PSYCHOANALYSIS.

In a 1928 entry on the subject for the Handwörterbuch der Sexualwissenschaft (Concise dictionary of sexual research), Sigmund Freud (1856–1939) defined psychoanalysis as "the name (1) of a procedure for the investigation of mental processes which are almost inaccessible in any other way, (2) of a method (based upon that investigation) for the treatment of neurotic disorders and (3) of a collection of psychological information obtained along those lines, which is gradually being accumulated into a new scientific discipline" (Freud, vol. 18, p. 235). Freud's description understates the immense richness and complexity of his achievements in the study of the workings of the ungovernable impulses of the mind, which have had far-reaching and lasting impact on humanities thinking about itself, and whose many facets can only be hinted at here below.

Overview

Initially trained as a neurologist, Freud began working with hysterical and neurotic patients as an outgrowth of his private medical practice beginning around 1883. In 1895, in Studies on Hysteria, co-written with his mentor Josef Breuer, Freud first formulated the theories and method that would later become psychoanalysis. In 1899, after a decade of working with such patients amid ridicule and isolation from the Viennese medical establishment, Freud published The Interpretation of Dreams, his major work. Though it sold only six hundred copies during the five years following its release, by 1910 Freud had attracted a number of students, mostly physicians, from throughout Europe to the practice of psychoanalysis, and succeeded in establishing the International Psychoanalytic Association. Among the most prominent of these early psychoanalysts were Karl Abraham (1877–1925), Sándor Ferenczi (1873–1933), Ernest Jones (1879–1958), and Carl Jung (1875–1961). Jung, a Swiss psychiatrist, enjoyed a particularly close relationship with Freud, and was for a time his anointed successor to the leadership of the analytic movement, until their relationship dissolved in 1912–1913 over Jung's denial of the centrality of sexuality in neurotic conflict. Jung went on to formulate his own ideas, including the notion of a collective unconscious governed by a universal symbolic order ("arche-types"), as "analytical psychology."

Freud continued to work and publish right up until his death from cancer in September 1939, revising and significantly expanding his theories; increasing numbers of psychoanalysts throughout Europe joined him in this effort. Psychoanalysis continued to flourish, in Europe and the United States, until the outbreak of World War II forced many analysts to flee their homes in Europe. Following the war, analytic institutions continued to expand, and became especially vital in the United States, England, and France.

Psychoanalytic Theory of Mind

In Studies on Hysteria, Freud wrote that "hysterics suffer mainly from reminiscences," and with those words summed up the fundamental insight of psychoanalysis. Through his work with his neurotic patients, and later, through his own self-analysis, Freud became convinced that the symptoms from which they suffered—which ranged from hysterical blindness to obsessive thoughts and behaviors, to near-catatonic states—were the result of conflicts in the mind between unacceptable ideas and wishes that sought expression, and forces in the mind opposing that expression. Unable to find an outlet in consciousness, these unacceptable, "repressed" wishes manifested themselves in other, compromised ways, in neurotic symptoms, slips of the tongue, and dreams. To explain how this came about, Freud devised a revolutionary concept of how the mind works.

Freud was influenced by the biological and physical sciences of his time, and his first theory of the mind was governed by a principle of energy discharge. Conceiving of the mental apparatus as an organism, Freud postulated a system whose purpose, as in a biological nervous system, was to maintain its equilibrium by reducing energy (or tension) in it—an imperative Freud called the pleasure principle.

Later, based on this model, Freud distinguished two modes of thinking, which he termed the primary and secondary processes, which were identified respectively with free and bound energy (with energy ultimately coming to mean libidinal, or sexual energy), and the workings of the pleasure and reality principles. These antagonistic pairs were the starting point for the conflictual, dynamic perspective from which Freud consistently viewed mental processes.

Conscious, preconscious, and unconscious.

To demonstrate his theory of mental functioning, Freud devised a topographical model made up of three connected systems—conscious, preconscious, and unconscious —which set up a stratified, differentiated relation among psychic contents, on a continuum from surface/conscious to depth/unconscious. The unconscious represents the largest set, comprising all sensory perceptions, both internal and external. The preconscious encompasses all those perceptions that have been perceived but not excluded from consciousness by repression. Finally, conscious perceptions are those that have come into awareness.

In this first model, the unconscious is identified with the primary process, whose purpose is the free discharge of energy; the preconscious/conscious system (the two agencies were often functionally united), on the other hand, is identified with the secondary processes, and with the binding of energy. Freud supposed that mental conflict was the result of antagonism between unconscious psychic contents pressing for discharge (according to the pleasure principle), and the censorship "guarding" the preconscious/conscious system (reality principle). When successfully kept out of consciousness, the repressed impulses continued to seek discharge, eventually succeeding through the "compromise formations" of dreams, slips of the tongue, and neurotic symptoms.

Repression.

Repression was the name Freud gave to the defensive warding off of unacceptable thought contents from consciousness. This process was the result of the dynamic conflict within the mind between opposing forces of instinct and "reality," and the agencies that housed them: the unconscious and the preconscious/conscious systems.

In The Interpretation of Dreams, Freud likened the agent of repression to a censor. The function of this censor—and of repression itself—is to keep from consciousness psychical contents that, though in their discharge (or expression) are pleasurable in themselves, must come into conflict with other exigencies, typically those that proceed from the external world, morality, or the person's own wishes.

Freud came to regard neurotic illness as the result of conflicts between the drive of unconscious products toward expression and their repulsion by the defenses of censorship. He saw repression as the cornerstone of all these defensive processes, and considered other defensive processes to be derived from it. It thus became the essential task of psychoanalysis to undo the effects of repression, to bring the unacceptable unconscious contents into awareness, and through this discharge to free up the psychical energy that was absorbed in the prevention of that discharge (in neurotic symptoms).

Fantasies.

In his earliest work with the neuroses, Freud supposed them to originate either in constitutional factors or in the traumatic effect of actual sexual seduction. In 1897, however, Freud concluded that the majority of the accounts of seductions he had from his patients had little basis in reality. To account for this conclusion, to the existing two "predispositions" to neurosis Freud added a third cause: repressed wishes for instinctual gratifications, which manifested themselves in fantasies. These fantasies, typically sexual (and incestuous) in nature, which Freud initially took for real events, actually belonged to the province of psychical reality and had the traumatic force of "material" reality. Because of their unacceptable nature, these fantasies, originating in the unconscious, threw the psychic apparatus into turmoil when they came up against the censor and were repressed, able to assert themselves only in the compromise formations of dreams and neurotic symptoms. Freud came to believe that it was these fantasies of unacceptable wishes that were the determining factor in the majority of neuroses.

Infantile Sexuality and the Oedipus Complex

This was so because of infantile sexuality, the discovery of which Freud was led to by his abandonment of the seduction theory. Freud's original theory of traumatic seduction as a two-phase process—in which the initial seduction was experienced passively, often without any traumatic significance, and registered only as traumatic and repressed as a result of a later event (often without sexual significance), typically during adolescence—prepared the way for Freud to understand the sexual desires (and autoerotic activities) of infants, which were themselves uninhibited until their repression at the time of the Oedipus crisis, and which were concealed behind the fantasies of seduction.

According to Freud, the establishment and eventual destruction of the Oedipus complex was the necessary, biologically determined culmination of the infant's progress through the psychosexual phases of development, and his initiation into the object world (the social order). These phases—oral, anal, genital, and phallic —were characterized by the development of the child's capacity for libidinal satisfaction (through the discharge of tension) from primitive autoerotism to object- (person-) oriented love, as well as the child's increasing psychic complexity. Each of these phases was rooted in the infant's physiological development, as well as in the development of the infant's relation to the world. The oral phase was modeled on the importance of eating, and the infant's relationship to its mother through the incorporation and refusal of her breast; the anal phase centered on the infant's struggles for control over bodily functions, as well as for autonomy from his or her parents; and the genital and phallic phases involved the discovery first of genital satisfaction, then satisfaction through others, and later of symbolic satisfactions outside one's own body.

Freud emphasized the psychological importance of the infant's first tie from birth (or before) with its mother, a quasi-symbiotic unity that gave way in stages to differentiation and autonomy. This tie to the mother was primary irrespective of gender, but left the child of each gender with a different imperative. For the male child, in order to reproduce, and in obedience to the incest taboo, he needed to give up his tie to and desire for his mother in favor of other, female objects. For the female child, she must give up her attachment to female objects altogether.

Around three to five years of age, in consequence of his approach and attainment of genital sexuality (which is also to say, object-related sexuality), the child experiences sexual desire for his parents. In the positive Oedipal situation, the male child feels desire toward his mother, and jealously regards the father as a rival; Freud assumed that most children had direct knowledge of this rivalry through witness of the primal scene of intercourse, either between their parents, or from another source (such as the sight of animal copulation). Freud also assumed that the child had by this time become aware of the anatomical difference between the sexes, and from this discovery, inferred the threat (or in the case of the female, the fantasized "fact") of castration —the loss of the penis as punishment for his incestuous wishes.

The conjoining in his mind of these factors, of his rivalry with his father for his mother's love and the threat of castration, awakened in the male child an intense anxiety, and set in motion the repression of the child's incestuous desires, and a subsequent switch in identification from the now dangerous mother to the powerful and punishing father. Significantly, the male child did not at the same time renounce his sexual desire for the opposite sex.

As a result of the dramatic repression of the Oedipus complex, the child unconsciously internalized the Oedipal situation, and especially the punitive idea of the father, as a way to ensure continued protection from castration. These new internalized others collectively became the new superego, which henceforth governed the child's object-oriented actions, and superintended his sense of morality.

In the female child, the discovery of the "reality" of her castration led to penis envy, and with it a hatred of her mother, a sense of rageful betrayal at having been left unmade, unfinished. In her anger, Freud postulated that she would turn toward the father, and seek from him a penis—his penis—and later a baby.

Freud believed a girl's sexuality was initially dominated by her clitoris, her "little penis." Only with the move to vaginal sexuality was a woman's sexual maturation complete. Freud himself, however, remained unconvinced as to the motives for this change.

The "phallocentric" nature of the Oedipus complex had far-reaching consequences for female development. Without the threat of castration, the girl's movement toward heterosexual object choice is not characterized by the same intensity of repression as the male's, and consequently, Freud believed, the superego development that was the legacy of the Oedipus complex was less developed.

Freud also suggested the presence in both genders of a negative Oedipus complex, involving the opposite series of identifications. In the male child, the father became the object of his (passive) sexual desire, fostering a sense of identification with his mother who was the father's sexual object. This constellation, too, required repression, and if this was insufficiently accomplished, Freud believed, it could serve as an important foundation for homosexual object choice.

Much of the rationale for the Oedipal struggle is rooted in the sexual, animal child's acceptance of the moral order of "civilized" culture, and it is often on this basis that it is criticized. Nevertheless, Freud believed that the Oedipus stage was central, not only because of its implications for the infant's psycho-sexual development, but also because it marked the infant's attainment of human subjectivity. With the Oedipus conflict the child also attained the capacity for "triadic relationships" (in which the child was able to regard others not simply from her own frame of reference, but as existing outside of and independent of her needs and wishes—and hence different from and at odds with her own) and with it the complex capacity for symbolism that was the precondition for language and for thought itself, as well as for the free association that was at the heart of analytic work.

In later years, many aspects of the Oedipus theory have received critical scrutiny. Emphasizing pre-Oedipal aspects of childhood development, female sexuality, and the degree to which the Oedipus complex was ever really abolished, many theorists have revised and extended the conception of the Oedipus complex and how it is used in clinical practice in the early twenty-first century.

Among the most vital of these contributions have been those of Hans W. Loewald, who came to regard the Oedipal conflict as an unending struggle perpetuated in the superego against the internalized imagos (unconscious representatives) of one's parents. Equally important are contributions from Karen Horney, Jessica Benjamin, and others, which emphasize the differences in female sexual development from those of the male, and question the central importance of the castration complex for girls. Other recent theorists, such as Arlene Kramer Richards, have emphasized the importance of female genital anxieties as a distinct influence on female psychosexual development, thereby further questioning the role of penis envy in the psychology of women.

Later Revisions: Mourning, Narcissism, and the Beginnings of Object Relations

In 1914 Freud began a series of major revisions of his theory with a discussion of the distinction between normal and pathological mourning, the latter of which he termed melancholia. The difference is this: In normal mourning, one gradually lets go of the love one has lost, piece by piece, and the libido (love) invested in them is taken back into oneself (into the ego) so that it can be used again, either for new love or for other creativity. In melancholia, the mourner holds on to the loved one's love like a phantom limb, refusing to let go, so that the libido never returns to its source, and is thus depleted, leading to the familiar symptoms of depression: exhaustion, loss of appetite, and lack of interest in the world. (The refusal to let go happens, according to Freud, because a person turns the anger felt toward the lost one upon oneself.)

This discussion extended the idea, already present in Three Essays on the Theory of Sexuality (1905), of the role of the object in human psychic development and function. The theory of object relations was to have far-reaching impact on psychoanalytic theory, especially through the work of Melanie Klein.

In the Three Essays, Freud described two main aspects of sexual striving, the aim and object (pressure and source were additional, largely biological aspects of the instinct). Aim named the kind of gratification pressed for by the instinct, determined by the oral, anal, or genital desires of the infant that engendered it; this aim sought its satisfaction from an object.

Freud described objects (loved ones) as either anaclitic or narcissistic. Anaclitic objects took their model from an infant's parents or caregivers—those the infant relied on for survival. Narcissistic objects, on the other hand, were taken from the model of one's self and body, the original sources of satisfaction and pleasure.

Freud believed narcissism played a vital role in healthy development, and was the source of healthy striving and ambition, as well as camaraderie and nationalism. In pathological cases, however, the narcissist was unable to form or maintain relationships with others or with the outside world.

Freud thought narcissism originated in infancy, when the child took his own body as his first object (this he called primary narcissism ). In normal development, narcissistic satisfactions were gradually replaced by anaclitic ones, as an infant became attached to, and then differentiated from, his care-givers. Far from disappearing however, narcissistic strivings were taken into the psyche as a vital component of a person's sense of self, eventually laying the foundation for the ego ideal, which was the individual's compass for his ambitions and strivings, for the self as he wished it to be, and which would reward him with new editions of the satisfactions he had taken in infancy from the pleasures of his own body. Later, as the child moved into the genital, adult phase of sexuality, it was the danger to the narcissistic object (the penis), that ushered in the castration complex, the Oedipus complex, and the whole order by which adult mental life is governed.

Narcissism, and the entire process of the formation of object relations in infancy, became increasingly important to psychoanalysis, as disturbances of these early processes came to be seen as the root of the most severe kinds of psychopathology—including (in current terminology) narcissistic personality disorder, borderline personality disorder, and the psychoses—which Freud had already termed the "narcissistic neuroses."

The Dual Instinct Theory/The Death Drive

In 1920 Freud opened Beyond the Pleasure Principle with a comparative discussion of the behavior of soldiers suffering from traumatic war neuroses (what would later be called post-traumatic stress disorder) and a child's game. In each of these situations, Freud observed behavior, such as the dreams of soldiers that compulsively reprised the occasion of their injury, or an infant's repetitive tossing away and retrieval of an object in symbolic enactment of her parent's departure, which seemed to contradict the impulse to satisfy and reduce tension. From these observations of the workings of the repetition compulsion, Freud adduced the existence of a force in human nature that operated against the pleasure principle and its imperatives of human self-preservation and gratification. Freud called this counterforce the Todestrieb —the death drive (or instinct ).

The death drive was an extension of Freud's earliest writings, having to do with conservation of energy in the organism, and was also the latest version of the dualism that was a constant in his work. In his earlier thinking, mental conflict had originated among component instincts of the libido—ego and object libido, self-preservative and erotic instincts. In the new conception, all these previous instincts were subsumed under the libido, or Eros, and opposed to the death instinct. According to the logic of the pleasure principle, energy was to be conserved at all costs. In view of the repetition compulsion, Freud amended his view: On the one hand, energy was to be conserved; on the other, according to the logic of the death drive, the reduction of tension demanded that energy be reduced to nothing, returned to a state of rest—a return to the inorganic stasis that Freud (borrowing from the science of his time) believed to be the original condition of all matter.

Freud saw evidence of the death drive in his observations of primary masochism and of hate, which he thought preceded any feeling of love. In these phenomena and others, Freud believed that the death drive was expressed as (or even synonymous with) aggression, and that it was frequently joined (fused ) to libidinal energy. Though evidence of aggression and the death drive were readily observable in these "fused" forms, Freud was unable to isolate pure expressions of the death drive. And indeed the operation of the drive remained opaque, "mythical," in contrast to the workings of the libido, which Freud had observed and described in detail.

Because of its opacity and apparent remoteness from clinical practice (Freud himself acknowledged the "speculative" nature of its origins), the death drive became perhaps the most controversial aspect of Freud's theoretical corpus. A number of analytic theorists continued to explore its implications following Freud's death, especially Melanie Klein, in whose work the death drive figures prominently.

Later Revisions: The Structural Theory

In 1923, in the wake of his revisions of the theory of instincts on the one hand, and of object relations on the other, Freud published The Ego and the Id, and with it sharply revised his original theory of the mind. In his new model, commonly called the "structural theory," Freud introduced three new agencies—ego ("I"), id ("It"), and superego ("Over-I")—to represent intrapsychic mental functioning. The ego referred to the self, as the executive agency of the psychic system, governed by the secondary process, and responsible for conscious thought, fantasy, defense, and symptom formation. The id was the realm of the unconscious processes and thoughts, governed by the instincts (libido and aggression) and the primary process. The superego represented the conscience, the critical (and also loving) internal representation of one's parents or caregivers that was the internalized legacy of the repression of the Oedipus complex. These new agencies reflected the increased prominence of object relations and the pervasive nature of conflict in the system, and a recognition that the essential goal of psychoanalysis was not merely to make the unconscious conscious, but to bring instinctual impulses under the sway of the ego.

Theory of Anxiety and Affects

Anxiety is at the core of the psychoanalytic theory of affects (feelings), and from the beginning of psychoanalytic thought has been recognized as central to an understanding of mental conflict (for it is through bad feelings that conflicts are felt and known). In his early work, Freud, in keeping with his early discharge model of mental function, considered anxiety to be a "toxic transformation" of undischarged libido. This failure of discharge could either be physiological ("realistic"), as in coitus interruptus or other incomplete or unsatisfactory sexual practices, resulting in "actual neuroses" or "anxiety neuroses"; or it could arise from repression (or its failure), as a symptom of the continued pressure of unacceptable desires, which led to the "psychoneuroses"—hysterias and obsessions.

In 1926 Freud radically revised his ideas about anxiety, abandoning the distinction between neurotic and realistic anxiety, and the claim that repression caused anxiety. In this new theory, Freud distinguished two types of anxiety, a traumatic, reality-oriented "automatic" anxiety in which the system was overwhelmed, and a secondary, "neurotic" anxiety in which reprisals of these situations were anticipated, thus setting in motion defensive processes. "Automatic anxiety" was an affective reaction to the helplessness experienced during a traumatic experience. The prototype for this experience lay in the helplessness of the infant during and after birth, in which the danger proceeded from outside, and flooded a psychic system essentially unmediated by the (as yet unformed) ego.

The second form of anxiety originated within the psychical system and was mediated by the ego. This "signal anxiety" presaged the emergence of a new "danger situation" that would be a repetition of one of several earlier, "traumatic states." These states, whose prototype lay in birth, corresponded to the central preoccupations of different developmental levels, as the infant's needs become progressively abstracted from the original situation of immediate sensory overload to more sophisticated forms of need regulation capable of synthesizing the many elements facing it (from the reality and pleasure principles and the object world). These moments—loss of the object, loss of the object's love, the threat of castration, and the fear of punishment by the internalized objects of the superego —which were experienced serially during the developmental process, could reemerge at any time in a person's subsequent adult life, typically brought on by some conflation of reality and intrapsychic conflict, as a new edition of anxiety.

This new way of conceptualizing anxiety was an outgrowth of Freud's late revisions of his theory (c. 1923) with the structural theory and his formulation of the mediating agency of the ego, and it had the effect of shifting clinical work on anxiety into the realm of the ego. The correlation of the dangerous situations with developmental stages also suggested a diagnostic aspect to anxiety, with the earlier types of anxiety indicating earlier fixations. In the work of later theorists, the presence of the earliest anxieties in clinical work were thought to be indicative of pre-Oedipal disturbances in development, and of corresponding structural deficits in the ego.

Despite his later formulations, Freud never explicitly abandoned his first idea of anxiety, and the two theories continued to coexist uneasily in Freudian metapsychology long after Freud's death.

Melanie Klein and Object Relations

Probably the most influential analytic thinker after Freud, Melanie Klein (1882–1960) articulated a prehistory of childhood development, whose history in Freudian thought commenced with the Oedipus crisis. Following Freud, the sequence of events she outlined had as its main theme the integration of the chaotic desiring world of the infant with the real world.

According to Klein, the infant's world was threatened from the beginning by intolerable anxieties, whose source she believed to be the infant's own death instinct (whose central importance she forcefully affirmed, in opposition to many other contemporary theorists). These "persecutory" anxieties, which were felt in the infant's own bodily needs as well as from the external frustrations to those needs, were overwhelming to the infant, and in order to combat them the infant resorted to defenses whose aim was to isolate her from them. Through these primitive defenses—projection, denial, splitting, withdrawal, and "omnipotent control" of these objects—the infant put threatening, "bad" objects, outside herself and into the external world; simultaneously, she preserved the "good" objects, both within herself and externally, by splitting them off from their malevolent counterparts.

Perhaps the most fundamental of these processes were projection and introjection, which described the infant's first, primitive attempts to differentiate himself from the world, inside from outside, self from other, based on the prototype of oral incorporation (and spitting out) and the infant's relation to his first, nurturing/frustrating object, the mother's breast. The first objects were not the mature, "whole" objects of Oedipal development, but primitive "part" objects whose existence for the infant was determined solely by its function in the infant's world.

In the course of maturation, Klein believed that the infant introjected both "bad" and "good" objects, and that through processes of progressive internalization, these fragmentary objects were taken into the self, and became forerunners of the superego. Klein emphasized that this process (of introjection, projection, and re-introjection) was continuous and cyclical, leading to increasing synthesis as the infant gradually attained greater degrees of reality testing, differentiation, and control over her own psyche.

Klein divided pre-Oedipal development into the "paranoid/schizoid" and "depressive" positions. She located the paranoid/schizoid position in the first months of an infant's life, a time in which the infant was in helpless thrall both to the outside world and to his own instincts. Deprivation, the experience of need, and frustration, even though emanating from the infant's own body, were perceived during this phase as persecutory, and the infant responded by putting them outside of himself, "projecting" or throwing them away.

The early objects—beginning with the breast—were experienced alternately as "good" or "bad" according to whether they were perceived as nurturing or destructive; and again partly on the model of the breast, the infant took in (introjected) or dispelled (projected) them according to their relative safety or danger. In this way, Klein believed, the infant took in and preserved those feelings in the external world that were felt as "good," while expelling from herself those destructive feelings directed "into" the object that threatened the relation with the object.

In the depressive position (roughly corresponding to the second six months of life), the trends established in the first months of life were extended. In this stage, the infant was able to bridge the gap between "good" and "bad" objects, and between his own experiences of love and hate, which created them. He became capable of ambivalence, and his awareness gradually grew to encompass the object world outside himself and his mother, who, in a crucial development, he now perceived as a discrete, whole object. The infant became aware of his own destructive impulses and, fearing the loss of his object's love (by his destructiveness), attempted to inhibit them, to preserve, protect, even resurrect the object that he continually destroyed in unconscious fantasy, or phantasy. His anxious awareness of his aggression toward the object/mother (which Klein called guilt ), and subsequent efforts to contain his own anxieties by curtailing these impulses (efforts Klein termed reparations ), led the child to an increasing tolerance for ambivalence, and acceptance of a position of mediation between the needed, loved object and his own instincts that threatened to destroy the object, preparing the way for stable object relations, first with the mother and then with other objects.

For Klein, both paranoid/schizoid and depressive positions represented normal developmental phases on the road to mature object relations; her use of the word position was indicative both of her view of this developmental scheme as normative and her conviction (derived from Freud) that "fixation" at such positions was the source of later psychopathology. The defenses of early infancy—including projection, splitting, withdrawal, and denial—became the prototype for the defenses of more severely disturbed patients, whose pathology Klein traced to disturbances in early development.

Klein saw the infant's efforts to bind and modify persecutory and depressive anxieties as the central struggle in the infant's development, and as the essential precursor to all subsequent mental development. Through this progressive process, the anxieties were modified, structuralization increased, and the anxieties and impulses that gave rise to them were themselves diminished. She saw all defense as directed against these anxieties, and regarded the earliest defenses, especially splitting, as the foundation for repression, which she viewed as itself a restricted and refined form of splitting. She also saw forerunners of the Oedipal conflict and the superego in the very first months of life. Indeed, Klein's theory attributed to the infant from the first months of life a range of sophisticated, dyadic and triadic emotions—including greed, envy, and jealousy—that implied an acute sense of others and her relation to them, far earlier than was accepted in Freudian psychology.

The Evolution of Psychoanalytic Practice

In "On Beginning the Treatment" (1913), in explaining the method of free association, a hallmark of psychoanalytic technique, Freud likened it to a train journey. "Act as though, for instance, you were a traveler sitting next to the window of a railway carriage and describing to someone inside the carriage the changing views which you see outside" (Freud, vol. 12, p. 135). The "landscape" thus revealed was that of the patient's own inner world, its features psychic conflicts; at the heart of the psychoanalytic method is the proposition that interpretation of unconscious conflicts, and the subsequent insight gained by the patient, are themselves mutations of those conflicts. The patient's fantasies and unconscious desires are thrown upon the person of the analyst, through a phenomenon known as transference. Transference, literally the unconscious carrying over into the present of the meaningful relationships of the past, and of the fantasies and repressed wishes that shaped them, is at the core of all kinds of analytic therapy.

But in clinical work, especially with more disturbed patients, many therapists of the early twenty-first century embrace the value of a "therapeutic object," and indeed believe that this kind of work is essential to any kind of therapeutic progress with such patients. The idea of the therapeutic object is related to British analyst D. W. Winnicott's notion of the holding environment and to analytic empathy, an idea especially prominent in Heinz Kohut's work with narcissistic patients. Both these writers assumed that an infant's development is inescapably bound to her relations with her first caregivers, and that the emergence of the subjective, intrapsychic world coincides with the development of the infant's relations with these early objects. They presume, in different ways, that pathology, particularly more disturbed pathology, results from disturbances in this process, and that it is among the tasks of psychodynamic therapy to supplement the patient's earliest, often deforming, object relationships with newer healthy models, which can be internalized over time. According to this view, by revisiting and remodeling the earliest patterns of relating to the world (through internalization of new objects), lasting change may be effected both in the patient's internal world and in her relationships with new objects in the present.

This point of view is not shared by all contemporary analysts, least of all those "classical" analysts, who maintain that psychopathology is by and large derived from Oedipal and post-Oedipal development, that is, the point at which a patient begins to make symbolic sense of inner impulses and distorts them according to the repression. The classical view tends to play down or deny the importance of structural, ego "deficits" in early (pre-Oedipal) development resulting from inadequate nurture.

Psychoanalysis and Its Vicissitudes

The fate of psychoanalysis seems emblematic of the whole history of the Western world during the twentieth century. Psychoanalysis first flourished in the final days of the Austro-Hungarian Empire, at a time of unrivaled prosperity and intellectual ferment. World War I disrupted the progress of analytic institutions, but its barbarities may have played a role in Freud's revisiting some of his fundamental assumptions, most notably about the role of aggression in the human psyche, which led him ultimately to the death drive.

World War II forced the mass exile of psychoanalysts from Europe, many of whom, like Freud, were Jews from the occupied nations. Four of Freud's sisters perished in concentration camps, as did many of those analysts who remained in their home countries. Many of the émigrés resettled in England, the United States, and South America, and the field flourished in these areas as a result. Psychoanalysis in each of these regions is marked by its local influences, and the variety of psychoanalytic discourses in the early twenty-first century is such that one group may find the theories and practices of another unrecognizable.

Even within each region, the evolution of psychoanalytic theory and technique since the death of Freud has been marked by discord and schism, perhaps stamped by the Oedipal struggles whose mysteries psychoanalysts seek to plumb. This has been the case since the birth of the field, and the history of psychoanalysis is replete with examples of this: Alfred Adler (1870–1937), Wilhelm Stekel (1868–1940), Jung, Otto Rank (1884–1939), Ferenczi, Wilhelm Reich (1897–1957)—all were close members of Freud's circle, and all broke with Freud, in disputes fueled as much by personal as theoretical tensions.

Later fissures in the analytic community include the secession of Jacques Lacan (1901–1981) from the "classical" French establishment; in London, the intense conflict between adherents of Klein and Anna Freud; and in New York, the divisions that caused Karen Horney (1885–1952), Sandor Rado (1890–1972), Harry Stack Sullivan (1891–1949), and others to leave their places of training to found independent institutes. This discord has persisted into modern times, though the diminished influence of psychoanalysis and the proliferation of rival therapies and theories of mind have muted and submerged the original tensions, even as new voices constantly emerge to challenge their predecessors.

Though its impact has been felt most strongly in the West, analytic ideas have traveled around the world. By the early twenty-first century, analytic institutes had been founded in India, Korea, and Japan.

Impact on Other Disciplines

The influence of psychoanalytic theory upon contemporary thought is difficult to overstate, and equally difficult to quantify. Fundamental concepts of a dynamic unconscious, repression, ego, infantile sexuality, and the Oedipus complex have passed into popular discourse. Psychoanalysis is the root of all contemporary forms of psychotherapy, and as a clinical modality has had an enormous impact on the treatment of mental illness and on the fields of psychology and psychiatry, though this influence has been challenged in recent years by the rise of biological psychiatry. Though the scientific validity of its methods and premises has been hotly disputed, neuro-scientists, including Mark Solms, Antonio Damasio, Jaak Panksepp, and Joseph LeDoux, were actively conducting research in the early twenty-first century to correlate psychoanalytic ideas with the latest findings in brain science.

In the humanities, psychoanalytic theory has strongly influenced approaches to literary texts, biography, history, creativity, and sociology. Freud himself was the first to apply psychoanalytic principles to the arts, through readings of Wilhelm Jensen's novel Gradiva (1903), Ernst Theodor Amadeus Hoffmann's "The Sand-Man" (1817), and several of William Shakespeare's works; and through psychobiographical essays on Johann Wolfgang von Goethe, Shakespeare, Fyodor Dostoyevsky, and Leonardo da Vinci. Freud also explored the implications of his ideas upon anthropology, history, and, perhaps most famously, religion, which Freud considered a primitive, quasi-psychotic projection, and which he considered at length in The Future of an Illusion (1927) and Moses and Monotheism (1939). The poet Wallace Stevens characterized Freud's influence as "a whole climate of opinion," and the writings of Freud and other analysts, especially those of Jacques Lacan, have inspired countless artists and thinkers, including André Breton, André Gide, Benjamin, Thomas Mann, Rainer Maria Rilke, Jean Cocteau, Salvador Dali, Jackson Pollock, Lionel Trilling, Edmund Wilson, Jacques Derrida, Gilles Deleuze, and Slavoj Zizek; and cultural movements such as surrealism, dada, existentialism, deconstruction, and postmodernism.

See also Consciousness ; Mind ; Psychology and Psychiatry .

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Matthew F. von Unwerth