, England, where Sigmund Freud died a year later.
In 1947, Freud and Burlingham established the Hampstead Child Therapy Course and Clinic in London, which provided training opportunities for individuals interested in the psychological and emotional development of children. From the 1950s until her death, psychoanalysts, child psychologists, and teachers worldwide sought opportunities to hear Freud lecture, and to benefit from the insights she developed from a lifetime of working with children.
After her father's death, Anna Freud's career flourished. She published several books of her own, adhering mostly to the psychoanalytic principles her father had set, but expanding or refining in places that set her apart from him. Among her important written works are: The Psychoanalytical Treatment of Children (1946), Normality and Pathology in Childhood (1965), and the seven-volume Writings of Anna Freud (1973).
and methods evolved. The first, the case of Anna O., was conducted by Dr. Joseph Breuer, Freud's mentor. The remaining two, the "Rat Man" and "Dora," were conducted and recorded by Freud.
Anna O.: free association
Joseph Breuer was a famous physician that had befriended the young Freud as he was just beginning his practice. The two men frequently discussed Breuer's patients at length. One in particular, a 21-year-old Anna O., would become a pivotal case in the development of psychoanalysis.
An intelligent and attractive woman, Anna O. suffered from severe hysterical complaints including paralysis, memory loss, mental deterioration, nausea, and disturbances of vision and speech. The symptoms first appeared when she was nursing her dying father, who had always pampered her.
Breuer began Anna's treatment by using hypnosis. He found that while hypnotized she would recall specific experiences that seemed to have given rise to certain symptoms. Talking about the experiences under hypnosis often relieved the symptoms. For more than a year Breuer saw Anna every day. She would recount the day's disturbing incidents and after they talked she sometimes reported that her symptoms had been eased. She referred to their conversations as the "talking cure."
Freud's interest in what lay beyond conscious life and in hypnotism and hysteria led him to study with the famous neurologist Jean-Martin Charcot in Paris. When Freud returned to Vienna, he began using hypnosis, massage, and pressure on the head to get patients to dredge up thoughts related to their symptoms. Only later did he ask them to say whatever crossed their minds. This he called free association, what the patient called Anna O. had already labeled as the "talking cure." Freud's investigations into internal conflicts such as this case also led him to determine that the mind was divided into three conflicting, now known as id, ego, and superego. So, in a very real sense, Anna O. was the first psychoanalytic patient even though Freud did not administer the treatment.
One of Freud's best known cases involved a young lawyer he assigned the name "Rat Man." The young man's case was thus named by Freud because he had obsessive thoughts concerning rats, torture, and punishment. Treatment included having the man talk about the first things that came to mind as he considered his disturbing thoughts. Freud used this technique, which he called free association, to probe the man's unconscious conflicts that resist direct expression. Anna Freud with her dog. (AP/Wide World Photos. Reproduced by permission.) Anna Freud with her dog. (AP/Wide World Photos. Reproduced by permission.) Freud then interpreted the man's symptoms and found them rooted in ambivalence about sexuality and about his hostile feelings toward his father. For Freud, interpretation was necessary to give meaning to the apparently random thoughts of free association. In the case of "Rat Man," Freud wove together elaborate stories, explanations, and speculations to make sense out of constellations of symptoms that seemed impossibly puzzling.
The famous and controversial case of "Dora," an 18-year old female, would become the first of Freud's major case histories. "Dora," as Freud called her, worked intensely with him in analysis initially but abruptly ended her work with him after just 11 weeks. Through the process of analysis, Dora had "transferred" on Freud some very passionate feelings ranging from love to fury during their work together. Freud initially did not recognize the significance of these emotions. Also embedded in her disclosures was a homosexual theme which Freud failed to fully appreciate, in large part because he had not yet discovered how homosexual urges manifested in neuroses.
Upon completion of the analysis, Freud had originally intended this case to be an exposition on dream interpretation but after reflection, considered it a failure in this regard. Instead he chose to evaluate the transfer of emotion that was a prominent dynamic of "Dora's" analysis. Freud used the concept of transference to refer to the strong emotions that are projected by the patient onto the therapist. This case, perhaps more than any other, helped formalize his concept of transference and its essential role in effective psychoanalysis.
Relevance to the modern reader
Freud and his theory of psychoanalysis have had a great impact on Western society and specifically on American popular culture. Perhaps one of the most obvious ways psychoanalysis has affected popular culture is the legitimization it gave to sexuality in the early part of the twentieth century. Sexual restraints were already starting to loosen around the time that Freud began espousing his ideas publicly, but the popularity of psychoanalysis was a great boost to public openness toward sexual issues.
Freud's psychoanalysis, though dated, can still provide students of psychology a number of helpful insights into the human condition. Nearly every person can benefit from understanding basic aspects of psychoanalytic thought like transference, resistance, ego-defense mechanisms, etc. Whether in a professional context or lay context, these and other psychoanalytic concepts provide a conceptual framework for looking at and understanding the origins and manifestations of behavior. This is something nearly everyone is curious about.
It is feasible for someone to not accept the orthodox Freudian position and still benefit from the many psychoanalytic concepts that shed light on inner conflicts and human relationships. From a broader perspective, psychoanalysis shows us that there are patterns to life and relationships, patterns that are often established in the early phases of development. This has significant implications for many areas of human interaction, such as intimate relationships, the family and child rearing, and therapeutic relationships.
As newer psychoanalytic theorists refine classical analytic techniques, it opens the possibility that psychoanalytic theory will regain some of the influence it has lost over the years. Current directions in psychoanalytic therapy are focusing on building collaborative working relationships with patients, instead of giving the therapist control over the therapeutic relationship. Also, there is a push in some circles to incorporate briefer forms of psychoanalytic therapy due to societal pressure for accountability and cost-effectiveness. This is also a trend that uses psychoanalytic theory as the basis for group therapy, which has been well received.