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Sigmund FREUD in the 1890's and then further developed by himself, his students,
and other followers. It consists of three kinds of related activities: (1) a
method for research into the human mind, especially inner experiences such as
thoughts, feelings, emotions, fantasies, and dreams; (2) a systematic
accumulation of a body of knowledge about the mind; and (3) a method for the
treatment of psychological or emotional disorders.
Psychoanalysis began with the discovery that HYSTERIA, an illness with physical
symptoms that occurred in a completely healthy physical body--such as a numbness
or paralysis of a limb or a loss of voice or a blindness--could be caused by
unconscious wishes or forgotten memories. (Hysteria is now commonly referred to
as conversion disorder.) The French neurologist Jean Martin CHARCOT tried to rid
the mind of undesirable thoughts through hypnotic suggestion, but without
lasting success. Josef Breuer, a Viennese physician, achieved better results by
letting Anna O., a young woman patient, try to empty her mind by just telling
him all of her thoughts and feelings.
Freud refined Breuer's method by conceptualizing theories about it and, using
these theories, telling his patients through interpretations what was going on
inside the unconscious part of their minds, thus making the unconscious become
conscious. Many hysterias were cured this way, and in 1895, Breuer and Freud
published their findings and theories in Studies in Hysteria.
CLASSIC PSYCHOANALYTIC THEORY
Traditional psychoanalytical theory states that all human beings are born with
instinctual drives that are constantly active even though a person is usually
not conscious of thus being driven. Two drives--one for sexual pleasure, called
libido, the other called aggression--motivate and propel most behavior. In the
infant, the libido first manifests itself by making sucking an activity with
pleasurable sensations in the mouth. Later similar pleasures are experienced in
the anus during bowel movements, and finally these erotically tinged pleasures
are experienced when the sexual organ is manipulated. Thus psychosexual
development progresses from the oral through the anal to the phallic stage.
(Phallic, in psychoanalytic theory, refers to both male and female sexual
During the height of the phallic phase, about ages three to six, these
libidinous drives focus on the parent of the opposite sex and lend an erotic
cast to the relation between mother and son or between father and daughter, the
so-called Oedipus COMPLEX. However, most societies strongly disapprove of these
sexual interests of children. A TABOO on incest rules universally. Parents,
therefore, influence children to push such pleasurable sensations and thoughts
out of their conscious minds into the unconscious by a process called repression.
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In this way the mind comes to consist of three parts: (1) an executive part, the
EGO, mostly conscious and comprising all the ordinary thoughts and functions
needed to direct a person in his or her daily behavior; (2) the id, mostly
unconscious and containing all the instincts and everything that was repressed
into it; and (3) the superego, the conscious that harbors the values, ideals,
and prohibitions that set the guidelines for the ego and that punishes through
the imposition of guilt feelings.
Strong boundaries between the three parts keep the ego fairly free from
disturbing thoughts and wishes in the id, thereby guaranteeing efficient
functioning and socially acceptable behavior. During sleep the boundaries
weaken; disturbing wishes may slip into the ego from the id, and warnings may
come over from the superego. The results are intrapsychic conflicts, often
manifested in dreams (see DREAMS AND DREAMING), sometimes even in frightening
NIGHTMARES. Freud elucidated this concept in his first major work, The
Interpretation of Dreams (1900; Eng. trans., 1913). Something very similar to
the weakening of boundaries during sleep sometimes happens during ordinary
daytime activities when some impulses from the id manages to cross the
repression barrier to invade the ego and cause faulty actions such as slips of
the tongue. Psychoneurotic symptoms occur if psychologically hurtful experiences
during childhood have left the repression too weak or have distorted the ego, or
if overstimulation has left the id wishes too strong, or if the delicate balance
between ego, id, and superego has been upset by injury or other events. Any kind
of psychic trauma may lead to the ego becoming an area of intrapsychic conflict
between the intruding id, the threatening superego, and the powerful influences
emanating from the surrounding environment. Furthermore, the damage done to the
basic psychological structures by traumatic experiences leaves those structures
weakened and with defective functioning.
Such conflicts and defects can cause intense ANXIETY and severe DEPRESSION. In
order to keep functioning effectively, the ego attempts to maintain control by
achieving some sort of compromise between the contending forces. Often such
compromises appear in the form of inhibitions or compulsions that affect
behavior. Abnormal behavior and the anxiety, depressions, and PHOBIAS that go
with them are called psychoneurotic symptoms in psychoanalytic theory. Neurotic
character is the phrase used to designate a consistent pattern of neurotic
behavior. When the damage abnormally distorts self-esteem, the resulting
disturbance is called a narcissistic personality disorder, or a disorder of the
Patients seek psychoanalytic treatment because they suffer from one or more of a
variety of psychological symptoms such as anxiety, depression, sexual and other
inhibitions, obsessive thoughts, compulsive actions, irrational angers, shyness
and timidity, phobias, inability to get along with friends or spouses or co-
workers, low self-esteem, a sense of feeling unfulfilled, nervous irritability,
and blocked creativity. The defects and repressed conflicts that cause these
symptoms are usually indicative of a psychoneurosis or a narcissistic
personality disorder. Normal ego functioning and the joy of life that comes with
easy relationship to others are seriously interfered with or sometimes lost
altogether. Psychoanalysis does not promise a quick cure but holds out the hope
that through better understanding of oneself and of others one can achieve an
amelioration of symptoms as well as a smoother and more effective socialization
of one's behavior.
Psychological maladaptations usually originate from painful misunderstandings or
outright failures in the child's relationship to his or her parents. Sometimes
parents lack the appropriate and attuned empathic understanding that children
need. Sometimes severe physical or mental illness or the death of a parent or
sibling causes serious psychic wounds. Consequently, even in adults, there
remain ever-present though usually unconscious fears that the early hurtful
experiences will now be repeated again with others. Transference is the
unconscious expectation that the old injuries and insults will now again be
suffered, only this time at the hands of friends, spouses, children, bosses,
just about anybody--as if transferred from the past into the present.
Transference makes one have irrational expectations from the people with whom
one lives and works. For example, one may feel a need to be appreciated by one's
supervisors similarly to a child's needing approval from his or her parents.
Frustration of these expectations may evoke immature rage or other immature
behavior. Transference causes great distress, but it also makes treatment
The method of treatment seems simple at first. The patient reclines on a
comfortable couch in the analyst's office with the analyst seated behind the
patient. The recumbent position, as well as not being able to see the analyst,
minimizes distraction and allows concentration on inner experiences, thoughts,
wishes, fantasies, and feelings. The patient is instructed to say absolutely
everything that comes to mind without censoring anything, a technique that is
called free association. This brings about a state of regression in which long-
forgotten events and painful encounters are remembered, often with great clarity
and intense emotions. At the same time, because of transference, the patient
experiences the analyst as well, as if he or she were a figure from the past,
perhaps resembling a parent.
The analyst often can trace the connection between the patient's current
fantasies and feelings about the analyst and the origin of these thoughts and
emotions in childhood experiences. The re-experienced conflicts and traumas,
together with the accompanying fears and feelings, then are interpreted by the
analyst. The patient learns to recognize the connections between the past and
the present. The combination of insight together with the powerful emotional re-
experience during the regressed state brought about by the analytic method cause
a reorganization of the psychological structures into more healthfully adaptive
patterns. The analyst's friendly and calmly explaining attitude that is devoid
of any moralizing or other biases creates an atmosphere in which, most of the
time, all human failings and foibles can be looked at, talked about, and finally
Typically, an analysis lasts for a few years, with four to five sessions per
week of about 45 minutes each. In this way the psychoneuroses and the
narcissistic personality disorders can be treated successfully in a majority of
patients. Serious mental illnesses such as schizophrenia, manic-depressive
illness, and the psychoses caused by organic malfunctioning of the brain cannot
be cured by psychoanalytic treatment, though the patient can often benefit from
psycho-pharmacological treatment--sedatives, tranquilizers, anti-depressants--in
combination with psychotherapy.
In the United States most psychoanalysts are physicians who, after medical
school, first specialized in PSYCHIATRY and who then were trained as
psychoanalysts in an institute for psychoanalysts. Institute training typically
takes from five to seven years. Outside the United States many non-medical
psychologists and other behavioral scientists have been trained as
psychoanalysts, and recently non-medical candidates are being trained in
increasing numbers by American institutes.
From the beginnings in the late 19th century, psychoanalytic theory and practice
have continued to develop into the present modern practices. Initially, Freud
believed that forgotten sexual seductions of children were the cause of neurosis
and that remembering the trauma and emotions was therapeutic. He later modified
and elaborated his views into the theory of infantile instinctual drives as the
motivating force for normal behavior and, when miscarried, as the cause of
neurosis. Drive psychology gradually expanded into a closer study of the ego's
ways of coping with the instinctual drive, the so-called ego psychology.
Continuing research has discovered much evidence that the early relationships
between children and parents, the so-called object relations, have the greatest
impact on later psychological development. The influence of the care givers,
especially during infancy, leaves a lasting imprint on the personality. Emphasis
on the object-relations theory developed by Melanie KLEIN characterizes
psychoanalysis in much of Britain and Latin America. In the United States a
particular aspect of object relations, namely their effects on the sense of self
and on self-esteem, are being studied by a growing number of psychoanalysts.
Initiated by Heinz Kohut, self-psychology is being developed by his followers
into one of the main concepts that make up the body of psychoanalytic theory.
Self-psychology is a psychology of subjective experience. The self-
psychologically oriented psychoanalyst, in addition to considering the usual
psychoanalytic data of inner experiences such as dreams and free associations,
emphasizes the use of empathic immersion by the analyst into the life experience
of the patient as an essential source of data for treatment and for theorizing.
Self-psychology postulates a nuclear self at the core of the individual. A
cohesive, vigorous, and balanced self lends the person a sense of self and of
Any experience with objects, including persons, that evoke and strengthen the
self are "self-object" experiences and are needed by every human being from
birth to death in order to sustain a cohesive self. Absence of or faulty self-
object experiences cause a loss of cohesion with attendant fragmentation of the
In addition to their clinical application, psychoanalytic theories have been
used as guides to doing research in certain social sciences as well as in the
humanities. Some cross-cultural anthropological investigations, for example,
have used interviewing techniques that were based on the psychoanalytic method.
Some psychohistorical studies have employed the theories of psychoanalysis in
the interpretation of the dynamic forces underlying historical events.
Biographical research has been enriched by adding the insights of psychoanalysis,
and the resulting psycho-biographies have added a dimension of depth to the
understanding of some outstanding persons, as, for example, in Gandhi's Truth
(1969) by Erik ERIKSON. But it is in the application of psychoanalysis to
artistic and literary criticism that analysts, especially Freud (on Leonardo da
Vinci and Michelangelo), Kurt Eissler (on Hamlet), Jacques Lacan (on Edgar Allen
Poe), and Heinz Kohut (on Thomas Mann), have made their most widely known
Research in the theories and methods of psychoanalysis presents special
difficulties. In contrast to the natural sciences, psychoanalytic data are
private, subjective, and often non-repeatable inner experiences. They are
grasped by introspection and by empathy and, therefore, are not publicly
verifiable in the same way that natural science data can be demonstrated.
Nevertheless, continuing attempts to compare and to check findings with
colleagues in a worldwide psychoanalytic community, in addition to finding
confirmation of psychoanalytic concepts from research in contiguous sciences,
provide a measure of verification.
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Alexander, Franz. The Scope of Psychoanalysis, 1961. Web. 27 May 2015.
Fenichel, Otto. The Psychoanalytic Theory of Neurosis, 1945. Web. 27 May 2015.
Ferenczi, Sandor, Selected Papers, 3 vols., 1955
Freud, Sigmund. Complete Psychological Works, 24 vols.,ed. by James Strachey
(1955-75); Web. 8 May 2015.
Hartmann, Heinz. "Essays on Ego Psychology" 1964. Web. 8 May 2015.
Klein, Melanie. The Psychoanalysis of Children, 1932. Web. 8 May 2015.
Kohut, Heinz. How Does Analysis Cure? University of Chicago Press, 2013.
Winnicott, D. W. Collected Papers: Through Paediatrics to Psycho-analysis. Routledge, 2001
Wolf, Ernest. Treating the Self: Elements of Clinical Self Psychology. Guilford Press, 2002