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: + .
is a set of
theories A theory is a rational type of abstract thinking about a phenomenon, or the results of such thinking. The process of contemplative and rational thinking is often associated with such processes as observational study or research. Theories may be s ...
and
therapeutic A therapy or medical treatment (often abbreviated tx, Tx, or Tx) is the attempted remediation of a health problem, usually following a medical diagnosis. As a rule, each therapy has indications and contraindications. There are many different ...
techniques"What is psychoanalysis? Of course, one is supposed to answer that it is many things — a theory, a research method, a therapy, a body of knowledge. In what might be considered an unfortunately abbreviated description, Freud said that anyone who recognizes transference and resistance is a psychoanalyst, even if he comes to conclusions other than his own.… I prefer to think of the analytic situation more broadly, as one in which someone seeking help tries to speak as freely as he can to someone who listens as carefully as he can with the aim of articulating what is going on between them and why.
David Rapaport David A. Rapaport (September 30, 1911, Budapest, Austria-Hungary – December 14, 1960, Stockbridge, Mass.) was a Hungarian clinical psychologist and psychoanalytic ego psychologist. Biography Rapaport was born in Budapest, Hungary on Septem ...
(1967a) once defined the analytic situation as carrying the method of interpersonal relationship to its last consequences." Gill, Merton M. 1999.
Psychoanalysis, Part 1: Proposals for the Future
" ''The Challenge for Psychoanalysis and Psychotherapy: Solutions for the Future''. New York:
American Mental Health Foundation The American Mental Health Foundation (AMHF) is a not-for-profit organization dedicated to the welfare of individuals with emotional problems and advancing mental-health research. AMHF is established to organize educational seminars and to dissemina ...
. Archived 10 June 2009.
that deal in part with the
unconscious mind The unconscious mind (or the unconscious) consists of the processes in the mind which occur automatically and are not available to introspection and include thought processes, memories, interests, and motivations. Even though these processes exis ...
,"All psychoanalytic theories include the idea that unconscious thoughts and feelings are central in mental functioning." Milton, Jane, Caroline Polmear, and Julia Fabricius. 2011. ''A Short Introduction to Psychoanalysis''.
SAGE Sage or SAGE may refer to: Plants * ''Salvia officinalis'', common sage, a small evergreen subshrub used as a culinary herb ** Lamiaceae, a family of flowering plants commonly known as the mint or deadnettle or sage family ** ''Salvia'', a large ...
. p. 27.
and which together form a method of treatment for
mental disorder A mental disorder, also referred to as a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features may be persistent, relapsing and remitti ...
s. The discipline was established in the early 1890s by Austrian
neurologist Neurology (from el, νεῦρον (neûron), "string, nerve" and the suffix -logia, "study of") is the branch of medicine dealing with the diagnosis and treatment of all categories of conditions and disease involving the brain, the spinal c ...
Sigmund Freud Sigmund Freud ( , ; born Sigismund Schlomo Freud; 6 May 1856 – 23 September 1939) was an Austrian neurologist and the founder of psychoanalysis, a clinical method for evaluating and treating psychopathology, pathologies explained as originatin ...
, who developed the practice from his theoretical model of personality organization and development,
psychoanalytic theory Psychoanalytic theory is the theory of personality organization and the dynamics of personality development that guides psychoanalysis, a clinical method for treating psychopathology. First laid out by Sigmund Freud in the late 19th century, psyc ...
.Mitchell, Juliet. 2000. ''Psychoanalysis and Feminism: A Radical Reassessment of Freudian Psychoanalysis''. London:
Penguin Books Penguin Books is a British publishing, publishing house. It was co-founded in 1935 by Allen Lane with his brothers Richard and John, as a line of the publishers The Bodley Head, only becoming a separate company the following year.Josef Breuer Josef Breuer ( , ; 15 January 1842 – 20 June 1925) was a distinguished physician who made key discoveries in neurophysiology, and whose work in the 1880s with his patient Bertha Pappenheim, known as Anna O., developed the talking cure (catharti ...
and others. Psychoanalysis was later developed in different directions, mostly by students of Freud, such as
Alfred Adler Alfred Adler ( , ; 7 February 1870 – 28 May 1937) was an Austrian medical doctor, psychotherapist, and founder of the school of individual psychology. His emphasis on the importance of feelings of belonging, family constellation and birth order ...
and his collaborator,
Carl Gustav Jung Carl Gustav Jung ( ; ; 26 July 1875 – 6 June 1961) was a Swiss psychiatrist and psychoanalyst who founded analytical psychology. Jung's work has been influential in the fields of psychiatry, anthropology, archaeology, literature, philo ...
,
Alfred Adler Alfred Adler ( , ; 7 February 1870 – 28 May 1937) was an Austrian medical doctor, psychotherapist, and founder of the school of individual psychology. His emphasis on the importance of feelings of belonging, family constellation and birth order ...
developed the school of thought known as
individual psychology Individual psychology (german: Individualpsychologie) is a psychological method or science founded by the Austrian people, Viennese psychiatrist Alfred Adler. The English language, English edition of Adler's work on the subject (1925) is a collecti ...
, while
Carl Jung Carl Gustav Jung ( ; ; 26 July 1875 – 6 June 1961) was a Swiss psychiatrist and psychoanalyst who founded analytical psychology. Jung's work has been influential in the fields of psychiatry, anthropology, archaeology, literature, philo ...
established
analytical psychology Analytical psychology ( de , Analytische Psychologie, sometimes translated as analytic psychology and referred to as Jungian analysis) is a term coined by Carl Jung, a Swiss psychiatrist, to describe research into his new "empirical science" ...
.
as well as by
neo-Freudian Neo-Freudianism is a Psychoanalytic theory, psychoanalytic approach derived from the influence of Sigmund Freud but extending his theories towards typically social or cultural aspects of psychoanalysis over the biological. The neo-Freudian School ...
thinkers, such as
Erich Fromm Erich Seligmann Fromm (; ; March 23, 1900 – March 18, 1980) was a German social psychologist, psychoanalyst, sociologist, humanistic philosopher, and democratic socialist. He was a German Jew who fled the Nazi regime and settled in the U ...
,
Karen Horney Karen Horney (; ; 16 September 1885 – 4 December 1952) was a German psychoanalyst who practised in the United States during her later career. Her theories questioned some traditional Freudian views. This was particularly true of her theories of ...
, and
Harry Stack Sullivan Herbert "Harry" Stack Sullivan (February 21, 1892, Norwich, New York – January 14, 1949, Paris, France) was an American Neo-Freudian psychiatrist and psychoanalyst who held that "personality can never be isolated from the complex interpersonal ...
.Birnbach, Martin. 1961. ''Neo-Freudian Social Philosophy''. Stanford:
Stanford University Press Stanford University Press (SUP) is the publishing house of Stanford University. It is one of the oldest academic presses in the United States and the first university press to be established on the West Coast. It was among the presses officially ...
. p. 3.
Freud distinguished between a conscious and unconscious mind, arguing that the unconscious mind largely determines
behaviour Behavior (American English) or behaviour (British English) is the range of actions and mannerisms made by individuals, organisms, systems or artificial entities in some environment. These systems can include other systems or organisms as wel ...
and
cognition Cognition refers to "the mental action or process of acquiring knowledge and understanding through thought, experience, and the senses". It encompasses all aspects of intellectual functions and processes such as: perception, attention, thought, ...
owing to instinctual unconscious drives. Freud observed that attempts to bring such drives into awareness triggers resistance in the form of
defense mechanisms In psychoanalytic theory, a defence mechanism (American English: defense mechanism), is an Unconscious mind, unconscious psychological operation that functions to protect a person from anxiety-producing thoughts and feelings related to interna ...
, particularly repression, and that conflicts between conscious and unconscious material can result in mental disturbances. He also postulated that unconscious material can be found in
dreams A dream is a succession of images, ideas, emotions, and sensations that usually occur involuntarily in the mind during certain stages of sleep. Humans spend about two hours dreaming per night, and each dream lasts around 5 to 20 minutes, alth ...
and unintentional acts, including mannerisms and
Freudian slips In psychoanalysis, a Freudian slip, also called parapraxis, is an error in speech, memory, or physical action that occurs due to the interference of an unconscious subdued wish or internal train of thought. Classical examples involve slips of t ...
. Psychoanalytic therapy developed as a means to improve mental health by bringing unconscious material into consciousness. Psychoanalysts place a large emphasis on
early childhood Early childhood is a stage in human development following infancy and preceding middle childhood. It generally includes toddlerhood and some time afterward. Play age is an unspecific designation approximately within the scope of early childhood. ...
in an individual's development. During therapy, a psychoanalyst aims to induce
transference Transference (german: Übertragung) is a phenomenon within psychotherapy in which the "feelings, attitudes, or desires" a person had about one thing are subconsciously projected onto the here-and-now Other. It usually concerns feelings from a ...
, whereby patients relive their infantile conflicts by projecting onto the analyst feelings of love, dependence and anger. During psychoanalytic sessions, typically lasting 50 minutes,Thompson, M. Guy. 2004. ''The Ethic of Honesty: The Fundamental Rule of Psychoanalysis''. Rodopi. p. 75. ideally 4–5 times a week, a patient traditionally lies on a couch, and an analyst traditionally sits just behind and out of sight. The patient expresses their thoughts, including free associations,
fantasies Fantasy is a genre of fiction. Fantasy, Fantasie, or Fantasies may also refer to: Arts and entertainment Music * Fantasia (music), a free-form musical composition * ''Fantasie'' (Widmann), a 1993 composition for solo clarinet by Jörg Widmann * ...
, and dreams, from which the analyst infers the unconscious conflicts causing the patient's symptoms and character problems. Through the analysis of these conflicts, which includes interpreting the transference and
countertransference Countertransference is defined as redirection of a psychotherapist's feelings toward a client – or, more generally, as a therapist's emotional entanglement with a client. Early formulations The phenomenon of countertransference (german: G ...
(the analyst's feelings for the patient), the analyst confronts the patient's pathological
defence mechanisms In psychoanalytic theory, a defence mechanism (American English: defense mechanism), is an unconscious psychological operation that functions to protect a person from anxiety-producing thoughts and feelings related to internal conflicts and ou ...
to help the patient understand themselves better. Psychoanalysis is a controversial discipline, and its effectiveness as a treatment has been contested, although it retains influence within
psychiatry Psychiatry is the medical specialty devoted to the diagnosis, prevention, and treatment of mental disorders. These include various maladaptations related to mood, behaviour, cognition, and perceptions. See glossary of psychiatry. Initial psych ...
."Psychoanalysis has existed before the turn of the 20th century and, in that span of years, has established itself as one of the fundamental disciplines within psychiatry. The science of psychoanalysis is the bedrock of psychodynamic understanding and forms the fundamental theoretical frame of reference for a variety of forms of therapeutic intervention, embracing not only psychoanalysis itself but also various forms of psychoanalytically oriented psychotherapy and related forms of therapy using psychodynamic concepts." Sadock, Benjamin J., and Virginia A. Sadock. 2007. ''Kaplan and Sadock's Synopsis of Psychiatry'' (10th ed.).
Lippincott Williams & Wilkins Lippincott Williams & Wilkins (LWW) is an American imprint of the American Dutch publishing conglomerate Wolters Kluwer. It was established by the acquisition of Williams & Wilkins and its merger with J.B. Lippincott Company in 1998. Under the LW ...
. p. 190.
"Psychoanalysis continues to be an important paradigm organizing the way many psychiatrists think about patients and treatment. However, its limitations are more widely recognized and it is assumed that many important advances in the future will come from other areas, particularly biologic psychiatry. As yet unresolved is the appropriate role of psychoanalytic thinking in organizing the treatment of patients and the training of psychiatrists after that biologic revolution has born fruit. Will treatments aimed at biologic defects or abnormalities become technical steps in a program organized in a psychoanalytic framework? Will psychoanalysis serve to explain and guide supportive intervention for individuals whose lives are deformed by biologic defect and therapeutic interventions, much as it now does for patients with chronic physical illness, with the psychoanalyst on the psychiatric dialysis program? Or will we look back on the role of psychoanalysis in the treatment of the seriously mentally ill as the last and most scientifically enlightened phase of the humanistic tradition in psychiatry, a tradition that became extinct when advances in biology allowed us to cure those we had so long only comforted?" Michels, Robert. 1999.
Psychoanalysis and Psychiatry: A Changing Relationship
" ''The Challenge for Psychoanalysis and Psychotherapy: Solutions for the Future''. New York:
American Mental Health Foundation The American Mental Health Foundation (AMHF) is a not-for-profit organization dedicated to the welfare of individuals with emotional problems and advancing mental-health research. AMHF is established to organize educational seminars and to dissemina ...
. Archived 6 June 2009.
Psychoanalytic concepts are also widely used outside the therapeutic arena, in areas such as
psychoanalytic literary criticism Psychoanalytic literary criticism is literary criticism or literary theory which, in method, concept, or form, is influenced by the tradition of psychoanalysis begun by Sigmund Freud. Psychoanalytic reading has been practised since the early de ...
, as well as in the analysis of film, fairy tales, philosophical perspectives as
Freudo-Marxism Freudo-Marxism is a loose designation for philosophical perspectives informed by both the Marxist philosophy of Karl Marx and the psychoanalytic theory of Sigmund Freud. It has a rich history within continental philosophy, beginning in the 19 ...
and other cultural phenomena.


History


1890s

The idea of psychoanalysis (german: Psychoanalyse) first began to receive serious attention under
Sigmund Freud Sigmund Freud ( , ; born Sigismund Schlomo Freud; 6 May 1856 – 23 September 1939) was an Austrian neurologist and the founder of psychoanalysis, a clinical method for evaluating and treating psychopathology, pathologies explained as originatin ...
, who formulated his own theory of psychoanalysis in
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in the 1890s. Freud was a
neurologist Neurology (from el, νεῦρον (neûron), "string, nerve" and the suffix -logia, "study of") is the branch of medicine dealing with the diagnosis and treatment of all categories of conditions and disease involving the brain, the spinal c ...
trying to find an effective treatment for patients with neurotic or hysterical symptoms. Freud realised that there were mental processes that were not conscious whilst he was employed as a neurological consultant at the Children's Hospital, where he noticed that many
aphasic Aphasia is an inability to comprehend or formulate language because of damage to specific brain regions. The major causes are stroke and head trauma; prevalence is hard to determine but aphasia due to stroke is estimated to be 0.1–0.4% in t ...
children had no apparent organic cause for their symptoms. He then wrote a
monograph A monograph is a specialist work of writing (in contrast to reference works) or exhibition on a single subject or an aspect of a subject, often by a single author or artist, and usually on a scholarly subject. In library cataloging, ''monograph ...
about this subject. In 1885, Freud obtained a grant to study with
Jean-Martin Charcot Jean-Martin Charcot (; 29 November 1825 – 16 August 1893) was a French neurology, neurologist and professor of anatomical pathology. He worked on hypnosis and hysteria, in particular with his hysteria patient Louise Augustine Gleizes. Charcot ...
, a famed neurologist, at the Salpêtrière in Paris, where he followed the clinical presentations of Charcot, particularly in the areas of hysteria, paralyses and the anaesthesias. Charcot had introduced hypnotism as an experimental research tool and developed photographic representation of clinical symptoms. Freud's first theory to explain hysterical symptoms was presented in ''
Studies on Hysteria ''Studies on Hysteria'' () is an 1895 book by Sigmund Freud, the founder of psychoanalysis, and the physician Josef Breuer. It consists of a joint introductory paper (reprinted from 1893); followed by five individual studies of hysterics – Breue ...
'' (1895; german: Studien über Hysterie, label=none), co-authored with his mentor the distinguished physician
Josef Breuer Josef Breuer ( , ; 15 January 1842 – 20 June 1925) was a distinguished physician who made key discoveries in neurophysiology, and whose work in the 1880s with his patient Bertha Pappenheim, known as Anna O., developed the talking cure (catharti ...
, which was generally seen as the birth of psychoanalysis. The work was based on Breuer's treatment of
Bertha Pappenheim Bertha Pappenheim (27 February 1859 – 28 May 1936) was an Austrian-Jewish feminist, a social pioneer, and the founder of the Jewish Women's Association (''). Under the pseudonym Anna O., she was also one of Josef Breuer's best-documented pat ...
, referred to in case studies by the
pseudonym A pseudonym (; ) or alias () is a fictitious name that a person or group assumes for a particular purpose, which differs from their original or true name (orthonym). This also differs from a new name that entirely or legally replaces an individua ...
"
Anna O. Bertha Pappenheim (27 February 1859 – 28 May 1936) was an Austrian-Jewish feminist, a social pioneer, and the founder of the Jewish Women's Association (''). Under the pseudonym Anna O., she was also one of Josef Breuer's best-documented pat ...
", treatment which Pappenheim herself had dubbed the "
talking cure ''The Talking Cure'' and ''chimney sweeping'' were terms Bertha Pappenheim, known in case studies by the alias Anna O., used for the verbal therapy given to her by Josef Breuer. They were first published in ''Studies on Hysteria'' (1895). As Erne ...
". Breuer wrote that many factors could result in such symptoms, including various types of emotional trauma, and he also credited work by others such as
Pierre Janet Pierre Marie Félix Janet (; 30 May 1859 – 24 February 1947) was a pioneering French psychologist, physician, philosopher, and psychotherapist in the field of dissociation and traumatic memory. He is ranked alongside William James and ...
; while Freud contended that at the root of hysterical symptoms were repressed memories of distressing occurrences, almost always having direct or indirect sexual associations.Freud, Sigmund, and
Josef Breuer Josef Breuer ( , ; 15 January 1842 – 20 June 1925) was a distinguished physician who made key discoveries in neurophysiology, and whose work in the 1880s with his patient Bertha Pappenheim, known as Anna O., developed the talking cure (catharti ...
. 1955
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''
Studies on Hysteria ''Studies on Hysteria'' () is an 1895 book by Sigmund Freud, the founder of psychoanalysis, and the physician Josef Breuer. It consists of a joint introductory paper (reprinted from 1893); followed by five individual studies of hysterics – Breue ...
'', '' Standard Editions'' 2, edited by J. Strachey. London:
Hogarth Press The Hogarth Press is a book publishing imprint of Penguin Random House that was founded as an independent company in 1917 by British authors Leonard Woolf and Virginia Woolf. It was named after their house in Richmond (then in Surrey and now ...
.
Around the same time, Freud attempted to develop a neuro-physiological theory of unconscious mental mechanisms, which he soon gave up. It remained unpublished in his lifetime. The term 'psychoanalysis' () was first introduced by Freud in his essay titled "Heredity and etiology of neuroses" (""), written and published in French in 1896. In 1896, Freud also published his ''seduction theory'', claiming to have uncovered repressed memories of incidents of sexual abuse for all his current patients, from which he proposed that the preconditions for hysterical symptoms are sexual excitations in infancy.Freud, Sigmund. 1953
896 __NOTOC__ Year 896 ( DCCCXCVI) was a leap year starting on Thursday (link will display the full calendar) of the Julian calendar. Events By place Europe * February – King Arnulf of Carinthia invades Italy at the head of an East ...
"
The Aetiology of Hysteria The Aetiology of Hysteria (german: Zur Ätiologie der Hysterie) is a paper by Sigmund Freud about the sexual abuse of children below the age of puberty and its possible causation of mental illness in adults. Presented in April or May 1896, it is whe ...
." Pp. 191–221 in '' The Standard Edition'' 3, edited by J. Strachey. London:
Hogarth Press The Hogarth Press is a book publishing imprint of Penguin Random House that was founded as an independent company in 1917 by British authors Leonard Woolf and Virginia Woolf. It was named after their house in Richmond (then in Surrey and now ...

Lay summary
via
University of Washington The University of Washington (UW, simply Washington, or informally U-Dub) is a public research university in Seattle, Washington. Founded in 1861, Washington is one of the oldest universities on the West Coast; it was established in Seattle a ...
.
Though in 1896 he had reported that his patients "had no feeling of remembering the nfantile sexualscenes", and assured him "emphatically of their unbelief", in later accounts he claimed that they had told him that they had been sexually abused in infancy. By 1898 he had privately acknowledged to his friend and colleague
Wilhelm Fliess Wilhelm Fliess (german: Wilhelm Fließ; 24 October 1858 – 13 October 1928) was a German otolaryngologist who practised in Berlin. He developed the pseudoscientific Biorhythm theory, theory of human biorhythms and a possible nasogenital conne ...
that he no longer believed in his theory, though he did not state this publicly until 1906.Freud, Sigmund. 1953
906 __NOTOC__ Year 906 ( CMVI) was a common year starting on Wednesday (link will display the full calendar) of the Julian calendar. Events By place Europe * February 27 – Battle of Fritzlar: The Conradines defeat the Babenberg co ...
"My Views on the Part Played by Sexuality in the Aetiology of the Neuroses." Pp. 269–79 in '' The Standard Edition'' 7, edited by J. Strachey. London:
Hogarth Press The Hogarth Press is a book publishing imprint of Penguin Random House that was founded as an independent company in 1917 by British authors Leonard Woolf and Virginia Woolf. It was named after their house in Richmond (then in Surrey and now ...
.
Building on his claims that the patients reported infantile sexual abuse experiences, Freud subsequently contended that his clinical findings in the mid-1890s provided evidence of the occurrence of unconscious fantasies, supposedly to cover up memories of infantile masturbation. Only much later did he claim the same findings as evidence for Oedipal desires. In the latter part of the 20th century, several Freud scholars challenged Freud's perception of the patients who informed him of childhood sexual abuse, arguing that he had imposed his preconceived notions on his patients. By 1899, Freud had theorised that dreams had symbolic significance, and generally were specific to the dreamer. Freud formulated his second psychological theory—which hypotheses that the unconscious has or is a "primary process" consisting of symbolic and condensed thoughts, and a "secondary process" of logical, conscious thoughts. This theory was published in his 1899 book, ''
The Interpretation of Dreams ''The Interpretation of Dreams'' (german: Die Traumdeutung) is an 1899 book by Sigmund Freud, the founder of psychoanalysis, in which the author introduces his theory of the unconscious with respect to dream interpretation, and discusses what w ...
'', which Freud thought of as his most significant work''.'' Freud outlined a new ''topographic theory'', which theorised that unacceptable sexual wishes were repressed into the "System Unconscious". These wishes were made unconscious due to society's condemnation of premarital sexual activity, and this repression created anxiety. This "topographic theory" is still popular in much of Europe, although it has fallen out of favour in much of North America, where it has been largely supplanted by structural theory. In addition, ''The Interpretation of Dreams'' contained Freud's first conceptualisation of the
Oedipal complex The Oedipus complex (also spelled Œdipus complex) is an idea in psychoanalytic theory. The complex is an ostensibly universal phase in the life of a young boy in which, to try to immediately satisfy basic desires, he unconsciously wishes to have ...
, which asserted that young boys are sexually attracted to their mothers and envious of their fathers for being able to have sex with their mothers. Psychologist
Frank Sulloway Frank Jones Sulloway (born February 2, 1947) is an American psychologist. He is a visiting scholar at the Institute of Personality and Social Research at the University of California, Berkeley and a visiting professor in the Department of Psycholo ...
in his book ''Freud, Biologist of the Mind: Beyond the Psychoanalytic Legend'' argues that Freud's biological theories like libido were rooted in the biological hypothesis that accompanied the work of
Charles Darwin Charles Robert Darwin ( ; 12 February 1809 – 19 April 1882) was an English naturalist, geologist, and biologist, widely known for his contributions to evolutionary biology. His proposition that all species of life have descended fr ...
, citing theories of
Krafft-Ebing Richard Freiherr von Krafft-Ebing (full name Richard Fridolin Joseph Freiherr Krafft von Festenberg auf Frohnberg, genannt von Ebing; 14 August 1840 – 22 December 1902) was a German psychiatrist and author of the foundational work ''Psychopathi ...
, Molland,
Havelock Ellis Henry Havelock Ellis (2 February 1859 – 8 July 1939) was an English physician, eugenicist, writer, progressive intellectual and social reformer who studied human sexuality. He co-wrote the first medical textbook in English on homosexuality in ...
,
Haeckel Ernst Heinrich Philipp August Haeckel (; 16 February 1834 – 9 August 1919) was a German zoologist, naturalist, eugenicist, philosopher, physician, professor, marine biologist and artist. He discovered, described and named thousands of new sp ...
,
Wilhelm Fliess Wilhelm Fliess (german: Wilhelm Fließ; 24 October 1858 – 13 October 1928) was a German otolaryngologist who practised in Berlin. He developed the pseudoscientific Biorhythm theory, theory of human biorhythms and a possible nasogenital conne ...
as influencing Freud.


1900–1940s

In 1905, Freud published ''
Three Essays on the Theory of Sexuality ''Three Essays on the Theory of Sexuality'' (german: Drei Abhandlungen zur Sexualtheorie), sometimes titled ''Three Contributions to the Theory of Sex'', is a 1905 work by Sigmund Freud, the founder of psychoanalysis, in which the author advance ...
'' in which he laid out his discovery of the ''psychosexual phases'', which categorised early childhood development into five stages depending on what sexual afinity a child possessed at the stage: * Oral (ages 0–2); * Anal (2–4); * Phallic-oedipal or First genital (3–6); * Latency (6–puberty); and * Mature genital (puberty–onward). His early formulation included the idea that because of societal restrictions, sexual wishes were repressed into an unconscious state, and that the energy of these unconscious wishes could be result in anxiety or physical symptoms. Early treatment techniques, including hypnotism and
abreaction Abreaction (german: Abreagieren) is a psychoanalytical term for reliving an experience to purge it of its emotional excesses—a type of catharsis. Sometimes it is a method of becoming conscious of repressed traumatic events. Psychoanalytic origin ...
, were designed to make the unconscious conscious in order to relieve the pressure and the apparently resulting symptoms. This method would later on be left aside by Freud, giving free association a bigger role. In ''
On Narcissism ''On Narcissism'' (german: Zur Einführung des Narzißmus) is a 1914 essay by Sigmund Freud, the founder of psychoanalysis. In the paper, Freud sums up his earlier discussions on the subject of narcissism and considers its place in sexual develop ...
'' (1915), Freud turned his attention to the titular subject of
narcissism Narcissism is a self-centered personality style characterized as having an excessive interest in one's physical appearance or image and an excessive preoccupation with one's own needs, often at the expense of others. Narcissism exists on a co ...
. Freud characterized the difference between energy directed at the self versus energy directed at others using a system known as ''
cathexis In psychoanalysis, cathexis (or emotional investment) is defined as the process of allocation of mental or emotional energy to a person, object, or idea. Origin of term The Greek term ''cathexis'' (κάθεξις) was chosen by James Strachey ...
''. By 1917, in "
Mourning and Melancholia ''Mourning and Melancholia'' (german: Trauer und Melancholie) is a 1917 work of Sigmund Freud, the founder of psychoanalysis. In this essay, Freud argues that mourning and melancholia are similar but different responses to . In mourning, a perso ...
", he suggested that certain depressions were caused by turning guilt-ridden anger on the self.Freud, Sigmund. 1955
917 __NOTOC__ Year 917 ( CMXVII) was a common year starting on Wednesday (link will display the full calendar) of the Julian calendar. Events By place Byzantine Empire * August 20 – Battle of Achelous: A Byzantine expeditionary fo ...

Mourning and Melancholia
." Pp. 243–58 in ''Standard Edition'' 17, edited by J. Strachey. London:
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. – via
University of Pennsylvania The University of Pennsylvania (also known as Penn or UPenn) is a private research university in Philadelphia. It is the fourth-oldest institution of higher education in the United States and is ranked among the highest-regarded universitie ...
. Also available vi
Internet Archive
In 1919, through "A Child is Being Beaten", he began to address the problems of
self-destructive behavior Self-destructive behavior is any behavior that is harmful or potentially harmful towards the person who engages in the behavior. Self-destructive behaviors have been shown by many people throughout the years. It is on a continuum, with one extr ...
and
sexual masochism Sadomasochism ( ) is the giving and receiving of pleasure from acts involving the receipt or infliction of pain or humiliation. Practitioners of sadomasochism may seek sexual pleasure from their acts. While the terms sadist and masochist refer ...
. Based on his experience with depressed and self-destructive patients, and pondering the carnage of
World War I World War I (28 July 1914 11 November 1918), often abbreviated as WWI, was one of the deadliest global conflicts in history. Belligerents included much of Europe, the Russian Empire, the United States, and the Ottoman Empire, with fightin ...
, Freud became dissatisfied with considering only oral and sexual motivations for behavior. By 1920, Freud addressed the power of identification (with the leader and with other members) in groups as a motivation for behavior in ''
Group Psychology and the Analysis of the Ego A group is a number of persons or things that are located, gathered, or classed together. Groups of people * Cultural group, a group whose members share the same cultural identity * Ethnic group, a group whose members share the same ethnic iden ...
''. In that same year, Freud suggested his ''dual drive theory'' of sexuality and aggression in ''
Beyond the Pleasure Principle ''Beyond the Pleasure Principle'' (german: Jenseits des Lustprinzips) is a 1920 essay by Sigmund Freud. It marks a major turning point in the formulation of his drive theory, where Freud had previously attributed self-preservation in human behav ...
'', to try to begin to explain human destructiveness. Also, it was the first appearance of his "structural theory" consisting of three new concepts
id, ego, and superego The id, ego, and super-ego are a set of three concepts in psychoanalytic theory describing distinct, interacting agents in the psychic apparatus (defined in Sigmund Freud's structural model of the psyche). The three agents are theoretical const ...
. Three years later, in 1923, he summarised the ideas of id, ego, and superego in ''
The Ego and the Id ''The Ego and the Id'' (german: Das Ich und das Es) is a prominent paper by Sigmund Freud, the founder of psychoanalysis. It is an analytical study of the human psyche outlining his theories of the psychodynamics of the id, ego and super-ego, wh ...
''.Freud, Sigmund. 1955 923 "
The Ego and the Id ''The Ego and the Id'' (german: Das Ich und das Es) is a prominent paper by Sigmund Freud, the founder of psychoanalysis. It is an analytical study of the human psyche outlining his theories of the psychodynamics of the id, ego and super-ego, wh ...
." In ''Standard Edition'' 19, edited by J. Strachey. London:
Hogarth Press The Hogarth Press is a book publishing imprint of Penguin Random House that was founded as an independent company in 1917 by British authors Leonard Woolf and Virginia Woolf. It was named after their house in Richmond (then in Surrey and now ...
. Lay summaries vi
Simply Psychology
an
JSTOR Daily RoundtableGlossary
via University of Notre Dame.
In the book, he revised the whole theory of mental functioning, now considering that repression was only one of many defense mechanisms, and that it occurred to reduce anxiety. Hence, Freud characterised repression as both a cause and a result of anxiety. In 1926, in "Inhibitions, Symptoms and Anxiety", Freud characterised how intrapsychic conflict among drive and superego caused
anxiety Anxiety is an emotion which is characterized by an unpleasant state of inner turmoil and includes feelings of dread over anticipated events. Anxiety is different than fear in that the former is defined as the anticipation of a future threat wh ...
, and how that anxiety could lead to an inhibition of mental functions, such as intellect and speech.Freud, Sigmund. 1955
926 Year 926 ( CMXXVI) was a common year starting on Sunday (link will display the full calendar) of the Julian calendar. Events By place Europe * Spring – The Italian nobles turn against King Rudolph II of Burgundy and request that ...
"Inhibitions, Symptoms and Anxiety." In ''Standard Edition'' 20, edited by J. Strachey. London:
Hogarth Press The Hogarth Press is a book publishing imprint of Penguin Random House that was founded as an independent company in 1917 by British authors Leonard Woolf and Virginia Woolf. It was named after their house in Richmond (then in Surrey and now ...
. . .
In 1924,
Otto Rank Otto Rank (; ; né Rosenfeld; 22 April 1884 – 31 October 1939) was an Austrian psychoanalyst, writer, and philosopher. Born in Vienna, he was one of Sigmund Freud's closest colleagues for 20 years, a prolific writer on psychoanalytic themes, ...
published
The Trauma of Birth ''The Trauma of Birth'' (german: Das Trauma der Geburt) is a 1924 book by the psychoanalyst Otto Rank. It was first published in English translation in 1929. Especially with its focus on the connection between microcosm and macrocosm, it foreshado ...
, which analysed culture and philosophy in relation to separation anxiety which occurred before the development of an
Oedipal complex The Oedipus complex (also spelled Œdipus complex) is an idea in psychoanalytic theory. The complex is an ostensibly universal phase in the life of a young boy in which, to try to immediately satisfy basic desires, he unconsciously wishes to have ...
. Freud's theories, however, characterized no such phase. According to Freud, the Oedipus complex was at the centre of neurosis, and was the foundational source of all art, myth, religion, philosophy, therapy—indeed of all human culture and civilization. It was the first time that anyone in Freud's inner circle had characterised something other than the Oedipus complex as contributing to intrapsychic development, a notion that was rejected by Freud and his followers at the time. By 1936 the "Principle of Multiple Function" was clarified by
Robert Waelder Robert Waelder (1900–1967) was a noted Austrian psychoanalyst and member of the Vienna Psychoanalytic Society. Waelder studied under Anna Freud and Hermann Nunberg. He was known for his work bringing together psychoanalysis and politics and wr ...
. He widened the formulation that psychological symptoms were caused by and relieved conflict simultaneously. Moreover, symptoms (such as
phobia A phobia is an anxiety disorder defined by a persistent and excessive fear of an object or situation. Phobias typically result in a rapid onset of fear and are usually present for more than six months. Those affected go to great lengths to avo ...
s and compulsions) each represented elements of some drive wish (sexual and/or aggressive), superego, anxiety, reality, and defenses. Also in 1936,
Anna Freud Anna Freud (3 December 1895 – 9 October 1982) was a British psychoanalyst of Austrian-Jewish descent. She was born in Vienna, the sixth and youngest child of Sigmund Freud and Martha Bernays. She followed the path of her father and contribu ...
, Sigmund's daughter, published her seminal book, ''The Ego and the Mechanisms of Defense'', outlining numerous ways the mind could shut upsetting things out of consciousness. Freud, Anna. 1968
937 Year 937 ( CMXXXVII) was a common year starting on Sunday (link will display the full calendar) of the Julian calendar. Events By place Europe * A Hungarian army invades Burgundy, and burns the city of Tournus. Then they go southward ...
''The Ego and the Mechanisms of Defence'' (revised ed.). London:
Hogarth Press The Hogarth Press is a book publishing imprint of Penguin Random House that was founded as an independent company in 1917 by British authors Leonard Woolf and Virginia Woolf. It was named after their house in Richmond (then in Surrey and now ...
.


1940s–present

When
Hitler Adolf Hitler (; 20 April 188930 April 1945) was an Austrian-born German politician who was dictator of Germany from 1933 until his death in 1945. He rose to power as the leader of the Nazi Party, becoming the chancellor in 1933 and then ...
's power grew, the Freud family and many of their colleagues fled to London. Within a year, Sigmund Freud died. In the United States, also following the death of Freud, a new group of psychoanalysts began to explore the function of the ego. Led by
Heinz Hartmann Heinz Hartmann (November 4, 1894 in Vienna, Austria-Hungary – May 17, 1970 in Stony Point, New York), was a psychiatrist and psychoanalyst. He is considered one of the founders and principal representatives of ego psychology. Life Hartmann was ...
, the group built upon understandings of the ''synthetic'' function of the ego as a mediator in psychic functioning, distinguishing such from ''autonomous'' ego functions (e.g. memory and intellect). These "ego psychologists" of the 1950s paved a way to focus analytic work by attending to the defenses (mediated by the ego) before exploring the deeper roots to the unconscious conflicts. In addition, there was growing interest in
child psychoanalysis Child psychoanalysis is a sub-field of psychoanalysis which was founded by Anna Freud. Freud used the work of her father Sigmund Freud with certain modifications directed towards the needs of children. Since its inception, child psychoanalysis has ...
. Psychoanalysis has been used as a research tool into childhood development,cf. ''
The Psychoanalytic Study of the Child The Psychoanalytic Study of the Child is an annual journal, published by Taylor & Francis, which contains scholarly articles on topics related to child psychiatry and psychoanalysis. The journal was founded in 1945 by Anna Freud, Heinz Hartmann, a ...
'', academic journal
and is still used to treat certain mental disturbances.Wallerstein. 2000. ''Forty-Two Lives in Treatment: A Study of Psychoanalysis and Psychotherapy''. In the 1960s, Freud's early thoughts on the childhood development of
female sexuality Human female sexuality encompasses a broad range of behaviors and processes, including female sexual identity and sexual behavior, the physiological, psychological, social, cultural, political, and spiritual or religious aspects of sexual ac ...
were challenged; this challenge led to the development of a variety of understandings of female sexual development, many of which modified the timing and normality of several of Freud's theories. Several researchers followed
Karen Horney Karen Horney (; ; 16 September 1885 – 4 December 1952) was a German psychoanalyst who practised in the United States during her later career. Her theories questioned some traditional Freudian views. This was particularly true of her theories of ...
's studies of societal pressures that influence the development of women. In the first decade of the 21st century, there were approximately 35 training institutes for psychoanalysis in the United States accredited by the
American Psychoanalytic Association The American Psychoanalytic Association (APsaA) is an association of psychoanalysts in the United States. APsaA serves as a scientific and professional organization with a focus on education, research, and membership development. APsaA comprises 3 ...
(APsaA), which is a component organization of the
International Psychoanalytical Association The International Psychoanalytical Association (IPA) is an association including 12,000 psychoanalysts as members and works with 70 constituent organizations. It was founded in 1910 by Sigmund Freud, from an idea proposed by Sándor Ferenczi. His ...
(IPA), and there are over 3000 graduated psychoanalysts practicing in the United States. The IPA accredits psychoanalytic training centers through such "component organisations" throughout the rest of the world, including countries such as Serbia, France, Germany, Austria, Italy, Switzerland, and many others, as well as about six institutes directly in the United States.


Psychoanalysis as a movement

Freud founded the ''Psychological Wednesday Society'' in 1902, which
Edward Shorter Edward Shorter (1767-1836) was an English engineer and inventor of several useful inventions including an early screw propeller. Early life Edward was born in London on 3 December 1767 in the parish of St Sepulchre, Newgate to Robert and Ann ...
argues was the beginning of psychoanalysis as a movement. This society became the
Vienna Psychoanalytic Society The Vienna Psychoanalytic Society (, WPV), formerly known as the Wednesday Psychological Society, is the oldest psychoanalysis society in the world. In 1908, reflecting its growing institutional status as the international psychoanalytic authority ...
in 1908 in the same year as the first international congress of psychoanalysis held in Salzburg, Austria.
Alfred Adler Alfred Adler ( , ; 7 February 1870 – 28 May 1937) was an Austrian medical doctor, psychotherapist, and founder of the school of individual psychology. His emphasis on the importance of feelings of belonging, family constellation and birth order ...
was one of the most active members in this society in its early years. The second congress of psychoanalysis took place in Nuremberg, Germany in 1910. At this congress, Ferenczi called for the creation of an International Psychoanalytic Association with
Jung Carl Gustav Jung ( ; ; 26 July 1875 – 6 June 1961) was a Swiss psychiatrist and psychoanalyst who founded analytical psychology. Jung's work has been influential in the fields of psychiatry, anthropology, archaeology, literature, philo ...
as president for life. A third congress was held in Weimar in 1911. The London Psychoanalytical Society was founded in 1913 by
Ernest Jones Alfred Ernest Jones (1 January 1879 – 11 February 1958) was a Welsh neurologist and psychoanalyst. A lifelong friend and colleague of Sigmund Freud from their first meeting in 1908, he became his official biographer. Jones was the first En ...
.


Developments of alternative forms of psychotherapy


Cognitive behavioural therapy (CBT)

In the 1950s, psychoanalysis was the main modality of
psychotherapy Psychotherapy (also psychological therapy, talk therapy, or talking therapy) is the use of psychological methods, particularly when based on regular personal interaction, to help a person change behavior, increase happiness, and overcome pro ...
. Behavioural models of psychotherapy started to assume a more central role in psychotherapy in the 1960s."By the 1960s it would assume a more central place in the psychotherapy arena"
Aaron T. Beck Aaron Temkin Beck (July 18, 1921 – November 1, 2021) was an American psychiatrist who was a professor in the department of psychiatry at the University of Pennsylvania.
, a psychiatrist trained in a psychoanalytic tradition, set out to test the psychoanalytic models of depression empirically and found that conscious ruminations of loss and personal failing were correlated with depression. He suggested that distorted and biased beliefs were a causal factor of depression, publishing an influential paper in 1967 after a decade of research using the construct of schemas to explain the depression. Beck developed this empirically supported hypothesis for the cause of depression into a talking therapy called
cognitive behavioral therapy Cognitive behavioral therapy (CBT) is a psycho-social intervention that aims to reduce symptoms of various mental health conditions, primarily depression and anxiety disorders. CBT focuses on challenging and changing cognitive distortions (suc ...
(CBT) in the early 1970s.


Attachment theory

Attachment theory Attachment theory is a psychological, evolutionary and ethological theory concerning relationships between humans. The most important tenet is that young children need to develop a relationship with at least one primary caregiver for normal ...
was developed theoretically by
John Bowlby Edward John Mostyn Bowlby, CBE, FBA, FRCP, FRCPsych (; 26 February 1907 – 2 September 1990) was a British psychologist, psychiatrist, and psychoanalyst, notable for his interest in child development and for his pioneering work in attachmen ...
and formalized empirically by
Mary Ainsworth Mary Dinsmore Ainsworth (; December 1, 1913 – March 21, 1999) was an American-Canadian developmental psychologist known for her work in the development of the attachment theory. She designed the strange situation procedure to observe early emot ...
. Bowlby was trained psychoanalytically but was concerned about some properties of psychoanalysis; he was troubled by the dogmatism of psychoanalysis at the time, its arcane terminology, the lack of attention to environment in child behaviour, and the concepts derived from talking therapy to child behaviour. In response, he developed an alternative conceptualization of child behaviour based on principles on
ethology Ethology is the scientific study of animal behaviour, usually with a focus on behaviour under natural conditions, and viewing behaviour as an evolutionarily adaptive trait. Behaviourism as a term also describes the scientific and objectiv ...
. Bowlby's theory of attachment rejects Freud's model of
psychosexual development In Freudian psychology, psychosexual development is a central element of the psychoanalytic sexual drive theory. Freud believed that personality developed through a series of childhood stages in which pleasure seeking energies from the child be ...
based on the Oedipal model. For his work, Bowlby was shunned from psychoanalytical circles who did not accept his theories. Nonetheless, his conceptualization was adopted widely by mother-infant research in the 1970s.


Theories

The predominant psychoanalytic theories can be organised into several theoretical schools. Although these perspectives differ, most of them emphasize the influence of unconscious elements on the conscious. There has also been considerable work done on consolidating elements of conflicting theories. There are some persistent conflicts among psychoanalysts regarding specific causes of certain syndromes, and some disputes regarding the ideal treatment techniques. In the 21st century, psychoanalytic ideas have found influence in fields such as
childcare Child care, otherwise known as day care, is the care and supervision of a child or multiple children at a time, whose ages range from two weeks of age to 18 years. Although most parents spend a significant amount of time caring for their child(r ...
,
education Education is a purposeful activity directed at achieving certain aims, such as transmitting knowledge or fostering skills and character traits. These aims may include the development of understanding, rationality, kindness, and honesty. Va ...
,
literary criticism Literary criticism (or literary studies) is the study, evaluation, and interpretation of literature. Modern literary criticism is often influenced by literary theory, which is the philosophical discussion of literature's goals and methods. Th ...
,
cultural studies Cultural studies is an interdisciplinary field that examines the political dynamics of contemporary culture (including popular culture) and its historical foundations. Cultural studies researchers generally investigate how cultural practices re ...
,
mental health Mental health encompasses emotional, psychological, and social well-being, influencing cognition, perception, and behavior. It likewise determines how an individual handles stress, interpersonal relationships, and decision-making. Mental health ...
, and particularly
psychotherapy Psychotherapy (also psychological therapy, talk therapy, or talking therapy) is the use of psychological methods, particularly when based on regular personal interaction, to help a person change behavior, increase happiness, and overcome pro ...
. Though most mainstream psychoanalysts subscribe to modern strains of psychaoanalytical thought, there are groups who follow the precepts of a single psychoanalyst and their school of thought. Psychoanalytic ideas also play roles in some types of literary analysis such as
archetypal literary criticism Archetypal literary criticism is a type of analytical theory that interprets a text by focusing on recurring myths and archetypes (from the Greek ''archē'', "beginning", and ''typos'', "imprint") in the narrative, symbols, images, and characte ...
.


Topographic theory

''Topographic theory'' was named and first described by
Sigmund Freud Sigmund Freud ( , ; born Sigismund Schlomo Freud; 6 May 1856 – 23 September 1939) was an Austrian neurologist and the founder of psychoanalysis, a clinical method for evaluating and treating psychopathology, pathologies explained as originatin ...
in ''
The Interpretation of Dreams ''The Interpretation of Dreams'' (german: Die Traumdeutung) is an 1899 book by Sigmund Freud, the founder of psychoanalysis, in which the author introduces his theory of the unconscious with respect to dream interpretation, and discusses what w ...
'' (1899). The theory hypothesizes that the mental apparatus can be divided into the systems
Conscious Consciousness, at its simplest, is sentience and awareness of internal and external existence. However, the lack of definitions has led to millennia of analyses, explanations and debates by philosophers, theologians, linguisticians, and scien ...
,
Preconscious In psychoanalysis, preconscious is the loci preceding consciousness. Thoughts are preconscious when they are unconscious at a particular moment, but are not repressed. Therefore, preconscious thoughts are available for recall and easily 'capable ...
, and
Unconscious Unconscious may refer to: Physiology * Unconsciousness, the lack of consciousness or responsiveness to people and other environmental stimuli Psychology * Unconscious mind, the mind operating well outside the attention of the conscious mind a ...
. These systems are not
anatomical Anatomy () is the branch of biology concerned with the study of the structure of organisms and their parts. Anatomy is a branch of natural science that deals with the structural organization of living things. It is an old science, having it ...
structures of the brain but, rather, mental processes. Although Freud retained this theory throughout his life he largely replaced it with the ''structural theory''. Langs, Robert. 2010. ''Freud on a Precipice: How Freud's Fate pushed Psychoanalysis over the Edge''. Lanham, MD:
Jason Aronson Jason Aronson was an American publisher of books in the field of psychotherapy. Topics dealt with in these books include child therapy, family therapy, couple therapy, object relations therapy, play therapy, depression, eating disorders, persona ...
.


Structural theory

Structural theory divides the psyche into the id, the ego, and the
super-ego The id, ego, and super-ego are a set of three concepts in psychoanalytic theory describing distinct, interacting agents in the psychic apparatus (defined in Sigmund Freud's structural model of the psyche). The three agents are theoretical cons ...
. The id is present at birth as the repository of basic instincts, which Freud called "''Triebe''" ("drives"). Unorganized and unconscious, it operates merely on the 'pleasure principle', without realism or foresight. The ego develops slowly and gradually, being concerned with mediating between the urging of the id and the realities of the external world; it thus operates on the 'reality principle'. The super-ego is held to be the part of the ego in which self-observation,
self-criticism Self-criticism involves how an individual evaluates oneself. Self-criticism in psychology is typically studied and discussed as a negative personality trait in which a person has a disrupted self-identity. The opposite of self-criticism would be ...
and other reflective and judgmental faculties develop. The ego and the super-ego are both partly conscious and partly unconscious.


Theoretical and clinical approaches

During the twentieth century, many different clinical and theoretical models of psychoanalysis emerged.


Ego psychology

Ego psychology Ego psychology is a school of psychoanalysis rooted in Sigmund Freud's structural id-ego-superego model of the mind. An individual interacts with the external world as well as responds to internal forces. Many psychoanalysts use a theoretical c ...
was initially suggested by Freud in ''Inhibitions, Symptoms and Anxiety'' (1926), while major steps forward would be made through
Anna Freud Anna Freud (3 December 1895 – 9 October 1982) was a British psychoanalyst of Austrian-Jewish descent. She was born in Vienna, the sixth and youngest child of Sigmund Freud and Martha Bernays. She followed the path of her father and contribu ...
's work on
defense mechanisms In psychoanalytic theory, a defence mechanism (American English: defense mechanism), is an Unconscious mind, unconscious psychological operation that functions to protect a person from anxiety-producing thoughts and feelings related to interna ...
, first published in her book ''The Ego and the Mechanisms of Defence'' (1936). The theory was refined by Hartmann, Loewenstein, and Kris in a series of papers and books from 1939 through the late 1960s. Leo Bellak was a later contributor. This series of constructs, paralleling some of the later developments of cognitive theory, includes the notions of autonomous ego functions: mental functions not dependent, at least in origin, on intrapsychic conflict. Such functions include: sensory perception, motor control, symbolic thought, logical thought, speech, abstraction, integration (synthesis), orientation, concentration, judgment about danger, reality testing, adaptive ability, executive decision-making, hygiene, and self-preservation. Freud noted that inhibition is one method that the mind may utilize to interfere with any of these functions in order to avoid painful emotions. Hartmann (1950s) pointed out that there may be delays or deficits in such functions. Frosch (1964) described differences in those people who demonstrated damage to their relationship to reality, but who seemed able to test it. According to ego psychology, ego strengths, later described by
Otto F. Kernberg Otto Friedmann Kernberg (born 10 September 1928) is a psychoanalyst and professor of psychiatry at Weill Cornell Medicine. He is most widely known for his psychoanalytic theories on borderline personality organization and narcissistic pathology. I ...
(1975), include the capacities to control oral, sexual, and destructive impulses; to tolerate painful affects without falling apart; and to prevent the eruption into consciousness of bizarre symbolic fantasy. Synthetic functions, in contrast to autonomous functions, arise from the development of the ego and serve the purpose of managing conflict processes. Defenses are synthetic functions that protect the conscious mind from awareness of forbidden impulses and thoughts. One purpose of ego psychology has been to emphasize that some mental functions can be considered to be basic, rather than derivatives of wishes, affects, or defenses. However, autonomous ego functions can be secondarily affected because of unconscious conflict. For example, a patient may have an hysterical amnesia (memory being an autonomous function) because of intrapsychic conflict (wishing not to remember because it is too painful). Taken together, the above theories present a group of metapsychological assumptions. Therefore, the inclusive group of the different classical theories provides a cross-sectional view of human mental processes. There are six "points of view", five described by Freud and a sixth added by Hartmann. Unconscious processes can therefore be evaluated from each of these six points of view: # Topographic # Dynamic (the theory of conflict) # Economic (the theory of energy flow) # Structural # Genetic (i.e. propositions concerning origin and development of psychological functions) # Adaptational (i.e. psychological phenomena as it relates to the external world)


Modern conflict theory

''Modern conflict theory'', a variation of
ego psychology Ego psychology is a school of psychoanalysis rooted in Sigmund Freud's structural id-ego-superego model of the mind. An individual interacts with the external world as well as responds to internal forces. Many psychoanalysts use a theoretical c ...
, is a revised version of structural theory, most notably different by altering concepts related to where repressed thoughts were stored. Modern conflict theory addresses emotional symptoms and character traits as complex solutions to mental conflict. It dispenses with the concepts of a fixed
id, ego and superego The id, ego, and super-ego are a set of three concepts in psychoanalytic theory describing distinct, interacting agents in the psychic apparatus (defined in Sigmund Freud's structural model of the psyche). The three agents are theoretical const ...
, and instead posits conscious and unconscious conflict among wishes (dependent, controlling, sexual, and aggressive), guilt and shame, emotions (especially anxiety and depressive affect), and defensive operations that shut off from consciousness some aspect of the others. Moreover, healthy functioning (adaptive) is also determined, to a great extent, by resolutions of conflict. A major objective of modern conflict-theory psychoanalysis is to change the balance of conflict in a patient by making aspects of the less adaptive solutions (also called "compromise formations") conscious so that they can be rethought, and more adaptive solutions found. Current theoreticians who follow the work of Charles Brenner, especially ''The Mind in Conflict'' (1982), include Sandor Abend,
Jacob Arlow Jacob A. Arlow (1912–2004) was an American teacher, scholar, and clinician who served as president of the American Psychoanalytic Association and the New York Psychoanalytic Institute. Arlow was an editor of the ''Psychoanalytic Quarterly'' fro ...
, and Jerome Blackman.Blackman, Jerome. 2003. ''101 Defenses: How the Mind Shields Itself''.


Object relations theory

''
Object relations theory Object relations theory is a school of thought in psychoanalytic theory centered around theories of stages of ego development. Its concerns include the relation of the psyche to others in childhood and the exploration of relationships between ...
'' attempts to explain human relationships through a study of how mental representations of the self and others are organized. The clinical symptoms that suggest object relations problems (typically developmental delays throughout life) include disturbances in an individual's capacity to feel: warmth, empathy, trust, sense of security, identity stability, consistent emotional closeness, and stability in relationships with significant others. Klein discusses the concept of
introjection In psychology, introjection is the unconscious adoption of the thoughts or personality traits of others. It occurs as a normal part of development, such as a child taking on parental values and attitudes. It can also be a defense mechanism in sit ...
, creating a mental representation of external objects; and
projection Projection, projections or projective may refer to: Physics * Projection (physics), the action/process of light, heat, or sound reflecting from a surface to another in a different direction * The display of images by a projector Optics, graphic ...
, applying this mental representation to reality.
Wilfred Bion Wilfred Ruprecht Bion DSO (; 8 September 1897 – 8 November 1979) was an influential English psychoanalyst, who became president of the British Psychoanalytical Society from 1962 to 1965. Early life and military service Bion was born in Ma ...
introduced the concept of ''containment'' of projections in the mother-child relationship where a mother understands an infants projections, modifies them and returns them to the child. Concepts regarding internal representation (aka 'introspect', 'self and object representation', or 'internalization of self and other'), although often attributed to
Melanie Klein Melanie Klein (née Reizes; 30 March 1882 – 22 September 1960) was an Austrian-British author and psychoanalyst known for her work in child analysis. She was the primary figure in the development of object relations theory. Klein suggested tha ...
, were actually first mentioned by Sigmund Freud in his early concepts of drive theory (''
Three Essays on the Theory of Sexuality ''Three Essays on the Theory of Sexuality'' (german: Drei Abhandlungen zur Sexualtheorie), sometimes titled ''Three Contributions to the Theory of Sex'', is a 1905 work by Sigmund Freud, the founder of psychoanalysis, in which the author advance ...
'', 1905). Freud's 1917 paper "
Mourning and Melancholia ''Mourning and Melancholia'' (german: Trauer und Melancholie) is a 1917 work of Sigmund Freud, the founder of psychoanalysis. In this essay, Freud argues that mourning and melancholia are similar but different responses to . In mourning, a perso ...
", for example, hypothesized that unresolved grief was caused by the survivor's internalized image of the deceased becoming fused with that of the survivor, and then the survivor shifting unacceptable anger toward the deceased onto the now complex
self-image Self-image is the mental picture, generally of a kind that is quite resistant to change, that depicts not only details that are potentially available to an objective investigation by others (height, weight, hair color, etc.), but also items that h ...
. Melanie Klein's hypotheses regarding internalization during the first year of life, leading to paranoid and depressive positions, were later challenged by
René Spitz René Árpád Spitz (January 29, 1887 in Vienna – September 11, 1974 in Denver) was an Austrian-American psychoanalyst. He is best known for his analysis of hospitalized infants in which he found links between marasmus and death with unmother ...
(e.g., ''The First Year of Life'', 1965), who divided the first year of life into a coenesthetic phase of the first six months, and then a diacritic phase for the second six months.
Mahler Gustav Mahler (; 7 July 1860 – 18 May 1911) was an Austro-Bohemian Romantic composer, and one of the leading conductors of his generation. As a composer he acted as a bridge between the 19th-century Austro-German tradition and the modernism ...
, Fine, and Bergman (1975) describe distinct phases and subphases of child development leading to "separation-individuation" during the first three years of life, stressing the importance of constancy of parental figures in the face of the child's destructive aggression, internalizations, stability of affect management, and ability to develop healthy
autonomy In developmental psychology and moral, political, and bioethical philosophy, autonomy, from , ''autonomos'', from αὐτο- ''auto-'' "self" and νόμος ''nomos'', "law", hence when combined understood to mean "one who gives oneself one's ...
. During adolescence,
Erik Erikson Erik Homburger Erikson (born Erik Salomonsen; 15 June 1902 – 12 May 1994) was a German-American developmental psychologist and psychoanalyst known for his theory on psychological development of human beings. He coined the phrase identity cr ...
(1950–1960s) described the 'identity crisis', that involves identity-diffusion anxiety. In order for an adult to be able to experience "Warm-ETHICS: (warmth, Empathy, Trust, Holding environment, Identity, Closeness, and Stability) in relationships, the teenager must resolve the problems with identity and redevelop self and object constancy.


Self psychology

''
Self psychology Self psychology, a modern psychoanalytic theory and its clinical applications, was conceived by Heinz Kohut in Chicago in the 1960s, 70s, and 80s, and is still developing as a contemporary form of psychoanalytic treatment. In self psychology, the ...
'' emphasizes the development of a stable and integrated
sense of self In the psychology of self, one's self-concept (also called self-construction, self-identity, self-perspective or self-structure) is a collection of beliefs about oneself. Generally, self-concept embodies the answer to the question ''"Who am I? ...
through empathic contacts with other humans, primary significant others conceived of as ' selfobjects'. ''Selfobjects'' meet the developing self's needs for mirroring, idealization, and twinship, and thereby strengthen the developing self. The process of treatment proceeds through "transmuting internalizations" in which the patient gradually internalizes the selfobject functions provided by the therapist. Self psychology was proposed originally by
Heinz Kohut Heinz Kohut (3 May 1913 – 8 October 1981) was an Austrians, Austrian-born United States, American psychoanalyst best known for his development of self psychology, an influential school of thought within psychodynamics, psychodynamic/psychoanaly ...
, and has been further developed by
Arnold Goldberg Arnold Goldberg (May 21, 1929 – September 24, 2020) was an American psychiatrist and psychoanalyst. Goldberg was the Cynthia Oudejans Harris Professor of Psychiatry at the Rush Medical School, Chicago, and a supervising and training analys ...
, Frank Lachmann,
Paul Paul may refer to: *Paul (given name), a given name (includes a list of people with that name) *Paul (surname), a list of people People Christianity *Paul the Apostle (AD c.5–c.64/65), also known as Saul of Tarsus or Saint Paul, early Chris ...
and
Anna Ornstein Anna Ornstein (née ''Anna Brünn''; born January 27, 1927) is a Hungarian-American Auschwitz survivor, psychoanalyst and psychiatrist, author, speaker, and scholar. Early life Anna Brünn was born into a wealthy Jewish family in Szendrő, H ...
, Marian Tolpin, and others.


Lacanian psychoanalysis

Lacanian psychoanalysis Lacanianism or Lacanian psychoanalysis is a theoretical system that explains the mind, behaviour, and culture through a structuralist and post-structuralist extension of classical psychoanalysis, initiated by the work of Jacques Lacan from the ...
, which integrates psychoanalysis with
structural linguistics Structural linguistics, or structuralism, in linguistics, denotes schools or theories in which language is conceived as a self-contained, self-regulating Semiotics, semiotic system whose elements are defined by their relationship to other element ...
and
Hegel Georg Wilhelm Friedrich Hegel (; ; 27 August 1770 – 14 November 1831) was a German philosopher. He is one of the most important figures in German idealism and one of the founding figures of modern Western philosophy. His influence extends a ...
ian philosophy, is especially popular in France and parts of Latin America. Lacanian psychoanalysis is a departure from the traditional British and American psychoanalysis.
Jacques Lacan Jacques Marie Émile Lacan (, , ; 13 April 1901 – 9 September 1981) was a French psychoanalyst and psychiatrist. Described as "the most controversial psycho-analyst since Freud", Lacan gave yearly seminars in Paris from 1953 to 1981, and pu ...
frequently used the phrase "retourner à Freud" ("return to Freud") in his seminars and writings, as he claimed that his theories were an extension of Freud's own, contrary to those of Anna Freud, the Ego Psychology,
object relations Object relations theory is a school of thought in psychoanalytic theory centered around theories of stages of ego development. Its concerns include the relation of the psyche to others in childhood and the exploration of relationships between e ...
and "self" theories and also claims the necessity of reading Freud's complete works, not only a part of them. Lacan's concepts concern the "
mirror stage The mirror stage (french: stade du miroir) is a concept in the psychoanalytic theory of Jacques Lacan. The mirror stage is based on the belief that infants recognize themselves in a mirror (literal) or other symbolic contraption which induces apper ...
", the "Real", the "Imaginary", and the "Symbolic", and the claim that "the unconscious is structured as a language." Though a major influence on psychoanalysis in France and parts of Latin America, Lacan and his ideas have taken longer to be translated into English and he has thus had a lesser impact on psychoanalysis and psychotherapy in the English-speaking world. In the United Kingdom and the United States, his ideas are most widely used to analyze texts in
literary theory Literary theory is the systematic study of the nature of literature and of the methods for literary analysis. Culler 1997, p.1 Since the 19th century, literary scholarship includes literary theory and considerations of intellectual history, mo ...
. Due to his increasingly critical stance towards the deviation from Freud's thought, often singling out particular texts and readings from his colleagues, Lacan was excluded from acting as a training analyst in the IPA, thus leading him to create his own school in order to maintain an institutional structure for the many candidates who desired to continue their analysis with him.


Adaptive paradigm

The ''adaptive paradigm'' of psychotherapy develops out of the work of
Robert Langs Robert Joseph Langs (June 30, 1928 – November 8, 2014) was a psychiatrist, psychotherapist, and psychoanalyst. He was the author, co-author, or editor of more than forty books on psychotherapy and human psychology. Over the course of more t ...
. The ''adaptive paradigm'' interprets psychic conflict primarily in terms of conscious and unconscious adaptation to reality. Langs' recent work in some measure returns to the earlier Freud, in that Langs prefers a modified version of the topographic model of the mind (conscious, preconscious, and unconscious) over the structural model (id, ego, and super-ego), including the former's emphasis on trauma (though Langs looks to death-related traumas rather than sexual traumas). At the same time, Langs' model of the mind differs from Freud's in that it understands the mind in terms of evolutionary biological principles.


Relational psychoanalysis

''
Relational psychoanalysis Relational psychoanalysis is a school of psychoanalysis in the United States that emphasizes the role of real and imagined relationships with others in mental disorder and psychotherapy. 'Relational psychoanalysis is a relatively new and evolving ...
'' combines interpersonal psychoanalysis with object-relations theory and with inter-subjective theory as critical for mental health. It was introduced by Stephen Mitchell. Relational psychoanalysis stresses how the individual's personality is shaped by both real and imagined relationships with others, and how these relationship patterns are re-enacted in the interactions between analyst and patient. Relational psychoanalysts have propounded their view of the necessity of helping certain detached, isolated patients, develop the capacity for "mentalization" associated with thinking about relationships and themselves.


Psychopathology (mental disturbances)


Adults

The various psychoses involve deficits in the autonomous ego functions (see above) of integration (organization) of thought, in abstraction ability, in relationship to reality and in reality testing. In depressions with psychotic features, the self-preservation function may also be damaged (sometimes by overwhelming depressive affect). Because of the integrative deficits (often causing what general psychiatrists call "loose associations", "blocking", "
flight of ideas This glossary covers terms found in the psychiatry, psychiatric literature; the word origins are primarily Greek language, Greek, but there are also Latin language, Latin, French language, French, German language, German, and English language, Engl ...
", "verbigeration", and "thought withdrawal"), the development of self and object representations is also impaired. Clinically, therefore, psychotic individuals manifest limitations in warmth, empathy, trust, identity, closeness and/or stability in relationships (due to problems with self-object fusion anxiety) as well. In patients whose autonomous ego functions are more intact, but who still show problems with object relations, the diagnosis often falls into the category known as "borderline". Borderline patients also show deficits, often in controlling impulses, affects, or fantasies – but their ability to test reality remains more or less intact. Adults who do not experience guilt and shame, and who indulge in criminal behavior, are usually diagnosed with
psychopathy Psychopathy, sometimes considered synonymous with sociopathy, is characterized by persistent Anti-social behaviour, antisocial behavior, impaired empathy and remorse, and Boldness, bold, Disinhibition, disinhibited, and Egotism, egotistical B ...
or
antisocial personality disorder Antisocial personality disorder (ASPD or infrequently APD) is a personality disorder characterized by a long-term pattern of disregard of, or violation of, the rights of others as well as a difficulty sustaining long-term relationships. Lack ...
. ''Neurotic symptoms''—including panic, phobias, conversions, obsessions, compulsions and depressions—are not usually caused by deficits in functions. Instead, they are caused by intrapsychic conflicts. The conflicts are generally among sexual and hostile-aggressive wishes, guilt and shame, and reality factors. The conflicts may be conscious or unconscious, but create anxiety, depressive affect, and anger. Finally, the various elements are managed by defensive operations—essentially shut-off brain mechanisms that make people unaware of that element of conflict. ''Repression'' is the term given to the mechanism that shuts thoughts out of consciousness. ''Isolation of affect'' is the term used for the mechanism that shuts sensations out of consciousness. Neurotic symptoms may occur with or without deficits in ego functions, object relations, and ego strengths. Therefore, it is not uncommon to encounter people with obsessive-compulsive disorder and schizophrenia, or patients with panic disorder who also have
borderline personality disorder Borderline personality disorder (BPD), also known as emotionally unstable personality disorder (EUPD), is a personality disorder characterized by a long-term pattern of unstable interpersonal relationships, distorted sense of self, and strong ...
, etc. This section above is partial to ego psychoanalytic theory ''autonomous ego functions''.


Childhood origins

Freudian theories hold that
adult An adult is a human or other animal that has reached full growth. In human context, the term ''adult'' has meanings associated with social and legal concepts. In contrast to a " minor", a legal adult is a person who has attained the age of major ...
problems can be traced to unresolved conflicts from certain phases of childhood and
adolescence Adolescence () is a transitional stage of physical and psychological development that generally occurs during the period from puberty to adulthood (typically corresponding to the age of majority). Adolescence is usually associated with the t ...
, caused by fantasy, stemming from their own drives. Freud, based on the data gathered from his patients early in his career, suspected that neurotic disturbances occurred when children were sexually abused in childhood (i.e. ''
seduction theory Freud's seduction theory (german: Verführungstheorie) was a hypothesis posited in the mid-1890s by Sigmund Freud that he believed provided the solution to the problem of the origins of hysteria and obsessional neurosis. According to the theory, ...
''). Later, Freud came to believe that, although child abuse occurs, neurotic symptoms were not associated with this. He believed that neurotic people often had unconscious conflicts that involved incestuous fantasies deriving from different stages of development. He found the stage from about three to six years of age (preschool years, today called the "first genital stage") to be filled with fantasies of having romantic relationships with both parents. Arguments were quickly generated in early 20th-century Vienna about whether adult seduction of children, i.e.
child sexual abuse Child sexual abuse (CSA), also called child molestation, is a form of child abuse in which an adult or older adolescent uses a child for sexual stimulation. Forms of child sexual abuse include engaging in sexual activities with a child (whet ...
, was the basis of neurotic illness. There still is no complete agreement, although nowadays professionals recognize the negative effects of child sexual abuse on mental health.


Oedipal conflicts

Many psychoanalysts who work with children have studied the actual effects of child abuse, which include ego and object relations deficits and severe neurotic conflicts. Much research has been done on these types of trauma in childhood, and the adult sequelae of those. In studying the childhood factors that start neurotic symptom development, Freud found a constellation of factors that, for literary reasons, he termed the
Oedipus complex The Oedipus complex (also spelled Œdipus complex) is an idea in psychoanalytic theory. The complex is an ostensibly universal phase in the life of a young boy in which, to try to immediately satisfy basic desires, he unconsciously wishes to have ...
, based on the play by
Sophocles Sophocles (; grc, Σοφοκλῆς, , Sophoklễs; 497/6 – winter 406/5 BC)Sommerstein (2002), p. 41. is one of three ancient Greek tragedians, at least one of whose plays has survived in full. His first plays were written later than, or co ...
, ''
Oedipus Rex ''Oedipus Rex'', also known by its Greek title, ''Oedipus Tyrannus'' ( grc, Οἰδίπους Τύραννος, ), or ''Oedipus the King'', is an Athenian tragedy by Sophocles that was first performed around 429 BC. Originally, to the ancient Gr ...
'', in which the protagonist unwittingly kills his father and marries his mother. The validity of the ''Oedipus complex'' is now widely disputed and rejected.Miller, Alice. 1984. ''Thou Shalt Not Be Aware: Society's Betrayal of the Child''. New York:
Farrar Straus and Giroux Farrar, Straus and Giroux (FSG) is an American book publishing company, founded in 1946 by Roger Williams Straus Jr. and John C. Farrar. FSG is known for publishing literary books, and its authors have won numerous awards, including Pulitzer ...
. pp. 105–227.
Kupfersmid, Joel. 1995. ''Does the Oedipus complex exist?''
American Psychological Association The American Psychological Association (APA) is the largest scientific and professional organization of psychologists in the United States, with over 133,000 members, including scientists, educators, clinicians, consultants, and students. It ha ...
.
The shorthand term, ''oedipal''—later explicated by
Joseph J. Sandler Joseph J. Sandler (10 January 1927 – 6 October 1998) was a British psychoanalyst within the Anna Freud Grouping – now the Contemporary Freudians – of the British Psychoanalytical Society; and is perhaps best known for what has been called h ...
in "On the Concept Superego" (1960) and modified by Charles Brenner in ''The Mind in Conflict'' (1982)—refers to the powerful attachments that children make to their parents in the preschool years. These attachments involve fantasies of sexual relationships with either (or both) parent, and, therefore, competitive fantasies toward either (or both) parents. Humberto Nagera (1975) has been particularly helpful in clarifying many of the complexities of the child through these years. "Positive" and "negative" oedipal conflicts have been attached to the heterosexual and homosexual aspects, respectively. Both seem to occur in development of most children. Eventually, the developing child's concessions to reality (that they will neither marry one parent nor eliminate the other) lead to identifications with parental values. These identifications generally create a new set of mental operations regarding values and guilt, subsumed under the term ''superego''. Besides superego development, children "resolve" their preschool oedipal conflicts through channeling wishes into something their parents approve of ("sublimation") and the development, during the school-age years ("latency") of age-appropriate obsessive-compulsive defensive maneuvers (rules, repetitive games).


Treatment

Using the various analytic and psychological techniques to assess mental problems, some believe that there are particular constellations of problems that are especially suited for analytic treatment (see below) whereas other problems might respond better to medicines and other interpersonal interventions. To be treated with psychoanalysis, whatever the presenting problem, the person requesting help must demonstrate a desire to start an analysis. The person wishing to start an analysis must have some capacity for speech and communication. As well, they need to be able to have or develop trust and insight within the psychoanalytic session. Potential patients must undergo a preliminary stage of treatment to assess their amenability to psychoanalysis at that time, and also to enable the analyst to form a working psychological model, which the analyst will use to direct the treatment. Psychoanalysts mainly work with neurosis and hysteria in particular; however, adapted forms of psychoanalysis are used in working with schizophrenia and other forms of psychosis or mental disorder. Finally, if a prospective patient is severely suicidal a longer preliminary stage may be employed, sometimes with sessions which have a twenty-minute break in the middle. There are numerous modifications in technique under the heading of psychoanalysis due to the individualistic nature of personality in both analyst and patient. The most common problems treatable with psychoanalysis include:
phobia A phobia is an anxiety disorder defined by a persistent and excessive fear of an object or situation. Phobias typically result in a rapid onset of fear and are usually present for more than six months. Those affected go to great lengths to avo ...
s, conversions, compulsions,
obsessions "Obsessions" is the second single from the album '' A New Morning'' by Suede, released on 18 November 2002 through Columbia Records. Background Though the single was another disappointment on the charts, reaching only 29 on the UK Singles Chart ...
,
anxiety attacks Panic attacks are sudden periods of intense fear and discomfort that may include palpitations, sweating, chest pain or chest discomfort, shortness of breath, trembling, dizziness, numbness, confusion, or a feeling of impending doom or of losing ...
, depressions,
sexual dysfunction Sexual dysfunction is difficulty experienced by an individual or partners during any stage of normal sexual activity, including physical pleasure, desire, preference, arousal, or orgasm. The World Health Organization defines sexual dysfunction as ...
s, a wide variety of relationship problems (such as dating and marital strife), and a wide variety of character problems (for example, painful shyness, meanness, obnoxiousness, workaholism, hyperseductiveness, hyperemotionality, hyperfastidiousness). The fact that many of such patients also demonstrate deficits above makes diagnosis and treatment selection difficult. Analytical organizations such as the IPA, APsaA and the European Federation for Psychoanalytic Psychotherapy have established procedures and models for the indication and practice of psychoanalytical therapy for trainees in analysis. The match between the analyst and the patient can be viewed as another contributing factor for the indication and contraindication for psychoanalytic treatment. The analyst decides whether the patient is suitable for psychoanalysis. This decision made by the analyst, besides made on the usual indications and pathology, is also based to a certain degree by the "fit" between analyst and patient. A person's suitability for analysis at any particular time is based on their desire to know something about where their illness has come from. Someone who is not suitable for analysis expresses no desire to know more about the root causes of their illness. An evaluation may include one or more other analysts' independent opinions and will include discussion of the patient's financial situation and insurances.


Techniques

The basic method of psychoanalysis is interpretation of the patient's unconscious conflicts that are interfering with current-day functioning – conflicts that are causing painful symptoms such as phobias, anxiety, depression, and compulsions.
Strachey Strachey is a surname. Notable people with the surname include: Strachey family of Sutton Court, Somerset *John Strachey (d. 1674), friend of John Locke **John Strachey (geologist) (1671–1743), British geologist ***Henry Strachey of Sutton Cour ...
(1936) stressed that figuring out ways the patient distorted perceptions about the analyst led to understanding what may have been forgotten.also see Freud's paper "Repeating, Remembering, and Working Through" In particular, unconscious hostile feelings toward the analyst could be found in symbolic, negative reactions to what
Robert Langs Robert Joseph Langs (June 30, 1928 – November 8, 2014) was a psychiatrist, psychotherapist, and psychoanalyst. He was the author, co-author, or editor of more than forty books on psychotherapy and human psychology. Over the course of more t ...
later called the "frame" of the therapy—the setup that included times of the sessions, payment of fees, and necessity of talking. In patients who made mistakes, forgot, or showed other peculiarities regarding time, fees, and talking, the analyst can usually find various unconscious "resistances" to the flow of thoughts (aka free association). When the patient reclines on a couch with the analyst out of view, the patient tends to remember more experiences, more resistance and transference, and is able to reorganize thoughts after the development of insight – through the interpretive work of the analyst. Although fantasy life can be understood through the examination of
dream A dream is a succession of images, ideas, emotions, and sensations that usually occur involuntarily in the mind during certain stages of sleep. Humans spend about two hours dreaming per night, and each dream lasts around 5 to 20 minutes, althou ...
s, masturbation fantasies
cf. The abbreviation ''cf.'' (short for the la, confer/conferatur, both meaning "compare") is used in writing to refer the reader to other material to make a comparison with the topic being discussed. Style guides recommend that ''cf.'' be used onl ...
Marcus, I. and J. Francis. 1975. ''Masturbation from Infancy to Senescence''.
are also important. The analyst is interested in how the patient reacts to and avoids such fantasies. Various memories of early life are generally distorted—what Freud called ''screen memories''—and in any case, very early experiences (before age two)—cannot be remembered.see the child studies of Eleanor Galenson on "evocative memory"


Variations in technique

There is what is known among psychoanalysts as ''classical technique'', although Freud throughout his writings deviated from this considerably, depending on the problems of any given patient. ''Classical technique'' was summarized by Allan Compton as comprising: * instructions: telling the patient to try to say what's on their mind, including interferences; * exploration: asking questions; and * clarification: rephrasing and summarizing what the patient has been describing. As well, the analyst can also use confrontation to bringing an aspect of functioning, usually a defense, to the patient's attention. The analyst then uses a variety of interpretation methods, such as: * Dynamic interpretation: explaining how being too nice guards against guilt (e.g. defense vs. affect); * Genetic interpretation: explaining how a past event is influencing the present; * Resistance interpretation: showing the patient how they are avoiding their problems; *
Transference Transference (german: Übertragung) is a phenomenon within psychotherapy in which the "feelings, attitudes, or desires" a person had about one thing are subconsciously projected onto the here-and-now Other. It usually concerns feelings from a ...
interpretation: showing the patient ways old conflicts arise in current relationships, including that with the analyst; or * Dream interpretation: obtaining the patient's thoughts about their dreams and connecting this with their current problems. Analysts can also use reconstruction to estimate what may have happened in the past that created some current issue. These techniques are primarily based on ''conflict theory'' (see above). As ''object relations theory'' evolved, supplemented by the work of
John Bowlby Edward John Mostyn Bowlby, CBE, FBA, FRCP, FRCPsych (; 26 February 1907 – 2 September 1990) was a British psychologist, psychiatrist, and psychoanalyst, notable for his interest in child development and for his pioneering work in attachmen ...
and
Mary Ainsworth Mary Dinsmore Ainsworth (; December 1, 1913 – March 21, 1999) was an American-Canadian developmental psychologist known for her work in the development of the attachment theory. She designed the strange situation procedure to observe early emot ...
, techniques with patients who had more severe problems with basic trust ( Erikson, 1950) and a history of
maternal deprivation Maternal deprivation is a scientific term summarising the early work of psychiatrist and psychoanalyst John Bowlby on the effects of separating infants and young children from their mother (or primary caregiver). Although the effect of loss of the ...
(see the works of Augusta Alpert) led to new techniques with adults. These have sometimes been called interpersonal, intersubjective (cf. Stolorow), relational, or corrective object relations techniques. These techniques include expressing an empathic attunement to the patient or warmth; exposing a bit of the analyst's personal life or attitudes to the patient; allowing the patient autonomy in the form of disagreement with the analyst (cf. I. H. Paul, ''Letters to Simon''); and explaining the motivations of others which the patient misperceives. Ego psychological concepts of deficit in functioning led to refinements in supportive therapy. These techniques are particularly applicable to psychotic and near-psychotic (cf., Eric Marcus, "Psychosis and Near-psychosis") patients. These supportive therapy techniques include discussions of reality; encouragement to stay alive (including hospitalization); psychotropic medicines to relieve overwhelming depressive affect or overwhelming fantasies (hallucinations and delusions); and advice about the meanings of things (to counter abstraction failures). The notion of the "silent analyst" has been criticized. Actually, the analyst listens using Arlow's approach as set out in "The Genesis of Interpretation", using active intervention to interpret resistances, defenses creating pathology, and fantasies. Silence is not a technique of psychoanalysis (see also the studies and opinion papers of Owen Renik). " Analytic neutrality" is a concept that does not mean the analyst is silent. It refers to the analyst's position of not taking sides in the internal struggles of the patient. For example, if a patient feels guilty, the analyst might explore what the patient has been doing or thinking that causes the guilt, but not reassure the patient not to feel guilty. The analyst might also explore the identifications with parents and others that led to the guilt. Interpersonal–relational psychoanalysts emphasize the notion that it is impossible to be neutral. Sullivan introduced the term '' participant-observer'' to indicate the analyst inevitably interacts with the analysand, and suggested the detailed inquiry as an alternative to interpretation. The detailed inquiry involves noting where the analysand is leaving out important elements of an account and noting when the story is obfuscated, and asking careful questions to open up the dialogue.


Group therapy and play therapy

Although single-client sessions remain the norm, psychoanalytic theory has been used to develop other types of psychological treatment. Psychoanalytic group therapy was pioneered by
Trigant Burrow Nicholas Trigant Burrow (September 7, 1875 – May 24, 1950) was an American psychoanalyst, psychiatrist, psychologist, and, alongside Joseph H. Pratt and Paul Schilder, founder of group analysis in the United States. He was the inventor of the conc ...
, Joseph Pratt, Paul F. Schilder, Samuel R. Slavson,
Harry Stack Sullivan Herbert "Harry" Stack Sullivan (February 21, 1892, Norwich, New York – January 14, 1949, Paris, France) was an American Neo-Freudian psychiatrist and psychoanalyst who held that "personality can never be isolated from the complex interpersonal ...
, and Wolfe. Child-centered counseling for parents was instituted early in analytic history by Freud, and was later further developed by Irwin Marcus, Edith Schulhofer, and Gilbert Kliman. Psychoanalytically based couples therapy has been promulgated and explicated by Fred Sander. Techniques and tools developed in the first decade of the 21st century have made psychoanalysis available to patients who were not treatable by earlier techniques. This meant that the analytic situation was modified so that it would be more suitable and more likely to be helpful for these patients. Eagle (2007) believes that psychoanalysis cannot be a self-contained discipline but instead must be open to influence from and integration with findings and theory from other disciplines. Psychoanalytic constructs have been adapted for use with children with treatments such as
play therapy Play therapy refers to a range of methods of capitalising on children's natural urge to explore and harnessing it to meet and respond to the developmental and later also their mental health needs. It is also used for Anatomically correct doll, f ...
,
art therapy Art therapy (not to be confused with ''arts therapy'', which includes other creative therapies such as drama therapy and music therapy) is a distinct discipline that incorporates creative methods of expression through visual art media. Art thera ...
, and
storytelling Storytelling is the social and cultural activity of sharing stories, sometimes with improvisation, theatrics or embellishment. Every culture has its own stories or narratives, which are shared as a means of entertainment, education, cultural pre ...
. Throughout her career, from the 1920s through the 1970s,
Anna Freud Anna Freud (3 December 1895 – 9 October 1982) was a British psychoanalyst of Austrian-Jewish descent. She was born in Vienna, the sixth and youngest child of Sigmund Freud and Martha Bernays. She followed the path of her father and contribu ...
adapted psychoanalysis for children through play. This is still used today for children, especially those who are preadolescent.see Leon Hoffman, New York Psychoanalytic Institute Center for Children Using toys and games, children are able to symbolically demonstrate their fears, fantasies, and defenses; although not identical, this technique, in children, is analogous to the aim of free association in adults. Psychoanalytic play therapy allows the child and analyst to understand children's conflicts, particularly defenses such as disobedience and withdrawal, that have been guarding against various unpleasant feelings and hostile wishes. In art therapy, the counselor may have a child draw a portrait and then tell a story about the portrait. The counselor watches for recurring themes—regardless of whether it is with art or toys.


Cultural variations

Psychoanalysis can be adapted to different
cultures Culture () is an umbrella term which encompasses the social behavior, institutions, and norms found in human societies, as well as the knowledge, beliefs, arts, laws, customs, capabilities, and habits of the individuals in these groups.Tyl ...
, as long as the therapist or counselor understands the client's culture. For example, Tori and Blimes found that defense mechanisms were valid in a normative sample of 2,624 Thais. The use of certain defense mechanisms was related to cultural values. For example, Thais value calmness and collectiveness (because of
Buddhist Buddhism ( , ), also known as Buddha Dharma and Dharmavinaya (), is an Indian religion or philosophical tradition based on teachings attributed to the Buddha. It originated in northern India as a -movement in the 5th century BCE, and ...
beliefs), so they were low on
regressive emotionality Emotionality is the observable behavioral and physiological component of emotion. It is a measure of a person's emotional reactivity to a stimulus. Most of these responses can be observed by other people, while some emotional responses can only b ...
. Psychoanalysis also applies because Freud used techniques that allowed him to get the subjective perceptions of his patients. He takes an objective approach by not facing his clients during his talk therapy sessions. He met with his patients wherever they were, such as when he used free association—where clients would say whatever came to mind without self-censorship. His treatments had little to no structure for most cultures, especially Asian cultures. Therefore, it is more likely that Freudian constructs will be used in structured therapy. In addition, Corey postulates that it will be necessary for a therapist to help clients develop a
cultural identity Cultural identity is a part of a person's identity, or their self-conception and self-perception, and is related to nationality, ethnicity, religion, social class, generation, locality or any kind of social group that has its own distinct cultur ...
as well as an ego identity.


Psychodynamic therapy

Psychodynamic therapies refer therapies that draw from psychoanalytic approaches but are designed to be shorter in duration or less intensive.


Cost and length of treatment

The cost to the patient of psychoanalytic treatment ranges widely from place to place and between practitioners. Low-fee analysis is often available in a psychoanalytic training clinic and graduate schools. Otherwise, the fee set by each analyst varies with the analyst's training and experience. Since, in most locations in the United States, unlike in Ontario and Germany, classical analysis (which usually requires sessions three to five times per week) is not covered by health insurance, many analysts may negotiate their fees with patients whom they feel they can help, but who have financial difficulties. The modifications of analysis, which include psychodynamic therapy, brief therapies, and certain types of group therapy,cf. Slavson, S. R., ''A Textbook in Analytic Group Therapy'' are carried out on a less frequent basis—usually once, twice, or three times a week – and usually the patient sits facing the therapist. As a result of the
defense mechanism In psychoanalytic theory, a defence mechanism (American English: defense mechanism), is an unconscious psychological operation that functions to protect a person from anxiety-producing thoughts and feelings related to internal conflicts and o ...
s and the lack of access to the unfathomable elements of the unconscious, psychoanalysis can be an expansive process that involves 2 to 5 sessions per week for several years. This type of therapy relies on the belief that reducing the symptoms will not actually help with the root causes or irrational drives. The analyst typically is a 'blank screen', disclosing very little about themselves in order that the client can use the space in the relationship to work on their unconscious without interference from outside. The psychoanalyst uses various methods to help the patient to become more self-aware and to develop insights into their behavior and into the meanings of symptoms. First and foremost, the psychoanalyst attempts to develop a confidential atmosphere in which the patient can feel safe reporting his feelings, thoughts and fantasies. Analysands (as people in analysis are called) are asked to report whatever comes to mind without fear of reprisal. Freud called this the "fundamental rule". Analysands are asked to talk about their lives, including their early life, current life and hopes and aspirations for the future. They are encouraged to report their fantasies, "flash thoughts" and dreams. In fact, Freud believed that dreams were, "the royal road to the unconscious"; he devoted an entire volume to the interpretation of dreams. Freud had his patients lay on a couch in a dimly lit room and would sit out of sight, usually directly behind them, as to not influence the patients thoughts by his gestures or expressions. The psychoanalyst's task, in collaboration with the analysand, is to help deepen the analysand's understanding of those factors, outside of his awareness, that drive his behaviors. In the safe environment of the psychoanalytic setting, the analysand becomes attached to the analyst and pretty soon he begins to experience the same conflicts with his analyst that he experiences with key figures in his life such as his parents, his boss, his significant other, etc. It is the psychoanalyst's role to point out these conflicts and to interpret them. The transferring of these internal conflicts onto the analyst is called "transference". Many studies have also been done on briefer "dynamic" treatments; these are more expedient to measure, and shed light on the therapeutic process to some extent. Brief Relational Therapy (BRT), Brief Psychodynamic Therapy (BPT), and Time-Limited Dynamic Therapy (TLDP) limit treatment to 20–30 sessions. On average, classical analysis may last 5.7 years, but for phobias and depressions uncomplicated by ego deficits or object relations deficits, analysis may run for a shorter period of time. Longer analyses are indicated for those with more serious disturbances in object relations, more symptoms, and more ingrained character pathology.


Training and research

Psychoanalysis continues to be practiced by psychiatrists, social workers, and other mental health professionals; however, its practice has declined. It has been largely replaced by the similar but broader
psychodynamic psychotherapy Psychodynamic psychotherapy or psychoanalytic psychotherapy is a form of psychological therapy. Its primary focus is to reveal the unconscious content of a client's psyche in an effort to alleviate psychic tension, which is inner conflict with ...
in the mid-20th century. Psychoanalytic approaches continue to be listed by the UK
National Health Service The National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom (UK). Since 1948, they have been funded out of general taxation. There are three systems which are referred to using the " ...
as possibly helpful for depression.


United States

Psychoanalytic training in the United States involves a personal psychoanalysis for the trainee, approximately 600 hours of class instruction, with a standard curriculum, over a four or five-year period. Typically, this psychoanalysis must be conducted by a Supervising and Training Analyst. Most institutes (but not all) within the American Psychoanalytic Association, require that Supervising and Training Analysts become certified by the American Board of Psychoanalysts. Certification entails a blind review in which the psychoanalyst's work is vetted by psychoanalysts outside of their local community. After earning certification, these psychoanalysts undergo another hurdle in which they are specially vetted by senior members of their own institute. Supervising and Training analysts are held to the highest clinical and ethical standards. Moreover, they are required to have extensive experience conducting psychoanalyses. Similarly, class instruction for psychoanalytic candidates is rigorous. Typically classes meet several hours a week, or for a full day or two every other weekend during the academic year; this varies with the institute. Candidates generally have an hour of supervision each week, with a Supervising and Training Analyst, on each psychoanalytic case. The minimum number of cases varies between institutes, often two to four cases. Male and female cases are required. Supervision must go on for at least a few years on one or more cases. Supervision is done in the supervisor's office, where the trainee presents material from the psychoanalytic work that week. In supervision, the patient's unconscious conflicts are explored, also, transference-countertransference constellations are examined. Also, clinical technique is taught. Many psychoanalytic training centers in the United States have been accredited by special committees of the APsaA or the IPA. Because of theoretical differences, there are independent institutes, usually founded by psychologists, who until 1987 were not permitted access to psychoanalytic training institutes of the APsaA. Currently there are between 75 and 100 independent institutes in the United States. As well, other institutes are affiliated to other organizations such as the
American Academy of Psychoanalysis and Dynamic Psychiatry The American Academy of Psychodynamic Psychiatry and Psychoanalysis (AAPDPP) is a scholarly society including psychiatrists interested in all aspects of psychodynamic psychiatry. History AAPDPP was founded in 1956 as the American Academy of Ps ...
, and the National Association for the Advancement of Psychoanalysis. At most psychoanalytic institutes in the United States, qualifications for entry include a terminal degree in a mental health field, such as Ph.D., Psy.D., M.S.W., or M.D. A few institutes restrict applicants to those already holding an M.D. or Ph.D., and most institutes in Southern California confer a Ph.D. or
Psy.D. The Doctor of Psychology (Psy.D. or D.Psych.) is a professional doctoral degree intended to prepare graduates for careers that apply Science, scientific knowledge of psychology and deliver empirically based service to individuals, groups and org ...
in psychoanalysis upon graduation, which involves completion of the necessary requirements for the state boards that confer that doctoral degree. The first training institute in America to educate non-medical psychoanalysts was The National Psychological Association for Psychoanalysis (1978) in New York City. It was founded by the analyst Theodor Reik. The Contemporary Freudian (originally the New York Freudian Society) an offshoot of the National Psychological Association has a branch in Washington, DC. It is a component society/institute or the IPA. Some psychoanalytic training has been set up as a post-doctoral fellowship in university settings, such as at Duke University, Yale University, New York University, Adelphi University and Columbia University. Other psychoanalytic institutes may not be directly associated with universities, but the faculty at those institutes usually hold contemporaneous faculty positions with psychology Ph.D. programs and/or with medical school psychiatry residency programs. The IPA is the world's primary accrediting and regulatory body for psychoanalysis. Their mission is to assure the continued vigor and development of psychoanalysis for the benefit of psychoanalytic patients. It works in partnership with its 70 constituent organizations in 33 countries to support 11,500 members. In the US, there are 77 psychoanalytical organizations, institutes and associations, which are spread across the states. APsaA has 38 affiliated societies which have 10 or more active members who practice in a given geographical area. The aims of APsaA and other psychoanalytical organizations are: provide ongoing educational opportunities for its members, stimulate the development and research of psychoanalysis, provide training and organize conferences. There are eight affiliated study groups in the United States. A study group is the first level of integration of a psychoanalytical body within the IPA, followed by a provisional society and finally a member society. The Division of Psychoanalysis (39) of the
American Psychological Association The American Psychological Association (APA) is the largest scientific and professional organization of psychologists in the United States, with over 133,000 members, including scientists, educators, clinicians, consultants, and students. It ha ...
(APA) was established in the early 1980s by several psychologists. Until the establishment of the Division of Psychoanalysis, psychologists who had trained in independent institutes had no national organization. The Division of Psychoanalysis now has approximately 4,000 members and approximately 30 local chapters in the United States. The Division of Psychoanalysis holds two annual meetings or conferences and offers continuing education in theory, research and clinical technique, as do their affiliated local chapters. The European Psychoanalytical Federation (EPF) is the organization which consolidates all European psychoanalytic societies. This organization is affiliated with the IPA. In 2002, there were approximately 3,900 individual members in 22 countries, speaking 18 different languages. There are also 25 psychoanalytic societies. The American Association of Psychoanalysis in Clinical Social Work (AAPCSW) was established by Crayton Rowe in 1980 as a division of the Federation of Clinical Societies of Social Work and became an independent entity in 1990. Until 2007 it was known as the National Membership Committee on Psychoanalysis. The organization was founded because although social workers represented the larger number of people who were training to be psychoanalysts, they were underrepresented as supervisors and teachers at the institutes they attended. AAPCSW now has over 1000 members and has over 20 chapters. It holds a bi-annual national conference and numerous annual local conferences. Experiences of psychoanalysts and psychoanalytic psychotherapists and research into infant and child development have led to new insights. Theories have been further developed and the results of
empirical research Empirical research is research using empirical evidence. It is also a way of gaining knowledge by means of direct and indirect observation or experience. Empiricism values some research more than other kinds. Empirical evidence (the record of one ...
are now more integrated in the
psychoanalytic theory Psychoanalytic theory is the theory of personality organization and the dynamics of personality development that guides psychoanalysis, a clinical method for treating psychopathology. First laid out by Sigmund Freud in the late 19th century, psyc ...
.


United Kingdom

The London Psychoanalytical Society was founded by
Ernest Jones Alfred Ernest Jones (1 January 1879 – 11 February 1958) was a Welsh neurologist and psychoanalyst. A lifelong friend and colleague of Sigmund Freud from their first meeting in 1908, he became his official biographer. Jones was the first En ...
on 30 October 1913. After
World War I World War I (28 July 1914 11 November 1918), often abbreviated as WWI, was one of the deadliest global conflicts in history. Belligerents included much of Europe, the Russian Empire, the United States, and the Ottoman Empire, with fightin ...
with the expansion of psychoanalysis in the United Kingdom, the Society was reconstituted and named the
British Psychoanalytical Society The British Psychoanalytical Society was founded by the British neurologist Ernest Jones as the London Psychoanalytical Society on 30 October 1913. It is one of two organizations in Britain training psychoanalysts, the other being the British P ...
in 1919. Soon after, the Institute of Psychoanalysis was established to administer the Society's activities. These include: the training of psychoanalysts, the development of the theory and practice of psychoanalysis, the provision of treatment through The London Clinic of Psychoanalysis, the publication of books in The New Library of Psychoanalysis and Psychoanalytic Ideas. The Institute of Psychoanalysis also publishes ''
The International Journal of Psychoanalysis ''The International Journal of Psychoanalysis'' is an academic journal in the field of psychoanalysis. The idea of the journal was proposed by Ernest Jones in a letter to Sigmund Freud dated 7 December 1918. The journal itself was established in 1 ...
'', maintains a library, furthers research, and holds public lectures. The society has a Code of Ethics and an Ethical Committee. The society, the institute and the clinic are all located at ''Byron House'' in
West London West London is the western part of London, England, north of the River Thames, west of the City of London, and extending to the Greater London boundary. The term is used to differentiate the area from the other parts of London: North London ...
. The Society is a constituent society of the
International Psychoanalytical Association The International Psychoanalytical Association (IPA) is an association including 12,000 psychoanalysts as members and works with 70 constituent organizations. It was founded in 1910 by Sigmund Freud, from an idea proposed by Sándor Ferenczi. His ...
(IPA) a body with members on all five continents which safeguards professional and ethical practice. The Society is a member of the British Psychoanalytic Council (BPC); the BPC publishes a register of British psychoanalysts and psychoanalytical psychotherapists. All members of the British Psychoanalytic Council are required to undertake
continuing professional development Professional development is learning to earn or maintain professional credentials such as academic degrees to formal coursework, attending conferences, and informal learning opportunities situated in practice. It has been described as intensive ...
, CPD. Members of the Society teach and hold posts on other approved psychoanalytic courses, e.g.:
British Psychotherapy Foundation The British Psychotherapy Foundation, Bpf, is the successor organisation to three former long-established British psychotherapy providers and clinical training institutions which merged in April 2013. The original constituents are the British ...
and in academic departments, e.g.
University College London , mottoeng = Let all come who by merit deserve the most reward , established = , type = Public research university , endowment = £143 million (2020) , budget = ...
. Members of the Society have included:
Michael Balint , , image = Monte Verità Gedenktafel Michael Balint 1K4A4638-b.jpg , caption = , birth_name = Mihály Maurice Bergsmann , birth_date = , birth_place = Budapest , death_date = , death_place = London , occupation = psychoan ...
,
Wilfred Bion Wilfred Ruprecht Bion DSO (; 8 September 1897 – 8 November 1979) was an influential English psychoanalyst, who became president of the British Psychoanalytical Society from 1962 to 1965. Early life and military service Bion was born in Ma ...
,
John Bowlby Edward John Mostyn Bowlby, CBE, FBA, FRCP, FRCPsych (; 26 February 1907 – 2 September 1990) was a British psychologist, psychiatrist, and psychoanalyst, notable for his interest in child development and for his pioneering work in attachmen ...
,
Ronald Fairbairn William Ronald Dodds Fairbairn () FRSE (11 August 1889 – 31 December 1964) was a Scottish psychiatrist, psychoanalyst and a central figure in the development of the Object Relations Theory of psychoanalysis. He usually used, and was known as ...
,
Anna Freud Anna Freud (3 December 1895 – 9 October 1982) was a British psychoanalyst of Austrian-Jewish descent. She was born in Vienna, the sixth and youngest child of Sigmund Freud and Martha Bernays. She followed the path of her father and contribu ...
,
Harry Guntrip Henry James Samuel Guntrip (29 May 1901 – 1975) was a British psychologist known for his major contributions to object relations theory or school of Freudian thought. He was a Fellow of the British Psychological Society and a psychotherapist an ...
,
Melanie Klein Melanie Klein (née Reizes; 30 March 1882 – 22 September 1960) was an Austrian-British author and psychoanalyst known for her work in child analysis. She was the primary figure in the development of object relations theory. Klein suggested tha ...
,
Donald Meltzer Donald Meltzer (1922–2004) was a Kleinian psychoanalyst whose teaching made him influential in many countries. He became known for making clinical headway with difficult childhood conditions such as autism, and also for his theoretical innovati ...
,
Joseph J. Sandler Joseph J. Sandler (10 January 1927 – 6 October 1998) was a British psychoanalyst within the Anna Freud Grouping – now the Contemporary Freudians – of the British Psychoanalytical Society; and is perhaps best known for what has been called h ...
,
Hanna Segal Hanna Segal (born Hanna Poznańska; 20 August 1918 – 5 July 2011) was a British psychoanalyst of Polish descent and a follower of Melanie Klein. She was president of the British Psychoanalytical Society, vice-president of the International Psych ...
,
J. D. Sutherland John Derg Sutherland (23 April 1905 – 14 June 1991), also known as Jock Sutherland, was a Scottish physician, psychoanalyst and theorist, notable also for his role as Medical Director of the Tavistock Clinic. Life and career John "Jock" Derg Su ...
and
Donald Winnicott Donald Woods Winnicott (7 April 1896 – 25 January 1971) was an English paediatrician and psychoanalyst who was especially influential in the field of object relations theory and developmental psychology. He was a leading member of the Br ...
. The
Institute of Psychoanalysis The British Psychoanalytical Society was founded by the British neurologist Ernest Jones as the London Psychoanalytical Society on 30 October 1913. It is one of two organizations in Britain training psychoanalysts, the other being the British P ...
is the foremost publisher of psychoanalytic literature. The 24-volume ''Standard Edition of the Complete Psychological Works of Sigmund Freud'' was conceived, translated, and produced under the direction of the British Psychoanalytical Society. The Society, in conjunction with
Random House Random House is an American book publisher and the largest general-interest paperback publisher in the world. The company has several independently managed subsidiaries around the world. It is part of Penguin Random House, which is owned by Germ ...
, will soon publish a new, revised and expanded Standard Edition. With the New Library of Psychoanalysis the Institute continues to publish the books of leading theorists and practitioners. ''The International Journal of Psychoanalysis'' is published by the Institute of Psychoanalysis. Now in its 84th year, it has one of the largest circulations of any psychoanalytic journal.


Psychoanalytic psychotherapy

There are different forms of psychoanalysis and
psychotherapies Psychotherapy (also psychological therapy, talk therapy, or talking therapy) is the use of psychological methods, particularly when based on regular personal interaction, to help a person change behavior, increase happiness, and overcome prob ...
in which psychoanalytic thinking is practiced. Besides classical psychoanalysis there is for example psychoanalytic psychotherapy, a therapeutic approach which widens "the accessibility of psychoanalytic theory and clinical practices that had evolved over 100 plus years to a larger number of individuals." Other examples of well known therapies which also use insights of psychoanalysis are
mentalization-based treatment Mentalization-based treatment (MBT) is an integrative form of psychotherapy, bringing together aspects of psychodynamic, cognitive-behavioral, systemic and ecological approaches. MBT was developed and manualised by Peter Fonagy and Anthony Ba ...
(MBT), and
transference focused psychotherapy Transference focused psychotherapy (TFP) is a highly structured, twice-weekly modified psychodynamic treatment based on Otto F. Kernberg's object relations model of borderline personality disorder.Clarkin, J. F., Yeomans, F., Kernberg, O. F. (200 ...
(TFP). There is also a continuing influence of psychoanalytic thinking in mental health care.


Research

Over a hundred years of case reports and studies in the journal ''Modern Psychoanalysis'', the ''
Psychoanalytic Quarterly ''The Psychoanalytic Quarterly'' is a quarterly academic journal of psychoanalysis established in 1932 and, since 2018, published by Taylor and Francis. The journal describes itself as "the oldest free-standing psychoanalytic journal in America". T ...
'', the ''International Journal of Psychoanalysis'' and the ''
Journal of the American Psychoanalytic Association The ''Journal of the American Psychoanalytic Association'' is a bi-monthly peer-reviewed healthcare journal covering all aspects of psychoanalysis and is the official journal of the American Psychoanalytic Association. The editor in chief is Mitch ...
'' have analyzed the efficacy of analysis in cases of
neurosis Neurosis is a class of functional mental disorders involving chronic distress, but neither delusions nor hallucinations. The term is no longer used by the professional psychiatric community in the United States, having been eliminated from th ...
and character or
personality Personality is the characteristic sets of behaviors, cognitions, and emotional patterns that are formed from biological and environmental factors, and which change over time. While there is no generally agreed-upon definition of personality, mos ...
problems. Psychoanalysis modified by object relations techniques has been shown to be effective in many cases of ingrained problems of intimacy and relationship (cf. the many books of Otto Kernberg). Psychoanalytic treatment, in other situations, may run from about a year to many years, depending on the severity and complexity of the pathology. Psychoanalytic theory has, from its inception, been the subject of criticism and controversy. Freud remarked on this early in his career, when other physicians in Vienna ostracized him for his findings that hysterical conversion symptoms were not limited to women. Challenges to analytic theory began with
Otto Rank Otto Rank (; ; né Rosenfeld; 22 April 1884 – 31 October 1939) was an Austrian psychoanalyst, writer, and philosopher. Born in Vienna, he was one of Sigmund Freud's closest colleagues for 20 years, a prolific writer on psychoanalytic themes, ...
and
Alfred Adler Alfred Adler ( , ; 7 February 1870 – 28 May 1937) was an Austrian medical doctor, psychotherapist, and founder of the school of individual psychology. His emphasis on the importance of feelings of belonging, family constellation and birth order ...
(turn of the 20th century), continued with behaviorists (e.g. Wolpe) into the 1940s and '50s, and have persisted (e.g.
Miller A miller is a person who operates a Gristmill, mill, a machine to grind a grain (for example corn or wheat) to make flour. Mill (grinding), Milling is among the oldest of human occupations. "Miller", "Milne" and other variants are common surname ...
). Criticisms come from those who object to the notion that there are mechanisms, thoughts or feelings in the mind that could be unconscious. Criticisms also have been leveled against the idea of "infantile sexuality" (the recognition that children between ages two and six imagine things about procreation). Criticisms of theory have led to variations in analytic theories, such as the work of
Ronald Fairbairn William Ronald Dodds Fairbairn () FRSE (11 August 1889 – 31 December 1964) was a Scottish psychiatrist, psychoanalyst and a central figure in the development of the Object Relations Theory of psychoanalysis. He usually used, and was known as ...
,
Michael Balint , , image = Monte Verità Gedenktafel Michael Balint 1K4A4638-b.jpg , caption = , birth_name = Mihály Maurice Bergsmann , birth_date = , birth_place = Budapest , death_date = , death_place = London , occupation = psychoan ...
, and
John Bowlby Edward John Mostyn Bowlby, CBE, FBA, FRCP, FRCPsych (; 26 February 1907 – 2 September 1990) was a British psychologist, psychiatrist, and psychoanalyst, notable for his interest in child development and for his pioneering work in attachmen ...
. In the past 30 years or so, the criticisms have centered on the issue of empirical verification. Psychoanalysis has been used as a research tool into childhood development (cf. the journal ''The Psychoanalytic Study of the Child''), and has developed into a flexible, effective treatment for certain mental disturbances. In the 1960s, Freud's early (1905) thoughts on the childhood development of
female sexuality Human female sexuality encompasses a broad range of behaviors and processes, including female sexual identity and sexual behavior, the physiological, psychological, social, cultural, political, and spiritual or religious aspects of sexual ac ...
were challenged; this challenge led to major research in the 1970s and 80s, and then to a reformulation of female sexual development that corrected some of Freud's concepts. Also see the various works of Eleanor Galenson,
Nancy Chodorow Nancy Julia Chodorow (born January 20, 1944) is an American sociologist and professor. She began her career as a professor of Women's studies at Wellesley College in 1973, and from 1974 on taught at the University of California, Santa Cruz, unti ...
,
Karen Horney Karen Horney (; ; 16 September 1885 – 4 December 1952) was a German psychoanalyst who practised in the United States during her later career. Her theories questioned some traditional Freudian views. This was particularly true of her theories of ...
,
Françoise Dolto Françoise Dolto (; November 6, 1908 – August 25, 1988) was a French pediatrician and psychoanalyst. Biography Born as Françoise Marette, she was the daughter of an affluent far-right royalist family of traditional Catholics in Paris. Her ...
,
Melanie Klein Melanie Klein (née Reizes; 30 March 1882 – 22 September 1960) was an Austrian-British author and psychoanalyst known for her work in child analysis. She was the primary figure in the development of object relations theory. Klein suggested tha ...
,
Selma Fraiberg Selma Fraiberg (1918–1981) was an American child psychoanalyst, author and social worker. She studied infants with congenital blindness in the 1970s. She found that blind babies had three problems to overcome: learning to recognize parents from ...
, and others. Most recently, psychoanalytic researchers who have integrated attachment theory into their work, including Alicia Lieberman,
Susan Coates Susan W. Coates (born 1940) is an American psychoanalyst, who has worked on gender identity disorder in children (GIDC) and early childhood trauma.Bryant K (2006). Making Gender Identity Disorder of Childhood: Historical Lessons for Contemporary De ...
, and
Daniel Schechter Daniel S. Schechter (born 1962 in Miami, Florida) is an American psychiatrist known for his clinical work and research on intergenerational transmission or "communication" of violent trauma and related psychopathology involving parents and very ...
have explored the role of parental traumatization in the development of young children's mental representations of self and others.


Effectiveness

The psychoanalytic profession has been resistant to researching efficacy. Evaluations of effectiveness based on the interpretation of the therapist alone cannot be proven.Myers, D. G. (2014). ''Psychology: Tenth edition in modules''. New York:
Worth Publishers Macmillan Publishers (occasionally known as the Macmillan Group; formally Macmillan Publishers Ltd and Macmillan Publishing Group, LLC) is a British publishing company traditionally considered to be one of the 'Big Five' English language publi ...
.


Research results

Numerous studies have shown that the efficacy of therapy is primarily related to the quality of the therapist, rather than to the school or technique or training.Horvath, A. 2001. "The Alliance." '' Psychotherapy: Theory, Research, Practice, Training'' 38(4):365–72. .
Meta-analyses A meta-analysis is a statistical analysis that combines the results of multiple scientific studies. Meta-analyses can be performed when there are multiple scientific studies addressing the same question, with each individual study reporting me ...
in 2012 and 2013 found support or evidence for the efficacy of psychoanalytic therapy, but further research is needed. Other meta-analyses published in recent years showed psychoanalysis and
psychodynamic therapy Psychodynamics, also known as psychodynamic psychology, in its broadest sense, is an approach to psychology that emphasizes systematic study of the psychological forces underlying human behavior, feelings, and emotions and how they might relate t ...
to be effective, with outcomes comparable to or greater than other kinds of
psychotherapy Psychotherapy (also psychological therapy, talk therapy, or talking therapy) is the use of psychological methods, particularly when based on regular personal interaction, to help a person change behavior, increase happiness, and overcome pro ...
or
antidepressant drugs Antidepressants are a class of medication used to treat major depressive disorder, anxiety disorders, chronic pain conditions, and to help manage addictions. Common side-effects of antidepressants include dry mouth, weight gain, dizziness, hea ...
, but these meta-analyses have been subjected to various criticisms. In particular, the inclusion of pre/post studies rather than randomized controlled trials, and the absence of adequate comparisons with control treatments, is a serious limitation in interpreting the results. A French 2004 report from INSERM concluded that psychoanalytic therapy is less effective than other psychotherapies (including
cognitive behavioral therapy Cognitive behavioral therapy (CBT) is a psycho-social intervention that aims to reduce symptoms of various mental health conditions, primarily depression and anxiety disorders. CBT focuses on challenging and changing cognitive distortions (suc ...
) for certain diseases. In 2011, the
American Psychological Association The American Psychological Association (APA) is the largest scientific and professional organization of psychologists in the United States, with over 133,000 members, including scientists, educators, clinicians, consultants, and students. It ha ...
made 103 comparisons between psychodynamic treatment and a non-dynamic competitor and found that 6 were superior, 5 were inferior, 28 showed no difference, and 63 were adequate. The study found that this could be used as a basis "to make psychodynamic psychotherapy an 'empirically validated' treatment." Meta-analyses of Short Term Psychodynamic Psychotherapy (STPP) have found
effect size In statistics, an effect size is a value measuring the strength of the relationship between two variables in a population, or a sample-based estimate of that quantity. It can refer to the value of a statistic calculated from a sample of data, the ...
s (
Cohen's d In statistics, an effect size is a value measuring the strength of the relationship between two variables in a population, or a sample-based estimate of that quantity. It can refer to the value of a statistic calculated from a sample of data, the ...
) ranging from 0.34 to 0.71 compared to no treatment and was found to be slightly better than other therapies in follow up. Other reviews have found an effect size of 0.78 to 0.91 for somatic disorders compared to no treatment and 0.69 for treating depression. A 2012 ''
Harvard Review of Psychiatry The ''Harvard Review of Psychiatry'' is a Peer review, peer-reviewed medical journal covering all aspects of psychiatry. The editor-in-chief is Joshua L. Roffman. According to the ''Journal Citation Reports'', the journal has a 2017 impact factor ...
'' meta-analysis of Intensive Short-Term Dynamic Psychotherapy (ISTDP) found effect sizes ranging from 0.84 for interpersonal problems to 1.51 for depression. Overall ISTDP had an effect size of 1.18 compared to no treatment. A meta-analysis of Long Term Psychodynamic Psychotherapy in 2012 found an overall effect size of 0.33, which is modest. This study concluded the recovery rate following LTPP was equal to control treatments, including treatment as usual, and found the evidence for the effectiveness of LTPP to be limited and at best conflicting. Others have found effect sizes of 0.44–0.68. According to a 2004 French review conducted by INSERM, psychoanalysis was presumed or proven effective at treating
panic disorder Panic disorder is a mental disorder, mental and Abnormal behavior, behavioral disease#Disorder, disorder, specifically an anxiety disorder characterized by reoccurring unexpected panic attacks. Panic attacks are sudden periods of intense fear th ...
,
post-traumatic stress Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that can develop because of exposure to a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on a ...
, and
personality disorders Personality disorders (PD) are a class of mental disorders characterized by enduring maladaptive patterns of behavior, cognition, and inner experience, exhibited across many contexts and deviating from those accepted by the individual's culture ...
, but did not find evidence of its effectiveness in treating
schizophrenia Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations (typically hearing voices), delusions, and disorganized thinking. Other symptoms include social withdra ...
,
obsessive compulsive disorder Obsession may refer to: Psychology * Celebrity worship syndrome, obsessive addictive disorder to a celebrity's personal and professional life * Fixation (psychology), a persistent attachment to an object or idea * Idée fixe (psychology), a preo ...
,
specific phobia Specific phobia is an anxiety disorder, characterized by an extreme, unreasonable, and irrational fear associated with a specific object, situation, or concept which poses little or no actual danger. Specific phobia can lead to avoidance of the o ...
,
bulimia Bulimia nervosa, also known as simply bulimia, is an eating disorder characterized by binge eating followed by purging or fasting, and excessive concern with body shape and weight. The aim of this activity is to expel the body of calories eate ...
and
anorexia Anorexia nervosa, often referred to simply as anorexia, is an eating disorder characterized by low weight, food restriction, body image disturbance, fear of gaining weight, and an overpowering desire to be thin. ''Anorexia'' is a term of Gre ...
.INSERM Collective Expertise Centre. 2004.
Psychotherapy: Three approaches evaluated
" ''INSERM Collective Expert Reports.'' Paris: Institut National de la Santé et de la Recherche Médicale (2000). .
NCBI The National Center for Biotechnology Information (NCBI) is part of the United States National Library of Medicine (NLM), a branch of the National Institutes of Health (NIH). It is approved and funded by the government of the United States. The ...
.
A 2001 systematic review of the medical literature by the
Cochrane Collaboration Cochrane (previously known as the Cochrane Collaboration) is a British international charitable organisation formed to organise medical research findings to facilitate evidence-based choices about health interventions involving health profess ...
concluded that no data exist demonstrating that psychodynamic psychotherapy is effective in treating schizophrenia and severe mental illness, and cautioned that medication should always be used alongside any type of
talk therapy Talk may refer to: Communication * Communication, the encoding and decoding of exchanged messages between people * Conversation, interactive communication between two or more people * Lecture, an oral presentation intended to inform or instruct ...
in schizophrenia cases. A French review from 2004 found the same. The Schizophrenia Patient Outcomes Research Team advises against the use of
psychodynamic therapy Psychodynamics, also known as psychodynamic psychology, in its broadest sense, is an approach to psychology that emphasizes systematic study of the psychological forces underlying human behavior, feelings, and emotions and how they might relate t ...
in cases of schizophrenia, arguing that more trials are necessary to verify its effectiveness.


Criticism

Both Freud and psychoanalysis have been criticized in extreme terms. Exchanges between critics and defenders of psychoanalysis have often been so heated that they have come to be characterized as the Freud Wars. Linguist
Noam Chomsky Avram Noam Chomsky (born December 7, 1928) is an American public intellectual: a linguist, philosopher, cognitive scientist, historian, social critic, and political activist. Sometimes called "the father of modern linguistics", Chomsky is ...
has criticized psychoanalysis for lacking a scientific basis. Evolutionary biologist
Stephen Jay Gould Stephen Jay Gould (; September 10, 1941 – May 20, 2002) was an American paleontologist, evolutionary biologist, and historian of science. He was one of the most influential and widely read authors of popular science of his generation. Gould sp ...
considered psychoanalysis influenced by pseudoscientific theories such as
recapitulation theory The theory of recapitulation, also called the biogenetic law or embryological parallelism—often expressed using Ernst Haeckel's phrase "ontogeny recapitulates phylogeny"—is a historical hypothesis that the development of the embryo of an ani ...
. Psychologists
Hans Eysenck Hans Jürgen Eysenck (; 4 March 1916 – 4 September 1997) was a German-born British psychologist who spent his professional career in Great Britain. He is best remembered for his work on intelligence and personality, although he worked on other ...
, John F. Kihlstrom and others have also criticized the field as pseudoscience.


Debate over status as scientific

The theoretical foundations of psychoanalysis lie in the same philosophical currents that lead to interpretive
phenomenology Phenomenology may refer to: Art * Phenomenology (architecture), based on the experience of building materials and their sensory properties Philosophy * Phenomenology (philosophy), a branch of philosophy which studies subjective experiences and a ...
rather than in those that lead to
scientific Science is a systematic endeavor that builds and organizes knowledge in the form of testable explanations and predictions about the universe. Science may be as old as the human species, and some of the earliest archeological evidence for ...
positivism Positivism is an empiricist philosophical theory that holds that all genuine knowledge is either true by definition or positive—meaning ''a posteriori'' facts derived by reason and logic from sensory experience.John J. Macionis, Linda M. G ...
, making the theory largely incompatible with positivist approaches to the study of the mind. Popper, Karl R. 1990. "Science: Conjectures and Refutations." Pp. 104–10 in ''Philosophy of Science and the Occult'', edited by P. Grim. Albany, p. 109
Preview Google Books
See also ''
Conjectures and Refutations Sir Karl Raimund Popper (28 July 1902 – 17 September 1994) was an Austrian-British philosopher, academic and social commentator. One of the 20th century's most influential philosophers of science, Popper is known for his rejection of the cl ...
''.
Webster, Richard. 1995. ''Why Freud was Wrong: Sin, Science, and Psychoanalysis''. London: Harper Collins. Early critics of psychoanalysis believed that its theories were based too little on quantitative and
experimental research An experiment is a procedure carried out to support or refute a hypothesis, or determine the efficacy or likelihood of something previously untried. Experiments provide insight into cause-and-effect by demonstrating what outcome occurs when a ...
, and too much on the clinical case study method. Philosopher
Frank Cioffi : ''Frank L. Cioffi, of Baruch College is Frank Cioffi's nephew.''
cites false claims of a sound scientific verification of the theory and its elements as the strongest basis for classifying the work of Freud and his school as pseudoscience.
Karl Popper Sir Karl Raimund Popper (28 July 1902 – 17 September 1994) was an Austrian-British philosopher, academic and social commentator. One of the 20th century's most influential philosophers of science, Popper is known for his rejection of the cl ...
argued that psychoanalysis is a
pseudoscience Pseudoscience consists of statements, beliefs, or practices that claim to be both scientific and factual but are incompatible with the scientific method. Pseudoscience is often characterized by contradictory, exaggerated or falsifiability, unfa ...
because its claims are not testable and cannot be refuted; that is, they are not
falsifiable Falsifiability is a standard of evaluation of scientific theories and hypotheses that was introduced by the philosopher of science Karl Popper in his book ''The Logic of Scientific Discovery'' (1934). He proposed it as the cornerstone of a so ...
:In addition,
Imre Lakatos Imre Lakatos (, ; hu, Lakatos Imre ; 9 November 1922 – 2 February 1974) was a Hungarian philosopher of mathematics and science, known for his thesis of the fallibility of mathematics and its "methodology of proofs and refutations" in its pr ...
wrote that "Freudians have been nonplussed by Popper's basic challenge concerning scientific honesty. Indeed, they have refused to specify experimental conditions under which they would give up their basic assumptions." In ''Sexual Desire'' (1986), philosopher
Roger Scruton Sir Roger Vernon Scruton (; 27 February 194412 January 2020) was an English philosopher and writer who specialised in aesthetics and political philosophy, particularly in the furtherance of traditionalist conservative views. Editor from 1982 t ...
rejects Popper's arguments pointing to the theory of repression as an example of a Freudian theory that does have testable consequences. Scruton nevertheless concluded that psychoanalysis is not genuinely scientific, on the grounds that it involves an unacceptable dependence on metaphor. The philosopher and physicist
Mario Bunge Mario Augusto Bunge (; ; September 21, 1919 – February 24, 2020) was an Argentine-Canadian philosopher and physicist. His philosophical writings combined scientific realism, systemism, materialism, emergentism, and other principles. He was ...
argued that psychoanalysis is a pseudoscience because it violates the
ontology In metaphysics, ontology is the philosophical study of being, as well as related concepts such as existence, becoming, and reality. Ontology addresses questions like how entities are grouped into categories and which of these entities exis ...
and
methodology In its most common sense, methodology is the study of research methods. However, the term can also refer to the methods themselves or to the philosophical discussion of associated background assumptions. A method is a structured procedure for bri ...
inherent to science. According to Bunge, most psychoanalytic theories are either untestable or unsupported by evidence.
Cognitive scientists Cognition refers to "the mental action or process of acquiring knowledge and understanding through thought, experience, and the senses". It encompasses all aspects of intellectual functions and processes such as: perception, attention, thought, ...
, in particular, have also weighed in. Martin Seligman, a prominent academic in
positive psychology Positive psychology is the scientific study of what makes life most worth living, focusing on both individual and societal well-being. It studies "positive subjective experience, positive individual traits, and positive institutions...it aims t ...
, wrote that:
Adolf Grünbaum Adolf Grünbaum (; May 15, 1923 – November 15, 2018) was a German-American philosopher of science and a critic of psychoanalysis, as well as Karl Popper's philosophy of science. He was the first Andrew Mellon Professor of Philosophy at the Unive ...
argues in ''Validation in the Clinical Theory of Psychoanalysis'' (1993) that psychoanalytic based theories are falsifiable, but that the causal claims of psychoanalysis are unsupported by the available clinical evidence. Grünbaum, Adolf. 1993. ''Validation in the Clinical Theory of Psychoanalysis: A Study in the Philosophy of Psychoanalysis''. Madison, CT:
International Universities Press International Universities Press, Inc. was a private publishing company of academic journals and books on psychotherapy and contiguous disciplines. It was established in 1944 and was based in Madison, CT. It published the following journals: *''Ps ...
. . .
Historian
Henri Ellenberger Henri Frédéric Ellenberger (Nalolo, Barotseland, Rhodesia, 6 November 1905 – Quebec, 1 May 1993) was a Canadian psychiatrist, medical historian, and criminologist, sometimes considered the founding historiographer of psychiatry. Ellenberger i ...
, who researched the history of Freud, Jung, Adler, and Janet, while writing his book ''The Discovery of the Unconscious: The History and Evolution of Dynamic Psychiatry'', argued that psychoanalysis was not scientific on the grounds of both its methodology and social structure:


Freud

Some have accused Freud of fabrication, most famously in the case of
Anna O Bertha Pappenheim (27 February 1859 – 28 May 1936) was an Austrian-Jewish feminist, a social pioneer, and the founder of the Jewish Women's Association (''). Under the pseudonym Anna O., she was also one of Josef Breuer's best-documented pat ...
. Others have speculated that patients had conditions that are now easily identifiable and unrelated to psychoanalysis; for instance, Anna O. is thought to have had an organic impairment such as
tuberculous meningitis Tuberculous meningitis, also known as TB meningitis or tubercular meningitis, is a specific type of bacterial meningitis caused by the '' Mycobacterium tuberculosis'' infection of the meninges—the system of membranes which envelop the central ...
or
temporal lobe epilepsy Temporal lobe epilepsy (TLE) is a chronic disorder of the nervous system which is characterized by recurrent, unprovoked focal seizures that originate in the temporal lobe of the brain and last about one or two minutes. TLE is the most common f ...
, rather than Freud's diagnosis of hysteria. Webster, Richard. 1996. ''Why Freud was Wrong. Sin, Science and Psychoanalysis''. London: Harper Collins.
Henri Ellenberger Henri Frédéric Ellenberger (Nalolo, Barotseland, Rhodesia, 6 November 1905 – Quebec, 1 May 1993) was a Canadian psychiatrist, medical historian, and criminologist, sometimes considered the founding historiographer of psychiatry. Ellenberger i ...
and
Frank Sulloway Frank Jones Sulloway (born February 2, 1947) is an American psychologist. He is a visiting scholar at the Institute of Personality and Social Research at the University of California, Berkeley and a visiting professor in the Department of Psycholo ...
argue that Freud and his followers created an inaccurate legend of Freud to popularize psychoanalysis. Borch-Jacobson and Shamdasani argue that this legend has been adapted to different times and situations.
Isabelle Stengers Isabelle Stengers (; ; born 1949) is a Belgian philosopher, noted for her work in the philosophy of science. Trained as a chemist, she has collaborated with Russian-Belgian chemist Ilya Prigogine and French philosopher/sociologist Bruno Latour am ...
states that psychoanalytic circles have tried to stop historians from accessing documents about the life of Freud.


Witch doctors

Richard Feynman Richard Phillips Feynman (; May 11, 1918 – February 15, 1988) was an American theoretical physicist, known for his work in the path integral formulation of quantum mechanics, the theory of quantum electrodynamics, the physics of the superflu ...
wrote off psychoanalysts as mere "witch doctors": Likewise, psychiatrist E. Fuller Torrey, in ''Witchdoctors and Psychiatrists'' (1986), agreed that psychoanalytic theories have no more scientific basis than the theories of traditional native healers, "witchdoctors" or modern "cult" alternatives such as EST. Torrey, E. Fuller. 1986. ''Witchdoctors and Psychiatrists''. p. 76. Psychologist Alice Miller charged psychoanalysis with being similar to the poisonous pedagogies, which she described in her book ''For Your Own Good''. She scrutinized and rejected the validity of Freud's
drive theory In psychology, a drive theory, theory of drives or drive doctrine is a theory that attempts to analyze, classify or define the psychological drives. A drive is an instinctual need that has the power of driving the behavior of an individual; an " ...
, including the Oedipus complex, which, according to her and
Jeffrey Masson Jeffrey Moussaieff Masson (born March 28, 1941 as Jeffrey Lloyd Masson) is an American author. Masson is best known for his conclusions about Sigmund Freud and psychoanalysis. In his ''The Assault on Truth'' (1984), Masson argues that Freud may ha ...
, blames the child for the abusive sexual behavior of adults. Psychologist Joel Kupfersmid investigated the validity of the Oedipus complex, examining its nature and origins. He concluded that there is little evidence to support the existence of the Oedipus complex.


Critical perspectives

Contemporary French philosophers
Michel Foucault Paul-Michel Foucault (, ; ; 15 October 192625 June 1984) was a French philosopher, historian of ideas, writer, political activist, and literary critic. Foucault's theories primarily address the relationship between power and knowledge, and how ...
and
Gilles Deleuze Gilles Louis René Deleuze ( , ; 18 January 1925 – 4 November 1995) was a French philosopher who, from the early 1950s until his death in 1995, wrote on philosophy, literature, film, and fine art. His most popular works were the two volu ...
asserted that the institution of psychoanalysis has become a center of power, and that its confessional techniques resemble those included and utilized within the
Christian religion Christianity is an Abrahamic monotheistic religion based on the life and teachings of Jesus of Nazareth. It is the world's largest and most widespread religion with roughly 2.38 billion followers representing one-third of the global popul ...
. French psychoanalyst
Jacques Lacan Jacques Marie Émile Lacan (, , ; 13 April 1901 – 9 September 1981) was a French psychoanalyst and psychiatrist. Described as "the most controversial psycho-analyst since Freud", Lacan gave yearly seminars in Paris from 1953 to 1981, and pu ...
criticized the emphasis of some American and British psychoanalytical traditions on what he has viewed as the suggestion of imaginary "causes" for symptoms, and recommended the return to Freud. Together with Deleuze, the French psychoanalyst and psychiatrist
Félix Guattari Pierre-Félix Guattari ( , ; 30 April 1930 – 29 August 1992) was a French psychoanalyst, political philosopher, semiotician, social activist, and screenwriter. He co-founded schizoanalysis with Gilles Deleuze, and ecosophy with Arne Næss, ...
criticized the Oedipal and schizophrenic power structure of psychoanalysis and its connivance with
capitalism Capitalism is an economic system based on the private ownership of the means of production and their operation for Profit (economics), profit. Central characteristics of capitalism include capital accumulation, competitive markets, pric ...
in ''
Anti-Oedipus ''Anti-Oedipus: Capitalism and Schizophrenia'' (french: Capitalisme et schizophrénie. L'anti-Œdipe) is a 1972 book by French authors Gilles Deleuze and Félix Guattari, the former a philosopher and the latter a psychoanalyst. It is the first vol ...
'' (1972) and ''
A Thousand Plateaus ''A Thousand Plateaus: Capitalism and Schizophrenia'' (french: link=no, Mille plateaux) is a 1980 book by the French philosopher Gilles Deleuze and the French psychoanalyst Félix Guattari. It is the second and final volume of their collaborativ ...
'' (1980), the two volumes of their theoretical work ''
Capitalism and Schizophrenia ''Capitalism and Schizophrenia'' (french: Capitalisme et Schizophrénie) is a two-volume theoretical work by the French authors Gilles Deleuze and Félix Guattari, respectively a philosopher and a psychoanalyst. Its volumes are ''Anti-Oedipus'' ...
''. Belgian psycholinguist and psychoanalyst
Luce Irigaray Luce Irigaray (born 3 May 1930) is a Belgian-born French feminist, philosopher, linguist, psycholinguist, psychoanalyst, and cultural theorist who examined the uses and misuses of language in relation to women. Irigaray's first and most well know ...
also criticized psychoanalysis, employing
Jacques Derrida Jacques Derrida (; ; born Jackie Élie Derrida; See also . 15 July 1930 – 9 October 2004) was an Algerian-born French philosopher. He developed the philosophy of deconstruction, which he utilized in numerous texts, and which was developed t ...
's concept of
phallogocentrism In critical theory and deconstruction, phallogocentrism is a neologism coined by Jacques Derrida to refer to the privileging of the masculine ( phallus) in the construction of meaning. The term is a blend word of the older terms ''phallocentri ...
to describe the exclusion of the woman both from Freudian and Lacanian psychoanalytical theories. Deleuze and Guattari in ''Anti-Oedipus'' take the cases of
Gérard Mendel Gérard Mendel (1930 – 14 October 2004) was a French psychoanalyst and psychiatrist. The revolt against the father His popularity began when he published his 1968 work ''La révolte contre le père'' (The revolt against the father). Deleuze and ...
,
Bela Grunberger Bela may refer to: Places Asia *Bela Pratapgarh, a town in Pratapgarh District, Uttar Pradesh, India *Bela, a small village near Bhandara, Maharashtra, India *Bela, another name for the biblical city Zoara * Bela, Dang, in Nepal * Bela, Janakpur, ...
, and
Janine Chasseguet-Smirgel Janine Chasseguet-Smirgel (1928 – March 5, 2006) (whose surname is alternatively spelled Chasseguet-Smirguel, but generally not in English-language publications) was a leading French psychoanalyst, a training analyst, and past President of the ...
, prominent members of the most respected psychoanalytical associations (including the
IPA IPA commonly refers to: * India pale ale, a style of beer * International Phonetic Alphabet, a system of phonetic notation * Isopropyl alcohol, a chemical compound IPA may also refer to: Organizations International * Insolvency Practitioners ...
), to suggest that, traditionally, psychoanalysis had always enthusiastically enjoyed and embraced a
police state A police state describes a state where its government institutions exercise an extreme level of control over civil society and liberties. There is typically little or no distinction between the law and the exercise of political power by the exe ...
throughout its history.


Freudian theory

A survey of scientific research suggested that while personality traits corresponding to Freud's oral, anal, Oedipal, and genital phases can be observed, they do not necessarily manifest as stages in the development of children. These studies also have not confirmed that such traits in adults result from childhood experiences. However, these stages should not be viewed as crucial to modern psychoanalysis. What is crucial to modern psychoanalytic theory and practice is the power of the unconscious and the transference phenomenon. The idea of "unconscious" is contested because human behavior can be observed while human mental activity has to be inferred. However, the unconscious is now a popular topic of study in the fields of experimental and social psychology (e.g., implicit attitude measures,
fMRI Functional magnetic resonance imaging or functional MRI (fMRI) measures brain activity by detecting changes associated with blood flow. This technique relies on the fact that cerebral blood flow and neuronal activation are coupled. When an area o ...
, and
PET scans Positron emission tomography (PET) is a functional imaging technique that uses radioactive substances known as radiotracers to visualize and measure changes in metabolic processes, and in other physiological activities including blood flow, r ...
, and other indirect tests). The idea of unconscious, and the transference phenomenon, have been widely researched and, it is claimed, validated in the fields of
cognitive psychology Cognitive psychology is the scientific study of mental processes such as attention, language use, memory, perception, problem solving, creativity, and reasoning. Cognitive psychology originated in the 1960s in a break from behaviorism, which ...
and social psychology,Westen and Gabbard, 2002 though a Freudian interpretation of unconscious mental activity is not held by the majority of cognitive psychologists. Recent developments in neuroscience have resulted in one side arguing that it has provided a biological basis for unconscious emotional processing in line with psychoanalytic theory i.e.,
neuropsychoanalysis Neuropsychoanalysis integrates both neuroscience and psychoanalysis, to create a balanced and equal study of the human mind. This overarching approach began as advances in neuroscience lead to breakthroughs which held pertinent information for the ...
, while the other side argues that such findings make psychoanalytic theory obsolete and irrelevant.
Shlomo Kalo Shlomo Kalo ( he, שלמה קאלו; February 25, 1928 – August 30, 2014) was a writer and microbiologist. He published approximately 80 fiction and nonfiction books in Hebrew, some of which are published in translation internationally. Biograp ...
explains that the
scientific materialism Metaphysical naturalism (also called ontological naturalism, philosophical naturalism and antisupernaturalism) is a philosophical worldview which holds that there is nothing but natural elements, principles, and relations of the kind studied by ...
that flourished in the 19th century severely harmed religion and rejected whatever called spiritual. The institution of the
confession A confession is a statement – made by a person or by a group of persons – acknowledging some personal fact that the person (or the group) would ostensibly prefer to keep hidden. The term presumes that the speaker is providing information th ...
priest in particular was badly damaged. The empty void that this institution left behind was swiftly occupied by the newborn psychoanalysis. In his writings, Kalo claims that psychoanalysis basic approach is erroneous. It represents the mainline wrong assumptions that happiness is unreachable and that the natural desire of a human being is to exploit his fellow men for his own pleasure and benefit.
Jacques Derrida Jacques Derrida (; ; born Jackie Élie Derrida; See also . 15 July 1930 – 9 October 2004) was an Algerian-born French philosopher. He developed the philosophy of deconstruction, which he utilized in numerous texts, and which was developed t ...
incorporated aspects of psychoanalytic theory into his theory of
deconstruction The term deconstruction refers to approaches to understanding the relationship between text and meaning. It was introduced by the philosopher Jacques Derrida, who defined it as a turn away from Platonism's ideas of "true" forms and essences w ...
in order to question what he called the '
metaphysics of presence The concept of the metaphysics of presence is an important consideration in deconstruction. Deconstructive interpretation holds that the entire history of Western philosophy with its language and traditions has emphasized the desire for immediat ...
'. Derrida also turns some of these ideas against Freud, to reveal tensions and contradictions in his work. For example, although Freud defines religion and metaphysics as displacements of the identification with the father in the resolution of the Oedipal complex, Derrida (
1987 File:1987 Events Collage.png, From top left, clockwise: The MS Herald of Free Enterprise capsizes after leaving the Port of Zeebrugge in Belgium, killing 193; Northwest Airlines Flight 255 crashes after takeoff from Detroit Metropolitan Airport, k ...
) insists that the prominence of the father in Freud's own analysis is itself indebted to the prominence given to the father in Western metaphysics and theology since
Plato Plato ( ; grc-gre, Πλάτων ; 428/427 or 424/423 – 348/347 BC) was a Greek philosopher born in Athens during the Classical period in Ancient Greece. He founded the Platonist school of thought and the Academy, the first institution ...
.
Derrida, Jacques Jacques Derrida (; ; born Jackie Élie Derrida; See also . 15 July 1930 – 9 October 2004) was an Algerian-born French philosopher. He developed the philosophy of deconstruction, which he utilized in numerous texts, and which was developed t ...
, and Bass, Alan. 1987. '' The Post Card: From Socrates to Freud and Beyond''. Chicago:
University of Chicago The University of Chicago (UChicago, Chicago, U of C, or UChi) is a private research university in Chicago, Illinois. Its main campus is located in Chicago's Hyde Park neighborhood. The University of Chicago is consistently ranked among the b ...
.


See also

*
Analytical psychology Analytical psychology ( de , Analytische Psychologie, sometimes translated as analytic psychology and referred to as Jungian analysis) is a term coined by Carl Jung, a Swiss psychiatrist, to describe research into his new "empirical science" ...
* Glossary of psychoanalysis *
List of schools of psychoanalysis This is a list of schools of psychoanalysis. International schools and organizations * International Federation of Psychoanalytic Societies (IFPS) * École Européenne de Psychanalyse (EEP) (Europe) * International Psychoanalytical Association ...
*
Psychoanalytic sociology Psychoanalytic sociology is the research field that analyzes society using the same methods that psychoanalysis applied to analyze an individual. 'Psychoanalytic sociology embraces work from divergent sociological traditions and political perspecti ...
* Psychoanalysis and music *
Training analysis A training analysis is a psychoanalysis undergone by a candidate (perhaps a physician with specialty in psychiatry or a psychologist) as a part of her/his training to be a psychoanalyst; the (senior) psychoanalyst who performs such an analysis is ...


Notes


References


Further reading


Introductions

*Brenner, Charles (1954). ''An Elementary Textbook of Psychoanalysis''. *Elliott, Anthony (2002). ''Psychoanalytic Theory: An Introduction'' (2nd ed.).
Duke University Press Duke University Press is an academic publisher and university press affiliated with Duke University. It was founded in 1921 by William T. Laprade as The Trinity College Press. (Duke University was initially called Trinity College). In 1926 Du ...
. --
An introduction that explains psychoanalytic theory with interpretations of major theorists. * Fine, Reuben (1990). ''The History of Psychoanalysis.'' (expanded ed.). Northvale: Jason Aronson. * Samuel, Lawrence R. (2013). ''Shrink: A Cultural History of Psychoanalysis in America''. University of Nebraska Press. 253 pp. *Freud, Sigmund (2014)
926 Year 926 ( CMXXVI) was a common year starting on Sunday (link will display the full calendar) of the Julian calendar. Events By place Europe * Spring – The Italian nobles turn against King Rudolph II of Burgundy and request that ...

Psychoanalysis
" ''
Encyclopædia Britannica The (Latin for "British Encyclopædia") is a general knowledge English-language encyclopaedia. It is published by Encyclopædia Britannica, Inc.; the company has existed since the 18th century, although it has changed ownership various time ...
''.


Reference works

* de Mijolla, Alain, ed. (2005). ''International dictionary of psychoanalysis'' nhanced American version1,2,&3. Detroit: Thomson/Gale. * Laplanche, Jean, and J. B. Pontalis (1974). "The Language of Psycho-Analysis". W. W. Norton & Company. *Freud, Sigmund (1940). ''An Outline of Psychoanalysis''. ePenguin.;General *Edelson, Marshall (1984). ''Hypothesis and Evidence in Psychoanalysis''. Chicago: Chicago University Press. * Etchegoyen, Horacio (2005). ''The Fundamentals of Psychoanalytic Technique'' (new ed.). Karnac Books. * Gellner, Ernest. ''The Psychoanalytic Movement: The Cunning of Unreason'', . A critical view of Freudian theory. * Green, André (2005). "Psychoanalysis: A Paradigm For Clinical Thinking".
Free Association Books Free Association Books is a project started in London in the 1980s. Bob Young and colleagues began a search using psychoanalysis to understand the problems of liberation. Other people became involved in the movement such as Andrew Samuels and B ...
. * Irigaray, Luce (2004). ''Key Writings''. Continuum. * Jacobson, Edith (1976). ''Depression; Comparative Studies of Normal, Neurotic, and Psychotic Conditions''.
International Universities Press International Universities Press, Inc. was a private publishing company of academic journals and books on psychotherapy and contiguous disciplines. It was established in 1944 and was based in Madison, CT. It published the following journals: *''Ps ...
. * Kernberg, Otto (1993). ''Severe Personality Disorders: Psychotherapeutic Strategies''. Yale University Press. * Kohut, Heinz (2000). ''Analysis of the Self: Systematic Approach to Treatment of Narcissistic Personality Disorders''.
International Universities Press International Universities Press, Inc. was a private publishing company of academic journals and books on psychotherapy and contiguous disciplines. It was established in 1944 and was based in Madison, CT. It published the following journals: *''Ps ...
. * Kovacevic, Filip (2007). ''Liberating Oedipus? Psychoanalysis as Critical Theory''. Lexington Books. * Kristeva, Julia (1986). ''The Kristeva Reader'', edited by T. Moi. Columbia University Press. * Meltzer, Donald (1983). ''Dream-Life: A Re-Examination of the Psycho-Analytical Theory and Technique''. Karnac Books. *— (1998). ''The Kleinian Development'' (new ed.). Karnac Books; reprint: *Mitchell, S. A., and M. J. Black (1995). ''Freud and beyond: a history of modern psychoanalytic thought.'' New York: Basic Books. pp. xviii–xx. * Pollock, Griselda (2006). "Beyond Oedipus. Feminist Thought, Psychoanalysis, and Mythical Figurations of the Feminine." In ''Laughing with Medusa'', edited by V. Zajko and M. Leonard. Oxford: Oxford University Press. * Spielrein, Sabina (1993). ''Destruction as cause of becoming''. * Stoller, Robert (1993). ''Presentations of Gender''. Yale University Press. *Stolorow, Robert, George Atwood, and Donna Orange (2002). ''Worlds of Experience: Interweaving Philosophical and Clinical Dimensions in Psychoanalysis''. New York: Basic Books. * Spitz, René (2006). ''The First Year of Life: Psychoanalytic Study of Normal and Deviant Development of Object Relations''. International Universities Press. *Tähkä, Veikko (1993). ''Mind and Its Treatment: A Psychoanalytic Approach.'' Madison, CT: International Universities Press.


Book series

*''
Contemporary Psychoanalytic Studies Contemporary history, in English-language historiography, is a subset of modern history that describes the historical period from approximately 1945 to the present. Contemporary history is either a subset of the late modern period, or it is o ...
''. Amsterdam & New York: Rodopi.


Analyses, discussions and critiques

*Aziz, Robert (2007). ''The Syndetic Paradigm: The Untrodden Path Beyond Freud and Jung'', Albany:
State University of New York Press The State University of New York (SUNY, , ) is a system of public colleges and universities in the State of New York. It is one of the largest comprehensive system of universities, colleges, and community colleges in the United States. Led by c ...
. * Borch-Jacobsen, Mikkel (1991). ''Lacan: The Absolute Master'', Stanford: Stanford University Press. *Borch-Jacobsen, Mikkel (1996). ''Remembering Anna O: A Century of Mystification'', London: Routledge. *Borch-Jacobsen, Mikkel and Shamdasani, Sonu (2012). ''The Freud Files: An Inquiry into the History of Psychoanalysis'', Cambridge University Press. . * * Burnham, John, ed. (2012). ''After Freud Left: A Century of Psychoanalysis in America'', University of Chicago Press. * Cioffi, Frank. (1998). ''Freud and the Question of Pseudoscience'', Open Court Publishing Company. * Crews, Frederick (1986). ''Skeptical Engagements'', New York: Oxford University Press. . Part I of this volume, entitled "The Freudian Temptation," includes five essays critical of psychoanalysis written between 1975 and 1986. * Crews, Frederick (1995). ''The Memory Wars: Freud's Legacy in Dispute'', New York: New York Review of Books. *Crews, Frederick, ed. (1998). ''Unauthorized Freud: Doubters Confront a Legend'', New York: Viking. *Crews, Frederick (2017). ''Freud: The Making of an Illusion'', Metropolitan Books. *Dufresne, Todd (2000). ''Tales From the Freudian Crypt: The Death Drive in Text and Context'', Stanford: Stanford University Press. *— (2007). ''Against Freud: Critics Talk Back'', Stanford: Stanford University Press. *Erwin, Edward (1996), ''A Final Accounting: Philosophical and Empirical Issues in Freudian Psychology''. *Esterson, Allen (1993). ''Seductive Mirage: An Exploration of the Work of Sigmund Freud.'' Chicago: Open Court. *Fisher, Seymour, and Roger P. Greenberg (1977). ''The Scientific Credibility of Freud's Theories and Therapy''. New York: Basic Books. *— (1996). ''Freud Scientifically Reappraised: Testing the Theories and Therapy''. New York: John Wiley. *Gellner, Ernest (1993), ''The Psychoanalytic Movement: The Cunning of Unreason''. A critical view of Freudian theory. * *— (1985). ''The Foundations of Psychoanalysis: A Philosophical Critique''. *Macmillan, Malcolm (1997), ''Freud Evaluated: The Completed Arc''. * *Roustang, Francois (1982). ''Dire Mastery: Discipleship from Freud to Lacan''. Baltimore: Johns Hopkins University Press. * Webster, Richard. (1995). ''Why Freud Was Wrong: Sin, Science, and Psychoanalysis'', New York: Basic Books, Harper Collins. * Wollheim, Richard, editor. (1974). ''Freud: A Collection of Critical Essays.'' New York: Anchor Books.


Responses to critiques

* Köhler, Thomas 1996: ''Anti-Freud-Literatur von ihren Anfängen bis heute. Zur wissenschaftlichen Fundierung von Psychoanalyse-Kritik.'' Stuttgart:
Kohlhammer Verlag W. Kohlhammer Verlag GmbH, or Kohlhammer Verlag, is a German publishing house headquartered in Stuttgart. History Kohlhammer Verlag was founded in Stuttgart on 30 April 1866 by . Kohlhammer had taken over the businesses of his late father-in-law ...
. * Ollinheimo, Ari — Vuorinen, Risto (1999): Metapsychology and the Suggestion Argument: A Reply to Grünbaum's Critique of Psychoanalysis. ''Commentationes Scientiarum Socialium'', 53. Helsinki: Finnish Academy of Science and Letters. *Robinson, Paul (1993). ''Freud and his Critics.'' Berkeley & Los Angeles: University of California Press. *Gomez, Lavinia
''The Freud Wars: An Introduction to the Philosophy of Psychoanalysis''
Routledge, 2005
Review
''Psychodynamic Practice'' 14(1):108–111. Feb., 2008. 


External links


International Psychoanalytical Association (IPA)
– world's primary regulatory body for psychoanalysis, founded by Sigmund Freud
Psychoanalysis – Division 39 – American Psychological Association (APA)
{{Authority control