Chapter 13
Psychoanalysis: The Beginnings
As a 7 year old child, Sigmund Freud dreamed that his mother was being taken by bird-like creatures. Upon waking, the image affected Freud so much that it stayed with him for the rest of his life. Thirty years later, he evaluated the meaning of the dream and determined that it revealed an unconscious longing to have sexual relations with his mother. Freud then developed a system called psychoanalysis for the treatment of abnormal behavior, which has since become widely popular. Freud equates the impact of his work to the impact of the work of Copernicus and Darwin because of its revolutionary ideas. His system began in 1895 when his first book was published. Unlike the other systems discussed so far, Freud’s system grew outside of academia and is not a “pure” science.
Although psychoanalysis was developed as a means of treatment, Freud’s system has a breadth of theoretical grounding that is mainly based on the unconscious. The idea of the unconscious was not novel, but Freud introduced a scientific way of examining it. The unconscious was first elaborated on by Gottfried Leibnitz in the early 1700’s and later refined by Freidrich Herbart 100 years later. Fechner also speculated about the unconscious, and compared the mind to an iceberg (most of which lies beneath the surface and is influenced by unobservable forces). Fechner came up with the “pleasure principle, psychic energy, and aggression,” all of which Freud later adopted. The idea of the unconscious was also popular and pervasive in the late 1800’s in media and literature (e.g., Dr. Jekyll and Mr. Hyde).
Because Freud’s system cannot be compared to academic psychology, it can only be considered a branch in the history of mental health treatment. Beginning in 2000 B.C., mental disorders were considered demonic possession and those with disturbances were treated humanely through magic and prayer. However, with the rise of Christianity in the fourth century, those with mental disorders started being tortured and put to death (such victims were considered possessed or guilty of witchcraft). By the 18th century imprisonment was the only treatment available. Those who advocated for the humane treatment of the mentally disturbed include Juan Vives (1500’s Spain), Philippe Pinel (early 1800’s France), and Dorothea Dix (mid- to late-1800’s U.S.). Two camps disagreed about whether mental disorders were somatic (“brain lesions, under-stimulated nerves”) or psychic (“emotional or psychological” etiology). Psychoanalysis grew in opposition to those who aligned with the somatic argument.
During this time, the Emmanuel movement was gaining steam in the United States (1906 to 1910), which also endorsed the idea that the mind was the source of mental disorder. The movement involved talk therapy, or psychotherapy, performed by religious leaders using the power of suggestion and moral authority to urge parishioners to behave righteously. Hypnosis had also been present before Freud, and began “mesmerism.” Franz Mesmer thought that he could use magnetism to heal the body and mind and reverse mental illness. For some time he and his treatment were influential in Europe. Mesmer’s system was reviewed scientifically by a committee who found no substance to Mesmer’s claim, but his ideas remained popular in Europe and the United States. Later, James Braid “called the trancelike state neuro-hypnology, from which the term hypnosis was eventually derived.” Hypnosis was used by Jean Charcot and Pierre Janet in Paris with mentally disturbed individuals. This emphasized the psychic causes of mental illness, instead of the somatic causes.
Author Frank Sulloway’s research on Freud revealed that he was heavily influenced by Darwin’s work. Darwin had discussed such things as “the significance of dreams,...and the importance of sexual arousal.” He also posited that there is a continuity between childhood and adulthood, and that the sex drive appears in infancy. Freud later said that Darwinian theory is an integral part of psychoanalytic training. Other influences on Freud’s thinking were the physiologists (like Helmholtz), the permissive sexual climate of Vienna at the time, Aristotle’s concept of catharsis, and the idea of dream symbolism.
Sigmund Freud was born in what is now known as the Czech Republic, and when Freud was 4 his family moved to Vienna, where he spent 80 years of his life. He feared his father, who was strict, and felt great love for his mother. His feelings towards his parents were later articulated in the Oedipus complex, which suggests that all young boys are jealous of their fathers and have romantic love for their mothers. His mother doted on him and believed he was destined for greatness. He was given special treatment compared to his seven siblings, yet he still resented them. Being academically inclined, he came to speak eight languages, some of which he taught himself.
Freud pursued medicine because he wanted a “career in scientific research,” and took classes in biology and philosophy. While at the university, he experimented with cocaine (which was not illegal) and enthusiastically gave it to his friends, family, and patients. His endorsement and writings on cocaine were “later held partly responsible for the epidemic of cocaine use in Europe and the United States that lasted well into the 1920’s.” Freud received his M.D. in 1881 and entered private medical practice because he needed the money (although he had wished for an academic job). He and Martha Bernays married after a four-year engagement. Although he had little time to spend with his new family, he was jealous of anyone receiving attention from his wife (even her own family).
In Vienna, Freud befriended Josef Breuer and they would sometimes discuss their patients. One of Breuer’s cases was the infamous Anna O, who suffered from “hysterical complaints including paralysis, memory loss, mental deterioration, nausea, and disturbances of vision and speech.” Her symptoms started when she was caring for her dying father. Breuer treated her with hypnosis (which reduced her symptoms) and saw her every day for about a year, but Breuer stopped the sessions at his wife’s request. Later records tell us that Anna O. was Bertha Pappenheim, and that Breuer’s sessions did not cure her illness. Later Bertha becomes “a social worker and feminist.” This case introduced Freud to the “talking cure” that became a hallmark of his therapy.
In 1885 Freud spent a few months in Paris working with Charcot, who emphasized the importance that sex played in his hysterical patients and who used hypnosis as treatment. This introduced Freud to the techniques of catharsis and hypnosis. Although he retained the former method, he became disillusioned with the benefits of hypnosis, claiming that it could not provide long-term cures. He then developed the therapeutic technique called “free association” where the patient is encouraged to say everything that comes to mind. Freud found that often the things that were said related to childhood events and to sexuality, both of which become prominent in his system.
The beginning of psychoanalysis is the publication of Studies on Hysteria (1895) by Freud and Breuer, which was well received. The book marked a rift between the authors because of Freud’s insistence on emphasizing sex as the root of neuroses, and a few years later their friendship was dissolved.
Freud presented a paper to a scientific society in 1896 in which he argued that most women are sexually abused as children by an adult figure, often the father. The paper was not well received because the dominant theories were based on somatic causes of neuroses, and Freud was criticized for his questionable methods. Freud reversed his position a year later, claiming that in most cases the childhood seduction experiences his patients described were not real experiences, but fantasy. There is some controversy about whether Freud changed this position to make his system more acceptable.
Freud himself had sexual difficulties. “He considered the sex act degrading” and gave up sex when he was 41, blaming the fact that his wife could easily conceive and that he wanted no more children. “He had occasionally experienced impotence,” and believed that sex was an animalistic drive that was of no use to him. As his theory would predict, he later developed neuroses and attributed the behaviors to the sex drive. To reduce his ailments, Freud psychoanalyzed himself through dream analysis. He then “realized the considerable hostility he felt toward his father,” the “sexual longings for his mother,” and “sexual wishes toward his eldest daughter.” He later wrote The Interpretation of Dreams (1900) based on this analysis, which is “now considered his major work.” He was a prolific writer and soon introduced the “Freudian slip” in the book The Psychopathology of Everyday Life (1901).
Freud’s system flourished and he attracted many followers. He was soon intolerant of anyone who disagreed with him. In 1909, he and Carl Jung were invited to speak at Clark University by G. Stanley Hall. His talks were well received, he met many prominent American psychologists, and shortly afterward psychoanalytic associations began forming in the United States. Freud’s students began to revise his system, which caused breaks between them and Freud; Alfred Adler left in 1911 and Jung two years later. Freud was diagnosed with mouth cancer in 1923 “and underwent 33 operations to remove portions of his palate and upper jaw.” Freud left Vienna for England in 1938 when it became clear that his life was in danger because of the Nazi regime. He died in England in 1939, having received a purposeful overdose of morphine because of the pain from his cancer. The authors include an excerpt from Freud’s first lecture at Clark, in which he describes the Anna O. case.
When using psychoanalysis as a therapeutic system, Freud found that patients would come to a point during free association where they would stop. He called this resistance and attributed it to thoughts that were “too shameful to be faced.” Because of this phenomenon, he formulated the idea of repression (forcefully excluding unwanted thoughts from consciousness). Another key aspect to his therapeutic system was dream analysis. Freud believed that dreams have a surface story line (manifest content) but also a “hidden or symbolic meaning” (latent content). The latent content of a dream implies one’s secret desires. Freud was less interested in helping patients and more interested in case-study research in order to build his theory. Although Freud was trained in scientific methods, his system was built on the case study method.
As a system of personality, Freud’s system included a variety of topics that other psychologists did not address. For example, Freud believed that humans had driving forces such as death instincts (destructive and aggressive forces) and life instincts (“hunger, thirst, sex”). The energy of the life instinct was the libido. Freud’s saw personality as having three components: the id (which is primitive and unconscious and operated under the pleasure principle), the ego (the mediator between the external world and the id), and the superego (an internalized parent/voice of morality). Such between the three aspects of personality causes anxiety and therefore tension, which is reduced by using defense mechanisms.
Freud “became one of the first theorists to emphasize the importance of child development” and “believed that the adult personality was formed almost completely by age five. He developed his psychosexual stage theory, which posits that all children pass through the same psychosexual stages in development. If a given stage was resolved then the child would pass into the next stage normally. However, too much or too little satisfaction of a stage would stunt development and cause adult personality problems. For example, in the anal stage, children who refuse to expel feces grow to be adults who are “anal retentive” and will be compulsively clean and neat. The stages include: oral, anal, phallic (when the Oedipus complex arises), latent, and genital. In this way, Freud believed that all adult disorders were caused by childhood experiences.
Freud’s system was deterministic in that he “believed that all mental events, even dreams, are predetermined; nothing occurs by chance or free will.”
Psychoanalysis was eschewed by American academic psychologists, particularly during World War I “when virtually everything German was considered suspect.” At the same time, his ideas were being included in psychology textbooks even though behaviorism was the prevailing thought. “But by the 1930’s and 1940’s psychoanalysis had captured public attention,” which irritated academicians because psychoanalysis was being equated with academic psychology. To fight this, academic psychologists tested psychoanalytic theory.
The scientific studies on psychoanalysis revealed support for “1. some characteristics of the oral and anal personality types, 2. castration anxiety, 3. the notion that dreams reflect emotional concerns, and 4. aspects of the Oedipus complex in boys.” There was no support found for “1. dreams satisfy symbolically repressed wishes and desires, 2. in resolving the Oedipus complex, boys identify with the father and accept his superego standards out of fear, 3. women have an inferior conception of their bodies, have less severe superego standards than men, and find it more difficult to achieve an identity, and 4. personality is formed by age 5 and changes little after that.” Other research has supported the idea of the unconscious influencing “thoughts, emotions, and behavior,” and the presence and use of some of the defense mechanisms and the Freudian slip.
Eventually many ideas from psychoanalysis were absorbed into psychology. For example, in the 1950’s and 1960’s, “behaviorists [were] translating psychoanalytic terminology into the language of behavior.”