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Psychoanalysis

Psychoanalysis

I. Classical TheoryCharles Brenner

BIBLIOGRAPHY

II. Ego PsychologyGeorge S. Klein

BIBLIOGRAPHY

III. Therapeutic MethodsRudolph M. Loewenstein

BIBLIOGRAPHY

IV. Experimental StudiesErnest R. Hilgard

BIBLIOGRAPHY

The articles under this entry provide an introduction to psychoanalytic theory and methods of therapy. The biography of Freudshould also be consulted; it includes the historical background of Freud’s thought, his major contributions to psychoanalysis, and a critique of his theories. Some major implications of psychoanalysis for behavior are discussed in Anxiety; Body image; Conflict, article on PSYCHOLOGICAL ASPECTS; Defense MECHANISMS; Emotion; Identity, PSYCHOSOCIAL; National CHARACTER; PERSONALITY, POLITICAL; Self concept; Socialization, article on PSYCHOLOGICAL ASPECTS; Suicide.Discussions that are relevant to an evaluation of the libido concept are contained in Affection; Aggression, article onpsychological aspects; DRIVES; INSTINCT; MOTIVATION. The relevance of psychoanalysis for the study of mental disorders is discussed in Character DISORDERS; Depressive disorders; Hysteria; Neurosis; Obsessive-compulsive DISORDERS; Paranoid reactions; Phobias; Psychopathic PERSONALITY; Psychosis; Psychosomatic illness; Schizophrenia.Psychoanalytic interpretations of the products of human behavior are contained in Dreams; Fantasy; Literature, article on THE PSYCHOLOGY OF LITERATURE; RELIGION, article onpsychological study. Methods of studying phenomena of interest to psychoanalysis are discussed in Dreams; Hypnosis; Interviewing, especially the article ontherapeutic interviewing; Projective METHODS. Different and often contrasting views of personality are found in Analytical psychology; Field theory; Gestalt theory; Individual psychology; Learning theory; Personality; Personality: CONTEMPORARY VIEWPOINTS; PHENOMENOLOGY; PSYCHOLOGY, article Onexistential psychology; thinking, article oncognitive organization and processes. Different conceptions of mental disorders and their treatment are described in Clinical PSYCHOLOGY; Mental DISORDERS; MENTAL DISORDERS, TREATMENT OF; Mental health; Psychiatry; Psychology, article onexistential psychology. Biographies of important figures (in addition to Freud) relevant either to Freud’s work or the psychoanalytic movement are Abraham; Adler; Alexander; Bleuler Charcot; Ferenczi; Horney; Jones; Jung Klein; Kris; Rank; Rapaport; Reich; Roheim Rorschach; Sullivan.

I CLASSICAL THEORY

The term “psychoanalysis” is commonly used in three different senses: a form of treatment for mental illness, a method for investigating the workings of the mind (the psychoanalytic method), and a branch of psychological or behavioral science. The term was coined by Sigmund Freud, who devised, developed, and applied the method over a period of fifty years and who is responsible for the major part of the theoretical formulations called psychoanalysis.

Psychoanalysis began as a method of treating mentally ill patients, and the theoretical formulations which Freud first made on the basis of his clinical experience concerned psychopathology. However, in the course of his work Freud came to recognize that there are close similarities between psychopathology and certain aspects of normal mental functioning. Thus by 1900 it was clear that psychoanalysis had definite contributions to make to the psychology of dreams, of jokes, and of various slips and errors of everyday life, which Freud proposed to call normal or everyday psychopathology. These were momentous discoveries which proved to be fruitful as well. Even more momentous was the discovery of the vital importance of childhood sexuality in both normal and pathological mental development, a discovery which was contained in a monograph published in 1905 and entitled Three Essays on the Theory of Sexuality.

The subsequent development of psychoanalytic theory, based on the application of the psychoanalytic method to an increasingly large number of cases, seems to justify the claim that it constitutes by far the most important contribution to the psychology of man that has been made up to this time. Psychoanalysis has been described epigrammatically as human nature viewed as conflict. And indeed it appears to be the case that many of the most important aspects of human mental development and functioning are intimately related to conflicts which have their origins in childhood and in particular in the sexual conflicts of childhood. This statement is as true of character traits and attributes which we class as normal as it is of those aspects of behavior which we class as symptoms of mental illness.

This, then, is the most important and the most unexpected contribution of psychoanalysis to normal psychology: the vital significance of instinctual conflict in normal as well as pathological mental functioning and development. Closely allied to this is the importance in mental life of unconscious mental phenomena, that is, of mental processes of which the subject himself has no conscious knowledge. In fact, the conflicts just mentioned, which play such an important part in mental life, are largely unconscious in later childhood and adult mental life. It may be noted parenthetically that in psychoanalytic terminology at present “unconscious” usually means “accessible to consciousness only with difficulty, or not at all,” while “preconscious” means “readily accessible to consciousness, though not conscious at the moment.” However, current psychoanalytic usage is not wholly consistent with respect to the meanings of “unconscious” and “preconscious,” since their meanings have varied somewhat in the course of the development of Freud’s theories concerning the mental apparatus.

A third contribution of psychoanalysis to normal psychology is its demonstration of the continuity or determinism of mental life. If one depends on simple introspection for one’s knowledge of what goes on in the mind, there appear to be many gaps and discontinuities in the current of mental life. It often happens that an idea comes to consciousness which bears no apparent connection with what one was consciously thinking a moment before. Similarly, behavior may bear no apparent connection to conscious volition or conscious thoughts. If, however, one is able to apply the psychoanalytic method, one is in a position to adduce evidence for the existence of unconscious mental processes that fill in the gaps and discontinuities which appear to be present in mental life if one judges only by the data of conscious introspection.

Finally, in addition to demonstrating the causal relationship between the present and the immediate past in mental life, the application of the psychoanalytic method has made it possible to establish relationships between current modes of thought and behavior, on the one hand, and various crucially important experiences and conflicts of early childhood, on the other. The emphasis on the relationship between the present and the more remote past in mental life, which is so characteristic of psychoanalytic psychology, is often referred to as the genetic point of view.

In summary, we may repeat that psychoanalysis, which began as a theory of psychopathology, has gradually developed into an important part of general psychology. The application of the psychoanalytic method has contributed more to our understanding of the important aspects of human mental functioning and development than has any other method of observation or experiment.

Assumptions and method

As a behavioral science, psychoanalysis is primarily concerned with the inner life of man. It assumes that man’s thoughts and ideas, his plans and fantasies, and his fears and daydreams are legitimate objects of study. It also assumes, as does biological science in general, that man is an animal. For the psychoanalyst, psychology is a branch of biology. The importance of somatic or organic influences on mental functioning is always borne in mind, particularly with relation to the instinctual drives, which, according to psychoanalytic theory, are assumed to be the basic motivational forces in mental life.

Free association

The method of psychoanalysis is often referred to, rather inexactly, as free association. The subject, who usually lies on a couch facing away from the observer or analyst, is instructed to communicate freely to the analyst, without reserve or editing, whatever thoughts occur to him, as well as whatever physical or bodily sensations intrude upon his consciousness. The analyst may, and often does, suggest that the patient associate to some particular idea or experience that he has communicated in this way. For example, he may suggest that the subject associate to one or another part of a dream which he has related. In addition, he may intervene with what are usually called interpretations in psychoanalytic terminology; that is, he may point out to the subject evidences of conflict, often unconscious conflict, within the subject’s mind. At other times, the analyst may attempt to reconstruct the nature of childhood experiences and fantasies which are important determinants of present behavior or mental activity. [SeeDreams.]

From these very brief examples it should be clear that the term “free association” is far from a satisfactory description of the psychoanalytic method, although it does point to certain essential elements of the method. Indeed the assumption that underlies the application of the psychoanalytic method is that if conscious control of one’s thoughts is given up, the direction of one’s thoughts, far from being free, will then be determined even more clearly than before by other motivational forces within the mind which are not subject to conscious volition and which are in many instances unconscious. To be more precise, the application of the psychoanalytic method reveals more clearly the presence and the consequences of inner conflict, conflict of which the subject himself often has little or no knowledge. Since, by the nature of things, the recognition of such conflict within oneself gives rise to shame, guilt, anxiety, or other unpleasant emotions, there is generally a strong resistance to revealing the presence of such conflict to another individual or even to oneself. In human mental life the most important things of all are often those which one least wants to tell. A conscious determination not to be influenced by one’s reluctance to speak of certain things is only partially helpful. The reluctance itself is in fact lifelong and to a large extent unconscious. It is for this reason that the satisfactory application of the psychoanalytic method is generally possible only in a therapeutic situation. Fortunately for our scientific curiosity, though unfortunately for each of us personally, there is enough that is neurotic even in the most normal of us so that any psychoanalysis soon becomes a therapeutic one, even though it may have been originally undertaken merely out of scientific curiosity or as part of a course of training.

Behavioral observation

In addition to listening to what the subject tells him of what is going on in his mind, the analyst observes the subject’s behavior during the entire time when it is accessible to his observation, neglecting no aspect or detail of it. It should be obvious that evidence of strong emotions, for example, tears, laughter, blushing, or anger, will be as important to the analyst as is the verbal content of what his subject tells him. Just as important are the subject’s tone of voice, his incidental gestures, and his behavior both before he lies down on the couch and after he rises from it.

In general, the psychoanalytic method may be described as a descriptive method as opposed to a quantitative one, a naturalistic approach as opposed to an experimental one. It is not apparent a priori that the psychoanalytic method is a reliable one. Its reliability is attested by the regularity with which observations can be confirmed or repeated by the same analyst on the same subject, by the same analyst on different subjects, and by different analysts on different subjects.

Other methods of study

Although the application of the psychoanalytic method has been and remains the chief source of data as far as psychoanalysis is concerned, it must not be supposed that it is the only one. In recent years in particular, the method of direct observation of children over a period of months or years of their development has come to occupy an increasingly important place in the field of psychoanalytic research. Other observations of human behavior also have contributed data of various sorts, in particular the observation of the behavior of mentally ill patients in clinical settings other than the psychoanalytic treatment situation. Finally, mention should be made of the importance of the study of the various products of man’s imagination. These include such examples of collective or folk creativity as myths, legends, religion, fairy tales, and, to a certain degree, the entire range of man’s social institutions or systems. Equally important are the products of individual creativity, such as works of literature or the visual arts, and closely allied to this is the study of individual history or biography. In the psychoanalytic literature, studies of this sort are generally referred to as applied psychoanalysis. The explanatory value of psychoanalytic theory in these various areas of human activity affords a valuable, if subsidiary, additional confirmation of the validity of the primary observations which are obtainable by the application of the psychoanalytic method—and of the theories which are primarily based upon those observations. [SeeFantasy; Literature, article onthe psychology of literature.]

The instinctual drives

Psychoanalytic theories of the mind are often divided into two major parts, the first of which comprises those aspects of the theory that have to do with the instinctual drives and the second those aspects that have to do with what Freud called the mental apparatus. Although this division has the disadvantage of being excessively schematic, it does have the advantage of somewhat simplifying the problem of presenting an extremely complex subject. We shall therefore adhere to it, and begin our presentation with a discussion of the instinctual drives.

As the term “drive” implies, the instinctual drives are assumed to be forces within the mind which impel it to activity. They are the driving forces of mental life. In addition to their impulsive quality, they have certain other characteristics, namely, a source, an object, and an aim. The source of an instinctual drive is assumed to be some bodily part or bodily process. The object is the person (or thing) which is necessary for the satisfaction of the drive. The aim is the particular activity or action by means of which satisfaction is achieved. The capacity of an instinctual drive to impel the mind to activity is accounted for by assuming that in mental life an instinctual drive possesses energy. This energy is assumed to be quantitatively variable, to be increased at times of instinctual tension or need and to be discharged in the process of instinctual gratification. The quantity of instinctual energy which is associated with a particular memory or idea is referred to as the cathexis of that mental element. [SeeDrives; Instinct; Motivation.]

Erotic and aggressive drives

Instinctual drives are divided into two major groups or types. The first is called the erotic or libidinal drive and the second the aggressive drive. The relationship of the erotic drive to bodily parts and processes is much clearer than is that of the aggressive drive, and the erotic drive in general has been more thoroughly studied and is better understood than the aggressive one. The principal sources of erotic drive tension or need in the body are referred to as erotogenic zones. The most important of these appear to be the mouth and related structures, the anus, and the genitalia. In the normal course of development it appears that the oral manifestations of the erotic drive are of particularly great importance during the first year of life, the anal ones during the next year and a half, and the phallic ones thereafter. However, the sexual life of childhood is not dominated exclusively by any one erotogenic zone or by any single aim, as is normally the case in adult life after adolescence. On the contrary, the sexual wishes and satisfactions of childhood are characterized by their diversity and manifold quality rather than by uniformity. What is normally characteristic for childhood sexuality, therefore, would be called perverse in adult life.

Since the somatic sources, if any, of aggression (the aggressive drive) are less clear than those of the erotic drive, it is not possible to describe phases of development of the aggressive drive in childhood in the same way that one can describe the erotic drive. It appears that there is a close relationship between manifestations of the aggressive and the erotic drives throughout life, however—a fact which is explained by assuming a degree of fusion between the two drives. It follows therefore that the oral, anal, and phallic phases of childhood sexuality are characterized by aggressive as well as by erotic wishes, fantasies, and behavior, so that it is proper to speak of oral, anal, or phallic aggressive impulses.

An important characteristic of the aggressive drive is its differentiation with respect to its object. Freud was led to the assumption of a special aggressive drive in the first place by his recognition of the very great importance in mental life of selfinjurious and self-destructive tendencies. It is clearly of utmost importance to any individual whether his aggressive impulses are directed toward himself or toward the mental representations of other persons and objects. It must not be assumed however that self-directed aggression is to be considered always pathological. On the contrary, it plays an important, indeed an essential role in normal mental life, for example, in the functioning of the superego, as well as a very important one in abnormal mental life. [SeeAggression, article onPSYCHOLOGICAL ASPECTS.]

The instinctual drives are of particular importance with respect to the emotional or affective life. In general, an intensification of instinctual need, or an increase in instinctual energy striving for discharge, is experienced as a source of pain and discomfort. A discharge of instinctual energy, that is, the gratification of an instinctual wish or need, which leads to a diminution in tension, is experienced as pleasurable.

Evaluation

The following summary statement may be of some value in helping to avoid certain misunderstandings concerning the current status of the psychoanalytic theory of the instinctual drives. The fact is that some aspects of that theory are considered to be much better validated than others. For example, it seems certain that any qualified observer who is in a position to apply the psychoanalytic method to the study of human mental life must agree that the sexual life of man begins long before puberty. The fact of infantile sexuality (childhood sexuality) appears to be incontrovertible. Equal validity would appear to accrue to the importance of sexual and aggressive wishes, as well as conflicts concerning those wishes, in the whole of mental development and functioning throughout life. Validating evidence is much less adequate concerning such aspects of instinctual-drive theory as the concepts of instinctual energy, cathexis, fusion, and related concepts of a quantitative nature. We may add, parenthetically, that in the psychoanalytic literature the quantitative aspect of instinctual-drive theory is frequently referred to as its economic aspect.

The psychic apparatus

The primary purpose of the psychic apparatus is assumed to be the regulation, control, and discharge of instinctual energy. It tends to function according to the pleasure principle, that is, in such a way as to achieve the pleasure of gratification which results from a discharge of instinctual energies. Formulated more generally, it may be said that the avoidance of discomfort or pain, which is associated with instinctual tension, and the achievement of pleasure, which is associated with gratification, is a basic tendency or regulatory principle of the psychic apparatus.

Psychoanalytic theories concerning the psychic apparatus are firmly based on the fact that the adult organization and functioning of the mind is the result of a period of gradual evolution and development during the course of the many years of childhood. In the last analysis, this is due to biological factors, that is, to the fact that the human infant is born into the world in a largely undeveloped state, both with respect to mental and physical functioning. As a result, during the first several years of its life, it is dependent on its parents for its very survival, as well as for the gratification of its instinctual needs. The offspring of no other mammal is so dependent on its parents for such a long period of time as is the human, and this fact is of profound importance in the mental life and development of man.

Structure of the psychic apparatus

In its mature form or organization the psychic apparatus is divided into three groups of related functions.

The id. That group of psychic functions which represents the instinctual drives in mental life and plays the role of stimulating or impelling the psychic apparatus to activity is called the id. The id is the part of the psychic apparatus which is in closest or most direct communication with the somatic processes of an instinctual nature, and it has often been referred to for that reason as the vital or somatic stratum of the psychic apparatus.

The ego. The ego is that part of the psychic apparatus which comprises the group of functions that have to do with the individual’s relationship to his environment. Ego functions include such gradually developing capacities of the mind as sensory perception, memory, thought, and voluntary motor control. These functions cannot appear before the neuromuscular apparatus which is a prerequisite for them has matured. The development of ego functions, therefore, is a result of interaction between maturation of the nervous system and various experiential factors. What is particularly characteristic of the psychoanalytic theory of the psychic apparatus, however, is the following additional consideration. Ego functions appear to serve primarily the purpose of gratification of instinctual drives. They are, so to say, the executants of the wishes or urges which are the mental representations of the drives. There is thus from the very beginning the most intimate connection between the functioning and, indeed, the development of the mental capacity to cope with the external environment, on the one hand, and the instinctual needs and wishes of each individual, on the other.

The superego. The third group of functions that constitute the psychic apparatus is known as the superego. These functions develop into a more or less coherent unity rather late in childhood, probably not before the sixth or seventh year. In general they are that group of mental functions which have to do with the moral prohibitions and ideals of the individual.

Conflict

It is of particular importance to bear the following fact in mind in considering the psychoanalytic theory of the psychic apparatus: The functional groupings of id, ego, and superego which are assumed to constitute the mental apparatus are sharply differentiated from one another only in situations of inner conflict. Indeed, the very divisions reflect the characteristic varieties of conflict within the mind as they can be observed by means of the psychoanalytic method. Thus, one frequent type of conflict is between an instinctual wish on the one hand and those aspects of mental activity on the other which have to do with the individual’s relationship to those about him, that is, between a wish of the id and various ego functions. Characteristically, in later life at least, the moral prohibitions (superego) are arrayed on the side of the ego against the id. Other frequently observed conflicts are between the so-called ego functions, on the one hand, and the self-punitive or self-destructive aspect of the moral demands of the mind (superego), on the other. Thus, in these typical situations of conflict, one can distinguish properly between groups of functions that have to do with instinctual demands, those that have to do with the external world, and those that have to do with moral prohibitions and ideals. In other situations, however, where there is no such inner conflict, there is no sharp line of division or cleavage that enables us to distinguish clearly between or among the three systems, or structures as they are often called, of the psychic apparatus. If ego functions are acting as executants of the drives without conflict, one can no longer distinguish clearly what is ego from what is id. All one sees is a harmoniously functioning whole. The same is true when superego demands or prohibitions are in harmony with the instinctual needs or wishes of the individual and with the demands of his environment. [SeeConflict, article onPSYCHOLOGICAL ASPECTS.]

The id

The id is that part of the mental apparatus which functions to impel the mind toward the gratification of the instinctual drives. The impulsive aspect of mental life is that which is most directly associated with the id.

Since the controlling and adaptive aspects of mental functioning, which are subsumed under the concept of the ego, are only developed gradually during the course of infancy and childhood, the id gives the impression of being the most archaic as well as the most infantile part of the psychic apparatus. In many senses it is correct to say that it represents the mind of the child that lives on in the mind of the grown man. Those processes which we assume constitute the id proceed according to the pleasure principle with little or no concern for the restrictions or demands either of external reality or of morality. These are the aspects of mental functioning which poets and philosophers in the past have referred to as demonic.

The functioning of the id is characterized by an insistent or imperious demand for gratification, that is, for discharge of mental energy. This mode of mental functioning is called the primary process in psychoanalytic terminology. As we have just noted, its essential attribute is a persistent striving for prompt and complete discharge of instinctual energy, that is, for prompt and full gratification. In keeping with this basic tendency, there is a propensity to substitute one or another instinctual object or instinctual aim for the primary one. Such substitution is called displacement, the reference being to the displacement of instinctual energy from one to another mental element. In addition to displacement, there may occur convergence of various instinctual cathexes on one particular aim or object which, because of its availability, or for other reasons, permits more ready and complete discharge of energy. Such a phenomenon is called condensation. These two related phenomena of displacement and condensation are typical and characteristic of mental phenomena which proceed according to the primary-process mode of discharge.

The ego

The ego is that group of mental functions which has to do primarily with the relation of the individual to the external environment. These functions operate as the executants of the instinctual drives and may thus be considered to mediate between the inner needs of the individual and his environment.

Some of the functions that are grouped together as the ego appear to be directly related to the form and functioning of the nervous system, as, for example, sensory perception and the control of voluntary muscular activity, while others, such as the ability to distinguish between subjective and objective reality (originally called reality principle), are more complex and more obviously related to experiential or learning processes in the course of development.

From a subjective, psychological point of view, the single most important object in an infant’s environment is his own body. His experiences of gratification and distress, and consequently his wishes and memories, are all centered about this unique object. Other objects of the environment, for example, his mother, although they may be of the greatest importance as far as his physical survival is concerned, do not compare with his own body in the first months and years of life as far as their psychological significance to him is concerned. These relationships are reflected in psychoanalytic theory by the statements, first, that the ego is first and foremost a body ego, and, second, that the infant’s instinctual orientation is at first largely a narcissistic one, that is, at first largely directed toward himself.

The proper development and organization of various ego functions as the infant grows appear to be intimately dependent upon a satisfactory balance between the instinctual gratifications which are supplied by the persons in his environment and the frustrations imposed by them. Proper mothering and, later, proper fathering as well are essential to proper development of the psychic apparatus and, more broadly, of the personality as a whole. The particular details of this complex interrelationship have been the object of many clinical and developmental studies. In psychoanalytic terminology, the most general formulation to express this relationship is that satisfactory object relationships promote the proper development of ego functions, while unsatisfactory ones impede their development.

Identification and ego development

Among the more obvious reasons why satisfactory object relationships are of importance in the development of ego functions is the fact that many ego functions develop by means of identification with the persons in the child’s or infant’s environment. This is most clearly apparent with respect to the acquisition of language, an accomplishment which is of the utmost importance for the individual’s capacity to adapt satisfactorily to his environment. However, it is true to an important extent for other ego functions as well. In psychoanalytic terminology, identification may be defined as the tendency to become like an object of one’s environment in one or more ways. It is also used to describe the end result of such a tendency. Identification appears to be intimately and necessarily connected with the objects of one’s instinctual wishes. The child identifies or tends to identify with those persons in his environment with whom he has a strong emotional tie. He wishes and tends to be or become like those whom he loves and hates most intensely. [SeeIdentity, Psychosocial; Imitation.]

Delayed gratification

The most general characteristic of the ego, one which is of fundamental importance in the development of most, if not all, of its other functions, is the capacity to postpone instinctual gratification, that is, to delay the discharge of instinctual energy. In psychoanalytic terminology, instinctual energy whose discharge is thus delayed is referred to as bound energy, in contradistinction to free energy. The introduction of delay into the process of instinctual discharge or gratification represents a modification of the pleasure principle and a deviation from the tendency to immediate discharge of instinctual energy, which, as noted above, is characteristic of the primary process. It is an essential capacity of the ego to impose delay or postponement of the gratification of an instinctual wish. This capacity permits a more efficient exploitation of the environment in the service of the individual’s search for gratification. The fact that the flux of mental energies which is characteristic of ego functions differs from that which characterizes the functioning of the id led Freud to the formulation that whereas the id functions according to the primary process, the ego functions according to the secondary process.

Defense mechanisms and anxiety

In addition to its capacity to delay the discharge of instinctual energies, the ego also includes among its functions those mental mechanisms which are referred to as defenses. It will be recalled from the introduction that the study of the consequences and nature of intrapsychic conflict occupies a central position in psychoanalytic theory. It is impossible to understand these conflicts without a thorough discussion of the mode of operation of the ego’s defenses, which is part and parcel of the psychoanalytic theory of anxiety. Because of their centrally important position in mental functioning, therefore, the topics of ego defenses and of anxiety will be treated rather more extensively than the other ego functions.

Freud based his theory of anxiety on the assumption that whenever the mental apparatus is subjected to an influx of stimuli which exceeds the capacity of the apparatus either to discharge or to bind the energies of the stimuli, a traumatic state develops. The affect which accompanies this traumatic state is anxiety. In early infancy and childhood, the capacity of the mental apparatus to bind stimuli and to discharge them is normally much less than it is later on in life. For this reason traumatic states accompanied by anxiety appear relatively frequently in early life. In particular, such traumatic states develop in the infant when an instinctual need arises in the absence of the object, usually the mother, necessary for the gratification of that need, that is, for the discharge of the instinctual energy connected with it. As the infant grows and as its ego functions develop, particularly the functions of memory and of sensory perception, it comes to recognize the absence of its mother (absence of the need-satisfying object) as a prelude or signal that traumatic anxiety may develop. In other words, the infant learns by experience of the danger that when its mother is absent an instinctual need may arise which the infant itself cannot satisfy and which will give rise to anxiety on the basis just described. What happens then is that the danger situation is reacted to with anxiety. This type of anxiety, which is connected with danger or, later, with the anticipation of danger, is called signal anxiety, since it is in effect a signal that a traumatic state may develop. When signal anxiety does develop it sets into operation the pleasure principle, according to which the mind functions in such a way as to avoid pain or discomfort. Thus it becomes necessary that the instinctual need or wish, which might give rise to a traumatic state in the absence of the mother, be prevented from developing into an urgent need. The various ways by which this can be accomplished are referred to in psychoanalytic terminology as the defenses or defense mechanisms of the ego. We shall discuss them in more detail presently.

In normal childhood development there is a regular sequence of danger situations which are associated with signal anxiety. The first of these is the one described above, which is referred to as loss of the object. The situation which next comes to be recognized by the infant as a danger is the possibility of loss of love or affection of the parent on whom it is dependent for instinctual gratification. This is referred to as loss of love. The term “separation anxiety” is often used to indicate anxiety related to either or both of these typical dangers. The third typical danger of childhood, which is characteristic of the phallic or Oedipal phase of instinctual development, is the fantasy of castration in the little boy or of analogous genital injury in the case of the little girl. The term “castration anxiety” designates anxiety related to this danger. The fourth danger, which appears only after the formation of the superego, an event to be described below, has to do with superego disapproval or prohibition. It is sometimes referred to as superego anxiety but more often simply as guilt. In psychoanalytic terminology, the term “guilt” is often used to refer as well to the need for self-punishment and also to the various associated phenomena of remorse, penance, and retribution.

It should be noted that the typical danger situations just described do not simply succeed one another in the sense that the first disappears from prominence in mental life as the second develops. On the contrary, as each new source of anxiety appears in the child’s mental life, the earlier ones continue to exist alongside of the new, and all the danger situations are important in everyone, though to varying degrees in each, depending on the life experiences of the individual and possibly on his constitutional endowment as well. [SeeAnxiety.]

In considering the defense mechanisms, it is important to recognize that the ego may use anything which is available to it as a defense against an instinctual wish or an unconscious need for self-punishment which arouses anxiety. Thus, for example, a diversion of attention may serve a defensive purpose, or muscular immobility may be used to defend against the possibility of being sexually or aggressively active. It may even happen that one instinctual derivative is gratified at least partly as a defense against the emergence of another. Thus, homosexual fantasies or even homosexual activity may appear as defense against dangerous heterosexual wishes, or vice versa. In order to avoid possible misunderstanding in this connection, it must be emphasized that, in general, instinctual wishes are reacted to as dangerous in adult life because they were conceived to be so in early childhood. It frequently happens that an adult vigorously defends himself unconsciously against the emergence of a dangerous instinctual wish which, as an adult, he considers either entirely permissible and natural or even trivial and unimportant. Thus it is fairly accurate to say that mental conflict in adult life derives from childhood or, to use psychoanalytic terminology, infantile sources. [SeeDefense mechanisms.]

Repression. While bearing in mind that the defensive activities of the ego may be extremely varied, we may mention and define briefly several defense mechanisms which are referred to frequently in psychoanalytic literature by specific names. The one which was first identified and has been most extensively discussed is called repression. In psychoanalytic terminology, repression signifies an active forgetting of the memories and other ideational representations of a dangerous wish, whether instinctual in origin or self-punitive. Repressed memories are no longer accessible to consciousness. Since they remain cathected with psychic energy, however, they are constantly striving for some sort of expression in conscious mental life and behavior, however remote from the original wish that expression may be. Thus a repressed wish or need may exert a considerable, even a decisive, influence in the mental life of an individual. The counterforce which is required to keep such a powerful urge repressed is referred to as a coun-tercathexis.

Reaction formation. Another important defense mechanism is reaction formation. In reaction formation one mental tendency is emphasized in order to prevent the emergence of its opposite. Thus, for example, dangerous aggressive wishes may be kept in check by the development of a character trait of kindness and gentleness. In the same way, the reverse may happen, that is, an individual may be bold and vigorous in his overt behavior partly in order to defend himself against a dangerous tendency to be submissive or passive. Similarly, cleanliness may appear as a reaction formation against dirtiness, particularly against coprophilia, etc. The most dramatic reaction formations are those in which love appears as a reaction formation against hate, or vice versa.

Isolation. The term “isolation,” though sometimes used in different senses, generally refers to what is more precisely called isolation of affect. In this defense mechanism, a wish or impulse is allowed to appear directly in consciousness but devoid of emotional significance. It seems to the individual “just an idea” rather than a desire or wish. Isolation, as used in this sense, is closely related to defensive intellectualization in general.

Identification as a defense. Identification, a phenomenon of mental life which we have seen to be of general significance in mental development, especially of the ego functions, often plays a defensive role. In psychoanalytic literature much emphasis has been put on the important part played by identification in connection with separation anxiety. However, it also plays a vitally important role in connection with castration anxiety in childhood and is of particular significance in superego formation.

Projection. The term “projection” refers to that phenomenon whereby an individual attributes to others wishes or impulses which in fact are his own but which would give rise to anxiety or guilt if he acknowledged them as such. Projection as a defense plays a particularly important part in the psychopathology of paranoid conditions, but it is of considerable significance in normal mental life as well. Prejudices of all sorts—for example, those directed against an enemy in time of war—are often closely dependent on projection.

Denial and undoing. The term “denial” is used to refer to a certain defensive attitude toward one or several aspects of the external world. One may fail to perceive an event in one’s environment in order to avoid the guilt or anxiety that would result if the event were perceived. Fairy tales and daydreams in general make considerable use of denial. The misperceptions of the environment that play such a large role in many psychoses are mainly related to the defensive use of denial in those conditions.

The term “undoing” refers to actions which are performed in order to undo or render harmless unconscious wishes or fantasies which are considered dangerous. They represent a kind of unconscious magical penance.

Regression. Regression is a mental tendency or capacity which often serves a defensive function. The dangers associated with Oedipal wishes or fantasies, for example, may be avoided by regressing to anal or oral wishes. This process is known as instinctual regression. Regression may also affect various of the ego functions in a defensive way. In general, if regression is permanent and not merely temporary, the greater its degree and the more extended its role in mental life and the more severe the distortion of personality or the mental illness that results.

The Oedipal phase and superego formation

At the age of two and a half or three the child normally enters into a phase of psychosexual development called the Oedipal period or phase. This lasts for about two and a half or three years and corresponds approximately with what we have earlier referred to as the phallic phase of libidinal development. The violent intrapsychic conflicts which are caused by the sexual wishes of the Oedipal period are of crucial importance in mental development and later mental functioning. They profoundly influence character development in general and are responsible for superego development and organization in particular. In addition, they form the basis or groundwork for the vast majority of whatever neurotic symptoms may appear in later life. [SeeDevelopmental psychology; Personality, article onpersonality development.]

Freud used the term “Oedipal” to designate this period of mental development because of the similarity between certain of the wishes that characterize it in the little boy and the legend of Oedipus as recounted in Sophocles’ play. The little boy in the Oedipal period normally is passionately enamored of his mother, wishes to marry her, and to displace his father in his mother’s bed. The corresponding wish to marry her father and take her mother’s place is equally characteristic of the little girl in the Oedipal period. Thus, the sexual wishes of the Oedipal period revolve around the fateful themes of incest and parricide.

In fact, however, the wishes and conflicts of the Oedipal period are somewhat more complex than the name would indicate. In his psychosexual life, man is clearly bisexual. This is nowhere more evident in the normal human being than during the years of early childhood. In the usual family constellation the little boy of the Oedipal period has sexual feelings toward both parents and jealously murderous wishes toward each, although normally the heterosexual wishes and the jealousy connected with them considerably outweigh the homosexual ones. The same is true for the little girl during her Oedipal period.

For a variety of reasons, not all of which are clearly understood, the Oedipal boy fears castration, specifically the loss of his penis, in connection with his incestuous and parricidal wishes, and the little girl during the same period fears some analogous genital injury. In the case of the girl, the conflict of feelings is complicated by an awareness that she has no penis, a fact which she regularly interprets as a sign of inferiority. Because of the castration anxiety aroused by their instinctual wishes, children of both sexes attempt to control their Oedipal wishes with a great variety of defensive reactions. [SeeSexual behavior, article Onsexual deviation: psychological aspects.]

Among the most important of these for the future development and functioning of the child’s mind are the reactions which give rise to what is called the superego. This group of mental functions may be defined as comprising those functions of the mind which are concerned with either moral prohibitions or exhortations. The functions which have to do with exhortation are sometimes referred to as the ego ideal. Activity of superego functions results either in a limitation of behavior to morally acceptable modes of instinctual gratification or to that particular state of unpleasant inner tension which is variously referred to as guilt or remorse and which leads to acts of penitence, of reparation, of self-punishment, and—in the most extreme instances—to self-injury or self-destruction.

Identification and the superego

The principal mental mechanism involved in superego formation is identification. Normally, the little child identifies with the prohibiting and punishing aspects of the parent who is his chief rival. By making the latter’s threats and prohibitions his own, he defends himself against the fantasied danger of castration. He thus achieves a considerable degree of control over the instinctual wishes which for him constitute an overwhelming danger. At the same time, however, this identification results in an appreciable degree of permanent limitation of opportunities for instinctual gratification. Thus, superego formation normally results in a considerable degree of interference with the operation of the pleasure principle, or at the very least it considerably complicates its operation.

It follows from what has been said that the core of every individual’s morality and, consequently, the invariant elements that one would expect to find at the center of the moral code of every human society, consist of a prohibition against incest, particularly between parent and child, and against parricide. One may add that for many, or perhaps most, individuals, one of the results of superego formation is a considerable degree of guilt over genital masturbation, since this is usually the physically gratifying activity which accompanies the sexually exciting wishes of the Oedipal period. It is also interesting to note that the threats and punishment associated with superego functioning in early childhood, and persisting unconsciously into later life, follow the principle of lex talionis. It would appear that the mind of the child, like the mind of the primitive, follows the principle of an eye for an eye and a tooth for a tooth.

It seems correct to say that the major share of superego formation is the result of the fateful conflicts of the Oedipal period. It should be noted, however, that a considerable degree of superego formation occurs gradually during the ensuing years of childhood. Some of the identifications with teachers and with childhood heroes, whether historic or contemporary, contribute their share to the growing child’s superego. It is also true that even in adult life, substantial changes may take place in superego functioning, sometimes in a dramatic way, as for example in cases of religious conversion. Freud also emphasized the changes in superego functioning that are characteristic of mob psychology. According to Freud, identification with a group leader—for example, with a political dictator—may produce as considerable an alteration in the superego functioning of many of his followers as results from religious conversion. [SeeMass phenomena; Moral development.]

Latency and adolescence

The institution and organization of the superego normally result in a considerable subsidence of instinctual conflict beginning at about six years of age. Although this subsidence is by no means complete, still the whole picture of a relative quiescence of psychosexual activity and conflict during the years between six and twelve is in considerable contrast to the turbulence and conflict so characteristic of the Oedipal period, which precedes it, and of adolescence, which follows it. Freud proposed to call this interim period a period of latency. When the physical, particularly the sexual, changes of adolescence begin, there is a recrudescence of sexual wishes and sexual conflicts. The course of these adolescent stirrings and conflicts is to a considerable degree predetermined by the defenses already established during the Oedipal period. Thus, to a greater degree than is usually appreciated, the psychosexual development of adolescence and early adult life is a recapitulation of childhood psychosexual development. [SeeAdolescence.]

The foregoing is an extremely brief summary of psychoanalysis as a general science of behavior. Because of its brevity, it is inevitable that the reader may often be misled in attempting to understand a subject which is at once so complex and so extensive. This is not, however, the most serious source of difficulty to the reader. A much greater difficulty is likely to arise from two rather different sources. The first of these is a lack of familiarity and experience with the use of the psychoanalytic method. As mentioned in the introduction, the data concerning human behavior which are available only by application of the psychoanalytic method are, generally speaking, quite foreign to the experience of anyone who has not had an opportunity to apply it. Lack of such opportunity, therefore, makes it difficult for one to form an adequate judgment concerning the validity of many psychoanalytic propositions. The second source of difficulty results from what astronomers call the personal equation. In the case of childhood sexuality, the personal equation is very great indeed. Each adult individual, as a result of having passed through the conflicts of the Oedipal period himself, has stubborn defenses within himself against his own childhood wishes. Even to recognize their existence in others is likely to arouse considerable guilt and anxiety. It is much more comfortable— that is, less frightening—to minimize the importance of childhood sexuality in human mental life or to deny its significance altogether. It is no accident, as Freud pointed out, that every adult has an extensive amnesia for the events of early childhood. Most individuals can overcome their inner conflicts over childhood sexual wishes only with the help of personal psychoanalytic treatment. For this reason, a personal analysis is a usual prelude to psychoanalytic practice, that is, to the systematic, usually therapeutic, application of the psychoanalytic method.

The unavoidable limitations which, until now, have been imposed by the above facts on the acceptance of psychoanalysis by many social and behavioral scientists are unfortunate. The fact is that psychoanalysis can supply to the social and behavioral scientist, as to the student of art and literature, a more profound, more complex, and more accurate knowledge of the nature of man— his needs, his fears, his conflicts, and his motives —than is available from any other source. Such knowledge is frequently important and often vital. It should properly be part of the education of all who deal professionally with man and his works.

Charles Brenner

BIBLIOGRAPHY

Arlow, Jacob A.; and Brenner, Charles 1964 Psychoanalytic Concepts and the Structural Theory. New York: International Universities Press.

Brenner, Charles 1955 An Elementary Textbook of Psychoanalysis. New York: International Universities Press.

Fenichel, Otto 1945 The Psychoanalytic Theory of Neurosis. New York: Norton.

Freud, Sigmund (1895-1926) 1953–1963 The Standard Edition of the Complete Psychological Works of Sigmund Freud. 24 vols. London: Hogarth; New York: Macmillan.

Hartmann, Heinz (1939) 1958 Ego Psychology and the Problem of Adaptation. Translated by David Rapa-port. New York: International Universities Press. → First published as Ich-Psychologie und Anpassungs-problem.

Hartmann, Hetnz 1960 Psychoanalysis and Moral Values. New York: International Universities Press. → Freud anniversary lecture, given in 1959 at the New York Psychoanalytic Institute.

Kris, Ernst 1947 The Nature of Psychoanalytic Propositions and Their Validation. Pages 239–259 in Sidney Hook and Milton R. Konvitz (editors), Freedom and Experience. A New School for Social Research publication. Ithaca, N.Y.: Cornell Univ. Press.

Ruitenbeek, Hendrik M. (editor) 1962 Psychoanalysis and Social Science. New York: Dutton. → A useful selection of essays on the impact of psychoanalytic thought upon anthropology, sociology, and the social sciences generally.

Waelder, Robert 1960 Basic Theory of Psychoanalysis. New York: International Universities Press.

II EGO PSYCHOLOGY

Although the term “ego” has meanings that go back to the beginnings of philosophy, it is only its place in psychoanalytic theory that will be the concern of this article. For this reason it is necessary from the start to rid the term of some of its popularly understood, nonpsychoanalytic meanings. The ego is not simply intelligence; neither is it an inflated sense of one’s own importance, nor does it refer to its traditional philosophical meaning of self-consciousness. It was not meant by Freud to be strictly a phenomenological concept. The ego is not simply the subject of experience, in contrast to the objects of experience, nor is it one’s own person (self), in contrast to others. These exclusions are neither arbitrary nor a matter of preference, but reflect the place that the concept is meant to fill in psychoanalytic theory: specifically, Freud’s need for suiting the meaning of the term “ego” as a “representative of reality” to the requirements of the parent body of psychoanalytic theory. Thus, in Freud’s last and most fully developed conception of the ego, self-feelings, the capacity to reflect on oneself as a person, and the capacity to experience distinctions between self and others are functions within the ego system, part of the ego’s adaptational repertoire of controls and defenses as a subsystem of the personality. The ego’s fundamental meaning for Freud was a hypothetical array of processes standing generally for self-preservation and survival and having to do with the structuring of purposive action in relation to various aspects of reality.

This is not to say that psychoanalytic theorists are always clear and consistent in their usage. Sometimes, the term is merely a taxonomical device to refer to defensive and adaptational motives and their instrumentalities. Sometimes, it is used in the more ambitious connotation of a distinctive subsystem of the personality whose regulatory functions extend to the control of two other subsystems, superego and id. In this sense it becomes more an independent variable that has a role in “affecting” behavior; it is not simply a taxonomy of motivational phenomena or of functions but an entity whose parameters, mode of operations, and functions are potentially capable of being specified in some model of self-regulation.

Confusion in psychoanalytic usage developed from the fact that while the ego concept was present from the very beginnings of Freud’s theory, it underwent a number of changes and shifts of emphasis in response to developments in psychoanalytic theory at large, a fact which Freud sometimes failed to acknowledge. Part of the intent of this review is to draw attention to invariant meanings that have clung to the term throughout its history in psychoanalysis, as well as to changes of emphasis. Of equal concern will be the logical place of the ego concept within psychoanalytic theory and its distinctive character as a framework for explaining behavior. Since the history of the ego concept has been described several times (e.g., Hartmann 1939; Kris 1951a), we will touch on historical considerations only to the extent of indicating how changes in the ego concept reflected conditions in the parent body of psychoanalytic theory —particularly the gradual emergence of the ego concept from its setting within a theory of illness to one concerned with normal development—and to the present status of the concept as constituting a distinctive field of psychoanalytic enterprise called ego psychology. A final and important consideration will be an assessment of its current status in psychoanalysis.

The ego in Freud’s earliest model

From the start, Freud needed a concept of ego. Indeed, it is a curious fact that his concept antedated his theory of psychosexual drives, generally considered to be the cornerstone of psychoanalysis. It is fair to say that Freud’s early theory of the mind was as unavoidably dependent on a concept of ego as his later theories were on a concept of instinctual drives. Believing that he had discovered the primary etiological basis of hysterical symptomatology—a psychical “lesion” traceable to a traumatic sexual experience in childhood—he envisioned, in a burst of temporary enthusiasm, the mechanics of neurosis, within a comprehensive neuropsychological model of normal behavior. In a work published posthumously as Project for a Scientific Psychology (1895), he developed his first systematic account of the fundamental forces in man’s behavior. Behavior, he said, is ultimately the expression both of the discharge of pressureful build-ups of internally and externally generated tensions through appropriate and effective actions upon the environment and of structural complications that develop in the organism in the course of its efforts to find the most effective means of discharge. He called these the primary and secondary functions of psychical structures, respectively.

The ego was conceived as an essential structural means of accomplishing the secondary function— the agency of effective discharge, one that could respond simultaneously to the demands of energic tension and to environmental conditions suited to tension reduction, that could monitor motoric instrumentalities of discharge (because effective discharge is achievable only through action) and that could be implemented by perceptual-cognitive operations of thought which guarantee the proving of reality or “reality testing.” The ego, then, was a coherent organization that was endowed with capacities for inhibiting energy flow and that operated in coordination with processes having to do with the “representation of realities”—thought, perception, judgment, reflection, etc. Freud even specified a latticelike arrangement of neurons with special capabilities of retaining excitation and directing energic transmission. In the Project, defense, which later was to be a dominant property of the ego, was construed, in both a broad and a narrow sense, as part of the secondary function: in the broad -sense, as an inhibiting, but adaptational, process which directs the course of discharge and, in the narrow sense, as a specific form of inhibition or “repression.” The point is of interest because for two whole decades following the Project, the latter, narrow sense of “defense” preempted all other meanings of “ego.” In this remarkable document, which merits more detailed study than is possible here, Freud spelled out the functions of the ego, which he was not again inclined to do in as systematic a way for some thirty years. [SeeDefense mechanisms.]

Status of the concept: 1900-1923

In what is generally regarded as the second and main period of Freud’s psychoanalytic writings— the period immediately following his writing of the Project, up to around 1923, and including The Interpretation of Dreams (1900) —Freud’s theoretical interest in the ego concept waned, although it frequently appeared as a necessary descriptive term. Functions that had been specifically assigned to the ego in the Project were now dealt with separately, without being explicitly associated with the ego. The term had a variety of descriptive usages, sometimes with the connotation “conscious inhibitive control,” sometimes with the meaning “motivations concerned with self-preservation” (e.g., “ego drives”), sometimes in the sense of “the internalized ideals and values of identification figures,” and sometimes in the sense of “feelings of self.” Mainly, however, it seemed to have the narrow connotation “an instrumentality of defense” and specifically of repression. In this last sense, the ego would refer variously to the conscious acceptable mass of ideas which took part in the conflict, the ideals which precipitated the conflict, or the resisting force in conflict, the agency of the regressive process itself. From the vantage point of both his earlier and later, final conception, these were all partial attributes of the ego concept. The idea of a comprehensive, coherent system of control was put aside.

Several reasons have been put forward for this and for the generally unsystematic way in which Freud used the concept in this period. In part, this reflects Freud’s style of theorizing. He tended to give main theoretical weight to his immediate empirical concerns, often without attention to the resultant, sometimes dissonant juxtapositions to earlier formulations. The lure of the next bend, beyond which new discoveries might be made, was always distracting him from the labor of theoretical inventory. It is, of course, also true that he wanted to rid himself of the neuronal model, which he considered a failure, and with it went his early strategy of trying to encompass pathological phenomena within a more comprehensive model of normal functioning. Instead, he now gave himself over entirely to the observations and phenomena that he was most immediately confronted with— those of illness, symptoms, and conflict. He not only moved toward a physiologically “neutral” form of theory but also became more specifically and dominantly preoccupied with the dynamics of illness and less with the task of a comprehensive general psychology of adaptation. Concern with illness meant a theory of its genesis in conflict and focusing on the roles of sexuality and instinctual drives. In the Project, he had tried to view issues of discharge and control, not simply in relation to sexual wishes and tensions, but in the broader perspective of a general biological enterprise of adaptation to stimulation. There the secondary function of defense was broadly construed; now it became identified with the ego in the narrower sense of repression produced by conflicts in which sexual wishes and desires were pre-eminent. The mental lesions—obsessions, hysterical symptoms, perversions, and the like—and their treatment were placed in the forefront, and elaboration of the principles of neuroses, conflict, and the relation of both to sexual bases became the core of Freud’s theoretical enterprise. In this connection two developments were of monumental importance in setting the direction of his work for the next two decades: his retraction of the etiological importance he had given to sexual trauma in childhood and his altered views of the nature of the con-flictual bases of neurosis.

His first conception of the importance of sexuality in the causation of hysteria (1896a) held that the memory of an actual traumatic sexual experience in childhood (e.g., seduction) was central; in this view, the memory of such a prepubertal experience becomes especially pathogenic in the later period of genital sexuality, creating the condition of neurosis-inducing conflict. However, he gave up the conception that the critical etiological event was an actual seduction when he became convinced that the disturbing idea in hysterical neuroses was not a memory, but a fantasy of seduction woven out of a tabooed sexual wish.

This had repercussions on the very fundamentals of psychoanalytic theory, for now it became important to ask how such a fantasy and the wishes involved in it came about. The three main sources of neurotic illness—the sexual core of conflict, the unconscious wishes, and the unsuccessful repressive defense against these wishes —leading to symptoms henceforth became the main themes of Freud’s theoretical efforts. He embarked on observations of continuities in sexual experiences at different stages of development and of their pathological miscarriages. His clinical data pointed to the autogenetic connection between both early infantile needs and bodily functions and the later development of genital gratification.

It was in this connection that the theory of instinctual sexual drives became a critical anchorage of Freud’s thought—the all-determining “reality” to which adjustment must be geared; an internal stimulus which, being inescapable through flight and being peremptory and periodic, creates a continuing and unrelenting source of wishes and strivings that has to be discharged through appropriate “objects.” The other vital appetitive instincts were not very important, because they seemed to contribute little to an understanding of neurosis. By far the most important source of motivation and of individual development was the sexual drives and the conflicts engendered by their momentum for gratification. Moreover, the sexual drives underwent a developmental change in respect to their aims (wishes) and their potentialities for possible gratification (objects). Indeed, they provided the primary momentum of growth. So great was their structuring power that Freud tended at times to believe that character development itself is patterned exclusively by fixation upon different aims and modes of drive gratification. The environment was accorded little significance as a participant in the development of instinctual drives—only in the conflicts generated by them; family life and rearing create obstacles to the discharge of drives, thereby necessitating indirect forms of discharge or total repression.

For Freud, by far the most crucial discovery was that of infantile sexuality—that is, that there is a developmental continuity in requirements of sensual gratification from infantile modes to the usual adult forms of sexuality. Freud wrestled with the formidable theoretical problem of how to fit into a uniform conception the facts of an erotic momentum, its seeming continuity in development, inter-changeability of sensual aims and modes of gratification, and pathological deflections into perversion, fixations, and regressions. Freud’s theoretical solution was to conceive of an active principle of sensual development, involving an energic quantum, which he called libido, having distinctive qualitative or directional properties. There is inherent in libido an implacable developmental course in respect to the aims of its discharge, these developmental changes appearing in stagelike progression. At the same time, within each stage, libido is capable of some degree of transformation of aim and of displacements in respect to actual objects of discharge. For example, “conscientiousness” could be an instance of the transformation of “anal libido.” Libidinal discharge became for Freud the most important single basis of motivation. He believed that the requirements for the relief of libidinal tensions, the conflicts to which they give rise, the shifts in distributions of libido, and the deflections in their discharge are not only the main issues in neurosis but the essential paradigm for picturing normal motivational development.

Through the simplification achieved by attributing directional attributes to a distinctive type of energy, Freud had an attractive and seemingly efficient means of coordinating the complex facts of sexual development and the autogenic heightening and lessening of the desire for sensual gratification in each period. Through the quantitative attributes of libido, the theory could account for intensity of drives, for the pressureful momentum of sensuality; through its qualitative attributes of directionality, it was possible to account for selectivity in respect to the objects which can elicit its discharge. Libidinal energy in its various drive forms had characteristics usually associated with animal instinct; at the same time, it had the crucial property of displace-ability, which distinguished it as specifically human. Thus, the forms of transformation from oral to anal, to phallic, and to genital stages are inherited, like the momentum of transition from one phase to the next, but within each stage the options of gratification are considerable. It must be noted, however, that the distinction between the energy, or activation, aspect of sensuality and the executive actions associated with its formation into drives was obscure in Freud’s formulation—and has remained so. This uneasy coexistence of quantitative and directional assumptions in the libido theory and their unclarified relationship with each other remain weak points in psychoanalytic theorizing to this day. It should be noted that Freud was also veering away sharply from his early emphasis on the importance of environmental (exteroceptive) stimulation.

Sharing the spotlight with libidinal drives at this time was the nature of conflict in neurotic disturbance. For Freud a key factor in neurotic conflict was repression—the blocking of a wish and its derivatives and associations from conscious understanding and action; symptoms of conflict were a manifestation and outcome of repression—they reflected a strategy of conflict resolution arising out of the impasse which repression imposes upon gratification. That his interest narrowed to the one adaptational function of defensive repression partly reflected the logical momentum of his theory which led to, and was continually fed by, particular emphases of clinical observation. It is also true, however, that clarification of the dynamics of repression seemed to be dictated by therapeutic necessity. For according to the theory, the goal of therapy is to uncover the repressed; therefore, it is crucial to give observational priority to indications of the “return of the repressed” and to the means of overcoming the ill effects of repression. [SeeConflict, article onpsychological aspects.]

Although the ego was present in this conception, its status was that of a curiously vague entity, identified most of the time, but not exclusively, as the agency of the repressive force. Emphasis was given to its resistive function, in relation to drive and wish, and its inhibitive capacity, rather than to its capacities for promoting effective gratification; it was identified not only with the repressing force but with the body of ideas—internalized value structures, as well as consciously acceptable and accessible ideas, which instigated resistiveness to drive discharge. Freud also tended to link capacities for conscious experience and will with the ego, but this was loosely developed and does not easily fit with the notion of the ego as an agency that promotes elisions of consciousness through repression. The absence of any detailed regard for how these oppositely effective functions are related within the ego is an example of Freud’s disinclination, in this period, to systematize the ego conception.

It is possible that the reduced importance of a specific environmental etiology of neurosis affected Freud’s interest in the ego, if not his assumption that the ego was necessary in his over-all conception of psychical structure; that aspect of the ego which is purely adaptational became less compelling. Parental behavior and family life were significant aspects of the environment—but significant only as potential impediments which produced conflict and provoked defense. The possible supportive importance of environmental structure to normal drive functioning as a molding and implementing influence—not simply an obstacle to the evolutionary-given momentum of libido—was not a natural fulcrum of interest for libido theory and, hence, received little attention. One also wonders if premonitions of possible contradiction with the libido theory contributed to the stasis of the ego concept in this period, since Freud’s account of the motivational and structuring force of libidinal drives included attributes that he later, under the pressure of observation, imputed to the ego.

As for motivations specifically attributable to the ego, Freud spoke about them only with respect to the ego’s role as an instrumentality of the pleasure principle and its role of defense. He did for a time speak of “ego drives,” but he gave up the notion, possibly because of difficulties in making it compatible with the libido theory. It seemed necessary to emphasize only reactivity to instinctual drive and containment of drive by defense. Indeed, this emphasis is common even today. Clinicians are still inclined to regard the ego mainly in the light of its participation in conflict and in its partnership with instinctual drives pressing for discharge.

Freud, nonetheless, had much to say about thinking processes in their adaptive, as well as drive-related, aspects. However, he did not bring these considerations into a single taxonomic concept of an ego system of control. Thus, in The Interpretation of Dreams appears his epoch-making distinction between primary and secondary thought processes. Secondary thought shows characteristics that follow the precepts and rules of logic, maintaining an identity or coordination with reality structures and events; in marked contrast, thought processes of the primary process are wholly in the service of drives, of promoting peremptory discharge. The distinction implies that there is an “objective reality” and that thought (in the secondary process) is capable of representing it without distorting it. However, Freud left largely unexplained and undescribed the developmental origins and nature of the secondary process. In fact, it never again received the attention he had given it in the Project.

It is possible that some of the difficulties that have persistently clung to the ego concept since Freud’s time are traceable to the fact that the secondary process and its reality-testing functions were not explicitly made a part of ego theory in this period; its status as a means of implementing effective drive control, as well as a means of representing reality relationships generally, was implicit but not developed. Also, the question ef whether the mechanisms of symbolization, condensation, and displacement of the primary process are best viewed as ego manifestations to this day is unresolved. To have confronted such questions— and generally that of making primary and secondary processes comprehensible within a conception of ego—would have drawn attention to the crucial issue of the independence of ego processes from libidinal control. Moreover, there was something contradictory in the view of the ego as primarily a reactive, defensive agency whose vital biological mission is to insure self-preservation. There are, in his writing, any number of hints that it was difficult to avoid the assumption of an autonomously active force in the ego. The critical point is that Freud did not consider in detail the problem of instrumentalities of control in general, whether in the service of drive or in nondrive adaptations. Had he done so, we would have had a psychological conception more consistent with the then current , as well as present, preoccupations of most psychologists.

It seems fair to conclude that during this period the assumptions of his libido theory muted Freud’s interest in an interaction of adaptive motivations and environment as a major motivational source of behavior. It required repeated clinical indications of the explanatory insufficiency of the theory of libidinal drives for him to widen the orbit of the ego’s meaning to embrace these phenomena.

Later development: 1924-1938

The decision to confront more directly and systematically the ego’s position in psychoanalytic theory was gradually forced upon Freud. Actually, this renewed interest picked up themes of the early Project. Clinical observations and considerations had much to do with forcing the issue—facts and special theoretical formulations that had no firm position in the general theory as it stood had been accumulating. We will consider several of these: (1) phenomena of unconsciously manifested resistance in psychoanalytic treatment; (2) a radically different appreciation of the meaning of anxiety; (3) the role of unconscious guilt and internalized parental commands and morality; and (4) psychotic breakdowns of thought functions.

Unconscious resistance

Freud became increasingly impressed with a peculiar resistance to being helped or understood that patients displayed. The patient could proclaim with conviction his willingness to participate in the treatment, but there were many indications that he was undermining it in a variety of ways. The patient seemed to resist knowing not only the repressed ideas but, more importantly, resisted knowing and acknowledging that he was repressing. The resistance seemed to operate quite unconsciously, indeed seemed even to gain in force from the fact that it was not conscious. These facts profoundly affected the strategy of therapy itself and also moved Freud toward a reformulation of the ego concept.

Accordingly, a great change eventually came about in psychoanalytic therapy—an emphasis upon working with defenses themselves and with resistances; a great deal of attention was now given to their various forms and vicissitudes in treatment. No longer was analysis considered to be simply the uncovering of repressed memories through catharsis. The conception of repression itself underwent change. Repression is a process that not only affects memory but promotes breaks in the conscious appreciation of associative links with the conflictual core of the neurotic symptoms; such “splits” produced by repression have different be havioral manifestations. Thus, even the meaning of uncovering repression became different; it could mean not only recovering a memory but the reestablishing of a conscious appreciation of causal connections among ideas.

The phenomena of resistance seemed also to point to an active principle in the structuring of behavior, independent of, and rivaling, that of instinctual drive. Defense could not simply be a reactive response fashioned out of repeated frustrations of drive discharge and modeled upon the discharge modes of instinctual drives. Moreover, the unconscious aspect of this seemingly drive-resistive force cast doubt upon the logic of Freud’s previous tendency to associate all unconscious determinants with instinctual drives alone.

The new theory of anxiety

Freud revised his views of anxiety, and his new conception had reverberations throughout the body of psychoanalytic theory and therapeutic practice. Previously, Freud had resolved the question of whether anxiety is a reaction to danger or a transformation of libido, by what seemed a parsimonious solution in terms of libido theory alone. Anxiety was simply a product of libidinal drive blocked from discharge, an overflow of libidinal energy which induced a passive reaction of inchoate restlessness and diffuse feelings of fearfulness. However, a number of clinical considerations—among them, the facts of resistance and the problem of how repression itself is initiated—compelled him to assign an active role to anxiety in a regulative system of response to danger. He proposed that small quanta of anxiety had utility as a signal, an informational sign of impending danger, in response to which defenses are alerted. Thus, anxiety became associated with a directive function distinct and separable from libido and able to determine the course of behavior independently of libido. He underscored the separation of libidinal drive discharge, but he avoided confronting the issue (If it did not originate from libido, whence the energic basis of anxiety?) by making it an ego function and part of the ego’s regulative system of defense.

The importance of this new view of anxiety can hardly be overemphasized; it brought into the foreground an anticipatory capacity in the schema of regulation. Effective regulation meant functioning guided by anticipated danger. The anxiety signal is more than a realistic response of fearfulness to actual danger. It reflects a regulatory system capable of initiating defensive action on the basis of a premonition; it indicates a system capable of the developmental feat of turning passively experienced, full-blown anxiety into a finely tuned means of anticipatory defense. Moreover, the anxiety signal is capable of mobilizing a great variety of defenses in this fashion.

The new theory also emphasized the qualitative, or conngurational, aspects of anxiety, in contrast with the earlier, purely quantitative energic conception. In general, anxiety is indicative of a state of mind in which a person is preoccupied with preserving, rather than with gratifying, himself. Anxiety is linked to internal representations of danger situations; these prototypic dangers differ at the various stages of psychosexual development, producing different anxiety configurations. For example, separation can provoke in the infant an experience of loss of love, which is internalized as a potential danger and is thereafter an occasion for anxiety. Separation and object loss are especially potent sources of anxiety in the period of infant helplessness; later, the dangers of retribution, castration, and fantasied loss of potency become sources of anxiety. Freud, thus, implied that the controlling system which embodied the anxiety signal had a developmental aspect coordinate with, and separate from, that of libidinal development, one in which different focuses of anxiety at different ages result in correspondingly different defensive patterns. The theory also led to a further elaboration of neurosis as the retention and reactivation of past or obsolete conditions of anxiety —for example, loss of love, castration, etc. [SeeAnxiety.]

The importance now attached to developmental circumstances that promote anxiety broadened psychoanalytic concerns to include the bases and content of ontological insecurities, their epigenesis and relation to social development. It began to turn attention to the patient’s personal construction of reality—that is, reality as he interprets it, whether of environment or of drive. The impact on psychoanalytic therapy was great and helped to redirect it. Now, in addition to asking what the patient desires, one has to ask what he is afraid of and what he does if he is afraid. Only by understanding the configuration of his anxiety and the modes of control associated with it can one get a complete picture of his conflicts and fears.

But the new conception posed a difficult problem for existing instinctual-drive theory. Since the link between anxiety and libido theory has been weakened by attributing anxiety’s essential quantitative factor only vaguely, if at all, to libido, how does one relate anxiety to the parent theory? Freud resolved the issue, not by revision, but by addition: by broadening the ego conception to include properties of activity that he had not before assumed it to have and by including anxiety among its signaling capacities. He thought that by endowing the ego with its own energy, he had an expedient solution which did not threaten the existing edifice of psychosexual theory, a solution which seemed to retain its explanatory usefulness and to accommodate certain observations that had stubbornly resisted interpretation.

Unconscious moral strictures and guilt

Observations of patients who hold on to suffering out of a need for punishment and of the phenomenon of guilt seemed also to be better provided for if one assumed some grade of regulative capacity independent of instinctual libidinal drive. The fact, too, that the qualms of conscience can be effective without being conscious called further attention to the inadequacy of a theoretical bias Freud had shown toward equating conscious and unconscious events with the polar participants in conflict. He now assigned motivational importance to this facet of regulation and termed it superego. The superego gives commands; it is an internal “must” system which can mount urgent motivational pressure. However, after so internalizing and elevating the motivating forces of a morality system, Freud had to cope with conceiving another system that was responsive to it, one that was responsible for modulating and implementing its demands. Freud called upon the ego concept to provide the supplement: the activity of internalized moral strictures and values became part of a general system of ego control, which is coordinate with the id and which is capable of imposing restraints, of staking out the range of permissible drive discharge, of determining different forms of conflict, and of bringing about their resolution. [SeeMoral development.]

Psychotic thought disorders

Psychoanalytic experiences with psychotics pointed to impairments of adaptive capacities and to defective personal constructions of reality as primary issues. For example, the difficulties that psychotics have in sustaining emotional investments (transference) seemed to Freud to indicate a fundamental adapta-tional deficit in the affective sphere, which was itself a precondition, rather than a result, of the breakthrough of drives into cognitive forms (the primary thought processes). Clearly, clinical observations increasingly pointed up limitations of the existing model, which regarded libidinal drives as the dominant regulatory force in behavior, counterpoised by a vaguely defined inhibiting ego.

Expansion of the ego concept

In confronting the insufficiencies of the general theory, Freud could have revamped his conceptions of psychosexual (libidinal) determinism, conflict, and defense. The solution Freud adopted consisted, instead, of broadening the ego concept; he converted it into a hypothetical system of regulation endowed with an activity principle of its own, one that was coordinate with instinctual drives. All processes of selectivity of thought and action in their adaptive aspect were assigned to it. No longer was the ego simply an ad hoc passive outcome of impulses meeting implacable external barriers to discharge. This seemed to take care of the principal requirements of the new data—providing for adaptational motive tendencies and for decision, choice, and integration; control of drives was now viewed as but one aspect of the organism’s development. Moreover, the new schema brought to psychoanalytic theory a symmetry that it had previously lacked, for now the two main regulative principles, the pleasure and reality principles, were unequivocally associated with two coordinate and corresponding structuring instrumentalities— the pleasure principle with the id and the reality principle with the ego (and superego) system. Freud stated his final conception of the ego as follows:

Here are the principal characteristics of the ego. In consequence of the pre-established connection between sense perception and muscular action, the ego has voluntary movement at its command. It has the task of self-preservation. As regards external events, it performs that task by becoming aware of stimuli, by storing up experiences about them (in the memory), by avoiding excessively strong stimuli (through flight), by dealing with moderate stimuli (through adaptation), and finally by learning to bring about expedient changes in the external world to its own advantage (through activity). As regards internal events, in relation to the id, it performs that task by gaining control over the demands of the instincts, by deciding whether they are to be allowed satisfaction, by postponing that satisfaction to times and circumstances favorable in the external world or by suppressing their excitations entirely. (An Outline of Psychoanalysis [1940] 1964, vol. 23, pp. 145-146)

Through the critical functions of inhibition, detour, postponement, and integration via thought and action, the functions of defense, of realistic drive implementation, and of adaptation were joined to a single regulative system, coordinate with the drive system itself. Perhaps the most critical capacity attributed to the ego was an autonomous integrative function (actually developed more explicitly by Hartmann) that specifically cast the ego in a much more active role than Freud had ever before accorded it. According to Hartmann, “The most incisive change which took place in Freud’s model of psychic personality …[was] its representation as a (more or less) integrated whole, subdivisible in centers of mental functioning—these substructures being defined by their functions, and their demarcation being based on the fact that empirically he found greater coherence among some functions than among others” (Hartmann [1927-1959] 1964, pp. 146-147). This reference to “centers of mental functioning” represents the “structural point of view” in psychoanalysis.

Adjustment, control, and integration, and not simply the direct and indirect forms of drive discharge, thus became the main concerns of psychoanalytic theory. The achieving of harmony, balance, and general equilibrium, as well as the equilibria which result from conflict-determined defensive maneuvers, became a legitimate and even necessary focus of psychoanalytic observation. There is even a hint that the ego not only is coordinate with drives but also serves as organizer of drives, as a kind of omnibus regulator in the personality.

In general, the key change in Freud’s conception of the ego from his previous uses of the term was his recognition of an active principle independent of libidinal drive energy, which involves the turning of enforced responses into ego-initiated processes. The new conception brought into the foreground the proposition that the causal matrix of human behavior cannot be limited to unconsciously active instinctual drives and was the first explicit recognition of this in Freud’s thinking. The motivations that develop from this activity are “ego motivations” as distinguished from “drive motivations.” The ego’s dominion over the pleasure principle became, as Hartmann remarks, a possibility that was unthinkable in the earlier theory.

Indeed, so far did Freud go in his appreciation of the regulative power of the ego that in a later, sobering reflection on negative therapeutic reactions in analysis, he even proposed that there might enter into a person’s ego development a peculiar characteristic or deformity of its growth that predisposes it to conflict, whatever the drive components of the conflict—an inherent tendency of the ego to promote the conditions of conflict. Clearly, it was implied that the ego has a degree of organizational independence giving it capabilities of motivating behavior independently of drives.

Although Freud intended to solve problems in the general theory, it is ironic that his respect for the organizing momentum of ego activity actually created a dilemma in psychoanalysis, raising the critical problem of what the energic basis of the ego’s autonomy is. Freud’s hint that the ego was energized by a “neutral,” nondrive quantity had the effect of sharpening issues of incompatibility with libido theory, which his expanded ego conception was intended to resolve. It has raised questions about the tenability of his drive and energic conceptions as explanatory tools. We will return to these issues.

Freud’s final conception of ego created the prospect of a new field of psychoanalytic endeavor concerned with ego development; it drew attention to a primary biological fact: a protracted period of helplessness in the child, which had a great influence on the development of adaptational apparatuses and controls. Psychoanalysts were urged to consider in more detail the gradual emergence of control and internalized values that are attached to relationships and the manner in which these become means of regulation. The purely ego aspect of “object relations” thus became an area of possible study.

Freud’s final conception, although clear enough in its outlines, was hardly more than a series of programmatic hints and was ambiguous in a number of respects, such as the following. (1) The line of distinction between conflict and adaptational problem was by no means clear. The ego, in the new conception, was seen as an active adaptational participant, implying that neither all encounters nor all experienced impasses necessarily involve conflict. But, the distinctions between disequilibrium and conflict—and, for that matter, between the varieties of disequilibria and of conflict themselves—were by no means clear. (2) Although the new conception implied a distinction between specifically defensive encounters and other modes of adaptational controls, Freud still tended to emphasize the ego’s regulation of conflict through defense, although it was an ego working with “its own energies.” However, the new conception encouraged the broader view that behavior has a “multiple function”—that the organism is responsive to a complex array of “realities,” not simply to the drive-defense polarities of conflict. But Freud had said little about the varieties of adaptational encounter or about developmental “tasks” other than those involving instinctual drives. (3) There was still no explicit recognition of self as a grade of ego organization with which may be associated distinctive organizing functions and motivations. (4) One could say with justification that Freud still intended to view the ego’s functions in relation to reality mainly from the perspective of an environment that embodied actual and potential dangers and frustrations. Thus, the ego’s functions in the positive role of creator, rather than defender or adjuster, were only hinted at. (5) Finally, the issues of the nature and bases of the ego’s autonomy were left hanging, as was the problem of how one might now conceptualize the ego’s development independent of drive development. A reflection of this incompleteness was a curious ambiguity that remained in Freud’s notion of the anxiety signal: the new conception of anxiety did not distinguish libidinal from nonlibidinal sources of anxiety, although it implied that there was such a distinction.

Post-Freudian development

The concepts of the new ego psychology were amplified and systematized by Heinz Hartmann and supplemented by Ernst Kris, Rudolph Loewen-stein, and David Rapaport, the torchbearers of the new ego psychology. Erik Erikson’s efforts to delineate a biosocial conception of adaptational development are also pertinent, although he does not explicitly use an ego-psychological frame of reference. Erikson’s work, in fact, highlights certain of the difficulties inherent in ego psychology’s attempts to distinguish between drive “structure” and ego.

Hartmann perceived the central importance of Freud’s assumption of an autonomous activity principle (he calls it the synthetic, or organizing, function of the ego) and made it the key feature of his conception of an ego system which undergoes a development that is coordinate and interactive with that of drives yet remains distinctive. Within Hart-mann’s scheme the ego emerges more clearly as a general adaptational “organ,” reflecting in the range of its responsiveness responsibility to “realities” in the broad sense, as well as in the narrow sense of serving the pleasure principle. He views the ego in a problem-solving role, not simply as mediator of conflict; responsiveness to conflict becomes but one aspect of the ego’s function in the adaptational task of “fitting in” with an “average expectable environment.” Even the scope of conflict itself is greater than the clash of drive impulse and defense. As a self-regulative system, the ego responds to the requirements of different types of “disequilibria.”

A central theme is Hartmann’s conception of the autonomy of the ego’s functions—that is, the degree of independence of ego activities from drives and from involvements in conflict. Phylogenetic development has ensured that the human child will come into the world with an array of functions potentially adaptive to an average expectable environment, provided adequate environmental opportunity is supplied. These functions include the basic capacities and abilities of the organism: the abilities to perceive, to learn, to remember, to think, to move, and to act; talent and inborn gifts of all kinds, as well as dispositions to organize, to synthesize, to achieve balance from disequilibrium. The development of these functions is also relatively independent of drive, guided in large measure by the necessities of stimulation or contact with an environment that supports the actualizing of these potentials. (Relevant to this point is the great difficulty experimenters encounter in demonstrating consistent effects of needs on perception.) The assumption of conflict-free structures is extended even to functions that are responsive to parental and social realities. For instance, there is a conflict-free superego aspect of ego development. This framework makes it possible to accommodate such nonpsychoanalytic developmental theories as that of Piaget, for whom stages of the development of thinking are essentially the outcomes of interactions of perception and of action accompaniments of cognitive operations. [SeeDevelopmental psychology, article onA THEORY OF DEVELOPMENT.]

These assumptions of primary autonomy of functions signify recognition of a range of phenomena that do not owe their essential form to psychosexual influence. Indeed, the issue of the participation of drive and more generally of libido on ego development now becomes a more troublesome matter. Hartmann is careful to point out that “conflict-free” does not mean “drive-free” and that actually, many ego functions are molded on the pattern of such instinctual drive manifestations as giving and taking, introjection and projection, holding on and letting go; in these instances the ego functions have their analogue in the modes of motor functioning of the various erogenous zones.

For Erikson, this has been a departure point for developing a psychosocial conception of drives. For example, each of the zones that successfully attain a place of principal importance in the discharge of drive tension has one or more modes of operation that are basic for dealing with reality. The mouth lends itself to getting (i.e., receiving) and taking, the anus to holding on and letting go, and so forth. A critical point is that there takes place a process of estrangement, or autonomous separation, of the modes from their original locus in zones. They become, then, general ways of approaching the world. Erikson offers clinical examples from play configurations, dreams, neurotic symptoms, social behavior, etc. which show the utility of this way of viewing consistencies in behavior.

It should be pointed out, however, that Erikson’s mode-zone conception is actually more a reformulation of drive theory than an extension of the new ego conception of autonomy, for the core of his theory is that the kinds of functions associated with autonomous ego functions in the Hartmann scheme (e.g., perception, motor, etc.) are present as a part of drive structure from the very first. It is no solution—nor is it meant to be—to the dilemma created by Hartmann’s notion of how much primary autonomy is to be allowed to ego. Erikson proposed that drives are always implicated in psychosocial adaptational modes, having a formative influence on the modes as well as being themselves shaped by the modes, but this seems to undermine the conception of a drive-autonomous development, in contradiction to Hartmann’s view.

Conflict retains its importance in Hartmann’s schema as an important condition for the emergence of new varieties of motivation and of action structures. There are two distinctly novel features, however, in his view of the relation of conflict to development. One is his proposal that structures of regulation can undergo a “change of function” from defense to adaptation. A regulative process that developed as a means of coping with conflict can be used for purposes other than defense; a defense such as intellectualization or denial may turn into a means of nondefensive adaptation. It becomes, as it were, a generalized mode of cognitive control suited to a range of encounters requiring resolution. These are examples of secondary autonomy in the sense that, although they originated from conflict in the service of drive control, they developed into effective instrumentalities of adaptation generally. Secondary autonomy is a reminder that the conflict-free realm of primary autonomous functioning can be enlarged by the development of new structures. The natural course of development is seen, then, to be enlargement of the conflict-free sphere, building on the base of the primarily autonomous structures additional structures that serve to contain the drives, slow them, and harness them to useful work.

A second novel feature of Hartmann’s views has to do with alternative origins of defense itself. It is possible for the primary autonomous structures to play a role in predisposing the person toward certain modes of defense when he experiences conflict. In Freud’s earlier views adaptive modes of control (usually termed character defenses) themselves originated in defensive reactions and/or in fixations on one or another mode of drive gratification. Now Hartmann is saying that characterological style and adaptive control may not only be fashioned from defenses but that the reverse is also possible —defenses may be patterned on an autonomous behavioral tendency. Thus, a special talent may affect the distribution of libidinal and aggressive energies; it may itself be useful as a means of resolving conflict and, therefore, become a factor in determining habitual forms of defense. In this connection, the relationship between special sensitivities of infants and subsequent development of defenses in neurotic conflict is incorporated in this principle.

The developmental momentum of the conflict-free functions constitutes a source of independent motivation, of incentives for contacting the environment, and of adaptive control—a “third force,” on a par with drive and social reality. For instance, one source of motivation arises from the appearance, motivationally, of an anticipatory capacity which makes possible what Erikson calls time-locked motives. Hartmann attributes great importance to the anticipation function in ego development. Drives by themselves cannot guarantee adaptation to reality; neither is a heightened appreciation of reality enough to guarantee success for the ego’s primary role nor renouncing an immediate pleasure enough to secure a greater and more certain one in the future. Neither are fear of pain nor the lure of pleasure, for that matter, in themselves precise indicators of direction and selection. It is necessary to assume a factor for anticipating the future, for orienting actions according to it, and for correctly relating means and ends to each other. This effort, if successful, yields pleasure secondarily; thus, integrative efforts become themselves a source of motives for contacting the environment and for developing interests and talents —none being derivable from drives directly.

Thus, Hartmann’s formulation gives a place in psychoanalytic theory to function pleasure—that is, the intrinsically pleasurable aspects of the sheer exercise of functions—as a motivational source. Indeed, there is a hint that such motivations and the search for opportunities of exercising these functions without drive discharge as their basis are even necessary to normal development. Such intrinsic activity motivations guarantee, in Rapaport’s view, the “stimulus nutriments” required for growth; Rapaport suggested that the seeking of stimulus nutriment is the basis of many activities described as “curiosity,” “search for novelty,” etc. Incidentally, another implication of these views is that growth itself and motives that stimulate activity to a great extent depend on the environment, not on the instinctual drives, in the sense that contact with the environment seems to be essential for the development and persistence of certain psychological structures. The pleasures of such contact—and particularly of successful and effective contact—enlarge the organism’s repertoire of motivations, beyond those originating in instinctual drives alone. [SeeStimulation drives.]

It must be noted that in enlarging the picture of the sources of human motivation—motivations for dealing with reality that originate at least relatively independently of drives—Hartmann has also produced a more complex picture than heretofore of the potential conditions of, and participants in, conflict. For instance, motivations having to do with the function motives or intrinsic activity of the type mentioned above are not always consonant with those which derive from drives nor with internalized values. The disequilibria produced by conflict over drives, as well as those arising from within the ego system itself, become, then, a matter of psychoanalytic concern. Through his insistence on the importance of processes of adaptation to reality, Hartmann focuses attention on conflicts within, as well as between, systems: between drives and superego, between ego and superego, and between ego motives themselves.

The contemporary emphasis on the ego as a synthesizing system reflects a broader perspective of motivation than the earlier view, which saw it as a means of responding to drive tension. In the current view, the ego is a balance-inducing system, not simply a system for reducing tensions. Resolving the conflict of drive and superego demands is only one such task of the ego. The basic motivational conditions are still regarded as disequilibria, but these are not always assumed to implicate drive, nor do they always imply the reduction of tension; indeed, some conditions of balance and harmony may require an increase in the tension level of the organism.

Because the ego’s synthesizing function is essential in modulating tension and achieving balance in a condition of disequilibrium, the ego is established as the prime—in fact, only—regulative system of the psychic apparatus to which the claims of drives and of superego are subordinated. The new ego psychology has irresistibly moved away from the tripartite model of control to a single control system in which the id and the superego are forces. The ego becomes the embodiment of all active purposive realignments of behavior. “Loss of control” in the new scheme connotes “ego deficiency.” While the dominance of the ego system is not an acknowledged precept of the Hartmann, Kris, and Rapaport conceptions, it is a logical implication of their views.

Ego functioning seen as a developmentally autonomous process extends psychoanalytic interest to the study of particular functions, such as perception and memory. A program for the analysis of thought functions encompasses the ways thought and behavior become alienated from reality, the conditions of conflict and drive investment that determine this alienation, and the behaviors that characterize it. For example, one might ask about the conditions under which, and the forms in which, perception develops adaptively in giving rise to effective psychical representations of reality; the conditions under which it may become sexualized or drawn into conflict; its role as helper or opponent of drives—that is, in its defensive, as well as drive-facilitative, forms; and its modification in relation to the equilibrating requirements of superego motivations.

Pathological phenomena can be conceptualized through consideration of conditions which produce a loss of “ego autonomy”—that is, a loss of the ego’s integrative capacity when drive and superego demands are beyond the organism’s tolerances. This derives from the view that ego autonomy is always relative; it is never absolute. Drives and their traces can invade thought organization and action.

In emphasizing the possibility that ego autonomy may be lost under conditions of increased drive pressure or weakened ego functions or, in Rapaport’s view, under conditions of an altered state of consciousness, provision is made for the fact that adaptations can take regressive, as well as progressive, forms. At the same time, the effort for adaptive synthesis and mastery (an ego motive) may come about in a temporary abeyance of ego control and may yield unique and novel forms of integration and insights into environmental realities—a conception which Kris brought into prominence while attempting to determine the conditions necessary for artistic creativity.

Two other contributions to the expanded significance given to the ego construct deserve mention. One is Rapaport’s attempt to reinstate consciousness as a decisive force in selection and action to a high place in the ego’s repertoire of regulative functions. While Freud emphasized the distinction between conscious and unconscious forces, the delineation of the functions of consciousness in adaptation and in the motivation of behavior was not one of his major interests. In the early period of the Project, consciousness was more or less identified with ego and was assigned adaptational importance, but later, when ego became virtually synonymous with defenses, consciousness receded in significance as a determining force of behavior. However, the anxiety concept did reopen the general issue of the independently motivational importance of conscious states of feeling and affect and of modes of experience generally. The qualitative distinction between conscious and unconscious cognitive activity again assumed importance. For instance, Freud’s view that ego functions have different behavioral consequences in different states of consciousness exemplifies this concern.

Rapaport has described a variety of states and types of awareness and their behavioral effects. Perhaps the most important of his suggestions is the proposition that the less the capacities for vigilance, for reflective awareness, and for directing attention at will, the more do thought processes take on passive characteristics (i.e., show evidence of the primary process) and the less effective is secondary-process thinking.

Ego psychology within the general theory

The radical reorientation within psychoanalysis brought about by the advent of ego psychology is perhaps most prominently exemplified in the development of psychoanalysis from a theory of pathology and illness to one that has ambitions of embracing all psychological disequilibria, whether specifically pathological or not. The change may be summarized as a shift from the conception of ego as an instrumentality of discharge of sexual and aggressive instinctual drives—and specifically as defense against those drives—to a concept of ego motivations derived from functions of adaptation and the resolution of crises. Several aspects of the changed emphases in the parent theory deserve comment.

From conflict to crisis resolution

Psychoanalytic theory resists single-trend interpretations of behavior; its propositions deal mainly with contrasting and incompatible forces, either actual or those of fantasy. It was the resolution of a particular form of opposition—the conflict between defense and drive—that occupied Freud in the main. This original insight into conflict as a source of motivation is now better regarded as a restricted expression of a more general view of life as a developmental process in which the resolution of incompatibility, crisis, and impasse is a critical condition of growth. The conflicts stressed by Freud are one aspect of a process of constant “adjudication” of incompatible polarities—for example, that we live in a phantom world of I-other relationships, whose code has to be understood by every person. Partly as a result of the impact of current ego psychology, the terms or polarities of potential impasse are more inclusive, encompassing a wide variety of conflicts, including those forms not previously provided for in the theory. For example, Hartmann refers to conflicts within, as well as between, subsystems. Important emphasis is now given to developmental crises, in which modes of action and adaptation perfectly suited to the bio-social conditions of one stage are no longer appropriate to new maturational conditions and to social expectations tied in with these.

Crisis, impact, and dilemma produce a requirement for adjudication, and out of the variety of such felt or actual incompatibilities, including conflicts in the narrower sense of psychosexuality and defense, emerge motives of action and thought. The development of psychoanalysis has consisted in part of an even more discriminating appreciation of varieties of conflict and generally of the conditions of incompatibility that demand mastery. Psychoanalysis is still a psychology of motivation with emphasis on motives arising out of incompatibility, and this key principle is central to its clinical applications.

From defense to adaptation

It is also recognized that not all adaptational efforts are defense in the narrow sense. The emphasis on defense originated in a concern with illness and neurosis, the concept of conflict being the core of the theory. Now, as ego psychology becomes more explicitly a conception of adaptation and of developmental solutions, it is logical that it embody the assumption that adaptation is multiple faceted, with defense only one of its forms.

From instinctual drives to motivational diversity

The distinction between drive-originated and non-drive-originated motivations is increasingly a sensitive issue in contemporary psychoanalysis. The important clinical concern with motivational genesis—how the patient’s goals came to be what they are—often turns out not to implicate psycho-sexuality. Clearly, not all motivations—in the sense of purposively instigated contact with the environment—can be referred to the main driving causes —sexuality and aggression. Confronting psychoanalytic theory is the problem of embracing the uneasy recognition of extrainstinctual motivations without repressing the hard-won realization that such drives as sexuality and aggression indeed have a plasticity not given to other sources of motivations—for example, displaceability of drive aims and objects, a not easily inhibited peremptoriness, and a higher potential for involvement in conflict. The strength and ubiquity of unconscious love and hate, including their self-directed aspects, must be incorporated into a comprehensive motivational theory in the future. Erikson’s formulations are the closest approximation we have at the present time. The capacity of traditional libido theory to effect this reconciliation is highly doubtful, and in fact, the uncritical acceptance of libido theory within the newer emphases of ego psychology sharpens the theoretical dilemma.

From explanatory priority of unconscious wishes to explanatory parity of conscious purpose

The polarity of consciousness-unconsciousness was always significant to Freud, but mainly in respect to consciousness as reactive to unconscious forces, particularly in his early formulation of the conscious-ego system. Mainly because of Rapaport’s efforts, the causal importance of consciousness and of modes of experience is generally acquiring increasing respect in psychoanalytic theory. One aspect of this emphasis is a set of new possibilities opened up in respect to the importance of affects, previously considered as part of the anxiety-signal theory. One possibility is that an affective experience can be an independent source of motivation. The possibility has even been suggested that only via affect signals do drives themselves become motivations—that is, directional influences. At any rate, affect signals have been increasingly regarded as antecedents that determine realistic and unrealistic implementations of drive activation.

This change of emphasis in contemporary psychoanalysis is well illustrated by a reinterpretation of depression offered by Bibring to replace the traditional theory (1953). In the older theory, guilt over oral and aggressive strivings were assumed to be central in depression. In Bibring’s theory, depression is considered to be primarily an ego phenomenon “representing an affective state of helplessness” which comes about because two incompatible sets of ego cognitions are simultaneously active: feelings of lowered self-esteem, on the one hand, and, at the same time, unrequited aspirations and a not yet relinquished sense of potential. Low self-esteem, inhibition of ego aspirations, and helplessness are the important focuses of the syndrome. Bibring actually assigns a peripheral role to the drive factors that are central in the accepted theory. Drives may precipitate or complicate depression or be exacerbated as a result of the ego state, but they are not primary determinants of depression, the crucial factor being the ego state. The theory is truly a radical reformulation in several respects: (1) It assigns priority, not to instinctual drives, but to an affective state of the ego. (2) It assigns importance to goals and motivations that are explicitly of the ego and not of drives. The incompatibility is “intrasystemic” and does not implicate the id. (3) It assumes conscious experience to be an active force in determining behavior, in asserting that the experience of helplessness is a key event in the depressive syndrome. (4) It draws attention to dilemma in the broad sense, rather than to conflict in the narrow sense, as a dynamic principle. (5) It accords a determining influence—even as a “fourth force” —to a grade of ego structure having to do with self-esteem. (6) Overlapping with the above, it regards instinctual sexual drives and aggression as complications, but not prior determinants, of the depressive state. [SeeDepressive disorders.]

The effects of the expanded conception of the psychoanalytic enterprise and of the newer emphasis on the ego have been both vitalizing and humbling. It has, for example, decisively checked the earlier pansexual reductionism with which psychoanalytic therapy and theory were burdened for years. Moreover, recent developments have brought a broadened appreciation of social and cultural influences into psychoanalytic theory. Psychoanalysis has come a long way from its beginnings, when the ego was the contravening agent against the id and against the culture, to appreciation of the fact that only a supporting society and a loving mother can make a functioning ego. Ego psychology attempts to correct the earlier de-emphasis, while avoiding a simple environmentalism.

At the same time ego psychology has been a vitalizing influence in making psychoanalysis aware of the processes by which reality is engaged, of the varying modes and styles of such adaptational approaches, and of the pathological consequences of a break in the equipment of effective engagement with the environment. This last aspect has been a particularly important spur to experimental work in nonclinical settings. Also prominent has been the burst of interest in conceptions of ego development, a field of study distinct from the study of cognitive development per se or of intelligence, and emotions.

Furthermore, psychoanalytic therapy no longer regards its main task to be the uncovering of unconscious memories. It is now more a matter of deciphering and revealing the pattern of object relationships and of specifying the scope of these patterns of relationship in behavior and experience. The goals of psychoanalysis have thus become more ambitious and more difficult, and the hopes of success, consequently, more modest.

Some psychoanalysts have cast a jaundiced eye on the current ego psychology, viewing it as a throwback to attempts to undo the importance of sexuality and aggression in behavior—to re-repress the insights gained from Freud’s long period of concern with instinctual drives. This is a misleading interpretation of the development. It seems more likely that it reflects an attempt to deal with motivations in behavior that cannot be easily explained in terms of libido theory. The explicit aim of ego psychology is not at all to pre-empt the importance of the hard-won clinical facts descriptive of conflict, defense, transference, regression, fixation, unconscious fantasy, and screen memories— all of which require proper understanding of the powerful forces of sexuality and hate—but to make them part of a larger framework which will encompass facts which these concepts are either not consistent with or insufficient to deal with.

Evaluation of the concept

This seeming vitality and broadened perspective ought to be the happy note on which to end the present account. Ego psychology would appear to be a vigorous development on the psychoanalytic scene, one of increasing explanatory promise. Unfortunately, for all of the incentives to investigation promoted by ego psychology, there are grave doubts about its viability as theory in its present form.

A suspicious sign is the very inclusiveness of ego psychology. The ego has come to connote all those structures of man which, in the face of peremptory drive motivations, make him responsive to reality. Here is a summary of ego functions offered by two spokesmen for the new ego psychology: (1) consciousness; (2) sense perception; (3) the perception and expression of affect; (4) thought; (5) control of motor action; (6) memory; (7) language; (8) defense mechanisms and defensive activity in general; (9) control, regulation, and binding of instinctual energy; (10) the integrative and harmonizing function; (11) reality testing; and (12) the capacity to inhibit or suspend the operation of any of these functions and to regress to a primitive level of functioning (Arlow & Brenner 1964, p. 39). And this list does not even include the functions of the superego, which could quite properly be included as an ego “subsystem.” It is freely admitted, moreover, that ego theory offers no systematic principles by which to order its component functions hierarchically; which functions are most central and which most peripheral to ego as a structure are by no means clear. One result is vagueness in distinguishing ego development as a process from the development of intelligence, affect, and cognition generally and, indeed, from drive development.

Scientific theories have a way of hiding difficulties by attempting to resolve impasses by complication. Certainly, current ego psychology complicates the picture of conflict, motivation, and determinism of behavior, compared to the earlier psychoanalytic conceptions. Conceptual complexity is no sure sign of better theory; indeed, it may well signify weakness and error. Some of the ambiguities and difficulties in current ego psychology therefore deserve scrutiny. Four unresolved issues in ego psychology cast doubt on the fundamental viability of the concept.

Entity or taxonomy?

One difficulty in current formulations has to do with confusion over the appropriate data language to be used in designating ego phenomena. An aspect of this problem has to do with specifying the essential referent of the ego concept: whether the ego is a hypothetical unit or system of self-regulation with as yet unknown operational parameters, simply a taxonomical device for grouping functions according to their relation to id and superego, or a class of nonlibidinal motivations. Proponents of ego psychology are equivocal on this matter, and various theorists have even tried to dismiss the issue altogether. The first meaning—the ego as a regulative system— has definitely the ring of reification. In some accounts a definite structure, in some sense, of a hypothetical central mechanism is implied—structure in the “hard sense,” as in holistic references to the ego as “strong” or “weak” or to “autonomy of ego” from id.

On the other hand, reification is often and vigorously disclaimed; it is said that the ego’s “existence” is a matter of convenient metaphor (e.g., Waelder 1960). Something of the same type of usage, it is said, is seen in modern physics; an electron can be located only when it sends a message—that is, when it emits the ray in transmission from one energy level to another. And so it is with ego, superego, and id. The ego has its usefulness as an agent in sharpening the picture of the forces of conflict.

Despite such disclaimers, it is difficult to wave aside the possibility that the structural point of view carries inescapable assumptions of agency and process. In the early phases of his theorizing, Freud did not consider the ego simply as a grouping of functions; it had specifiable operational characteristics. Even if one takes the notion of the ego as a “group of functions”—that is, in its most popular current, taxonomical meaning—the very word “group” brings up questions of the processes of grouping, the nature of coherence, of why and how certain functions collaborate and others do not. Moreover, avoiding the ego as a motivational organization—a meaning also encountered—carries with it the assumption of interlocking purposes and development, and again, the nature of the coherence becomes an issue. Loewald has made this point well. There is a distinction, he says, between processes and the structures between and within which subprocesses take place. He and Eissler raise the question of how the three structures of personality function. It is difficult to see how current ego psychology working from the “structural point of view” can avoid assuming some kind of operational model of a system working as a whole, especially in presenting itself as an explanatory theory of causation and in eschewing the more modest and achievable goal of being a descriptive psychology of meaning and purpose. But failing to confront its covert assumptions of a process model, the causal explanations offered by ego psychology are bound to appear to beg the question.

There is more than mere suspicion that the new ego psychology does indeed lean upon a model of hypothetical process without acknowledging it as such—namely, the tension-discharge-equilibrium model. Disclaiming reification, ego psychology, nevertheless, does implicitly hold to the pseudo-neurological conception of psychical structure that is embodied in Freud’s energy conception of drives, and to the extent that it does, it inevitably has to reflect the limitations and inadequacies of this model of process and structure.

Some theorists (e.g., Rubenstein 1967) propose that ego theory ought to be directed toward the development of a model of self-regulation, one which would fill the gap in an uncertain meta-psychology of mechanism, which the theory implies. Thus, there have been proposals to conceptualize autonomy in terms of some actual—perhaps physiological—model of information processing. This would put ego psychology squarely into the business of investigating central processes.

Most psychoanalytic theorists are understandably reluctant to move in these directions, for to do so would commit theorists to a data language not easily suited to the observables and aims of the clinical situation and would very likely even require data of a different order than are obtainable in the consulting room. More important are well-founded doubts as to whether such models could ever be productive to clinical work or could ever move beyond the stage of simply translating the purposivistic concepts of clinical work to a seemingly nonteleological cast. The challenge to those calling for psychoanalysis to move toward developing models of operational process is this: unless such models have built into them capacities for consciousness, modes of experience, and reflection on social responsibility, they are not likely to be of much use to the clinician.

One could try to wave aside the issue by democratic gesture: Let those who wish go the direction of mechanism; live and let live. This is well and good, but it requires the existence of an alternative course. It is doubtful, however, that the currently popular structural point of view provides such a clear alternative. Proponents of the structural point of view—certainly the prevalent one—shun the responsibility of developing the operations model they implicitly avow, in hopes that an explicit concern with the functions through which reality-adaptive efforts are carried out will suffice.

However, a serious contributor to theoretical ambiguity is the fact that several meanings of “function” are used interchangeably and confounded in contemporary ego psychology: “function” in the sense of “survival utility,” “function” as “purpose” or “motivational aim,” “function” with the non-motivational meaning of “capacity” (e.g., perception, memory).

Vagueness in the conception of functions affects the meaning and utility of the key concept of primary and secondary autonomy of functions. A common illustration of primary autonomy is the great extent to which perception, motility, and learning are relatively independent of conflict and drive. Here the word “function” clearly has the meaning of “capacity,” “faculty,” or “apparatus,” without implication of “purpose.” But, if “perception” and “motility” are not motivational terms, in what sense can they be autonomous, especially since perception can be an instrumentality both of ego and id motivations? Secondary autonomy almost always refers to a “change of function” in the purposive sense, rather than in the sense of “capacity.” Defense, for instance, can become a generalized character trait. Thus, the seemingly unitary term “autonomy” lacks theoretical symmetry. The notions of primary and secondary autonomy are anchored to different meanings of “function,” and in the theory what is presumed to be autonomous is ambiguous.

Relationship to drive

Ego psychology presents a paradox, rather than offering a solution, in assuming, on the one hand, that certain functions undergo a development outside of conflict, and, on the other, that “conflict-free” does not mean “drive-free.” Autonomy means “autonomy from conflict,” not “autonomy from drive.”

Ego psychology seems not to have confronted the implication that if there is only one set of instrumentalities of perceiving, motility, etc., involved in the structuring of drives and, indeed, of all motivations, the necessity of assuming an agency distinct from id (and therefoic two sets of instrumentalities, one for drives and one for ego motivations) becomes rather less urgent, even superfluous; if the distinct agency is retained, it becomes simply another and redundant way of referring to self-regulation in the organism as a whole, which includes drive as one aspect of its totality.

A key change in Freud’s later conception of the ego was his recognition of an active motivational principle of growth that went beyond the pleasure principle of libidinal gratification—the turning of enforced responses into ego-initiated responses. The explication of this critical precept of ego psychology is still in its beginnings (Erikson’s formulations are a most promising start). The unsettled question is whether there is a psychoanalytic version of ego development that is distinguishable from psy-chosexual development.

Catch-all or distinctive theory?

In this sense, contemporary ego psychology is a reminder to psychoanalysis of theoretical tasks hardly begun. Merely to list the ego’s functions is not to account for the logic of their grouping and the dynamic principles by which functions cohere and differentiate. What Hartmann and his collaborators have done in acknowledging conflict-free processes, as Loevinger points out, is to give ego functions “a local habitation and a name within systematic psychoanalysis” (1966, p. 433). This is an achievement, but it is not yet an integration of ego psychology into psychoanalysis. Acknowledging a “synthetic,” or “integrative,” function of the ego is not to state a dynamic principle by which to explain behavior in terms of synthesis activity. It is less important to assert that motivations can emerge from a process of “secondary autonomy” than to specify the dynamic principles that account for their origin and their subsequent predominance over developmentally earlier motivations. Lacking such dynamical principles of epigenesis, many of the concepts of ego psychology, such as primary or secondary autonomy, seem less like explanations than descriptive and classificatory formulations of phenomena that psychoanalytic theory had previously made it difficult to recognize.

The fundamental issue, then, confronting ego psychology is the question of whether the broad conception of the ego as an arbiter of reality is a parsimonious theory, which, under a few principles , systematizes the seemingly diverse and unrelated purposes and motives observable in behavior, or is a means of developing ad hoc propositions to provide for observations that do not square with the theory of libidinal energy.

It should be pointed out that the discoveries of the pervasive influences of sexuality in pathology and the observations of developmental continuity in sexuality are the bases of, but are not identical with, the libido theory. The conception of a libido energy which is inherently directional and has an inherited developmental course is a special hypothesis designed to pull together diverse manifestations and developmental aspects of sensual pleasure. Thus, confirmation of the pervasiveness of sexuality is by no means confirmation of the libido theory. There is extraordinary resistance to making the separation, even though it has been many times demonstrated that the libido theory far from suffices to deal with many strands of evidence and observation of sexuality. Yet, these inadequacies forced Freud to revise his account of the nature of motivation, and these revisions are a prominent part of ego psychology.

To appreciate better the link between the ego conception and the libido theory, recall Freud’s early model, which assumed a flow of energy into the mental apparatus from two peripheral sources, external and internal. Drive, the internal source, pervades and energizes the mental apparatus as an uncoded stimulus; “drive” thus had the dual connotation “stimulus and energizer.” The ego concept was introduced to provide a responsible controlling agent, some means by which the uncoded stimulus is made cognitively sensible and given direction and which accomplishes and modulates the drive’s “aim” of discharge. In libido theory, too, the notion of an energy which builds up tension, requires discharge, and is modulated to an equilibrium is fundamental. In the libido conception the notion of ego control came to place more emphasis on defense, variously described in terms of censor, repression, and even for a short time ego drive.

However, the challenge of how to conceive of the ego apparatus was a much more formidable one in the context of the libido theory than in the simplistic model of “endogenous” and “exogenous” energies of the Project. In the latter, drive was simply an internal energic quantity. The ego concept could accommodate that. But, the libido theory proposes something more: it connotes an energy quantum having its own aims, range of objects of discharge, epigenesis, and even its own mechanisms (e.g., displacement, consideration). In the later, tripartite model, id is truly an agency of impetus, requiring a very special agency of control. It gradually became evident that not all motivational phenomena could be encompassed by the libido conception. Freud faced a choice: Was the trouble to be diagnosed as a defect of the libido conception or as an inadequate picture of ego? Freud’s decision was unequivocal. The conception of the ego as a controlling agent was changed, not the libido theory. Thus, a case can be made for the proposition that every change made thereafter in the ego conception was indirectly a supportive effort to retain the libido conception unaltered.

With expansion of the ego concept, however, the strains of coexistence have become even more evident. Ego theory in its late development has had to take account of the adaptive plasticity of behavior, cognitive autonomy from stimulation, capacities for choice and volition, and the independence of abilities and intelligence. But, the libido concept presents an impediment to such a picture of the ego; it assumes a distinctive quality of energy, having its own aims and structuring implementations independent of the ego and undergoing its own distinctive development, and requires an ego whose dominant function is to serve as a control over the claims for discharge of sexual and aggressive energies. This simply contradicts the trend toward a broadened conception of an ego as an autonomously motivating agent. The trouble began with accumulated evidence of reality-adaptive motivations that had no easily determined relationship to sexuality. It is to Hartmann’s great credit that he confronted the motivational phenomena that forced extension of ego theory, but recourse to continuous enlargement of the ego concept is no strategy of parsimonious solutions.

The signs of strain are evident in the ingenious recourse to the concept of neutralized drive energy as a solution to this dilemma. Libido retains its status as an independent energic force. However, this hardly clarifies how the allegedly independent drive energy can come under the sway of the structuring functions of the organism. There seems to be evidence that for sexuality to develop, the right psychosocial setting and adaptive instrumentalities must be present; in Rapaport’s terms, drives also need their “appropriate supplies” of environmental stimulation. Solution of this dilemma still confronts contemporary psychoanalysis. [SeeSexual behavior.]

It seems likely that resolution of the difficulties in meshing libido theory and ego psychology will come neither by further expansion of the ego concept nor by inventions of bridging concepts such as neutralization, but through a different theory of psychosexual development, which will replace the libido concept. Erikson’s conception points the way. Erikson’s is a configurational, rather than an energic, conception of psychosexuality; qualitative aspects of mode (apparatus) and zone are fundamental. If one were to look at these in the conventional psychoanalytic framework, one would have to say that such mode-zone applications are simultaneously ego-drive structures. But, obviously the latter terminology and the tripartite model of ego, superego, and id, whose sense rests on the assumption of distinguishable energic forces, simply does not suit such a schema as Erikson’s, in which the configurations of mode-zone relationships are the drive structure.

Equilibria versus motivational explanation

Analysts waver between two modes of theoretical explanation, and ego theory reflects this uncertainty. One mode of explanation uses the impersonal terms “tension reduction,” “equilibria,” and “discharge.” The other mode is couched in terms of purpose in the extended sense of direction and aim of behavior. For the early Freud, only a nonteleological mode of explanation was satisfactory, and when he failed to accomplish this in a neurophysiological model, he kept on trying with a neutral language of energy, cathexis, delay of discharge, and the like. This model persists to this day and with it the conflict between the “clinical” side of psychoanalysis (i.e., its bias toward motivational explanation in the extended sense) and its nonteleological, impersonal focus on alleged energic processes. Despite the fact that everyday clinical work is nothing if not an investigation of the purposes or motivations of behavior, when it comes to explanation, theoreticians feel this is to be avoided like the plague. Thus, Hartmann ([1927-1959] 1964, p. 89) comments that Freud’s regulative principles protect psychoanalysis from teleology. Directions and aims are construed as reflecting trends toward different types of equilibria —for example, self-preservation (reality principle), pleasure principle, nirvana principle, repetition compulsion. The regulation set in motion by equilibration requirements is accomplished through particular functions—for example, the organizing function of the ego, the trend toward synthesis, and the trend toward independence from environmental stimuli. On this level of explanation, the purposivistic cast of the clinical explanation of specific goals and objects is not explicitly acknowledged; the causative principle is equilibration. This duality of orientation in explanation lends uncertainty to ego theory. [SeeHomeostasis.]

The uncertainty consists in the fact that attempts to cast explanation in nonteleological form logically moves ego psychology toward a theory of self-regulation which, if it is to have empirical utility, requires theoretical models of system operation—of how such equilibria are actually established. At the same time, to accept this challenge distracts from the fundamental clinical tasks of the psychoanalytic enterprise, which is to account for behavior purposivistically, with reference to its aims, directions, and goals; the conflicts that enmesh purposes and generate others, conscious and unconscious; their developmental epigenesis; and their consequences in pathology. Moreover, if ego functions rather than operational structure are to be the central concerns of ego psychology, it is surely not the ego apparatuses as such, but mainly their engagement in purposes and meanings, that is properly the focus. Certainly, the latter program seems more natural to psychoanalytic clinical objectives. Such a focus would offer ego psychology the sorely needed basis on which to distinguish itself, on the one hand, from a psychology of intelligence and cognitive functioning and, on the other, from a psychophysiological theory of sexual and aggressive drives.

But, this commitment is far from clear in present ego theory. Two different theoretical enterprises are implied in the two modes of explanation with which ego psychology is identified. Current ego psychology tries to straddle both, with no gain to either. When these two explanatory focuses are combined, the result is often unhappy. As an example, take Rapaport’s conception of “autonomy of the ego from drive.” This combines a seemingly telic concept of autonomy—but not developed as such—with a special conception of drive as a directionless, contentless quantity seeking discharge. (Rapaport, in fact, avoids the libido conception, arguing that it is expendable, and reverts to Freud’s earliest conception of a nonspecific drive quantity.) Rapaport presumes to explain behavior in the nonteleological terms of an assumed state of equilibrium. “Autonomy” is not meant in an experiential or phenomenological sense as Erikson uses it (as a “sense of autonomy” which characterizes self-identity), but as a purely hypothetical condition of the status of an energy quantity. If one chooses to dispense with the notion of a directionless drive energy which banks up against psychical dikes and flows to its discharge, Rapaport’s autonomy notion holds little appeal. It is once again Freud’s notion of endogenous, undirected energy demanding discharge . As in Freud’s original model, the environment is essentially a matter of demands and noxious impingements of impersonal stimuli.

At the same time, the energic conception of drive and of libido in particular obscures the distinctive motivational aspects of ego theory by foisting upon it a dubious data language of cathexis, energy, and discharge. This burden will remain with the ego concept as long as the parent model, of which it is a part, holds that there are independent, “blind” forces to be controlled and that there must be an agency of such control. The language of psychoanalysis has, thanks to ego psychology, become enriched with references to nonsexual factors in motivation, but it has not yet become a theory of such motivations. Contemporary ego psychology is to be likened more to a melting pot of phenomena and propositions that are not readily encompas-sable by a tension-reduction, stimulus conception of drive.

Psychoanalytic theory currently faces the choice either of continuing to explicate a model of the ego as a regulatory mechanism—building into it more detailed process assumptions to implement its heretofore implied, but unspecified, reifications and, with this, to take on a commitment for types of nonpsychological data on physical and physiological processes—or of frankly restricting its scope and its terms to the orientation that brought the theory into being, an endeavor concerned with motivational meanings of behavior and with understanding behavior in relation to psychological dilemma and conflict, an enterprise termed by Waelder the exploration of the multiple functions of action. Further efforts in this direction would have to shed all pretense of offering a nonteleological mechanistic picture, such as are implied by impersonal processes of homeostasis, equilibria, cathexis, energy and its modifications, and the like, which imply and require a different domain of data. The direction would be the use of theoretical terms and a data language that has a frank and direct reference to basic purposivistic tendencies of man and their evolution and epigenesis in a lifetime. This is actually what analysts do in their clinical work; it is not yet fully reflected in the systematic theoretical enterprise of psychoanalysis.

George S. Klein

[Directly related are the entriesConflict, article onPSYCHOLOGICAL ASPECTS; DEFENSE MECHANISMS; Drives, article onACQUIRED DRIVES; Identity, Psychosocial; INSTINCT; MOTIVATION, article OnHUMAN MOTIVATION. Other relevant material may be found inAnxiety; Perception, article onPerceptual DEVELOPMENT; PERSONALITY; PERSONALITY: CONTEMPORARY VIEWPOINTS; and in the biographies ofFreud; Kris; Rapaport.]

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Rapaport, DavidThe Collected Papers of David Rapaport. Edited by Merton M. Gill. New York: Basic Books, 1967.

Rubenstein, B. R. 1967 Explanation and More Description: A Metascientific Examination of Certain Aspects of the Psychoanalytic Theory of Motivation. Pages 20–79 in Robert R. Holt (editor), Motives and Thought: Psychoanalytic Essays in Memory of David Rapaport. New York: International Universities Press.

Shakow, David; and Rapaport, David 1964 The Influence of Freud on American Psychology. Psychological Issues, Vol. 4, No. 1. New York: International Universities Press.

Sperling, Samuel J. 1958 On Denial and the Essential Nature of Defence. International Journal of Psychoanalysis 39:25-38.

Spitz, Rene A. 1960 A Genetic Field Theory of Ego Formation: Its Implications for Pathology. New York: International Universities Press.

Stein, M. 1965 States of Consciousness in the Analytic Situation, Including a Note on the Traumatic Dream. Volume 2, pages 60–86 in Max Schur (editor), Drives, Affects, Behavior: Essays in Memory of Marie Bonaparte. New York: International Universities Press.

Stone, Leo 1962 The Psychoanalytic Situation: An Examination of Its Development and Essential Nature. New York: International Universities Press.

Waelder, Robert 1936 The Principle of the Multiple Functions: Observations on Overdetermination. Psychoanalytic Quarterly 5:45-62.

Waelder, Robert 1960 Basic Theory of Psychoanalysis. New York: International Universities Press.

White, Robert W. 1963 Ego and Reality in Psychoanalytic Theory: A Proposal Regarding Independent Ego Energies. Psychological Issues, Vol. 3, No. 3. New York: International Universities Press.

III THERAPEUTIC METHODS

The psychoanalytic technique is a method of treating psychoneurosis which is based on uncovering the forces and motives that underlie the patient’s symptoms. It originated in a chance discovery made in 1882 by Josef Breuer while treating a severely disturbed hysteric (the famous case of “Anna O.“). When she was in a hypnotic state, this patient would talk to Breuer either spontaneously or in answer to his questions and would recount painful, upsetting events of her life that appeared to relate to elements of her symptoms or to words she would utter while in twilight states. The patient herself called this treatment “chimney-sweeping, “because each recall of a traumatic event was followed by the disappearance of symptoms related to that event. For instance, her inexplicable terror of drinking water from a glass vanished after she remembered that she had once seen her governess let a lap dog drink out of a glass and that the sight had aroused considerable disgust in her.

Freud’s development of psychoanalytic therapy

In 1889 Freud began to apply this cathartic method, as it was called, to other hysterical patients and was able to confirm Breuer’s discovery. Freud and Breuer described their experiences in their Studies on Hysteria (1893-1895). In a later work (1914a), Freud made a record of some additional observations concerning the technique evolved by him. He stressed that for a satisfactory therapeutic result it was essential that the patient remember all traumatic events: the earliest and the most recent, as well as all intermediate ones; moreover, the remembering of traumatic situations had to be accompanied by the re-experiencing and verbal discharge of the affects connected with the traumata, affects that had been “strangulated.“[SeeHypnosis; Hysteria.]

As he continued to treat patients in this way, Freud met with two shortcomings of the cathartic method. Some patients could not be hypnotized; others, although susceptible to hypnosis, experienced only temporary relief of their symptoms. In brief, he found hypnosis an unreliable therapeutic tool. For a short time he experimented with what he called the method of concentration, which consisted in prompting the patient to remember the forgotten events while pressing his hand on the patient’s forehead. He described how the patient would respond to this prompting with ideas that occurred to him (free associations), which were either the looked-for traumatic events or some other experiences or thoughts or fantasies or dreams. In these seemingly unrelated associations, Freud soon learned to discern connections, allusions, and hints referring to symptoms, on the one hand, and to some as yet unremembered traumatic situations, on the other. Gradually he became able to guess or to infer, from all this material, the traumata on which the neurosis was based. At this point he developed the framework of what later was to be called the method of interpretation and reconstruction (1900; 1916-1917; 1937a; 1937b). At the time he developed this method, Freud made another discovery which was to become fundamental for psychoanalytic technique. His patients had great difficulties in remembering and were reluctant to communicate even seemingly innocuous ideas. Freud concluded that these inner obstacles —resistances, as he called them, borrowing a term from physics—were in fact the counterpart of the forces that kept the relevant memories and related affects shut off from consciousness.

The actual psychoanalytic technique, as we know it today, started when Freud replaced the method of concentration with that of free association. This technique has progressed throughout the past decades, but its essential features were laid down by Freud between 1900 and 1915 (1905a; 1908; 1909a; 1909b; 1911-1915; 1941a). Freud’s gradual development of the method over those years resulted in successive changes in his theoretical views on the etiology and pathogenesis of neuroses.

Freud’s early ideas on the nature of pathogenic traumatic events were epitomized in his theory of sexual seduction during childhood. The realization that many such sexual traumata had not really occurred, but represented the patient’s unconscious fantasies, opened the way to his first discovery of childhood sexuality (1905b). Neurotic symptoms were recognized as determined not merely by some fortuitous traumatic event but by an interplay of forces: by pathogenic conflicts between warded-off (repressed) instinctual demands and warding-off (defensive) forces of the ego. The psychoanalytic method strives to make conscious both the warded-off and the warding-off unconscious elements involved directly or indirectly in the patient’s symptoms. It leads to therapeutic results on the basis of this transformation. The investigative and therapeutic aspects of the psychoanalytic method overlap partly, but not to the same extent in each case.

Free association

The method of free association expects the patient in analysis to say whatever occurs to him, without “censoring. “This is called the basic rule of psychoanalysis. The method leads to a gradual unfolding of preconscious derivatives of the conflicting forces. In practice, this process is initiated by a compact made between the psychoanalyst and his patient: the patient promises complete candor; the analyst, total discretion. That is how Freud (1940) defined the psychoanalytic situation. The practical arrangements, consisting of regular and frequent treatment sessions, commonly of fifty minutes’ duration and held four to six times per week, with the patient lying on a couch and the analyst seated in a chair behind him, have valid technical reasons. The psychoanalytic process unfolds in the most favorable way under these conditions.

The rationale for the method of free association is based on the observation that when conscious, goal-directed thinking is partly relinquished in favor of spontaneously emerging thought contents, part of the habitual defense against preconscious and unconscious material can be bypassed. The analysand’s supine position tends to eliminate or weaken a further source of automatic censorship; it facilitates the verbalization of thoughts which would automatically be left unspoken in the usual face-to-face conversation. The result may be that the patient remembers situations he had forgotten, or expresses thoughts that at first seem foreign to him, or that familiar memories appear unexpectedly in a new psychological context. Or again, during some session a number of thoughts and memories may emerge in which the analyst will discern a common theme or denominator. The frequency and relative length of psychoanalytic sessions promote a gradual reactivation of past emotions, fantasies, memories, and thoughts, which are thus made available to the conscious ego of the patient.

The initial psychoanalytic situation develops into a process of interaction between analyst and patient in which each has a task to perform. The patient gradually learns to comply with the basic rule. The analyst assists him in doing so, learns to understand him, and communicates this understanding to him. It is a lengthy and highly complex procedure, mainly because some derivatives of pathogenic conflicts are, or become, involved in the process of free association itself and interfere with the patient’s ability to follow the basic rule.

Resistance and transference. The way in which a given analysand observes the basic rule results in a variety of individual modes of free associating. These diverse modes are influenced, above all, by the particular resistances against the basic rule which inevitably emerge in every psychoanalytic treatment.

Despite sincere efforts to be candid, patients cannot avoid censoring some of their thoughts. Either they are ashamed or feel guilty about certain actions or wishes, or what occurs to them seems too irrelevant or stupid, too indiscreet or too offensive, to be uttered. At times, they go to any length to avoid expressing such a thought; or they recount it but omit some detail that is essential for its understanding. Or again, they communicate important thoughts or memories in a clinical and impersonal fashion, without being aware of, or able to express, the corresponding affect. And sometimes, although they feel they have very much to tell, they find it impossible even to utter a single word. These inner obstacles (resistances) to free association represent effects of the defensive forces, transferred from the pathogenic conflicts as such onto the psychic material which might reveal them during treatment. The unconscious struggle against bringing the warded-off pathogenic conflicts to consciousness reveals the underlying, unconscious, individually variable trend to preserve the neurosis.

Often the thoughts which patients are most reluctant to express have to do with the person of the analyst. The material of the free associations is connected either with the neurosis or with reactions to the analyst, and these reactions, feelings, and general attitude of the patient toward the analyst are so important that the outcome of the treatment may depend upon them. Freud took an essential step in elaborating the psychoanalytic technique when he recognized them as transferences, i.e., as transpositions from an infantile object onto the analyst or as modified unconscious repetitions, in the treatment situation, of early warded-off tendencies and experiences, but now with the analyst as object.

This objective approach in dealing with the patient’s reactions to the analyst has become an essential tool in analyzing those resistances which are of particularly far-reaching influence on the treatment: the so-called transference resistances. These may manifest themselves as direct obstacles to free association or may influence the associations in more subtle ways. For instance, the basic rule may be made inoperative by being taken too literally; it may be used for concealed parody of the analytic treatment or used in various indirect ways to gratify complex, unconscious transference reactions. The diverse transference resistances comprise old defenses and the instinctual demands themselves. Thus they represent a new version of infantile pathogenic conflicts unconsciously relived in the patient’s efforts to associate.

The genetic approach. The fact that the psychoanalyst understands the patient’s reactions toward him as manifestations of transference, and analyzes them from a dynamic as well as an ontogenetic point of view, is referred to as the genetic approach (Hartmann & Kris 1945). It calls for the use of genetic interpretations and of reconstructions of the patient’s warded-off past experiences. This genetic approach is particularly prominent in the analyst’s work when dealing with those phenomena which constitute a transference neurosis or, better, transferred neurosis; that is, when transferences are no longer isolated manifestations, but a considerable part of the patient’s symptoms becomes involved with the person of the analyst or the process of analysis itself.

The work of interpreting becomes effective mainly when applied under favorable conditions and in particular ways. An important aspect of the analyst’s work consists in working through the resistances which oppose progress and success of the treatment (Freud 1914a; 1914b).

When the patient has difficulties in following the basic rule of free association, the task of the analyst is twofold. He must assist his patient in overcoming these obstacles. On the other hand, he must understand, and help the patient to understand, what they reveal with regard to the neurosis. For example, if he becomes aware that the patient’s free associating is hampered by an effort to avoid the expression of hostile thoughts against him, he will point out this conflict and will strive to understand and to interpret it as a modified repetition of similar situations that the patient has encountered with other persons. These actions of the analyst further the process of free association, and at the same time affect the patient in a therapeutic sense.

Interpretation

The analyst has at his disposal a number of possible interpretations that are characteristic and specific for the psychoanalytic method. In psychoanalysis the term “interpretation” is applied to those explanations which add to the patient’s knowledge of what has been warded off in himself. Interpretations aim at both the defensive and the instinctual motivational aspects of the conflict. In the example mentioned above, the interpretation can stress the struggle against aggression (resistance analysis); it can stress the aggressive (instinctual) character of the warded-off thought; ultimately, it should encompass both in their genetic perspective.

Although Freud had early emphasized the crucial importance of the analysis of resistances (1912a; 1912fo), his major scientific interest for a long time focused on the study of instinctual drives. The psychoanalytic investigation of his patients’ pathogenic conflicts led him to important discoveries concerning the repressed (or otherwise warded-off) instinctual impulses. These could be understood as derivatives of the libidinal and aggressive drives. He thus was able to reconstruct the maturational and developmental sequences of those drives in early childhood, as well as the specific types of object relations that correspond to their various developmental stages. The Oedipal phase of development is the best-known example. [SeePersonality, article onPERSONALITY DEVELOPMENT.]

In the course of the treatment, the existence of these drives, and their impact upon the patient’s behavior in the past and in the present, are pointed out to him by interpreting his dreams, associations, symptoms. This is often referred to as id interpretation. However, these interpretations alone do not generally enable the patient to become conscious of the drive derivatives in a genuine, therapeutically effective way. They must therefore be preceded or supplemented by an analysis of his resistances, which makes the patient’s adult ego better capable of tolerating his hitherto warded-off drives. The therapeutic objective of psychoanalysis is to change the balance of psychic forces that prevailed when the pathogenic conflicts were formed to a new balance better adapted to the patient’s adult condition. Both the-warded-off and the defensive forces are inaccessible to change so long as they remain unconscious. Hence the importance of analyzing the latter as well and making them conscious.

Elaborations on Freud’s initial contribution

Since Freud laid down the principles of psychoanalytic technique, our knowledge both of normal psychic functioning and of mental illness has grown considerably, and progress in psychoanalytic technique proper has been made. Many analysts have contributed to this technical progress and refinement. Of the many, I should like to mention only a few: Freud, in his papers “Analysis Terminable and Interminable“(1937a) and “Constructions in Analysis“(1937b); Ferenczi (1908-1933); Ferenczi and Rank (1924); Abraham (1907-1925); Nunberg (1920-1942). Other books are devoted entirely to psychoanalytic technique: Glover (1928); Lorand (1946); Menninger (1958); Nacht (1950); Alexander and French (1946).

Ego psychology

A particularly important development in psychoanalysis was the introduction of ego psychology. The scientific basis for a systematic, effective analysis of resistances (defenses) had been lacking before Freud’s reformulation, in the 1920s, of certain fundamental propositions. The new theoretical concepts he advanced at that period laid the ground for a psychoanalytic ego psychology. Most important for the progress of analytic technique were his new formulations referring to unconscious defenses of the ego, to unconscious self-critical or self-punitive forces (the superego), and to anxiety as a signal operating as a trigger of defenses (1923; 1926).

Technical innovations based on Freud’s theoretical reformulations were introduced by Wilhelm Reich (1933) and in a particularly fruitful way by Anna Freud. The application of ego psychology to psychoanalytic technique was further elaborated by such authors as Fenichel (1941); Hartmann (1951); Hoffer (1954); Kris (1951; 1956a; 1956k; 1956c); Loewenstein (1951a; 1951fc; 1954; 1956; 1957; 1958; 1963); Nacht (1951); Stewart (1961).

The importance of the defenses of the ego has influenced the analyst’s approach to the patient’s free association. In the treatment situation the analyst thus pays attention not only to the material emerging when the patient follows the basic rule but equally to his struggles against it (Anna Freud 1936). The latter tend to reveal the characteristics of particular mechanisms of defense. For instance, whether a patient reacts to a hidden aggressive impulse against the analyst with fear of punishment, with exaggerated solicitude, with sudden silence, or in some other way may disclose a great deal about the character of his relevant defenses against aggression, not only in the present but also in the past, and hence shed light on their role in his pathogenic conflicts. Thorough understanding of an individual patient’s defensive mechanisms, and of their impact upon his neurosis, his general behavior, and the course of his analysis, is as important as the understanding of his instinctual drives. [SeeDefense mechanisms.]

The functions of the ego are not limited to defensive mechanisms; some are relatively independent of the disturbing influence of drive derivatives. This has an important bearing on psychoanalytic technique, for the patient’s ability to associate, to recover childhood memories, to gain insight, rests upon the autonomy of the relevant ego functions (Hartmann 1939). Their roles in the psychoanalytic process are of paramount significance (Hartmann 1951; Kris 1951; 1956a; 1956b; Loewenstein 1951a; 1951b; 1957; 1963).

Sources of resistance

In Freud’s earliest formulation, the therapeutic effect of psychoanalysis had been attributed to the recall of forgotten traumatic events and to the abreaction of strangulated affects. That assumption has long since been discarded. Current psychoanalytic theory sees the major therapeutic agent in the overcoming of resistances and in the bringing to consciousness of warded-off material: recovery of memories, re-establishment of disrupted connections, gaining of insight.

Psychoanalytic treatment must overcome many obstacles in order to achieve satisfactory results (Bibring 1937). Resistances to cure originate in the three “systems“of the psychic apparatus—the ego, the id, and the superego—and in external reality as well.

Rigidity, primitiveness, and the relative strength of defensive mechanisms represent the major part of observable resistances. Also, in most instances, the patient’s ego derives advantage from his neurosis (epinosic, or “secondary” gain), causing him to cling to it, which can be a serious hindrance (Freud 1926). Such disturbances of specific autonomous ego functions impair analyzability (Hartmann 1951).

The strength and tenacity of pregenital components of the instinctual drives and, conversely, the weakness of their genital components constitute barriers to cure. These quantitative factors in the id must be considered in relation to the strength of the ego and not in terms of absolute values (Freud 1937a; 1937b).

Unconscious self-punitive demands of the superego often play a decisive role among the resistances to cure. While somatic illness usually activates or complicates neurosis, it produces the opposite effect in a category of patients known as moral masochists. Their neurotic symptoms disappear when they are affected by a somatic disease. Once well again physically, they relapse into their neurosis. In these cases one can best observe the so-called negative therapeutic reaction (Freud 1923).

Social, cultural, and economic conditions can contribute to neurotic illness in some cases, to favorable conflict resolution in others. Familial circumstances especially may hold the balance in this respect. The momentous impact of parental behavior upon psychic development in childhood is well known. But also the presence or absence of neurotic disorder in other members of the family, or in the patient’s husband or wife, may prove decisive for the outcome of an analytic treatment.

The recent advances in our knowledge, briefly outlined above, have not changed the technique of psychoanalysis itself. Rather, they have led to some shifts of emphasis and considerable refinements in its use. These modifications have broadened the applicability of psychoanalytic treatment and have improved its efficacy. In many instances, they can make the difference between failure and success.

Originally, psychoanalysis was found effective exclusively in the treatment of symptom neuroses in adults. Its successful use in treating the neuroses of children and adolescents opened up an important area for psychoanalytic therapy. Except for some changes in the procedure, e.g., substitution of the play technique for free association, the method in child analysis is basically the same as in the treatment of adults (see Anna Freud 1936).

The application of psychoanalysis to an ever greater variety of behavioral disorders, even to psychoses, produce striking results but also a number of disappointing failures. Many patients, and some analysts as well, set their aims too high. They expect psychoanalysis to achieve not merely a cure of neurotic illness, or even the emergence of a new and better personality, but—above all— lasting happiness for the patient. These hopes have obviously not been realized.

The widening scope of analytic treatment led, in its turn, to a greatly increased use of psycho-analytically oriented psychotherapy. The dividing line may be tenuous at times, but most forms of psychotherapy differ technically from psychoanalysis in rationale as well as in practical use. However, virtually all contemporary forms of psychotherapy draw to some degree upon psychoanalysis, either as a method or as a body of knowledge. Psychoanalysis has enriched and profoundly influenced the entire fields of psychiatry and psychology.

Rudolph M. Loewenstein

[Directly related is the entryInterviewing, article onTHERAPEUTIC INTERVIEWING. Other relevant material may be found inClinical PSYCHOLOGY; Mental DISORDERS, TREATMENT OF, especially the article onPsychological Treatment; Neurosis; Psychiatry; and in the biographies ofAbraham; Alexander; Ferenczi; Freud; Rank; Reich.]

BIBLIOGRAPHY

Abraham, Karl (1907-1925) 1953–1955 Selected Papers. 2 vols. New York: Basic Books. → Papers and essays translated from the German, including Abraham’s more important psychoanalytic works.

Alexander, Franz; and French, Thomas M. 1946 Psychoanalytic Therapy: Principles and Application. New York: Ronald.

Birring, Edward 1937 Versuch einer allgemeinen The-orie der Heilung. Internationale Zeitschrift fur Psychoanalyse 23:18-37.

Fenichel, Otto 1941 Problems of Psychoanalytic Technique. New York: Psychoanalytic Quarterly.

Ferenczi, Sandor (1908-1914) 1952 First Contributions to Psycho-analysis. London: Hogarth. → A selection of Ferenczi’s essays originally published in German. First published in English as Contributions to Psycho-analysis.

Ferenczi, Sandor (1908-1925)1927 Further Contributions to the Theory and Technique of Psycho-analysis. New York: Liveright. → A collection of some of Ferenczi’s most important contributions to psychoanalysis. Translated from the German.

Ferenczi, Sandor (1908-1933) 1955 Final Contributions to the Problems and Methods of Psycho-analysis. London: Hogarth. → Contains Ferenczi’s papers, translated from the German, that were written after 1926, as well as papers, fragments, and notes published posthumously.

Ferenczi, Sandor; and Rank, Otto (1924) 1925 The Development of Psychoanalysis. New York: Nervous and Mental Disease Monographs. → First published as Entwicklungsziele der Psychoanalyse.

Freud, Anna (1936) 1957 The Ego and the Mechanisms of Defense. New York: International Universities Press. → First published as Das lch und die Abwehrmechanismen.

Freud, Sigmund (1895-1926) 1953— The Standard Edition of the Complete Psychological Works of Sigmund Freud. 24 vols. London: Hogarth; New York: Macmillan. First published in German. Twenty-three volumes have been published as of 1967.

Freud, Sigmund (1897-1902) 1954 The Origins of Psychoanalysis: Letters to Wilhelm Fliess, Drafts and Notes, 1887-1902. New York: Basic Books. → Translated from the German.

Freud, Sigmund (1900) 1953 The Interpretation of Dreams. Volumes 4–5 in The Standard Edition of the Complete Psychological Works of Sigmund Freud. London: Hogarth; New York: Macmillan.

Freud, Sigmund (1905a) 1953 Fragment of an Analysis of a Case of Hysteria. Volume 7, pages 3–122 in The Standard Edition of the Complete Psychological Works of Sigmund Freud. London: Hogarth; New York: Macmillan.

Freud, Sigmund (1905b) 1953 Three Essays on the Theory of Sexuality. Volume 7, pages 123–245 in The Standard Edition of the Complete Psychological Works of Sigmund Freud. London: Hogarth; New York: Macmillan.

Freud, Sigmund (1908) 1955 From the History of an Infantile Neurosis. Volume 17, pages 3–122 in The Standard Edition of the Complete Psychological Works of Sigmund Freud. London: Hogarth; New York: Macmillan.

Freud, Sigmund (1909a) 1955 Analysis of a Phobia in a Five-year-old Boy. Volume 10, pages 3–149 in The Standard Edition of the Complete Psychological Works of Sigmund Freud. London: Hogarth; New York: Macmillan.

Freud, Sigmund (1909b) 1953 Notes Upon a Case of Obsessional Neurosis. Volume 10, pages 151–249 in The Standard Edition of the Complete Psychological Works of Sigmund Freud. London: Hogarth; New York: Macmillan.

Freud, Sigmund (1911-1915) 1953 Papers on Technique. Volume 12, pages 85–173 in The Standard Edition of the Complete Psychological Works of Sigmund Freud. London: Hogarth; New York: Macmillan.

Freud, Sigmund (1912a) 1953 The Dynamics of Transference. Volume 12, pages 97–108 in The Standard Edition of the Complete Psychological Works of Sigmund Freud. London: Hogarth; New York: Macmillan.

Freud, Sigmund (1912b) 1953 Recommendations to Physicians Practising Psycho-analysis. Volume 12, pages 109–120 in The Standard Edition of the Complete Psychological Works of Sigmund Freud. London: Hogarth; New York: Macmillan.

Freud, Sigmund (1914a) 1957 On the History of the Psycho-analytic Movement. Volume 14, pages 7–66 in The Standard Edition of the Complete Psychological Works of Sigmund Freud. London: Hogarth; New York: Macmillan.

Freud, Sigmund (1914b) 1953 Remembering, Repeating and Working-through (Further Recommendations on the Technique of Psycho-analysis II). Volume 12, pages 145–156 in The Standard Edition of the Complete Psychological Works of Sigmund Freud. London: Hogarth; New York: Macmillan.

Freud, Sigmund (1916-1917) 1953 Introductory Lectures on Psycho-analysis. Part III: General Theory of the Neuroses. Volume 16 in The Standard Edition of the Complete Psychological Works of Sigmund Freud. London: Hogarth; New York: Macmillan.

Freud, Sigmund (1923) 1961 The Ego and the Id. Volume 19, pages 12–63 in The Standard Edition of the Complete Psychological Works of Sigmund Freud. London: Hogarth; New York: Macmillan.

Freud, Sigmund (1926) 1959 Inhibitions, Symptoms and Anxiety. Volume 20, pages 77–178 in The Standard Edition of the Complete Psychological Works of Sigmund Freud. London: Hogarth; New York: Macmillan.

Freud, Sigmund (1937a) 1959 Analysis Terminable and Interminable. Volume 5, pages 316–357 in Sigmund Freud, Collected Papers. International Psychoanalytic Library, No. 10. New York: Basic Books; London: Hogarth. → First published as Die endliche und die unendliche Analyse.

Freud, Sigmund (1937b) 1959 Constructions in Analysis. Volume 5, pages 358–371 in Sigmund Freud, Collected Papers. International Psycho-analytic Library, No. 10. New York: Basic Books; London: Hogarth. → First published in German.

Freud, Sigmund (1940) 1949 An Outline of Psychoanalysis. New York: Norton.

Freud, Sigmund (1893-1895) 1955 The Standard Edition of the Complete Psychological Works of Sigmund Freud. Volume 2: Studies on Hysteria, by Josef Breuer and Sigmund Freud. London: Hogarth; New York: Macmillan.

Glover, Edward (1928) 1955 The Technique of Psychoanalysis. New York: International Universities Press.

Greenacre, Phyllis 1956 Re-evaluation of the Process of Working Through. International Journal of Psychoanalysis 37:439-444.

Hartmann, Heinz (1939) 1958 Ego Psychology and the Problem of Adaptation. New York: International Universities Press. → First published in German in the Internationale Zeitschrift fur Psychoanalyse und Imago.

Hartmann, Heinz 1951 Technical Implications of Ego Psychology. Psychoanalytic Quarterly 20:31-43.

Hartmann, Heinz; and Kris, Ernst 1945 The Genetic Approach in Psychoanalysis. Psychoanalytic Study of the Child 1:11-30.

Hoffer, W. 1954 Defensive Process and Defensive Organization: Their Place in Psycho-analytic Technique. International Journal of Psycho-analysis 35: 194-198.

Kris, Ernst 1951 Ego Psychology and Interpretation in Psychoanalytic Therapy. Psychoanalytic Quarterly 20: 15-30.

Kris, Ernst 1956a On Some Vicissitudes of Insight in Psycho-analysis. International Journal of Psychoanalysis 37:445-455.

Kris, Ernst 1956b The Recovery of Childhood Memories in Psychoanalysis. Psychoanalytic Study of the Child 11:54-88.

Kris, Ernst 1956c The Personal Myth: A Problem in Psychoanalytic Technique. Journal of the American Psychoanalytic Association 4:653-681.

Loewenstein, Rudolph M. 1951a The Problem of Interpretation. Psychoanalytic Quarterly 20:1—14.

Loewenstein, Rudolph M. 1951b Ego Development and Psychoanalytic Technique. American Journal of Psychiatry 107:617-622.

Loewenstein, Rudolph M. 1954 Some Remarks on Defences, Autonomous Ego and Psycho-analytic Technique. International Journal of Psycho-analysis 35: 188-193.

Loewenstein, Rudolph M. 1956 Some Remarks on the Role of Speech in Psycho-analytic Technique. International Journal of Psycho-analysis 37:460-468.

Loewenstein, Rudolph M. 1957 Some Thoughts on Interpretation in the Theory and Practice of Psychoanalysis. Psychoanalytic Study of the Child 12:127-150.

Loewenstein, Rudolph M. 1958 Remarks on Some Variations in Psycho-analytic Technique. International Journal of Psycho-analysis 39:202-210.

Loewenstein, Rudolph M. 1963 Some Considerations on Free Association. Journal of the American Psychoanalytic Association 11:451-473.

Lorand, Sandor 1946 Technique of Psychoanalytic Therapy. New York: International Universities Press.

Menninger, Karl A. 1958 Theory of Psychoanalytic Technique. New York: Basic Books.

Nacht, Sacha 1950 De la pratique a la theorie psych- analytique. Paris: Presses Universitaires de France.

Nacht, Sacha 1951 Les nouvelles theories psychanalytiques sur le moi et leurs repercussions sur l’orientation methodologique. Revue francaise de psychanalyse 15:569-576.

Nunberg, Hermann (1920-1942) 1948 Practice and Theory of Psychoanalysis: A Collection of Essays. New York: Nervous and Mental Disease Monographs.

Reich, Wilhelm (1933) 1961 Character-analysis. 3d ed., enl. New York: Noonday Press. → First published in German.

Stewart, Walter 1961 The Development of the Therapeutic Alliance in Borderline Patients. Psychoanalytic Quarterly 30:165-166.

IV EXPERIMENTAL STUDIES

The impact of Sigmund Freud upon psychology and the social sciences generally has been very great. Freud is to be compared with other great figures in the history of science over the last century such as Darwin, Pavlov, and Einstein. His observations and discoveries about people, brilliantly set forth, assure him a place in history regardless of the changes that may be wrought in the theories that he proposed. The clarification of the place of psychoanalytic facts and theories within the social sciences must rest eventually on their absorption into the social sciences after they have been reconstructed and validated in their new form. Such reconstruction and validation can take place by applying the methods of empirical study, model building, and hypothesis testing already familiar within these fields, or perhaps by new methods invented to deal with the subtleties of the clinical interaction between analyst and patient.

Historical background

Psychoanalysis has a special history because it was dominated for such a long time by Sigmund Freud, who began theory construction at the very start of his career and fought the social battles for recognition. There had been defections from the ranks during his lifetime by such early favorites as Adler, Jung, and Rank, so that the central core of psychoanalysis was defined by and remained dominated by Freud. During his lifetime a unity within a developing theory could be maintained by accepting his leadership; after his death those who remained in the mainstream of psychoanalysis felt they needed to be free to modify their views, as Freud would have done were he still alive, but they felt some obligation to show that they followed Freud’s main teachings in reference to both method and theory, enough at least to preserve unity among themselves. This inevitably resulted in a certain amount of in-group rigidity and out-group antagonism, understandable in view of the social history of psychoanalysis during Freud’s lifetime. Within institutionalized psychoanalysis the main cleavage has come between those who hold to the instinct theory and the universality of the Oedipus complex, on the one hand, and those who believe in the relatively greater importance of sociocultural influences and learning, on the other.

There are some consequences for research that lie in the history of psychoanalysis as a movement. Earlier psychoanalysts, whose motivations were primarily therapeutic and who were untrained in the use of experimental methods in the investigation of psychoanalytic phenomena, tended to disparage the use of such methods. Some still do, believing that the essence of psychoanalysis is displayed only in the continuous relationship between the patient and analyst, resting upon free association in the context of transference. For them, special research on psychoanalysis is often believed to be unnecessary, and simulation of psychoanalysis outside the patient-therapist relationship is thought to be either trivial or misleading. Because of their commitment to the method of psychoanalysis, younger psychoanalysts familiar with research methods seldom turn their attention to psychoanalysis as being itself in need of investigation, but instead study psychotherapy, which is less codified, or turn to topical investigations which do not question the central tenets of psychoanalysis. Those who favor an examination of the role of sociocultural influences are likely to select their problems more as anthropologists or sociologists select theirs. Now that many years have passed since Freud’s death, there are signs that these institutional influences upon research are lessening. However, the official institutes for the training of psychoanalysts have as yet given relatively little attention to research; for example, in a careful account of training in psychoanalysis in the United States (Lewin & Ross 1960), only 4 of 460 pages were devoted to research, and it was reported that only 3 of the 14 institutes had brought research at all prominently into the training pattern. The task of consolidating psychoanalysis as a science will continue to call for the collaboration of others if it is to move ahead with any rapidity.

The others who have interested themselves in psychoanalytic research are primarily psychologists, sociologists, and anthropologists, each with his own methods and preoccupations. There was great enthusiasm for investigating psychoanalytic problems after World War n, and a number of social scientists underwent both personal analyses and training in the psychoanalytic institutes in order to qualify themselves better for such research. However, as pointed out by Shakow (1962), in the early 1960s there was evidence of a growing dissatisfaction and disenchantment with psychoanalysis even on the part of persons fundamentally sympathetic to it. He believed that these reactions were due to the relative absence of research and scholarly activity around psychoanalysis proper, with the result that psychoanalysis was not attracting its share of “the restless souls with questioning minds who were attracted to it in the early days.“Shakow recommended that serious consideration be given to the psychoanalytic education of social and behavioral scientists for research.

Psychoanalysis, as a body of facts and theories about behavior and about therapy, cannot have any official spokesmen. The facts and theories are in the public domain, to be studied by any who are interested and competent. Therefore, one interested in psychoanalysis as science need not be concerned about the problems within psychoanalysis as a movement, although it is inevitable that the attitudes of the official psychoanalysts will make the field more or less inviting as an area in which to do research or in which to make a research career.

Psychoanalytic observation as research

Kris (1947) distinguished between the validation of psychoanalytic propositions through psychoanalytic observation and other “objective methods.“He pointed out that the total course of the association between observer and subject provides the equivalent of an experimental setting which permits the testing of long-range predictions; each interview, he said, potentially provides a number of opportunities for the testing of forecasts. The simplest examples of confirmatory evidence are given through interpretations that help the subject to fill in gaps of recall, later confirmed by evidence for the veridicality of the recall. Thus Frenkel-Brunswik (1940) reported an illustration from her own analysis in which the analyst interpreted her reactions as a “Cordelia motive,“referring to the youngest daughter of King Lear, who, while the most deserving, lost favor to the other daughters who were more flattering to him. She denied having ever read King Lear and at first refused the interpretation, but she later discovered that at the age of 15 she had copied all of Cordelia’s lines. Thus we have evidence of repression and support for an analytic reconstruction. Kris recognized that Freud had used this method successfully on himself, although he saw that there were many issues within psychoanalysis that did not get resolved by psychoanalytic observations and required other methods. Kubie (1953), while recognizing many contributions of psychoanalytic observation to basic science, detailed the following limitations within current psychoanalysis as a scientific research method: limitations with respect to the gathering of primary data, conceptual limitations and ambiguities, lack of quantitative methods of validation, lack of control groups, and deficiencies in specific instruments for measuring many of the processes whose interplay lies at the heart of psychoanalytic theory.

Freud’s observations within psychoanalysis (including his own) served as the sole basis for his many insights, and doubtless fresh insights will continue to come from such observations by other psychoanalysts. In view of the limitations noted by both Kris and Kubie, however, it is essential that these observations be supplemented by data of a different kind if psychoanalytic science is to progress.

Appropriateness of experimental investigation. A full-fledged psychoanalysis is such a rich and complex process that dissecting out parts of it for special study presents hazards. According to Rapaport, most of those who tried to test psychoanalytic theory either did not understand it or they ignored what they knew: “The overwhelming majority of experiments designed to test psychoanalytic propositions display a blatant lack of interest in the meaning, within the theory of psychoanalysis, of the propositions tested“(1959, p. 142). Although the warning should be heeded that psychoanalysis must be understood if relevant experiments are to be designed, there are ample precedents for gaining insight into psychoanalysis outside the analytic hour itself. While Freud was in no sense an experimentalist, he set the stage for considering observations made outside the analytic hour not only in his Psychopathology of Everyday Life but also in his analyses of historical figures, such as Leonardo da Vinci.

It is in the nature of experimental science that it must abstract from the totality of actual events and thus lose some of the richness of events in nature. This applies as inevitably to psychoanalytic investigations as to other kinds of scientific research. The problem confronting the investigator is not that of being made to study everything at once, but of being careful not to simplify his conditions in such a way as to sacrifice relevance to significant aspects of theory. Experimental tests of the Freudian theory of repression illustrate these problems. Early investigators, doing what Rapaport said others have done, oversimplified the theory by making it assert that anything pleasant is favored in recall over anything unpleasant. Hence they tested whether the words “quinine“and “bitter“would be forgotten more readily than “sugar“and “sweet“from a list containing these and affectively neutral words. Zeller (1951), representative of later experimenters, created a paradigm for inducing repression through experienced failure and then lifted the repression, thus coming much closer to psychoanalytic theory. Others have gone on to show that there are individual differences, so that the circumstances which produce repression for one subject do not do so for others (e.g., Truax 1957). With such refinements, experiments gradually become more sophisticated and relevant.

Not all aspects of psychoanalysis are open to experimental inquiry, but the ingenuity of investigators has opened up areas of study that at first seemed unpromising. Thus it has not proved possible to assert in advance which propositions were most suitable for study. Because psychoanalysis is not an internally consistent and highly integrated theory, the investigator has had to choose which propositions to test or has had to formulate as best he could a few precise propositions for testing. The purpose of experimental study is not only to test or validate the theoretical structure as it now stands, but also to correct and refine it. A scientific psychoanalysis, developed from and supported by controlled investigations, doubtless will differ in some respects from contemporary psychoanalytic theory.

There is by now a sizable literature showing that many workers have been able to formulate testable propositions on the basis of psychoanalytic theory and practice. Freud was raised in the scientific tradition of Hermann von Helmholtz and Ernst Briicke that made him propose psychoanalysis in a form such that much of it is subject to test, at least in principle. That is, it is stated as a deterministic system with lawful relationships expressed in terms of force and energy. While these force and energy concepts have proved troublesome in trying to conceptualize psychoanalysis, they are to be contrasted, for example, with the romanticism and mysticism of Jung. The differences between Freud and Jung are somewhat comparable to the differences between Darwin and Lamarck. Thus Darwin’s position, unlike that of Lamarck, permitted the congenial development of the mathematical approach of modern genetics to the problems of evolution, although Darwin was not himself mathematical. In a somewhat similar sense, Freud, in contrast to Jung, expressed his theories in a form that makes possible experimental testing, although he was not an experimentalist. [SeeAnalytical psychologyand the biography ofJung.]

Some representative empirical approaches

In dealing with experimental studies of psychoanalysis, emphasis need not be placed on a narrow definition of experiment; the main point is that some aspects of psychoanalysis are open to empirical studies done in the spirit of experimental science—that is, using methods that are objective, quantitative, and controlled. For example, when apparatus is attached to the patient in order to measure physiological changes associated with verbally expressed anxiety, this approximates an experiment, even though the interaction between the therapist and patient is not experimentally manipulated.

In what follows, instead of organizing experimental studies around an outline of psychoanalytic propositions, nine disparate approaches to the investigation of psychoanalysis—as both a theory of behavior and a therapeutic technique—are used to illustrate the possibilities open for research. Within each of these, one or more specimen studies are cited.

The study of psychoanalytic psychotherapy

The recording of what goes on within psychoanalysis by means of electromagnetic tape or sound motion pictures has opened up psychoanalysis for detailed study. It yields more precise and detailed observations than would otherwise be possible, and the data can be used for hypothesis testing, thus approaching the conditions of experimental investigation. One illustration of subsequent analyses of two recorded psychotherapeutic interviews is provided in a symposium in which psycholinguistic aspects of the communication between therapist and patient were studied in relation to some physiological changes that were also recorded (American Psychiatric Association 1961). A number of related studies have not yet come to fruition.

The data obtained by appropriate recording techniques are not only detailed and accurate, but they are also in permanent form and can be reviewed for various purposes. Various content analyses are possible (based, for example, on type-token ratios, silences, kinesic and other para-linguistic features, dyadic interactions, the effects of interpretations). It is possible to place the coded material, with various transitional probabilities, into a computer and then test hypotheses by asking questions of the computer.

One of the unresolved problems in this kind of study is the degree to which the analysis should be microscopic or macroscopic (thematic). To some extent, each analytic hour has a “topic,“and it may be that this will in some cases be lost in the detailed linguistic analysis. The answers will not come a priori but only after much work has been done to find the methods most fully appropriate to the subject matter under investigation. Care has to be taken not to obtain so much data that there is an information overload upon the investigator; selectivity with due regard for objectivity and criteria of relevance will have to be worked out here as in all quantitative investigations.

Outcome versus process studies. An important distinction has to be made within studies of psychoanalysis and psychotherapy between outcome studies and process studies. While there is a place for outcome studies (”What proportion of the treated patients improve or get well?“), these are extremely difficult to do in the case of psychotherapy, for a great many reasons: (1) Diagnosis of the severity of the presenting symptoms can be made on a quantitative basis with only the greatest of difficulty. For one thing, a patient who appears more severely disturbed may be in a temporary crisis that would disappear spontaneously, while another patient who appears less disturbed may have a deep-seated character disorder very resistant to change. A long-standing illness, which is usually more difficult to cure than one of more recent origin, may be brought to the therapist’s attention because for some reason the patient is now ready to be cured and presents himself for treatment at a time when the therapeutic result can be quickly achieved. (2) Estimates of degree of improvement are hard to obtain, even with careful follow-ups, for the patient and his relatives are subject to the same difficulties in estimating improvement that the therapist faces in diagnosing severity of ailment. (3) The degree of skill of the therapist and his appropriateness for the given patient are not sufficiently stated by a record of his training or by a knowledge of the general method that he claims to use. (4) Appropriate control groups of patients with similar severity of symptoms treated either by other methods, or not treated at all, are hard to establish. The reported success of easier and superficially more objective therapies, such as the so-called behavior therapies, have to be judged against the successes of all sorts of magical and faith cures that take place without the benefit of science. Although outcome studies are difficult, improved ones are very much needed to establish the therapeutic value of alternative therapies. [SeeMental disorders, treatment of, article onbehavior therapy.]

Studies of process, that is, of movement (whether progressive or regressive) taking place within and between psychotherapeutic sessions, are at present much more promising, although these too are hard to design and the results yielded to date are not very striking. In the careful study by Bellak and Smith (1956) of progress in therapy, it was found that the judges were in substantial agreement about the patients, but what they agreed on was the persisting personality structure of the patients, not the dynamic changes taking place as therapy progressed. [SeeMental Disorders, Treatment Of, article onPsychologicalTreatment.]

Miniaturized procedures with nonpatients

Rather than study the records of a patient in psychoanalysis, it is possible to select out certain features, such as free association, and study them. A start in this direction was made by Colby (1960a), who had a subject free associate alone with a tape recorder and then with a silent observer present; the differences in the subject’s productions were noted. A number of possible parameters come to mind: sitting up, lying down, facing or not facing the therapist, note taking and recording, the number of days between sessions, having parallel sessions of husband and wife, mother and child. Many of these focal points recur in treatises on psychoanalytic method, but few have been put to actual comparative tests.

The early studies of Masserman (Masserman & Yum 1946) show how aspects of therapy can be studied through the treatment of experimentally induced neuroses in animals, particularly aspects of “working through“in the overcoming of fears, and aspects of the influence of drugs (alcohol) in relation to conflict. While these studies are limited when done with nonverbal subjects, they pose some searching questions for psychoanalysis. For example, if the experimental neurosis can indeed be defined as a neurosis, it raises doubts about a very central psychoanalytic dictum, namely, that the Oedipus complex constitutes the nuclear complex of every neurosis.

Hypnosis as a means of study

The fact that psychoanalysis grew out of Freud’s experience with hypnosis, of which the psychoanalytic couch is a historical residual, makes the bridges between what happens in hypnosis and what happens in psychoanalysis easy to construct. Although Freud turned his back upon hypnosis early in his career, other psychoanalysts have continued to see its relevance. Two illustrations may serve to show some of the many experimental possibilities.

Some psychoanalysts, particularly Franz Alexander, have proposed what has been called the specificity hypothesis regarding psychosomatic symptoms—that is, that under defined kinds of stress some people will give symptoms of one kind while others will yield different symptoms. Using hypnosis, Graham, Stern, and Winokur (1958) induced differential attitudes hypothesized as appropriate to Raynaud’s disease and to urticaria (hives) in subjects not suffering these ailments. When these subjects were placed under stress, the physiological responses were indeed found to be the ones more nearly appropriate to the ailment corresponding to the induced attitude.

In somewhat related experiments, Kehoe and Ironside (1963) produced depressive reactions under hypnosis and then studied both the gastric secretions and other correlates of the experimentally evoked depression.

The possible services of hypnosis in the study of various motivational and psychodynamic problems have been reviewed by Hilgard [1964; see alsoHypnosis].

Psychophysiological studies

In establishing a functional system, Freud somewhat reluctantly turned away from the neurophysiology in which he was trained, which he had used extensively and not unwisely in his early theorizing. At a number of times, however, Freud indicated that he hoped eventually for a physiological basis for psychoanalysis (e.g., 1920). Some contemporary investigators in the field of psychoanalysis believe that the time is now ripe to provide a better neuro-physiological anchorage for psychoanalytic propositions, and their research endeavors illustrate this concern. Weiner and others (1957) were able to predict which of a number of inductees would become peptic ulcer casualties as a result of the strains of military service. They used data on serum pepsinogens in defining the sample, and then, using psychological information alone, predicted that ten cases among a much larger number would be most likely to develop ulcers during basic training. Of these, seven had proven ulcers before the end of training; of the remaining inductees in the sample, only two developed ulcers. Hence, the psychological tests not only had picked out the promising cases but had missed very few. The psychological factors emphasized as predisposing to ulcers were an intense need to maintain relations with others, a need to please and placate authority figures, and fears of expressing hostility or of experiencing loss.

The newer physiological methods of studying dreams have made possible another contact between experiment and psychoanalysis. Thus the function of dreams as tension reducers is supported by studies of dream deprivation in which the sleeper “catches up“by dreaming more frequently on nights following those during which his dreaming has been interrupted [Dement 1960; see alsoDreamsandPsychosomatic illness].

Studies of motivational conflicts

Psychoanalysis can be considered a motivational psychology with primary emphasis upon motivational conflicts and their consequences. These areas lend themselves well to experimental study, including animal studies. One of the experimental studies of the derivatives of conflicting motives is that of Clark (1952), in which he aroused sexual motives by displaying nude pictures to college students and studied the overt and symbolic expression of sex under various conditions, including mild intoxication at a fraternity beer party. He found that anxiety under ordinary circumstances (for example, being in a college classroom) inhibited manifest sexual expression but gave rise to increased symbolic expression of sex; the reverse occurred under the influence of alcohol—that is, there was more manifest sexual expression and less symbolic expression [SeeConflict, article onPSYCHOLOGICAL ASPECTS; MOTIVATION].

Studies of cognitive processes

There is by now a large literature based upon tachistoscopic perception and related methods, much of it motivated by an interest in psychoanalytic concepts. Many of the studies on tachistoscopic perception relevant to psychoanalysis were reviewed by Charles Fisher in the introduction to a monograph translating two classical studies (Pbtzl et al. 1960).

We may take as representative of these the study by Paul and Fisher (1959) which investigated the hypothesis that the exposure of a figured visual stimulus below the level of awareness would produce images that would reflect, both directly and in transformed ways, the influence of the stimulus, its meanings, and its forms. The experimental procedure was to expose a simple double-profile figure within a circular outline at 1/100 of a second, slightly out of focus; this alternated with the exposure of a blank slide. After each exposure the subject was asked to draw whatever images came to mind. These drawings were then sorted by a number of experienced judges as more likely to have followed the figured stimulus or the blank one. The judges were only moderately successful, but taken together the results were highly significant statistically, indicating some influence from the exposed figure. From the published figures it is evident that there was little direct representation of the exact figure as exposed; the most directly representative figures consisted of overlapping or multiple circles. Some degree of transformation would, of course, be implied by psychoanalytic theory as well as by other theories [SeeAttentionandPerception, article onUNCONSCIOUS PERCEPTION].

Studies of learning and retention

The concept of motivated forgetting is represented in psychoanalysis through some aspects of repression, in which memories, while active, are not available to direct recall.

Clemes (1964) gave a Kent-Rosanoff test to subjects of known hypnotic susceptibility in order to find the words which in the normal waking state were affect-laden and caused difficulties in response (”complex indicators“), such as long reaction times. He hypothesized that these words should be appropriate targets for repression relative to words more neutral for the subject. He tested the hypothesis by constructing for each subject a list of words to be memorized, half neutral and half affect-laden for him. The list was memorized under hypnosis, and then the suggestion was given that half the words would be forgotten (posthypnotic amnesia) until a release signal was given. Counting only the words that fitted the paradigm of repression (temporarily forgotten but recovered), he found that these were disproportionately the target words selected on the basis of the word association test. Thus hypnosis served conveniently to test an appropriate hypothesis about repression.

A study of associative priming by Schwartz and Rouse (1961) illustrates another convergence between research formulated within a psychoanalytic frame of reference and the kinds of study generally familiar within the laboratories of academic psychology. These investigators found, for example, that in a test of immediate memory words that were forgotten had nevertheless “primed“their associates, so that the associated words were selected beyond chance expectation on a subsequent recognition test from which the original stimulus words were omitted. Thus their results bear on free association in relation to recall, as well as upon the experimental psychology of learning, recall, and recognition.

Maturation and development

Psychoanalysis is also a developmental psychology. The formal theory of psychosexual stages is well known, with the child experiencing and coping with various stages of development on the way to maturity (the characteristics of each of which have been correlated under the general headings termed oral, anal, phallic, latency, and genital stages). The addition of the psychosocial stages by Erikson (1959) has enriched the theory, showing that eventually early identifications become welded into either a healthy or a pathological identity. He also carried the scheme through adolescence into later maturity. Erikson’s psychosocial scheme is an appealing one, but so far it has received essentially literary treatment; it needs both theoretical and empirical clarification [SeeIdentity, PSYCHOSOCIAL].

The success with which Whiting and Child (1953) were able to predict, on the basis of reported child-rearing practices, certain beliefs about illness on the part of adults in many nonliterate cultures gives some support to the significance of early childhood in shaping personality structure. Of course, these same children are brought up by the very adults who trained them in childhood, so that the impact of their training is not over once and for all. A learning-theory interpretation fits the facts as well as a psychoanalytic one, and indeed, Whiting and Child use such an interpretation. Yet the influences they chose to study (feeding, toilet training, sex, aggression, dependency) have their origins in psychoanalytic modes of thought. The corresponding animal studies, initiated by Hunt (1941), showed that white rats which experienced early feeding frustration hoarded food excessively later on, when new frustrations presumably reactivated the early patterns of insecurity.

The attempts to support psychoanalytic conceptions about the importance of breast feeding, weaning, toilet training, and the like have led to somewhat equivocal results, with Orlansky (1949) concluding from his review of cross-cultural data that the ground plan of formal psychosexual stages through which infantile libidinal drives are channeled is less satisfactory than some sort of sociocultural interpretation. However, it is clear that the answers have not all been found, and psychoanalysis has made an abiding contribution by calling attention to the significance of the early years and of appropriate mothering to personality development [SeePersonality, article onPERSONALITY DEVELOPMENT; Socialization].

Personality structure, defenses, and cognitive styles

Psychoanalytic personality theory assumes that in the course of his history (particularly, but not exclusively, early history), the individual achieves a personality structure which is relatively stable. If some kinds of influences are extreme, a personality “syndrome“such as anal compulsivity may emerge, with the triad of traits—-orderliness, stinginess, and obstinacy (Sears 1943). Another such syndrome is said to be the authoritarian personality (Adorno et al. 1950). These personality structures are relatively stable, but may change slowly, as within a successful psychoanalysis. [SeePersonality, Political, article onconservatism and radicalism.]

Empirical assessment of personality structures, cognitive styles, defense preferences, and coping mechanisms has assumed large proportions, one evidence of it being the prominence of projective tests (Rorschach inkblots, the Thematic Apperception Test, Blacky dog pictures) designed to reveal aspects of the personality structure not always manifested in outward behavior [SeeDefense mechanisms].

The literature on cognitive styles is represented by Witkin and others (1962) and by Gardner and others (1959). Witkin and his associates have been concerned with field dependency and field independency, aspects of cognition with personality correlates. Gardner and his associates have given more emphasis to such distinctions as that between the sensitizers and the levelers. While these studies have a background in gestalt conceptions as well as in psychoanalytic ones, what makes them relevant to psychoanalysis is their demonstration that personality structure and momentary needs affect cognitive activity. This is, of course, a prominent conception in psychoanalysis—as, for example, in rationalization and projection.

Studies of a more ecological character are also possible, as in the investigations of differences in defense preferences of children of blue-collar workers and white-collar workers (Miller & Swanson 1960). It is difficult to intervene experimentally in the upbringing of children to study the long-term effects, but it is possible to capitalize upon some naturally occurring events which produce similar data to those that would be obtained from a controlled experiment. One such naturally occurring event is the loss in childhood of a parent through death. The consequence of such a loss can be studied in groups as though an experiment had been undertaken to see what happens to the child if a parent is permanently removed. Such studies have been done and through a combination of statistical and clinical observations have reached two major conclusions. First, the age at which a mother has been lost in childhood provides a target date for personality disturbance or mental illness, the illness being triggered when the child who suffered loss has grown to adulthood and has a child of the age at which the loss occurred (J. R. Hilgard & Newman 1959). Second, the incidences of certain mental illnesses, particularly schizophrenia, are related to these losses of a parent in childhood (J. R. Hilgard & Newman 1961). Such studies give support to the role of parents in normal personality development and to the reactivation at times of adult crisis of the stresses associated with periods of deprivation in childhood.

Because too many inferences are involved it is not possible to draw up a scoreboard to mark the successes and failures of experiments in validating psychoanalytic propositions. However, those non-psychoanalysts who have summarized experimental investigations of psychoanalytic theories have found a great deal of the evidence favorable to psychoanalysis (Blum 1953; Farrell 1951; Hilgard 1952; Hilgard & Bower 1966; Sarnoff 1962; Sears 1943). Unfortunately they have not been able to point to many experimental findings that have clarified and strengthened psychoanalysis, or, indeed, that have had much impact on either its theories or its practices. The full impact of experiment will not be felt until psychoanalysis is moved forward and enriched by the results that are reported. Experimental studies cannot be expected to do all the work of theoretical reconstruction as psychoanalysis advances and becomes assimilated within social science, but the interaction between experiment and theory should prove to be a vital part of that reconstruction.

Ernest R. Hilgard

[Directly related are the entriesExperimental design; Mental disorders, article onexperimental study.Other relevant material may be found inFantasy; Interviewing, article ontherapeutic interviewing; Observation; ProjectiveMethods.]

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Psychoanalysis

PSYCHOANALYSIS.

In a 1928 entry on the subject for the Handwörterbuch der Sexualwissenschaft (Concise dictionary of sexual research), Sigmund Freud (18561939) 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 (18771925), Sándor Ferenczi (18731933), Ernest Jones (18791958), and Carl Jung (18751961). 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 19121913 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 sufferedwhich ranged from hysterical blindness to obsessive thoughts and behaviors, to near-catatonic stateswere 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 itan 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 systemsconscious, 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 censorand of repression itselfis 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 processin 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 adolescenceprepared 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 phasesoral, 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 penishis penisand 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 wishesand 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 caregiversthose 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 psychopathologyincluding (in current terminology) narcissistic personality disorder, borderline personality disorder, and the psychoseswhich 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 libidoego 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 resta 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 agenciesego ("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 momentsloss 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 (18821960) 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 defensesprojection, denial, splitting, withdrawal, and "omnipotent control" of these objectsthe 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 objectsbeginning with the breastwere 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 infancyincluding projection, splitting, withdrawal, and denialbecame 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 emotionsincluding greed, envy, and jealousythat 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 (18701937), Wilhelm Stekel (18681940), Jung, Otto Rank (18841939), Ferenczi, Wilhelm Reich (18971957)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 (19011981) 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 (18851952), Sandor Rado (18901972), Harry Stack Sullivan (18911949), 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 .

bibliography

Anzieu, Didier. Freud's Self-Analysis. Translated by Peter Graham. London: Hogarth Press and the Institute of Psycho-analysis, 1986.

Deutsch, Helene. The Psychology of Women: A Psychoanalytic Interpretation. 2 vols. New York: Grune and Stratton, 19441945.

Freud, Sigmund. Standard Edition of the Complete Psychological Works of Sigmund Freud. 24 vols. Edited and translated by James Strachey. London: Hogarth Press, 19531974.

Gay, Peter. Freud: A Life for Our Time. New York: Norton, 1988.

Grünbaum, Adolf. The Foundations of Psychoanalysis: A Philosophical Critique. Berkeley and Los Angeles: University of California Press, 1984.

Hale, Nathan G., Jr. The Beginnings of Psychoanalysis in the United States, 18761917. New York: Oxford University Press, 1971.

. The Rise and Crisis of Psychoanalysis in the United States: Freud and the Americans, 19171985. New York: Oxford University Press, 1995.

Horney, Karen. Feminine Psychology. New York: Norton, 1967.

Jones, Ernest. The Life and Work of Sigmund Freud. 3 vols. New York: Basic, 19531957.

Kernberg, Otto F. Borderline Conditions and Pathological Narcissism. New York: Aronson, 1975.

Klein, Melanie. The Writings of Melanie Klein. 4 vols. New York: Delacorte Press/Seymour Lawrence, 1975.

Kohut, Heinz. The Analysis of the Self: A Systematic Approach to the Psychoanalytic Treatment of Narcissistic Personality Disorders. New York: International Universities Press, 1971.

Kutter, Peter, ed. Psychoanalysis International: A Guide to Psychoanalysis throughout the World. 2 vols. Stuttgart-Bad Cannstatt, Germany: Fromann-Holzboog, 1995.

Lacan, Jacques. Écrits: A Selection. Translated by Alan Sheridan. New York: Norton, 1977.

. The Four Fundamental Concepts of Psycho-analysis. Edited by Jacques-Alain Miller and translated by Alan Sheridan. New York: Norton, 1978.

Laplanche, Jean. Life and Death in Psychoanalysis. Translated by Jeffrey Mehlman. Baltimore: Johns Hopkins University Press, 1976.

Laplanche, Jean, and J.-B. Pontalis. The Language of Psychoanalysis. Translated by Donald Nicholson-Smith. New York: Norton, 1973.

Lear, Jonathan. Love and Its Place in Nature: A Philosophical Interpretation of Freudian Psychoanalysis. New York: Farrar, Straus and Giroux, 1990.

Loewald, Hans W. Papers on Psychoanalysis. New Haven, Conn.: Yale University Press, 1980.

Mahler, Margaret S., Fred Pine, and Anni Bergman. The Psychological Birth of the Human Infant: Symbiosis and Individuation. New York: Basic, 1975.

Masson, Jeffrey Moussaieff, trans. and ed. The Complete Letters of Sigmund Freud to Wilhelm Fliess, 18871904. Cambridge, Mass.: Harvard University Press, Belknap Press, 1985.

McWilliams, Nancy. Psychoanalytic Diagnosis: Understanding Personality Structure in the Clinical Process. New York: Guilford Press, 1994.

Pine, Fred. Drive, Ego, Object, and Self: A Synthesis for Clinical Work. New York: Basic, 1990.

Tyson, Phyllis, and Robert L. Tyson. Psychoanalytic Theories of Development. New Haven, Conn.: Yale University Press, 1990.

Winnicott, D. W. Collected Papers: Through Paediatrics to Psychoanalysis. New York: Basic, 1958.

Matthew F. von Unwerth

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Psychoanalysis

PSYCHOANALYSIS

Sigmund Freud himself provided the most complete, and now most classical definition for his invention, psychoanalysis: "Psycho-analysis is the name (1) of a procedure for investigating 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" (1923a [1922], p. 235). This definition, intended for the Encyclopaedia Britannica, is still widely used today by many psychoanalytic training institutes.

Freud also wrote that the best way to understand psychoanalysis was to study its history. Its origins could be traced to the young Viennese doctor's medical practice. He frequently treated "nervous" patients, for the most part described as suffering from "hysteria," a field he came to specialize in after his return from Paris and his work assisting Jean Martin Charcot. He needed to heal these patients and develop a clientele large enough to support his growing family, even though therapeutic procedures at the time were practically nonexistent. The available techniqueselectric shock, isolation in medical clinics, and sedativeswere soon abandoned. Hypnosis appeared to him at first to produce miraculous results, but it turned out to be a dead end, and he decided to apply the "cathartic method" that his mentor, Joseph Breuer, had discovered during the treatment of the patient known as Anna O. Taking the symptom as its starting point, this method strove to have the patient recall the circumstances of its first occurrence, and a successful outcome depended on this recollection by means of talk, which was supposed to make the symptom disappear.

Freud then discovered the "resistance" that patients would put up during the search for pathogenic "primal scenes," as if they wanted to keep the origin of their illness secret. The material that was "repressed" in this way always involved old memories associated with specific events related to the earliest sexual activity of children. His suggestion that such a sexuality even existed greatly shocked many of his contemporaries. His patients soon began drawing his attention to their dreams, which he encouraged them to recount. In keeping with his belief in determinism, Freud concluded that dreams fulfilled a functionthe safeguarding of sleep through the fulfillment of wishes that had been ignored by consciousnessand consequently had an "unconscious" content, a meaning that could be deciphered. The analysis of resistance and the interpretation of dreams, together with the method of "free association," became the pillars of the psychotherapy to which Freud, in 1896, gave the name "psychoanalysis." The term appeared for the first time in an article written in French, "Heredity and the Aetiology of the Neuroses" (1896a).

By the first years of the twentieth century, the principal features of psychoanalytic treatment that still define it at the beginning of the twenty-first had been established: The patient was placed on a couch and the therapist remained out of sight. The patient was asked to say whatever came to mind. Sessions were fairly long, frequent, and expensive, so that the treatment would become an important part of the patient's life and so that the bond with the psychoanalystthe "transference"would become the principal engine of the attempt to reconstruct the past and weaken the defenses the patient had set up against the pressure from contradictory drives. But the initial therapeutic successes were not as consistent or as long-lasting as Freud had hoped. The transference could become hostile and give rise to a "negative therapeutic reaction," leading to the discontinuation of treatment or its indefinite extension.

Freud was less a therapist than a researcher, something he often recognized; it was primarily his students and successors who introduced improvements to his methods, or different but connected methods, to make the "therapeutic" aspect of psychoanalysis more effective.

Thus Carl G. Jung and Hermine von Hug-Hellmuth worked with psychotic patients, and Anna Freud and Melanie Klein with children. Otto Rank and Sándor Ferenczi sought to improve psychoanalytic therapy and make it more effective. They introduced so-called "active" techniques and tried to shorten the length of therapy, even exploring a form of "mutual analysis." Traces of these early initiatives can be found in psychotherapeutic methods developed years later. Similarly, the extension of psychotherapy to patients presenting problems of psychosis or addiction, and the development of group analysis and psychodrama all tended to point up the therapeutic value of psychoanalysis. Some psychoanalysts sought to render their approach more effective by forging links with the neurosciences.

Following Freud, however, who quipped about the profession's "furor sanandi, " other psychoanalysts emphasized the research implications of treatment. Thus Jacques Lacan, who in 1957 spoke of curing patients as merely an "extra" benefit of psychoanalysis, and who in 1964, when he founded theÉcole freudienne de Paris, described training analysis as "pure"as opposed to simply "therapeutic"psychoanalysis, clearly represents the tendency that embraces the third of Freud's three basic definitions of psychoanalysis.

In his daily practice, however, Freud never differentiated between what he experienced and what he theorized later. His letters to Wilhelm Fliess allow us to follow, almost day by day, the theory-building that turned psychoanalysis into the "depth psychology" Freud hoped would supplant academic psychology. A work of construction thenbut also of deconstructionFreud considered his ideas to be superstructures whose existence was necessarily ephemeral, and anticipated new discoveries better adapted to the knowledge obtained from clinical practice. A first model, developed in 1900, which described a psychic apparatus formed of three agenciesthe unconscious, preconscious, and consciouswas replaced in 1923 by another conceptual scheme comprising the id, the ego, and the superego. And while Freud remained firmly committed to the Oedipus complex, he had, over a period of forty years of work, fleshed out the speculative aspects of his metapsychology with new concepts that improved and sometimes reversed his earlier hypotheses: narcissism, the death instinct, the phallic stage, the splitting of the ego.

Alfred Adler, in 1911, and Jung, in 1913, made their final breaks with Freud over theoretical disagreements and formed their own schools. The first psychoanalytic theory to be developed that broke with Freud's theories while also claiming to further the Freudian tradition was Melanie Klein's, developed between 1930 and 1962. Klein radically revised the Freudian view of the first moments of the formation of the mental apparatus, on the basis of her clinical experience with very young children and her interest in psychoses. Her theoretical model invoked very early stages she referred to as "depressive" or "paranoid-schizoid" positions, and she held that the Oedipus complex originated at a much earlier age than Freud thought. Her opposition to Anna Freud, who insisted on strict fidelity to the spirit and letter of her father's theories, gave rise to several important "controversies" (1941-1945) that determined the orientation of the British Psycho-Analytical Society after the Second World War. Following Klein, Donald Winnicott, Wilfred Bion, and Ronald Fairbairn helped develop British psychoanalytical theory and practice. In the United States a number of derivative psychoanalytic theories came into being, some of which parted ways with classical Freudian theory. The theory of ego-psychology was introduced by Heinz Hartmann, Ernst Kris, and Rudolph Loewenstein, and was for years the major reference point of American psychoanalysis. Heinz Kohut developed a theory of narcissism, and Karen Horney and Harry Stack Sullivan were cofounders of a "culturalist" approach. Erik Erikson's work was also notable.

In France, Jacques Lacan, under the banner of the "return to Freud" in November 1955, proposed new models that in his view could better account for the constitution of the "subject" and the relationship between the subject and the unconscious. The three categories of the real, the imaginary, and the symbolic; the primacy of the phallus; the object a ; Borromean knots; and mathemes were so many milestones in an evolving theory that Lacan developed week by week, from 1954 to 1981, in his famous seminars. His idiosyncratic use of the findings of modern linguistics, inspired by Ferdinand de Saussure, of structuralism, and of logical and mathematical models, enabled him to make an audience of even communities like the Catholic Church and the Marxist orthodoxy, which had previously rejected "Freudian doctrine" as "unscientific."

Whether or not psychoanalysis is a science has been debated for years, and the issue reappears regularly in the news. For epistemologists like Karl Popper and a host of other critics, the statements made by psychoanalysis cannot be considered scientific since they cannot be "falsified" and because the theory cannot be "refuted." For Freud, the scientific status of his theory was never in doubt, and he considered his metapsychological hypotheses no more implausible than those of contemporary physics. Psychoanalysis, as far as he was concerned, was a "natural science" ("Naturwissenschaft "). Despite holding a position deemed by some close to "scientism," Freud clearly distinguished his belief in a scientific ideal and the consistency of his hypotheses concerning the unconscious from a Weltanschauung, a "vision of the world" whose totalizing tendencies and illusory nature he feared. In The Question of Lay Analysis, he wrote: "Science, as you know, is not a revelation; long after its beginnings it still lacks the attributes of definiteness, immutability and infallibility for which human thought so deeply longs. But such as it is, it is all that we can have" (1926e, p. 191).

Freud also insisted on the importance of psychoanalysis as a cultural phenomenon and a special instrument for studying and understanding other cultural phenomena. On July 5, 1910, he wrote to Jung: "I am becoming more and more convinced of the cultural value of psychoanalysis, and I long for the lucid mind that will draw from it the justified inferences for philosophy and sociology" (p. 340).

His letters to Wilhelm Fliess already illustrate the extent to which his psychological discoveries provided new insights for the understanding of literature and visual art, and how their study provided him with new ideas or proofs of the correctness of his views. It was Sophocles who provided Freud with the name for his "Oedipus complex," discovered during his self-analysis in October 1897. In 1913 he indicated the fields of knowledge he felt would benefit (1913j) from psychoanalytic concepts. Aside from psychology, he listed the science of language, philosophy, biology, the history of the development of civilization, aesthetics, sociology, and pedagogy.

He confirmed this interaction in the Introductory Lectures on Psychoanalysis : "In the work of psychoanalysis links are formed with numbers of other mental sciences, the investigation of which promises results of the greatest value: links with mythology and philology, with folklore, with social psychology and the theory of religion. You will not be surprised to hear that a periodical has grown up on psychoanalytic soil whose sole aim is to foster these links. This periodical is known as Imago, founded in 1912 and edited by Hanns Sachs and Otto Rank. In all these links the share of psychoanalysis is in the first instance that of giver and only to a less extent that of receiver" (1916-1917a, p. 167-68).

Despite the charge that Freudian concepts cannot be applied outside the framework of the treatment and notwithstanding the superficial way they have indeed too often sometimes been used, the fact is that "applied psychoanalysis" has profoundly modified our view of literature and the fine arts, of biography, and of sociological and political realities. Freud set the example by the way he approached Wilhelm Jensen's story "Gradiva," Leonardo da Vinci's life, and Michelangelo's sculpture, to mention only a few of his contributions. But on several occasions he expressed his reservations about the value of the psychobiographies produced by some of his followers and successors.

Toward the end of his life his clinical work took a secondary position to his writings on the great problems of religion and culture: The Future of an Illusion (1927c), Civilization and Its Discontents (1930a [1929]), and especially his last work, Moses and Monotheism (1939a [1934-1938]), which expands upon the anthropological ideas he had extensively covered in Totem and Taboo (1912-13a).

Later, the spread of Freudian ideas attracted the interest of writers, artists, and critics, who made use of them to enrich their own work. The Surrealists were among the first, but novelists, painters, and dramatists borrowed from psychoanalysis as well. Created at the same time as cinematography, psychoanalysis has inspired filmmakers from the early days. One has only to think of Secrets of a Soul (Geheimnisse einer Seele ), the film G. W. Pabst made in 1926 in spite of Freud's reservations; or of the films of Alfred Hitchcock, Spellbound and Vertigo ; or of Freud, the Secret Passion, by John Huston, prepared with the help of Jean-Paul Sartre and released in 1962, in which Montgomery Clift plays the role of Freud; or, for that matter, of the comic treatment of psychoanalysis by Woody Allen.

Throughout the twentieth century, the discoveries of psychoanalysis and its theory of the unconscious have profoundly modified the rules mankind has established concerning its behavior and sexual taboos, its relation to guilt, to femininity, and more generally to other people, about whom a whole new unconscious aspect was now apprehended. Obviously, however, the wide dissemination and renown of psychoanalysis were themselves the product of the twentieth century. Psychoanalysis was inspired and carried along by that century, with its excesses, its political ideologies, its economic and religious ups and downs, and above all, its terrible conflicts, which despite all claims to civilized behavior mobilized the darkest and most barbaric of human impulses just as Freud had understood and feared (1915b, 1933b [1932]).

In so many waysthe liberalization of behavior, the advancement of the status of women (both inside and outside feminist movements and in spite of their virulent criticisms of Freudianism), the dawning recognition of sexual minorities (even though in Freudian theory their preferences have been explained as arrested libidinal development and more or less archaic fixations), a different approach to the subject and its relation to itself and the otherpsychoanalysis has become a part of everyday life throughout the so-called "Western" world and is not about to simply disappear, despite all the wild swings of fashion.

Its expansion toward other cultural sensibilities, like the multiplication of the often contradictory theories and techniques that claim allegiance to it, as demonstrated by this Dictionary, show that psychoanalysis has never been a dogma or the kind of closed theory caricatured by dishonest critics. In his own time Freud defined those "cornerstones," which seemed to him to provide the foundation that his successors would trace back to him: "The assumption that there are unconscious mental processes, the recognition of the theory of resistance and repression, the appreciation of the importance of sexuality and of the Oedipus complexthese constitute the principal subject-matter of psycho-analysis and the foundations of its theory. No one who cannot accept them all should count himself a psycho-analyst" (1923a [1922], p. 247). Nothing has really changed regarding the basic principles, in spite of the considerable diversity found in theoretical research and methods of practice, which has enriched the great network of the global psychoanalytic movement.

The recent rapid development of the neurosciences does not signal any decline in the value of the listening procedure that psychoanalysis has offered for more than a century in its attempt to understand and treat mental suffering. Apparently contradictory theoretical systems will eventually intersect and enrich each other, and the pessmism of the Cassandras can be answered with Freud's remarks, written in 1914: "At least a dozen times in recent years, in reports of the proceedings of certain congresses and scientific bodies or in reviews of certain publications, I have read that now psychoanalysis is dead, defeated and disposed of once and for all. The best answer to all this would be in the terms of Mark Twain's telegram to the newspaper which had falsely published news of his death: 'Report of my death is grossly exaggerated"' (1914d, p. 35).

Alain de Mijolla

Bibliography

Freud, Sigmund. (1912-13a). Totem and taboo. SE, 13: 1-161.

. (1913j). The claims of psycho-analysis to scientific interest. SE, 13: 163-190.

. (1915b). Thoughts for the times on war and death. SE, 14: 273-300.

. (1916-17a [1915-17]). Introductory lectures on psycho-analysis. Parts I and II. SE, 15-16.

. (1923a [1922]). Two encyclopaedia articles. Psycho-analysis. SE, 18: 234-255.

. (1926e). The question of lay analysis. SE, 20: 177-250.

. (1930a [1929]). Civilization and its discontents. SE, 21: 57-145.

. (1933b [1932]). Why war? (Einstein and Freud). SE, 22: 195-215.

. (1939a [1934-38]). Moses and monotheism: Three essays. SE, 23: 1-137.

Freud, Sigmund, and Jung, Carl. (1974a [1906-13]). The Freud/Jung letters: The correspondence between Sigmund Freud and C. G. Jung (William McGuire, Ed., and Ralph Manheim and R.F.C. Hull, Trans.). Princeton, NJ: Princeton University Press.

Mijolla, Alain de. (1996). Psychoanalysts and their history. International Psychoanalysis: The Newsletter of the IPA, 5 (1), 25-28.

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Psychoanalysis

Psychoanalysis

Definition

Psychoanalysis is a form of psychotherapy used by qualified psychotherapists to treat patients who have a range of mild to moderate chronic life problems. It is related to a specific body of theories about the relationships between conscious and unconscious mental processes, and should not be used as a synonym for psychotherapy in general. Psychoanalysis is done one-on-one with the patient and the analyst; it is not appropriate for group work.

Purpose

Psychoanalysis is the most intensive form of an approach to treatment called psychodynamic therapy. Psychodynamic refers to a view of human personality that results from interactions between conscious and unconscious factors. The purpose of all forms of psychodynamic treatment is to bring unconscious mental material and processes into full consciousness so that the patient can gain more control over his or her life.

Classical psychoanalysis has become the least commonly practiced form of psychodynamic therapy because of its demands on the patient's time, as well as on his or her emotional and financial resources. It is, however, the oldest form of psychodynamic treatment. The theories that underlie psychoanalysis were worked out by Sigmund Freud (18561939), a Viennese physician, during the early years of the twentieth century. Freud's discoveries were made in the context of his research into hypnosis. The goal of psychoanalysis is the uncovering and resolution of the patient's internal conflicts. The treatment focuses on the formation of an intense relationship between the therapist and patient, which is analyzed and discussed in order to deepen the patient's insight into his or her problems.

Psychoanalytic psychotherapy is a modified form of psychoanalysis that is much more widely practiced. It is based on the same theoretical principles as psychoanalysis, but is less intense and less concerned with major changes in the patient's character structure. The focus in treatment is usually the patient's current life situation and the way problems relate to early conflicts and feelings, rather than an exploration of the unconscious aspects of the relationship that has been formed with the therapist.

Not all patients benefit from psychoanalytic treatment. Potential patients should meet the following prerequisites:

  • The capacity to relate well enough to form an effective working relationship with the analyst. This relationship is called a therapeutic alliance.
  • At least average intelligence and a basic understanding of psychological theory.
  • The ability to tolerate frustration, sadness, and other painful emotions.
  • The capacity to distinguish between reality and fantasy.

People considered best suited to psychoanalytic treatment include those with depression, character disorders, neurotic conflicts, and chronic relationship problems. When the patient's conflicts are long-standing and deeply entrenched in his or her personality, psychoanalysis may be preferable to psychoanalytic psychotherapy, because of its greater depth.

Precautions

Psychoanalysis is not usually considered suitable for patients suffering from severe depression or such psychotic disorders as schizophrenia, although some analysts have successfully treated patients with psychoses. It is also not appropriate for people with addictions or substance dependency, disorders of aggression or impulse control, or acute crises; some of these people may benefit from psychoanalysis after the crisis has been resolved.

Description

In both psychoanalysis and psychoanalytic psychotherapy, the therapist does not tell the patient how to solve problems or offer moral judgments. The focus of treatment is exploration of the patient's mind and habitual thought patterns. Such therapy is termed "non-directed." It is also "insight-oriented," meaning that the goal of treatment is increased understanding of the sources of one's inner conflicts and emotional problems. The basic techniques of psychoanalytical treatment include:

CARL GUSTAV JUNG (18751961)

Carl Gustav Jung was born in Kesswil, Switzerland, on July 26, 1875, to a Protestant clergyman who moved his family to Basel when Jung was four. While growing up, Jung exhibited an interest in many diverse areas of study but finally decided to pursue medicine at the University of Basel and the University of Zurich, earning his degree in 1902. He also studied psychology in Paris. In 1903, Jung married Emma Rauschenbach, his companion and collaborator. The couple had five children.

Jung's professional career began in 1900 at the University of Zurich where he worked as an assistant to Eugene Blueler in the psychiatric clinic. During his internship, he and some co-workers used an experiment that revealed groups of ideas in the unconscious psyche which he named complexes. Jung sent his publication Studies in Word Association (1904) to Sigmund Freud after finding his own beliefs confirmed by Freud's work. Jung and Freud became friends and collaborators until 1913 when Jung's ideas began to conflict with Freud's. During the time following this split, Jung published Two Essays on Analytical Psychology (1916, 1917) and Psychological Types (1921). Jung's later work developed from the concepts in his Two Essays publication and he became known as a founder of modern depth psychology.

In 1944, Jung gave up his psychological practice and his explorations after he suffered a severe heart attack. Jung received honorary doctorates from numerous universities and in 1948 he founded the C. G. Jung Institute in Zurich. Jung died on June 6, 1961.

Therapist neutrality

Neutrality means that the analyst does not take sides in the patient's conflicts, express feelings about the patient, or talk about his or her own life. Therapist neutrality is intended to help the patient stay focused on issues rather than be concerned with the therapist's reactions. In psychoanalysis, the patient lies on a couch facing away from the therapist. In psychodynamic psychotherapy, however, the patient and therapist usually sit in comfortable chairs facing each other.

Free association

Free association means that the patient talks about whatever comes into mind without censoring or editing the flow of ideas or memories. Free association allows the patient to return to earlier or more childlike emotional states ("regress"). Regression is sometimes necessary in the formation of the therapeutic alliance. It also helps the analyst to understand the recurrent patterns of conflict in the patient's life.

Therapeutic alliance and transference

Transference is the name that psychoanalysts use for the patient's repetition of childlike ways of relating that were learned in early life. If the therapeutic alliance has been well established, the patient will begin to transfer thoughts and feelings connected with siblings, parents, or other influential figures to the therapist. Discussing the transference helps the patient gain insight into the ways in which he or she misreads or misperceives other people in present life.

Interpretation

In psychoanalytic treatment, the analyst is silent as much as possible, in order to encourage the patient's free association. However, the analyst offers judiciously timed interpretations, in the form of verbal comments about the material that emerges in the sessions. The therapist uses interpretations in order to uncover the patient's resistance to treatment, to discuss the patient's transference feelings, or to confront the patient with inconsistencies. Interpretations may be either focused on present issues ("dynamic") or intended to draw connections between the patient's past and the present ("genetic"). The patient is also often encouraged to describe dreams and fantasies as sources of material for interpretation.

Working through

"Working through" occupies most of the work in psychoanalytic treatment after the transference has been formed and the patient has begun to acquire insights into his or her problems. Working through is a process in which the new awareness is repeatedly tested and "tried on for size" in other areas of the patient's life. It allows the patient to understand the influence of the past on his or her present situation, to accept it emotionally as well as intellectually, and to use the new understanding to make changes in present life. Working through thus helps the patient to gain some measure of control over inner conflicts and to resolve them or minimize their power.

Although psychoanalytic treatment is primarily verbal, medications are sometimes used to stabilize patients with severe anxiety, depression, or other mood disorders during the analysis.

The cost of either psychoanalysis or psychoanalytic psychotherapy is prohibitive for most patients without insurance coverage. A full course of psychoanalysis usually requires three to five weekly sessions with a psychoanalyst over a period of three to five years. A course of psychoanalytic psychotherapy involves one to three meetings per week with the therapist for two to five years. Each session or meeting typically costs between $80 and $200, depending on the locale and the experience of the therapist. The increasing reluctance of most HMOs and other managed care organizations to pay for long-term psychotherapy is one reason that these forms of treatment are losing ground to short-term methods of treatment and the use of medications to control the patient's emotional symptoms. It is also not clear as of 2003 that long-term psychoanalytically oriented approaches are more beneficial than briefer therapy methods for many patients. On the other hand, patients who can benefit from a psychoanalytic approach but cannot afford private fees may wish to contact the American Psychoanalytic Association, which maintains a list of analysts in training who offer treatment for reduced fees.

Preparation

Some patients may need evaluation for possible medical problems before entering psychoanalysis because numerous diseasesincluding virus infections and certain vitamin deficiencieshave emotional side effects or symptoms. The therapist will also want to know whether the patient is taking any prescription medications that may affect the patient's feelings or ability to concentrate. In addition, it is important to make sure that the patient is not abusing drugs or alcohol.

Risks

The primary risk to the patient is related to the emotional pain resulting from new insights and changes in long-standing behavior patterns. In some patients, psychoanalysis produces so much anxiety that they cannot continue with this treatment method. In other cases, the therapist's lack of skill or differences in cultural background may prevent the formation of a solid therapeutic alliance.

Normal results

Psychoanalysis and psychoanalytic psychotherapy both have the goal of basic changes in the patient's personality structure and level of functioning, although psychoanalysis typically aims at more extensive and more profound change. In general, this approach to treatment is considered successful if the patient has shown:

  • reduction in intensity or number of symptoms
  • some resolution of basic emotional conflicts
  • increased independence and self-esteem
  • improved functioning and adaptation to life

Attempts to compare the effectiveness of psychoanalytical treatment to other modes of therapy are difficult to evaluate. Some aspects of Freudian theory have been questioned since the 1970s on the grounds of their limited applicability to women and to people from non-Western cultures. In particular, some psychiatrists with cross-cultural experience maintain that psychoanalysis presupposes a highly individualistic Western concept of human personhood that is alien to traditional Asian and African societies. There is, however, general agreement that psychoanalytic approaches work well for certain types of patients, specifically those with neurotic conflicts.

Resources

PERIODICALS

Blass, R. B. "On Ethical Issues at the Foundation of the Debate Over the Goals of Psychoanalysis." International Journal of Psychoanalysis 84 (August 2003): 929-943.

Gabbard, G. O., and D. Westen. "Rethinking Therapeutic Action." International Journal of Psychoanalysis 84 (August 2003): 823-841.

Lombardi, R. "Mental Models and Language Registers in the Psychoanalysis of Psychosis: An Overview of a Thirteen-Year Analysis." International Journal of Psychoanalysis 84 (August 2003): 843-863.

Roland, A. "Psychoanalysis Across Civilizations: A Personal Journey." Journal of the American Academy of Psychoanalysis and Dynamic Psychiatry 31 (Summer 2003): 275-295.

ORGANIZATIONS

American Psychoanalytic Association. 309 East 49th Street, New York, NY 10017. (212) 752-0450. http://www.apsa-co.org.

KEY TERMS

Free association A technique used in psychoanalysis in which the patient allows thoughts and feelings to emerge without trying to organize or censor them.

Interpretation A verbal comment made by the analyst in response to the patient's free association. It is intended to help the patient gain new insights.

Neurosis A mental and emotional disorder that affects only part of the personality and is accompanied by a significantly less distorted perception of reality than in psychosis.

Psychodynamic An approach to psychotherapy based on the interplay of conscious and unconscious factors in the patient's mind. Psychoanalysis is one type of psychodynamic therapy.

Regression The process in which the patient reverts to earlier or less mature feelings and behaviors.

Therapeutic alliance The working relationship between a therapist and a patient that is necessary to the success of therapy.

Transference The process that develops during psychoanalytic work during which the patient redirects feelings about early life figures toward the analyst.

Working through The repeated testing of insights, which takes up most of the work in psychoanalysis after the therapeutic alliance has been formed.

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Psychoanalysis

Psychoanalysis

Definition

Psychoanalysis, as a form of therapy, is based on the understanding that human beings are largely unaware of the mental processes that determine their thoughts, feelings, and behavior, and that psychological suffering can be alleviated by making those processes known to the individual.

Sigmund Freud originally developed the theory and technique of psychoanalysis in the 1890s. Freud's ideas are still used in comptemporary practice; however, many have been further developed or refined and some even abandoned. The theory and technique of psychoanalyis contnues to integrate new insights about human development and behavior based on psychoanalytic research and discoveries from related fields. Different schools of psychoanalytic theory have evolved out of the original Freudian one, reflecting a variety of ideas and perspectives. Psychoanalysis is practiced by a trained psychoanalyst, also referred to as an analyst.

Purpose

Primary goals of psychoanalysis include symptom relief, increased self-awareness, and a more objective capacity for self-observation. Other aims might include improved relationships with others and the capacity to live a more deeply satisfying life. Typically, an individual seeks treatment in order to alleviate some difficulty, such as unhappiness in work or love, disturbances in mood or self-esteem, or troubling personality traits. With the exception of those that are physically based, psychoanalysis views such symptoms as related to unconscious mental processes, and because these mental forces are not within the individual's awareness, symptoms cannot be relieved with perseverance or with the help of friends or family. Through a slowly unfolding process, psychoanalysis demonstrates to the individual how unconscious mental processes affect current modes of thinking, feeling and interacting with others. It also demonstrates that these processes can be traced back to early experiences and relationships with caregivers and family members. This kind of insight enables the person to identify the sources of their sometimes troubling thoughts, feelings and behavior and, as a result, gives new meaning to current modes of functioning. This kind of transformation of character takes several years to accomplish due to the intense nature of the process. It requires a sacrifice of time, money, and mental energy. The resulting transformation offers the means for adaptive, enduring changes in personality. These are changes that enable the individual to live a more productive, satisfying and pleasurable life.

Precautions

The term "psychoanalyst" can be used by anyone, so it is important to know the credentials of an analyst prior to beginning treatment.

Credentials

In addition to having received advanced degrees in mental health (psychiatry, psychology, social work), trained psychoanalysts have also graduated from psychoanalytic training institutes. Institute training consists of three parts: course work on psychoanalytic theory and technique; supervised analyses (meaning that the candidate conducts analyses while being supervised by a seasoned psychoanalyst); and, third, candidates undergo a personal psychoanalysis. A personal analysis is considered a vital part of the training, as it enables candidates to learn about their own psychological processes. In turn, the knowledge enhances their capacity to treat others. This type of training program takes a minimum of four years to complete. Psychoanalysts also practice psychoanalytic psychotherapy , a less intensive form of treatment. It relies on the same theory of human development and a similar technique.

Description

In psychoanalysis, an individual in treatment is seen four to five times per week for 45- to 50-minute sessions. The individual lies comfortably on a couch while the analyst sits in a chair behind the person, out of view. The person is then asked to say whatever comes into his or her mind. Although this structure varies depending on the theory and style of the analyst, this is the most typical and traditional manner in which sessions are conducted. These conditions are maintained consistently, making it possible for thoughts and feelings to emerge that had once been outside of the person's awareness. The process of free associating, or saying whatever comes to mind, is challenging because people are taught at a young age to keep many ideas and feelings to themselves. When the analyst is out of view, it removes the possibility for eye contact, making it easier to speak spontaneously. Free association is also made easier by the analyst's nonjudgmental attitudein listening to the individual, in the attention and interest given to seemingly unimportant details, and the objective and caring attitude with which the analyst understands the individual.

As the person speaks, unconscious sources of present-day difficulties gradually appear. Specifically, the analyst begins to notice repetitive aspects of behavior. Some of them may include particular subjects about which the person finds it hard to speak, as well as habitual ways in which the person relates to the psychoanalyst. The analyst begins to reveal these to the person in a gradual and thoughtful manner. Sometimes these revelations are accepted as correct and helpful. At other times they are rejected, corrected, or refined.

During the years of an analysis, the individual will grapple with new insights repeatedly, each time comprehending them in new ways. There will be an enhanced emotional and intellectual understanding, in addition to seeing matters from the perspective of different periods of life. As in all worthwhile learning processes, this one includes times of deep satisfaction and great frustration, periods of growth and regression. Overall, the analyst and individual work together to modify debilitating life patterns, to ameliorate troubling symptoms, and to release emotional and intellectual resources bound up in unconscious psychological processes. A transformation will occur eventually, and be one in which the person's understanding of themselves and of others, along with their productivity in work and capacity to love, changes in profound and enduring ways.

Who can benefit from psychoanalysis?

Anyone interested should seek a consultation with a psychoanalyst in order to determine if this treatment is appropriate. People often begin psychoanalysis also after having participated in psychoanalytic psychotherapy, which is a less intense form of treatment.

Individuals who are the most suited for psychoanalysis are those who have experienced satisfactions in work, with friends, in marriage, but who nonetheless experience a general dissatisfaction with their lifesuffering from long-standing depression, anxiety, sexual difficulties, physical symptoms without physical basis, or typically feel isolated or alone. Some people need analysis because their habitual ways of living interfere with experiencing greater pleasure or productivity in life. Individuals need to be psychologically minded with an interest in becoming more self-aware, and a determination to forgo quick symptom relief in favor of a more gradual therapeutic process.

Psychoanalysis is also practiced with children and adolescents, with some variation in technique. Specifically, fantasy play and drawings are used with children in addition to verbal communication. During the treatment of children and young adolescents, parents are consulted on a regular basis so that the analyst can develop a more holistic understanding of the youngster's world. The goal of child and adolescent psychoanalysis is to alleviate symptoms and to remove any obstacles that interfere with normal development.

With other treatments

Psychoanalysis is used at times with other forms of treatment. Medication may be warranted in selected situationsif an individual suffers from a severe mood disturbance which interferes with his or her capacity to participate in treatment, for example. In general, medication is used as a tool that allows the individual to benefit from the psychoanalytic process; it is an adjunct therapy, while psychoanalysis is the primary curative one. There are also occasions in which psychoanalysis is provided concurrently with couples therapy or family therapy or with group therapy . Treatment recommendations, whether for psychoanalysis alone or in combination with couples, family, or group therapy, are based both on the individual's particular needs and the practice of the treating psychoanalyst.

Finally, psychoanalysis is not only a type of therapy. It is also a theory of human development from infancy to old age, a method for understanding thought processes. It offers a way of thinking about aspects of society and culture such as religion, prejudice, and war.

Normal results

Normal results include symptom relief and an enduring, adaptive change in personality.

Abnormal results

Some individuals do not benefit from this in-depth form of treatment. They instead experience increased distress, or do not progress after a sufficient amount of treatment sessions have elapsed. In these cases, people are typically transitioned to a less intensive form of treatment such as psychoanalytic psychotherapy.

Resources

BOOKS

Galatzer-Levy, Robert, M.D. Does Psychoanalysis Work? New Haven: Yale University Press, 2000.

Mitchell, Stephen A. and Margaret J. Black. Freud and Beyond. New York: Basic Books, 1995.

Oldham, John M., M.D. "Combining Treatment Modalities." In Textbook of Psychoanalysis, edited by Edward Nersessian, M.D. and Richard G. Kopff Jr., M.D. Washington, DC: American Psychiatric Press, Inc.,1996.

Weinshel, Edward M., M.D. and Owen Renik, M.D. "Psychoanalytic Technique." In Textbook of Psychoanalysis edited by Edward Nersessian, M.D and Richard G. Kopff, Jr., M.D. Washington, DC:American Psychiatric Press, Inc., 1996.

ORGANIZATIONS

American Psychoanalytic Association. 309 East 49th Street, New York, NY 10017. (212) 752-0450. <http://www.apsa.org>.

International Psychoanalytical Association. Broomhills, Woodside Lane, London N128UD.<http//www.ipa.org.uk>.

Susan Fine, Psy.D

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Psychoanalysis

Psychoanalysis

A method of treatment for mental, emotional, and behavioral dysfunctions as developed by Sigmund Freud.

Developed in Vienna, Austria, by Sigmund Freud (1856-1939), psychoanalysis is based on an approach in which the therapist helps the patient better understand him- or herself through examination of the deep personal feelings, relationships, and events that have shaped motivations and behavior. Freud developed his theories during the end of the 19th and the early part of the 20th centuries in Vienna, Austria, where he was a practicing physician specializing in neurological disorders. Freud's interest originated in his medical practice when he encountered patients who were clearly suffering physical symptoms for which he could find no organic, or biological, cause. Freud's first attempt to get at the psychological cause of these patients' pain was through hypnosis , which he studied in Paris in 1885. He found the results to be less than he'd hoped, however, and soon borrowed from a Viennese contemporary the idea of getting a patient to simply talk about his or her problems. Freud expanded upon this practice, however, by creating the idea of "free association," in which a patient is encouraged to speak in a non-narrative, non-directed manner, with the hope that he or she will eventually reveal/uncover the unconscious heart of the problem. This sort of unbridled, undirected self-exploration became one of the signature tenets of psychoanalysis.

Continuing his research of the mind and the unconscious, Freud published The Interpretation of Dreams in 1900. In this work he outlined his ideas about the construction of the mind and human personality . This book was followed by the now basics of the Freudian canon: The Psychopathology of Everyday Life in 1904 and A Case of Hysteria and Three Essays on the Theory of Sexuality, both in 1905. By the second decade of the 20th century, Freud had become an internationally renowned thinker, and psychoanalysis had emerged as a significant intellectual achievement on par with the work of Albert Einstein in physics and in many ways comparable to the modernist movement in the visual arts. Psychoanalysis was in its prime and it became something of a fad to undergo psychoanalytic treatment among the Western world's elite.

Psychoanalysis and the development of personality

Freud believed that human personality was constructed of three parts: the id , the ego , and the superego . The id, according to this schema, is comprised largely of instinctual drivesfor food and sex, for instance. These drives are essentially unconscious and result in satisfaction when they are fulfilled and frustration and anxiety when they are thwarted. The ego is linked to the id, but is the component that has undergone socialization and which recognizes that instant gratification of the id urges is not always possible. The superego acts in many ways like the ego, as a moderator of behavior; but whereas the ego moderates urges based on social constraints, the superego operates as an arbiter of right and wrong. It moderates the id's urges based on a moral code. Having theorized this framework of human personality, Freud used it to demonstrate how instinctual drives are inevitably confounded with strictly social codes (by the ego) and by notions of morality (by the superego). This conflict, psychoanalytic theory supposes, is at the heart of anxiety and neuroses.

In dealing with these conflicts, Freud's psychoanalytic theory suggests that the human mind constructs three forms of adaptive mechanisms: namely, defense mechanisms, neurotic symptoms, and dreams. Freud believed dreams were vivid representations of repressed urges: the id speaking out in wildly incongruous nighttime parables. He considered dreams to have two parts, the manifest content, the narrative that one is able to remember upon waking, and the latent content, the underlying, largely symbolic message. Because Freud believed dreams to represent unfulfilled longings of the id, psychoanalysis deals heavily with dream interpretation.

Psychoanalytic theory also sees various neurotic symptoms as symbolic acts representing the repressed longings of the id. For Freud, a neurotic symptom was what we now consider a psychosomatic disorder, some physical symptom that has a psychological, or in Freud's terms, neurological, origin. Psychoanalytic theory suggests that conditions like blindness, paralysis, and severe headaches can result from unfulfilled longings that the patient is unable to confront on a conscious level. Because of this inability, the patient develops some acceptable symptom, such as headaches, for which he or she can then seek medical attention .

The final adaptive mechanism Freud suggested are defense mechanisms . Freud identified several defense mechanisms, such as repression, displacement, denial, rationalization, projection, and identification. Each has its own peculiar dynamic but all work to distance a person from a conflict that is too difficult to confront realistically. These conflicts, according to psychoanalytic theory, originate during one of the four developmental stages Freud identified. These stages, and the infantile sexuality he identified as occurring within them, are some of the most controversial aspects of psychoanalytic theory. Freud suggested that adult neuroses was a result of and could be traced back to frustrated sexual gratification during these stages, which are: the oral stage, birth to one year; the anal stage, 1-3 years; the phallic stage, 3-5 years; and latency, five years to puberty . Each of these stages is in turn divided into sub-stages. In each of the major stages, the infant has sexual needs which, because of social mores, are left largely unfulfilled, causing neuroses to originate.

It is during the phallic stage that Freud hypothesized the development of the Oedipus complex , easily the most renowned and controversial theoretical construction of the Freudian canon. The Oedipus complex suggests that during the phallic stage, a child begins associating his genitals with sexual pleasure and becomes erotically attracted to the parent of the opposite sex while at the same time developing an intense jealousy of the same-sex parent. While Freud's original theory excludes consideration of females, his contemporary, Carl Jung (1875-1961), expanded this particular dynamic and theorized an Electra complex for women in which the same psychodrama of erotic attraction and jealousy is played out from the young girl's point of view.

Freud's critics

From nearly the beginning, Freud and his construction of psychoanalytic theory have faced intense criticism. His most famous dissenter is Jung, his former disciple. Jung split with Freud in 1913 over a variety of issues, including, but certainly not limited to, Freud's emphasis on infantile sexuality. Jung had a different view of the construction of human personality, for instance, and had different ideas about how dreams should be interpreted and viewed as part of psychoanalysis. Alfred Adler , another disciple of Freud, broke with the master over infantile sexuality, positing a view that infants and children are driven primarily by a need for self-affirmation rather than sexual gratification. In modern times, Freud has been the target of criticism from many corners. Feminists especially criticize his understanding of "hysteria" and his theory of Oedipal conflict.

Freudian psychoanalysis focuses on uncovering unconscious motivations and breaking down defenses. Many therapists feel that psychoanalysis is the most effective technique to identify and deal with internal conflicts and feelings that contribute to dysfunctional behavior. Through psychoanalysis, the patient increases his understanding of himself and his internal conflicts so that they will no longer exert as much influence on mental and emotional health.

Further Reading

Hall, Calvin S. A Primer of Freudian Psychology. New York: Harper and Row, 1982.

Menninger, K. and P.S. Holzman. Theory of Psychoanalytic Technique. New York: Basic Book, 1973.

Mitchell, Juliet. Psychoanalysis and Feminism. New York: Vintage Book, 1975.

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psychoanalysis

psychoanalysis, name given by Sigmund Freud to a system of interpretation and therapeutic treatment of psychological disorders. Psychoanalysis began after Freud studied (1885–86) with the French neurologist J. M. Charcot in Paris and became convinced that hysteria was caused not by organic symptoms in the nervous system but by emotional disturbance. Later, in collaboration with Viennese physician Josef Breuer, Freud wrote two papers on hysteria (1893, 1895) that were the precursors of his vast body of psychoanalytic theory. Freud used his psychoanalytic method primarily to treat clients suffering from a variety of mild mental disorders classified until recently as neuroses (see neurosis). Freud was joined by an increasing number of students and physicians, among whom were C. G. Jung and Alfred Adler. Both made significant contributions, but by 1913 ceased to be identified with the main body of psychoanalysts because of theoretical disagreements with Freud's strong emphasis on sexual motivation. Other analysts, including Melanie Klein and Jacques Lacan, also have contributed greatly to the field. Psychoanalysis and its theoretical underpinnings have had an enormous influence on modern psychology and psychiatry and in fields as diverse as literary theory, anthropology, and film criticism.

Psychoanalytic Therapy and Theory

The basic postulate of psychoanalysis, the concept of a dynamic unconscious mind, grew out of Freud's observation that the physical symptoms of hysterical patients tended to disappear after apparently forgotten material was made conscious (see hysteria). He saw the unconscious as an area of great psychic activity, which influenced personality and behavior but operated with material not subject to recall through normal mental processes. Freud postulated that there were a number of defense mechanisms—including repression, reaction-formation, regression, displacement, and rationalization—that protect the conscious mind from those aspects of reality it may find difficult to accept. The major defense mechanism is repression, which induced a "forgetfulness" for harsh realities. Observing the relationship between psychoneurosis and repressed memories, Freud made conscious recognition of these forgotten experiences the foundation of psychoanalytic therapy. Hypnosis was the earliest method used to probe the unconscious, but due to its limited effectiveness, it was soon discarded in favor of free association (see also hypnotism). Dreams, which Freud interpreted as symbolic wish fulfillments, were considered a primary key to the unconscious, and their analysis was an important part of Freudian therapy.

To clarify the operation of the human psyche, Freud and his followers introduced a vast body of psychoanalytic theory. In considering the human personality as a whole, Freud divided it into three functional parts: id, ego, and superego. He saw the id as the deepest level of the unconscious, dominated by the pleasure principle, with its object the immediate gratification of instinctual drives. The superego, originating in the child through an identification with parents, and in response to social pressures, functions as an internal censor to repress the urges of the id. The ego, on the other hand, is seen as a part of the id modified by contact with the external world. It is a mental agent mediating among three contending forces: the outside demands of social pressure or reality, libidinal demands for immediate satisfaction arising from the id, and the moral demands of the superego. Although considered only partly conscious, the ego constitutes the major part of what is commonly referred to as consciousness. Freud asserted that conflicts between these often-opposing components of the human mind are crucial factors in the development of neurosis.

Psychoanalysis focused on early childhood, postulating that many of the conflicts which arise in the human mind develop in the first years of a person's life. Freud demonstrated this in his theory of psychosexuality, in which the libido (sexual energy) of the infant progressively seeks outlet through different body zones (oral, anal, phallic, and genital) during the first five to six years of life.

Criticisms of and Changes in Freudian Psychoanalysis

Orthodox Freudian psychoanalysis was challenged in the 1920s by Otto Rank, Sandor Ferenczi, and Wilhelm Reich; later, in the 1930s, by Karen Horney, Erich Fromm, and Harry Stack Sullivan. These critics of Freud stressed the interpersonal aspect of the analyst-patient relationship (transference), and placed more emphasis on the processes of the ego. Despite a number of detractors and a lack of controlled research, Freudian psychoanalysis remained the most widely used method of psychotherapy until at least the 1950s.

Today, Freud's method is only one among many types of psychotherapy used in psychiatry. Many objections have been leveled against traditional psychoanalysis, both for its methodological rigidity and for its lack of theoretical rigor. A number of modern psychologists have pointed out that traditional psychoanalysis relies too much on ambiguities for its data, such as dreams and free associations. Without empirical evidence, Freudian theories often seem weak, and ultimately fail to initiate standards for treatment.

Critics have also pointed out that Freud's theoretical models arise from a homogeneous sample group—almost exclusively upper-class Austrian women living in the sexually repressed society of the late 19th cent. Such a sample, many psychologists contend, made Freud's focus on sex as a determinant of personality too emphatic. Other problems with traditional psychoanalysis are related to Freud's method of analysis. For Freudian analysis to reach its intended conclusions, the psychoanalyst required frequent sessions with a client over a period of years: today, the prohibitive costs of such methods compels most to seek other forms of psychiatric care.

Traditional psychoanalysis involved a distancing between therapist and client—the two did not even face each other during the sessions. In recent years, many clients have preferred a more interactive experience with the therapist. The subject matter of Freudian analysis has also fallen into disuse, even among those who still practice psychoanalysis: early childhood receives much less emphasis, and there is generally more focus on problems the client is currently experiencing. By the early 21st cent., various kinds of psychoanalysis continued to be practiced, but the theory and practice of psychoanalysis was increasingly overshadowed by cognitive psychology and discoveries in neurobiology.

Bibliography

See the works of Freud; A. Bernstein and G. Warner, An Introduction to Contemporary Psychoanalysis (1981); J. Reppen, ed., Beyond Freud (1984); C. G. Jung, The Collected Works, Vol. 4: Freud and Psychoanalysis (tr. 1985); S. Marcus, Freud and the Culture of Psychoanalysis (1984, repr. 1987); O. A. Olsen and S. Koppe, The Psychoanalysis of Freud (1988); C. Badcock, Essential Freud (1988); E. Kurzweil, The Freudian Establishments (1989); G. Makari, Revolution in Mind: The Creation of Psychoanalysis (2008).

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Psychoanalyst

PSYCHOANALYST

"Whoever has admitted that transference and resistance constitute the linchpins of treatment forever belongs in our untamed horde," Freud wrote to Georg Groddeck on June 15th, 1917. He would later add: "The acceptance of unconscious psychical processes, the acknowledgement of the doctrine on resistance and repression, the taking into consideration of sexuality and the Oedipus complex are the principle tenets of psychoanalysis and the bases of its history, and whosoever is not prepared to subscribe to all of them should not count himself among Psychoanalysts" (1923a).

Since then, disputes have run to the heart of the various psychoanalytic institutes over didactic analyses and training. The absence of a consistent code, compounded by inconsistent statutory regulations which governmental authorities have and have not have enacted in different region, has further multiplied the number of pronouncements as to what each institute reckons should best define what a psychoanalyst is.

Freud had already stated a few of his own prescriptions: "It is therefore reasonable to expect of an analyst, as a part of his qualifications, a considerable degree of mental normality and correctness. In addition, he must possess some kind of superiority, so that in certain analytic situations he can act as a model for his patient and in others as a teacher. And finally we must not forget that the analytic relationship is based on a love of truththat is, on a recognition of realityand that it precludes any kind of sham or deceit" (1937c, p. 248).

The work of the psychoanalyst has been described as being quite similar to that of the patient. First of all he or she should be committed to the relationship and to analyzing his or her own motivations for being in it. He or she must also engage in interpretive listening, including to the manifestations of their own defenses. In short, a "free-floating" or "evenly-suspended" attention must be paid when dealing with the processes inevitably evoked or generated by the highly-charged affective moments to which psychoanalytic activity leads.

The term counter-transference has been considerably expanded upon since it first appeared in 1910, and the various meanings attributed to it attest to the intricacies that develop within the analytic situation (Sandler, Joseph, et al., 1973; Blum, Howard, 1986). These conceptual responses, like the so-called "neutrality" intended to make the analyst into a "mirror," attest to the receptiveness with which personal analysis, often called a "didactic" or "training analysis," was meant to equip the psychoanalyst. In the event, only a presumptive judgment may be made in this respect. It should be recalled that language is the analyst's fundamental operation medium. The psychoanalytic candidate must have mastered the unique system of language that a psychoanalytic dialogue will engage him in, as this language is far from being something that unfolds through one voice alone.

The "Rules and Procedures of the Training Committee, Representing the French SPP [Société psychanalytique de Paris]," composed in France in 1949, in which the style of Jacques Lacan is very much in evidence, detailed the criteria for the selection of candidates for apprenticeship in psychoanalysis in France in the wake of the Second World War: "Only through clinical examination may light be shed upon the deficiencies which disqualify the candidate as an aide to memory or judgment: traits pointing to future intellectual frailty, latent psychoses, cognitive difficulties compensated for otherwise; or as a guiding agent: psychical difficulties in the form of crises and mood swings including epilepsy, meaning Cyclothymia."

The "Rules and Procedures" also advise: "Among other disqualifying elements should be included such problems as might impair the basis of imaginary support the person of the analyst may furnish to transferential identifications in the generic homeomorphism of his body image: shocking deformities, visible mutilations and overt functional impairments . . . Secondly, the examiner should consider the candidate's cultural education, which is evidenced in the special kind of intellectual open-mindedness that grasps the meanings of words and inspires their usage."

Freud, relying less on specifics and caricatures in his catalogue of counter-indications, emphasized above all the characteristic element of commitment to the activity, which "cannot well be handled like a pair of glasses that one puts on for reading and takes off when one goes for a walk. As a rule, psycho-analysis possesses a doctor either entirely or not at all" (1933a, p. 153). The arguments that have taken place surrounding whether it is possible to practice psychoanalysis part-time, on the margins of other medical or university activities, are extensive.

While Freud regretted the fact that "It cannot be disputed that analysts in their own personalities have not invariably come up to the standard of psychical normality to which they wish to educate their patients" (1937c, p. 247), he also added: "It almost looks as if analysis were the third of those 'impossible' professions in which one can be sure beforehand of achieving unsatisfying results. The other two, which have been known much longer, are education and government" (p. 248).

Alain de Mijolla

See also: Abstinence/rule of abstinence; Active technique; Analysand; Boundary violations; Collected Papers on Schizophrenia and Related Subjects ; Counter-transference; Cure; Elasticity; Ethics; Evenly-suspended attention; Face-to-face situation; Framework of the psychoanalytic treatment; Fundamental rule; Initial interview(s); Interpretation; Lay analysis; Money and the psychoanalytic treatment; Mutual analysis; Negative therapeutic reaction; Neutrality/benevolent neutrality; Pass, the; Psychoanalysis; Psychoanalytic technique with adults; Psychoanalytic technique with children; Psychoanalytic treatment; Psychotherapy; "Recommendations to Physicians Practicing Psychoanalysis"; Supervised analysis (control case); Tact; Termination of treatment; Therapeutic alliance; Training of the psychoanalyst.

Bibliography

Blum, Howard P. (1986). Countertransference and the theory of technique: discussion. Journal of the American Psychoanalytical Association, 34.

Freud, Sigmund. (1923a [1922]). Encyclopaedia article: "The libido theory." SE, 18: 255-259.

. (1933a [1932]). New introductory lectures on psycho-analysis. SE, 22: 1-182.

. (1937c). Analysis terminable and interminable. SE, 23: 209-253.

. (1960a). Letters of Sigmund Freud. (Ernst L. Freud, Ed.; Tania and James Stern, Trans.) New York: Basic Books.

Revue française de psychanalyse. (1949). Règlement et doctrine de la Commission de l'enseignement déléguée par la S.P.P., Paris, France. 13, (3), 426-435.

Sandler, Joseph; Dare, Christopher; and Holder, Alex. (1973). The patient and the analyst: the basis of psychoanalytic practice. New York: International Universities Press.

Further Reading

Litowitz, Bonnie, et al. (2003). The contemporary psychoanalyst at work. Journal of the American Psychoanalytic Association, 51, 9-24.

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psychoanalysis

psychoanalysis A psychological theory and a method of treatment of psychological disorders, developed initially by Sigmund Freud, and extended in a variety of ways by later psychoanalysts. James A. C. Brown's Freud and the Post-Freudians (1964) is still a good introduction to the various schools.

The core of psychoanalysis is the theory of the unconscious and the structural model of the psyche as consisting of three interrelated systems of id, ego, and superego. The unconscious comprises ideas (and some would argue feelings) that are unacceptable, either because they are experienced as internally threatening to the existence of the individual, or because they are experienced as threatening to society. These ideas might be sexual in origin (Freud), aggressive and destructive ( Melanie Klein), or connected with early experiences of fear and helplessness ( D. W. Winnicott). The id is seen as the source of drives demanding immediate satisfaction, and the superego as internalized parental and social authority, the work of the ego being to mediate the resultant conflicting demands.

Freud's account of dreams provides the most elaborate analysis of the workings of the unconscious. He begins by stating that all dreams are wish fulfilments: they provide a fantasy satisfaction of desires that have been repressed into the unconscious. The unconscious itself is timeless and does not mature: we remain, at this level, infantile throughout our lives, demanding immediate satisfaction. Neither is it subject to the laws of logic, desiring contradictory things at the same time, a feature of human life often recognized when people point out that love and hatred of the same person are closely connected. When we sleep the repression of our unconscious desires is relaxed. However, they do not appear directly in our dreams, but are censored through processes that Freud refers to as dream work, of which there are four types: condensation, or the merging of several thoughts into one dream symbol (for example, a policeman in a dream might stand for a range of authority figures in life); displacement, in which a desire is displaced onto an object in some way connected with the original, perhaps by chance or similarity (thus, in the hackneyed example, we might dream of sexual intercourse as a train going through a tunnel); symbolization, or the turning of ideas into pictures (for example, dreaming of setting a table, but laying knives and forks without handles might indicate a feeling of being unable to handle a situation); and, finally, secondary revision, the rational gloss we put on a dream, turning it into a manageable story as we remember it. Freud thought that dream analysis should concentrate on symbols, rather than the story, which is merely a disguise.

The analysis of dreams leads to the central feature of psychoanalytic treatment—free association. The patient is asked to talk about whatever comes into his or her head in connection with the symbol, and from this a pattern of meaning emerges which allegedly takes us back to the original unconscious thoughts (see Freud 's The Interpretation of Dreams, 1900
).

Over recent years these ideas have been taken up in particular by structuralist and post-structuralist thinkers in various disciplines: as a theory of literary criticism, for example, when a text is read as a dream; as a theory of the production of meaning; and as providing a so-called decentred theory of the subject. The Marxist philosopher Louis Althusser incorporated the idea of a ‘symptomatic reading’ into his epistemology as a way of identifying the underlying structure (or problematic) of a theory.

Freud's theory of sexual development is probably the most widely known aspect of psychoanalysis. The child is seen as developing initially through oral, anal, and phallic stages, where the libido is expressed and satisfied at different points of contact between the body and the outside world—the mouth, anus, and genitals. Individuals can become arrested at or regress to any of these levels. However progress through them is the same for both sexes. An essential element of Freud's argument is that we begin life as bisexual, if not polymorphously perverse, and that heterosexuality is an often tenuous achievement, involving the subordination (repression or sublimation) of homosexual and other desires. This is achieved largely but not entirely unconsciously through the Oedipal stage of development. Both sexes take the mother as the first love-object. In the case of the little boy, sexual feelings towards his mother cannot be physically realized, and are experienced by him as a challenge to the father. This puts him in danger because of the father's superior strength and power. The danger is experienced as a threat of castration, and in the face of this threat combined with the promise of a woman of his own when he reaches puberty, the boy relinquishes his desire for his mother. The little girl has to make a more dramatic change from mother to father as the primary love-object. According to Freud, she experiences herself as already castrated, leading to early identification with her mother (see Three Essays on the Theory of Sexuality, 1905).

This theory has played a prominent role in the development of modern feminism. For many it established Freud as irredeemably in favour of patriarchy; for others it provides a basis for an analysis of patriarchy. Juliet Mitchell, a British feminist, Marxist, and psychoanalyst, was the first modern feminist to defend Sigmund Freud, arguing that psychoanalysis offers a description and analysis of patriarchy, rather than a prescription for male domination (see Psychoanalysis and Feminism, 1976).

Freud's analysis of the development of the sexual object choice involves an understanding of the process by which the infant first of all seeks satisfaction through its own body (primary narcissism) and then through identifying with and introjecting the mother as part of its own psyche. Whereas classical psychoanalysis and Freud concentrated on the Oedipal stage, the development of psychoanalytic theory in Melanie Klein's work and British psychoanalysis in general focused on very early relationships with the mother, so that some feminists have tried to explain the development of gender differences in terms of the distinctive relationships between mothers and their young male and female children.

Psychoanalytic theory is not a monolithic block, but has developed through different national schools, and these schools tend to relate to social theory in different ways. The principal link between British psychoanalysis and social theory has been via feminist accounts of mothering. French psychoanalysis, through Lacan, has been associated with post-structuralism in general and post-structuralist feminism in particular. American ego psychology was incorporated by Talcott Parsons as a general theory of socialization. See also BOWLBY, JOHN; CRITICAL THEORY; JUNG, CARL GUSTAV.

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psychoanalysis

psy·cho·a·nal·y·sis / ˌsīkōəˈnaləsəs/ • n. a system of psychological theory and therapy that aims to treat mental disorders by investigating the interaction of conscious and unconscious elements in the mind and bringing repressed fears and conflicts into the conscious mind by techniques such as dream interpretation and free association. DERIVATIVES: psy·cho·an·a·lyze / ˌsīkōˈanlˌīz/ (Brit. psy·cho·an·a·lyse) v. psy·cho·an·a·lyt·ic / ˌsīkōˌanlˈitik/ adj. psy·cho·an·a·lyt·i·cal / ˌsīkōˌanlˈitikəl/ adj. psy·cho·an·a·lyt·i·cal·ly / ˌsīkōˌanlˈitik(ə)lē/ adv.

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psychoanalysis

psychoanalysis Therapy for treating behaviour disorders, particularly neurosis, based on the work of Sigmund Freud. Psychoanalysis emphasises unconscious mental processes and the determination of personality by instinct, chiefly sexual development in childhood. Psychoanalytic techniques include free association and the analysis and interpretation of dreams. The patient expresses repressed conflicts through transference to the analyst. See also Adler; ego; Fromm; id; Jung; Klein; Oedipus complex; Reich; repression; superego

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psychoanalysis

psychoanalysis (sy-koh-ă-nal-i-sis) n. a school of psychology and a method of treating mental disorders based upon the teachings of Sigmund Freud (1856–1939). Psychoanalysis employs the technique of free association in the course of intensive psychotherapy in order to bring repressed fears and conflicts to the conscious mind, where they can be dealt with (see repression).
psychoanalyst (sy-koh-an-ă-list) n. —psychoanalytic (sy-koh-an-ă-lit-ik) adj.

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psychoanalysis

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Psychoanalysis

PSYCHOANALYSIS

The term psychoanalysis pertains to the theory, therapy, and method of inquiry created by Sigmund Freud (18561939). The origin of psychoanalysis is often traced to Freud's Interpretation of Dreams (1900), but some of its key elements can be found in his earlier writings, especially his Studies on Hysteria (1895), cowritten with Josef Breuer.

Freudian Theory

"Freudian theory" is not a single theory but a set of smaller ones, at least some of which are familiar to most philosophers and educated people. One of the most significant and best known of these is Freud's theory of dreams.

Freud theorized that all dreams are fulfillments of repressed infantile wishes. During sleep, these repressed wishes can enter into the dreamer's consciousness, but only in a disguised form, after the dream censor has altered their appearance. Freud calls what survives the dream censorship the "manifest content"; what exists prior to the censorship is the dream's "latent content." By having a patient free associate to a dream's manifest content, Freud hoped to determine the dream's latent content and ultimately to glean information about a patient's unconscious conflicts.

In The Interpretation of Dreams, Freud distinguishes three areas of the human mind: consciousness, the preconscious, and the unconscious. Consciousness contains all that we are immediately aware of; the preconscious contains mental contents that we can easily become aware of; and the unconscious contains mental contents that cannot be brought to consciousness except through the use of psychoanalytic therapy.

The reason that unconscious ideas cannot readily be brought to consciousness, according to Freud, is that they are repressed. Repression and the unconscious are closely linked in his early writings: "Thus we obtain our concept of the unconscious from the theory of repression. The repressed is the prototype of the unconscious for us" (Freud 1923, p. 15). On his early theory of the dynamic unconscious, what is repressed is unconscious and what is unconscious is repressed.

On September 26, 1922, however, Freud read a short paper at the Seventh International Psycho-Analytical Congress, "Some Remarks on the Unconscious," in which he indicated dissatisfaction with his theory. In an abstract of the paper (the abstract may have been written by Freud himself), it is noted that the speaker (i.e., Freud) had retold the history of the development of the theory of the unconscious and had pointed out that it had been deemed necessary to equate the dynamic unconscious with the repressed. "It has turned out, however, that it is not practicable to regard the repressed as coinciding with the unconscious and the ego with the preconscious and conscious. The speaker discussed the two facts which show that in the ego too there is an unconscious, which behaves dynamically like the repressed unconscious." (author unknown, 1923, p. 367). The two facts are resistance proceeding from the ego during analysis and an unconscious sense of guilt.

This short paper and its abstract anticipated the publication of his The Ego and the Id (1923), in which Freud makes another important modification of his earlier views. Here he introduces the expression "das Es " ("the it"), which he explicitly borrows from Georg Groddeck; it has been translated by Freud's English translators as "the id." On his new theory, the structural theory, the unconscious is not equated with the repressed. All that is repressed is unconscious, but some of what is unconscious is not repressed. Some of what is in the id is repressed, but some of it is not. In addition, Freud now divides the mind into the id, ego, and superego.

The ego is held to be partly conscious and partly unconscious. It negotiates the demands of the outside world and those of the id and the superego. The id is largely unknowable, according to Freud, but we can know that it exists and know some of its properties. The id is entirely unconscious; it seeks satisfaction only of its instinctual needs, and it is the source of much psychic conflict. The superego develops out of the ego and maintains a system of ideals, values, and prohibitions.

At first, Freud tended to equate repression and defense, but in later works he classifies repression as but one type of defense. Other defense mechanisms include projection, reaction formation, sublimation, isolation, and regression. Despite his work on these other types of defenses, Freud still held that repression was the most important type of defense. In fact, he saw repression as the "cornerstone" of the whole structure of psychoanalysis.

Freud appealed to repression as the important causal determinant of parapraxes, which include memory mistakes, slips of the tongue, and neuroses, although not all neuroses. What Freud called "actual neuroses," including anxiety neuroses and neurasthenia, are caused by events in later life and are not explainable by Freudian theory. What Freudian theory does purport to explain are the "psychoneuroses," such as obsessional neurosis, hysteria, and depression. The psychoneuroses are said to arise from the repression of erotic wishes; their symptoms are "compromise formations"they represent a solution to unconscious conflicts among the id, ego, and superego.

Another significant Freudian theory concerns sexual stages of development. Each of us, it is theorized, goes through four such stages. In the first year, the infant passes through the oral stage, during which its mouth is its primary source of pleasure. The focus then changes in the anal stage, where, during the next three years or so, the infant's interest shifts to its anus. From three to five years, the child passes through the phallic period, and its genitals are of major interest. There is then a latency period lasting until puberty, when an interest in sex reemerges.

How a child reacts to events during the various stages of sexual development can help determine its adult personality. Both Freud and his followers theorized that certain personality clusters, such as obstinacy, parsimony, and orderliness, were causally linked to specific events in one or other of the infantile stages of development.

In addition to the four stages of sexual development, Freud postulated another stage, the oedipal phase, lasting roughly from age three to five years. During this period, the male child unconsciously desires to possess his mother sexually, but because of perceived threats from his father, the child develops what Freud terms the "oedipal complex." The boy begins to fear that his father will cut off his penis and develops castration anxiety. Freud's first published discussion of castration anxiety occurs in his discussion of the case of Little Hans (1909), whose mother told him that if he continued to touch his penis, she would ask the doctor to cut it off.

Some Freudians postulate in little girls a complex analogous to the oedipal complex, the "electra complex." It was Carl Jung, however, not Freud, who introduced this concept. Freud himself doubted that the concept was useful and even that the phenomenon occurred (Freud 1931, p. 229).

Psychoanalytic Therapy and Method of Inquiry

Standard psychoanalysis, or "analysis," has certain features that distinguish it from other types of psychotherapy. The analysand, the patient, reclines on a couch, while the analyst remains out of sight. The therapy is scheduled for four or five times per week, and, in contrast to short-term psychoanalytically oriented psychotherapy, it typically lasts three years or more.

Some analysts distinguish three phases of an analysis: the beginning, middle, and end. In the beginning phase, the analyst has a preliminary consultation with the patient, sets the fee schedule, determines (in consultation with the patient) the days and hours of analysis, and decides whether the patient is a suitable candidate for analysis. The initial phase of the analysis can last from a week or two to several months.

In the middle phase, which can last years, the heart of the analysis take place. The patient is instructed to report childhood memories and dreams and to free-associate about their contents, saying whatever comes to mind without pause or hesitation. The main methods of inquiry used by the analyst are free association and interpretation. The analyst uses the observed data from the patient's free associations in conjunction with other observations from the therapy sessions to form preliminary interpretations, or hypotheses, about the cause of the patient's problems. These hypotheses are modified as the analysis progresses, with the analyst taking into account some very important factors that tend to emerge later in the analysis.

One of these factors is resistance. Freud explained the resistance that eventually emerges as the attempt to defend against remembering what has been repressed. Resistance can take different forms, including certain verbalizations, expressions of recalcitrant attitudes, and the unwillingness to free-associate. In his Inhibitions, Symptoms, and Anxieties (1926 [1925], p. 159), Freud refers to the patient's resistance as "the resistance of the unconscious."

The solution to the resistance problem is to let the patient "work through" the resistances:

One must allow the patient time to become more conversant with this resistance with which he has now become acquainted, to work through it, to overcome it, by continuing, in defiance of it, the analytic work according to the fundamental rule of analysis. Only when the resistance is at its height can the analyst, working in common with his patient, discover the repressed instinctual impulses which are feeding the resistance; and it is this kind of experience which convinces the patient of the existence and power of such impulses. The doctor has nothing else to do than to wait and let things take their course, a course which cannot be avoided nor always hastened" (1914, p.155).

Another significant factor, one of "undreamt-of importance" (Freud 1940, p. 174), is transference. In the course of the analysis, the patient comes to see the analyst as the reincarnation of some important figure in his or her past and "transfers" to the analyst the negative or positive feelings formerly directed to the figure from the past. An important part of the analysis consists of the analyst's attempt to analyze the overt manifestations of the patient's transference in order to reach a final interpretation of the patient's problems.

In the third and last phase of the analysis, the final interpretation is revealed to the patient: The repressed is made conscious. Yet no mere telling of the interpretation is likely to have any lasting therapeutic effect unless the ego has been strengthened enough to enable the patient's acceptance of the interpretation.

In Analysis Terminable and Interminable (1937), Freud gives two criteria for terminating the analysis: first, symptom relief, with the patient overcoming his anxieties and inhibitions; and, second, the analyst's judging that so much material has been made conscious and so much resistance conquered that there is no need to fear a repetition of the pathological processes that caused the patient's problems. These criteria are relevant to deciding in one sense, Freud says, if there is to be "the end of an analysis," but in another sense, more is required. In asking whether the analysis is at an end in this second sense, we are asking whether the analyst has had such a far-reaching influence on the patient that no further change could be expected to take place in him if his analysis were to continue. "It is as though," Freud writes, "it were possible by means of analysis to attain to a level of absolute psychical normality," as though the analyst had succeeded in resolving every one of the patient's repressions (1937, pp. 219220).

The above material contains the main outlines of Freud's most important theories, his method of inquiry, and his therapy, but not all of his theories are covered, and important details are necessarily omitted. For brief discussions of additional psychoanalytic concepts, see B. Moore and B. Fine (1990); for more detailed discussions of nearly all of Freud's theories, the history of the psychoanalytic movement and its development in countries around the world, and the contributions of other major figures to the development of psychoanalysis, see E. Erwin (2002).

Fissures in the Movement

In the early years of the psychoanalytic movement, two serious schisms occurred: Alfred Adler (18701937) broke with Freud in 1911 and, at approximately the same time, Carl Jung (18751961) began fighting with Freud and in 1914 resigned from the International Psycho-analytical Association. These figures disagreed with Freud about several matters, but especially about the theoretical importance placed by Freud on infantile sexuality.

After breaking with Freud, Adler went on to develop his own general psychology. One of his key ideas is that the psychologically disturbed individual suffers from extreme feelings of inferiority. One of the main goals of Adlerian therapy is to eliminate this feeling of inferiority and to put in its place a feeling of community and connectedness with others. Carl Jung also developed his own type of psychotherapy and along with it a rich and complex theoretical framework that included the postulation of the collective unconscious, his theory of archetypes, and his distinction between "extroverts" and "introverts."

One could view the theorizing of Adler and Jung as taking psychoanalysis in new directions, but their theories are so radically different from Freud's that it is doubtful that either's theory or therapy is a form of psychoanalysis at all. When Adler leftor rather was pushed out ofthe Vienna Psycho-Analytical Society, he started his own group, "The Society for Free Psycho-Analysis," but he quickly changed the name of his theory to "Individual Psychology," a step for which, Freud said, "we are all thankful." ("There is room enough on God's earth, and anyone who can has a perfect right to potter about on it without being prevented; but it is not a desirable thing for people who have ceased to understand one another and have grown incompatible with one another to remain under the same roof." [Freud 1914, p. 52]). Jung, like Adler, also did not characterize his theory or therapy as a form of psychoanalysis; he preferred the name "analytical psychology."

Long after the departure of Adler and Jung, other cracks developed in the psychoanalytic movement, but these were much smaller. One of the first of these resulted from the work of Melanie Klein, a Budapest psychoanalyst who in 1926 moved to London, where she continued her work analyzing children. Klein saw herself as continuing Freud's work, although she did depart from his theories in certain respects, such as postulating the occurrence of oedipal conflicts in little girls and at an earlier time than specified by Freud's theory. Klein claimed to have made a series of important discoveries about infants, including their having a terrifying mental life, populated by beasts and monsters, and having cannibalistic urges causally linked to earlier contact with the mother's breast. Anna Freud, also working in London at the same time, strongly disagreed with some of Klein's theorizing and managed to win the support of the Vienna Psycho-Analytical Society in condemning Klein's views. The result was a bitter dispute between the "Kleinians" and London psychoanalysts who sided with Anna Freud.

A second division occurred because of the development of ego psychology, the groundwork for which was laid first by Freud's The Ego and the Id (1923) and developed further by Anna Freud in her work The Ego and the Mechanisms of Defense (1946 [1936]). Ego psychology began to flourish within the psychoanalytic tradition with the publication of Heinz Hartmann's Ego Psychology and the Problem of Adaptation (1958 [1939]). Hartmann and his colleagues did not see themselves as breaking with the Freudian tradition in any serious way, but they placed far more emphasis than did Freud on the role of the ego, while greatly reducing the theoretical significance of the id and superego.

Two further theoretical sharp turns occurred in the second half of the twentieth century with the development of object-relations theory and self psychology, now two of the most dominant forms of psychoanalysis.

Object-relations theory developed out of the work of British psychoanalysts, among them Melanie Klein, W. D. Fairbairn, and D. W. Winnicott. This theory is also associated with the work of psychoanalysts living in the United States, such as Otto Kernberg. According to traditional Freudian theory, there exists in each individual biological, instinctual urges, the mental representation of which are referred to as "drives." There are two sorts of drives: the sexual drive and the drive for self-preservation. Object-relations theorists reject Freud's biologically oriented drive theory and argue that the infant is motivated not by instinctual urges but by the need to relate to another person, such as the mother. Freud, like the object-relations theorists, also used the term object in his discussion of infants, but he was referring not to people or things external to the infant but to the child's mental representation of them.

In contrast, object-relations theorists tend to refer to things or persons in close proximity to the infant as "objects," but, somewhat confusingly, the theory also talks of "internalized objects," which clearly are not objects in the external world. One leading theorist, W. D. Fairbairn, in his Psychoanalytic Studies of the Personality (1952, p. 137) distinguishes between "objects" and "internalized objects" in terms of a contrast between normal and pathological psychology. In the object-relations theory, psychology becomes "the study of the relationships of the individual to his objects, whilst, in similar terms, psychopathology may be said to resolve more specifically into a study of the relationships of the ego to its internalized objects" (Fairbairn, 1952, p. 137).

In self psychology, the key theoretical concept, that of a "self object," also has a double use; it is sometimes applied to persons and at other times to their mental representations. Self psychology was developed by Heinz Kohut and his colleagues. Kohut became known for his theory of the narcissistic personality disorder, said to have a different etiology from the "transference neuroses" talked about by Freudian theory. This disorder, Kohut claimed, can be recognized partly by observing its distinct symptoms and partly by analyzing the different types of transference that develop in the course of the analysis: a mirroring, idealizing, and twinship transference. Each of these transferences reflects the failure of a parent to respond adequately to a different type of need of the infant, such as the child's need to confirm its own sense of greatness (the need for a "mirroring" response) or the need to experience others who resemble it (the need for a "twin" response). The result of these failures to respond is the narcissistic pathology, the subsequent failure of the narcissistic person to develop an intact self.

The Current Status of Psychoanalysis

Freud's theorizing has had an enormous influence on psychiatry, clinical psychology, art, cinema, literature, religion, anthropology, history, biography, sociology, and philosophy. The remnants of his theorizing survives through the work of individual psychoanalysts and the work of the psychoanalytic institutes and associations that exist in the United States, Great Britain, Brazil, Sweden, Finland, Mexico, South Africa, France, Austria, and in many other countries.

The work of the breakaway theorists, Alfred Adler and Carl Jung, has been considerably less popular than Freudian theory, but their theories have nonetheless been influential and are still accepted by many. Many Adlerians belong either to the International Association for Individual Psychology or to the North American Society of Adlerian Psychology. There are also Alfred Adler institutes and schools in Chicago, San Francisco, Washington, New York, and other cities.

Many adherents of the theories of Jung belong to the International Association for Analytical Psychology. C. G. Jung institutes and societies are located in this country in New York, Seattle, Portland, Boston, Los Angeles, and other large cities, and in Canada, Australia, Great Britain, and other countries.

The continued influence of various psychoanalytic theories is important, but there is also the question of truth: How much of psychoanalytic theorizing is at least approximately true? Some of the things that Adler and Jung said were rather commonsensical and not controversial or original. If we subtract these propositions, how many of their distinctive and original claims have been shown to be true? Not very many. There are few, if any, formal empirical studies of their theories. The verdict must be that their theories remain little more than interesting but unproven conjectures.

The work of the ego psychologists, the object-relations theorists, and the self psychologists has been the subject of more empirical inquiry, but there is nothing that can be said to constitute a firm body of supporting evidence for any one of these modifications of Freudian theory. This fact has led one prominent psychoanalyst to point out that the developments in ego psychology were not prompted by new data in the psychoanalytic situation but by the recognition of obvious deficiencies in Freudian theory, and that none of these three theories has remedied the epistemological and methodological difficulties associated with Freudian theory (Eagle 1993).

The sheer quantity of the empirical evidence for Freudian theory and therapy is far greater than that of its newer psychoanalytic rivals. It includes not only Freud's case studies but also the published case studies of many of his followers, data from anthropology and the "psychopathology of every day life," and more than 1,500 experimental studies. There are also Freud's arguments to consider: They are designed to show that even without the benefit of controlled studies, his theories receive powerful support from the data obtained from psychoanalytic case studies.

In evaluating the Freudian evidence, one issue concerns its subject. There is a watered-down, commonsensical version of Freud's theories and there are the original, distinctively Freudian versions articulated and modified over the years principally by Freud himself. On the watered-down version, the unconscious exists if a person has mental states that exist below the threshold of consciousness, whether or not these states can be brought to consciousness without the aid of psychoanalysis. Repression is said to occur whenever one tries to keep something painful out of consciousness, which obviously happens when one tries to forget a sad love affair or a hurtful insult. There are "Freudian slips," it is said, if people make linguistic mistakes with sexual innuendoes, regardless of what causes the errors. Defense mechanisms such as "projection," "reaction formation," and "displacement" are said to be operative so long as certain types of defensive behavior are displayed, such as attributing to others one's own faults or doing just the opposite of what one would like to do, no matter what causal mechanism explains the behaviors.

The evidence for some of the best-known hypotheses of the popularized, watered-down version of Freudian theory is quite strong but not new: the evidence for some sort of unconscious mind, intentional forgetting, slips of the tongue, and defensive behaviors was known to psychologists and philosophers of the nineteenth century, before Freud invented psychoanalysis. Recent historical research has shown that even many of Freud's seemingly distinctive ideas were anticipated, not merely in some vague way but in detail, by the philosophers Arthur Schopenhauer (17881860), Friedrich Nietzsche (18441900), Eduard von Hartmann (18421906), and J. F. Herbart (17761844) (Zentner 2002).

If we limit the discussion to what is distinctively Freudian, scholars still disagree about what the evidence shows. Some still claim that the evidence gleaned from clinical case studies strongly supports some parts of Freudian theory, although that view is losing adherents even among Freudians, partly or largely due to the trenchant and systematic criticisms of the Freudian clinical evidence by the philosopher Adolf Grünbaum (2002). If, as Grünbaum argues, the clinical evidence has little probative value with respect to Freudian theory, that leaves mainly the Freudian experimental evidence, said by some to firmly support some central parts of the Freudian corpus (Kline 1981, Fisher and Greenberg 2002). Another review of the very same experimental evidence concludes that it provides almost no support for any distinctively Freudian hypothesis (Erwin 1996).

As regards Freud's therapeutic claims, there are uncontrolled case studies and correlational studies of long term orthodox psychoanalytic therapy, but there has never been a randomized clinical trial studying its effects. Two retrospective studies of long-term psychoanalysis have been published in recent years; some analysts argue that despite their lack of controls, they provide support for the effectiveness of psychoanalysis because of the employment of novel statistical techniques or the presence of other features that obviate the need for experimental controls. These studies and the claims on their behalf are criticized in Erwin (2002).

See also Freud, Sigmund.

Bibliography

works by freud

All references to Freud's works are to The Standard Edition of the Complete Psychological Works of Sigmund Freud. 24 vols. Translated by James Strachey. London: Hogarth Press, 19531974.

Breuer, J., and S. Freud. Studies on Hysteria (1895). S. E. 2, 19305.

The Interpretation of Dreams (1909). S. E. 4 and 5: 1627.

"Analysis of a Phobia in a FiveYearOld Boy" (1909). S. E. 10: 5149.

"On the History of the Psycho-Analytic Movement" (1914). S. E. 14: 386.

The Ego and the Id (1923). S. E. 19: 1263.

Inhibitions, Symptoms and Anxiety (1926). S. E. 20: 87172.

"Female Sexuality" (1931). S. E. 21: 225243.

Analysis Terminable and Interminable (1937). S. E. 23: 216253.

An Outline of Psychoanalysis (1940). S. E. 23: 174.

works about freud

Freud, A. The Ego and the Mechanisms of Defense. New York: International Universities Press, 1946 [1936].

Author Unknown. Abstract. Int. J. Psycho-Anal., 1923, 4: 367.

Eagle, M. "The Dynamics of Theory Change in Psychoanalysis." Philosophical Problems of the Internal and External Worlds: Essays on the Philosophy of Adolf Grünbaum, edited by J. Earman, A. Janis, G. Massey, and N. Rescher. Pittsburgh: Pittsburgh University Press, 1993.

Erwin, Edward. A Final Accounting: Philosophical and Empirical Issues in Freudian Psychology. Cambridge, MA: MIT Press, 1996.

Erwin, Edward. The Freud Encyclopedia: Theory, Therapy, and Culture. New York: Routledge, 2002.

Fairbairn, W. D. Psychoanalytic Studies of the Personality. London: Tavistock Publications and Routledge & Keegan Paul, 2002.

Fisher, S., and R. Greenberg. "Scientific Tests of Freud's Theories and Therapy." In The Freud Encyclopedia: Theory, Therapy, and Culture, edited by Edward Erwin. New York: Routledge, 2002.

Grünbaum, A. "Critique of psychoanalysis." In The Freud Encyclopedia: Theory, Therapy, and Culture, edited by Edward Erwin. New York: Routledge, 2002.

Grünbaum, A. The Foundation of Psychoanalysis: A Philosophical Critique. Berkeley: University of California Press, 2002.

Hartmann, H. Ego Psychology and the Problem of Adaptation. New York: International Universities Press, 1958 [1939].

Kline, P. Fact and Fantasy in Freudian Theory. London: Methuen, 1981.

Moore, B., and B. Fine, eds. Psychoanalysis: The Major Concepts. New Haven: Yale University Press, 1995.

Edward Erwin (2005)

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Psychoanalysis

Psychoanalysis

CINEMA AND THE UNCONSCIOUS
CINEMA AND THE MIRROR
REDISCOVERING THE GAZE
FURTHER READING

It is not accidental that psychoanalysis and the cinema were born in the same year. In 1895, Auguste (1862–1954) and Louis Lumière (1864–1948) conducted the first public film screening in the basement of the Grand Café in Paris; the same year also witnessed the publication of Sigmund Freud (1856–1939) and Josef Breuer's Studies on Hysteria, the founding text of psychoanalysis. In this book, Freud and Breuer make public their discovery of the unconscious, the central psychoanalytic concept that, in fact, inaugurates psychoanalysis as a discipline. The existence of the unconscious means there is a limit to human self-knowledge. Our desire exists beyond this limit and thus remains fundamentally unknown to us. The unconscious includes repressed ideas, ideas we cannot consciously know because they are too traumatic for us. The traumatic nature of the unconscious renders it irreducible to our knowledge: it exceeds every attempt to know it directly. But this is not to say we cannot encounter the unconscious. Freud's conception of how one encounters the unconscious highlights the importance of psychoanalytic theory for the cinema.

As Freud makes clear in the Interpretation of Dreams (1900), the dream provides us with access to the unconscious through the way it distorts our latent thoughts in the process Freud calls the "dream-work." The dream-work alters thoughts existing in the mind by condensing multiple thoughts into one and displacing traumatic thoughts onto related nontraumatic ones. Above all, the dream-work translates our thoughts into images structured in a narrative form that is the dream itself. Through this activity of translation and distortion, the dream allows us to encounter unconscious ideas too traumatic for waking life. The dream enacts a traumatic encounter with our unconscious desire. The bizarre nature of dreams thus becomes evidence of unconscious processes, which are only visible indirectly through the distortion they create. For this reason, according to Freud, the dream is "the royal road to the unconscious." (This distortion is also evident, however, in slips of the tongue, forgetting, and jokes.) In light of the importance of the dream for the development of psychoanalysis, the link between psychoanalysis and the cinema becomes clearer: this structure can be seen in cinema as the site of public dreams, a unique opportunity to examine the unconscious outside of an analytic session.

CINEMA AND THE UNCONSCIOUS

Unfortunately, few filmmakers have actively taken up the possibilities that an understanding of psychoanalysis affords the cinema. Much of this is due, undoubtedly, to the place that film production occupies within a capitalist economy: the exigencies of profit place a premium on films that will appease rather than traumatize spectators. If Hollywood films open themselves to the trauma of the unconscious, they most often close this opening through their denouements. As a result, most commercial films show us how we can subdue and master trauma, not, as psychoanalysis has it, how trauma subdues and masters us. Films about psychoanalysis, including John Huston's Freud (1962) and Alfred Hitchcock's Spellbound (1945), deal with psychoanalysis on the level of their content rather than integrating it into their form (though Hitchcock's film does include a dream sequence with images created by the surrealist painter Salvador Dali).

Psychoanalysis made its presence felt most directly through the development of the film noir tradition. While few noir films explicitly address psychoanalytic concepts, the narrative structure and mise-en-scène of the noir universe evinces a kind of fidelity to them. The noir detective figure is much like the analyst: he probes the underside of society—the night—in search of the repressed truth that one cannot discover in the light of day. On this quest for truth, the noir detective discovers the essential corruption and disorder of society—the absence of any purity. Hence the noir detective discovers that truth is inseparable from desire, that truth is desire itself. This structure can be seen in classic noirs such as The Maltese Falcon (1941), The Big Sleep (1946), and Out of the Past (1947), as well as in neo-noirs such as Chinatown (1974).

Despite its forceful exploration of the unconscious dimension of experience, film noir remains, on the structural level, pre-Freudian. It sustains a narrative structure that obscures rather than emphasizes the workings of the unconscious. Serious attempts to integrate Freud's ideas on the unconscious and on dreams directly into film form were confined primarily to avant-garde, nonnarrative cinema. One notable exception is surrealist director Luis Buñuel (1900–1983), who formally emphasizes the repetitive nature of desire and its constitutive failure to find its object in such films as Belle de Jour (1967), Le Charme discret de la bourgeoisie (The Discreet Charm of the Bourgeoisie, 1972), and Cet obscur objet du désir (The Obscure Object of Desire, 1977). In each case, the very narrative itself remains caught up in a cycle of repetition that forces us as spectators to experience the distorting power of desire itself.

Despite the importance of Buñuel to the cinematic development of the insights of psychoanalysis, perhaps no director, either in Hollywood or outside of it, has done more to develop an aesthetic on the basis of dream-work than David Lynch (b. 1946). Lynch's films depart from the structure of traditional narrative in order to follow the logic of the dream. Especially in films such as Lost Highway (1997) and Mulholland Drive (2001), Lynch includes narrative turns that seem to defy any versimilitude in an effort to respect this logic. However, unlike many avant-garde filmmakers, Lynch does not attempt to break from narrative altogether. The spectator can always discern the narrative trajectory of a Lynch film, even though this trajectory itself may confound expectations. When characters are miraculously transformed into other characters or the laws of temporality are ignored, this indicates Lynch's attempt to construct a realism of the unconscious. One often sees montage sequences, as in Blue Velvet (1986), that do not advance the narrative but work instead to reveal the unconscious associations of a particular character. Most importantly, all of Lynch's films lead the spectator to a traumatic encounter with the spectator's own desire elicited by the film. In the act of watching a Lynch film, one has one's own desire as a spectator exposed, in a way similar to the patient on the analytic couch. Though film for a long time resisted the full implications of psychoanalysis in favor of a form that worked to quiet the spectator's desire, with the films of David Lynch, cinema finally registers the potentially radical impact that psychoanalytic insights might have on film form and on the relationship between film and spectator.

Because of their investment in cinematically exploring the unconscious, Lynch's films have produced many exemplary psychoanalytic interpretations. These works tend to see the films in terms of fantasy, repetition compulsion, or Oedipal crisis. For instance, psychoanalytic interpretations of Blue Velvet often understand the film as reenacting the fantasy of the primal scene in order to investigate the role this fantasy plays in the development of male sexuality and subjectivity. Or they see the circular structure of Lost Highway as the depiction of the inescapability of repetition. Even beyond Lynch, these are the directions that psychoanalytic interpretation often takes, but such interpretive uses of psychoanalysis are relatively recent.

CINEMA AND THE MIRROR

Film theory, too, despite the structural link between psychoanalysis and cinema, did not immediately develop in the direction of psychoanalysis. The first attempt to understand the cinema in psychological terms occurred in 1916, when Hugo Münsterberg (1863–1916) wrote The Photoplay: A Psychological Study, a book that stressed the parallel between the structure of the human mind and the filmic experience. However, Münsterberg's concern is only the conscious mind, not the unconscious; he is thus a psychologist, not a psychoanalyst, more neo-Kantian than Freudian. From 1916 onward, this focus on the conscious experience of the spectator predominated in film theory, as attested by the work of important film theorists such as André Bazin and Sergei Eisenstein. Though Bazin and Eisenstein agree on little, they do share a belief that film's importance lies in its conscious impact. Neither considers the unconscious. Film theory took many years to begin to think of the cinematic experience in terms of the unconscious, but when it commenced, psychoanalytic film theory came in the form of a tidal wave in the 1970s and 1980s.

The primary focus of this wave of psychoanalytic film theory was the process of spectator identification understood through French psychoanalyst Jacques Lacan's idea of the mirror stage. Even more than Freud himself, Lacan, despite the difficulty of his work and its lack of availability in English translation, was the central reference point for the emergence of psychoanalytic film theory. In truth, psychoanalytic film theory has from its incipience been almost exclusively Lacanian film theory. According to Lacan, the mirror stage occurs in infants between six and eighteen months of age, when they misrecognize themselves while looking in the mirror. The infant's look in the mirror is a misrecognition because the infant sees its fragmentary body as a whole and identifies itself with this illusory unity. In the process, the infant assumes a mastery over the body that it does not have, and this self-deception forms the basis for the development of the infant's ego. By detailing the formation of the ego through an imaginary process, Lacan thereby undermines the substantial status that the ego has in some versions of psychoanalysis (especially American ego psychology, often the target of Lacan's most vituperative attacks). The attractiveness of this idea for film theory is readily apparent if we can accept the analogy between Lacan's infant and the cinematic spectator.

Psychoanalytic film theorists such as Christian Metz and Jean-Louis Baudry took this analogy as their point of departure. For them, the film screen serves as a mirror through which the spectator can identify himself or herself as a coherent and omnipotent ego. The sense of power that spectatorship provides derives from the spectator's primary identification with the camera itself. Though the spectator is in actual fact a passive (and even impotent) viewer of the action on the screen, identification with the camera provides the spectator with an illusion of unmitigated power over the screen images. Within the filmic discourse, the camera knows no limit: it goes everywhere, sees everyone, exposes everything. The technological nature of the filmic medium (unlike, say, the novel) prevents a film from capturing absence. The camera inaugurates a regime of visibility from which nothing escapes, and this complete visibility allows spectators to believe themselves to be all-seeing (and thus all-powerful). What secures the illusory omnipotence of the spectator is precisely the spectator's own avoidance of being seen. Like God, the spectator sees all but remains constitutively unseen in the darkened auditorium.

The above scenario functions, however, only insofar as it remains unconscious and the spectator sustains the sense of being unseen. This is why, according to this version of psychoanalytic film theory, classical Hollywood narratives work to hide the camera's activity. Once the camera itself becomes an obvious presence rather than an invisible structuring absence, the spectator loses the position of omnipotence along with the camera and becomes part of the cinematic event. When this happens, the spectator becomes aware that the film is a product and not simply a reality. To forestall this recognition, classical Hollywood editing works to create a reality effect, a sense that the events on the screen are really happening and not just the result of a filmic act of production. In this regard, classical Hollywood cinema functions like commodity fetishism, working to hide the labor that goes into the production of its commodity. When thinking about early psychoanalytic film theory, a reference to commodity fetishism is almost unavoidable, which suggests the strong link that has existed between psychoanalytic film theory and Marxist theory.

One cannot separate the early manifestation of psychoanalytic film theory from its political dimension. In addition to relying on Lacan's notion of the mirror stage, Baudry and other psychoanalytic film theorists take their bearings from Marxist philosopher Louis Althusser. For them, Althusser's notion of ideological interpellation (developed in his essay "Ideology and Ideological State Apparatuses," 1970) provides a way of thinking about the political implications of the mirror stage. For Althusser, ideology hails concrete individuals as subjects, causing them to regard themselves—mistakenly—as the creative agents behind their experiences. The illusion of agency is thus the fundamental ideological deception.

According to psychoanalytic film theorists, the cinematic experience perpetuates this ideological deception through the mirror relationship it sets up for the spectator. Insofar as traditional narrative film blinds the spectator to the way that film addresses or hails the spectator as a subject, every traditional narrative participates in the process of ideological interpellation and control. Hollywood film invites spectators to accept an illusory idea of their own power, and in doing so, it hides from spectators their actual passivity. For early psychoanalytic film theory, cinema's ideological victory consists of convincing spectators to enjoy the very process that subjugates them. This line of thought finds its fullest development in the British journal Screen throughout the 1970s.

It is also in Screen that theorists first began to link psychoanalytic film theory to feminist concerns. One of the most fecund developments in psychoanalytic film theory occurred through this alliance. In 1975 Laura Mulvey wrote "Visual Pleasure and Narrative Cinema," perhaps the most anthologized and most quoted essay in the entire history of film theory. The importance of this essay for the subsequent development of film theory cannot be overstated. Basing her essay on the pioneering work of Metz and Baudry, Mulvey links the process of spectator identification to sexual difference. According to Mulvey, a secondary identification with character accompanies the spectator's primary identification with the camera, and this identification with a filmic character is most often, at least in Hollywood cinema, an identification with a male character.

The spectator's sense of power is, for Mulvey, a definitively masculine sense of power. The spectator, then, is gendered male. On the screen, the male character, the site of identification, drives the movement of the film's narrative and is the character whose movement the camera follows. The female character serves as a spectacle for both the spectator and the latter's screen proxy, the male character, to look at. This process, which Mulvey termed the "gaze," deprives the female subject of her subjectivity, reducing her to a "to-be-looked-at-ness" that provides pleasure for the male spectator. Mulvey's appropriation of psychoanalysis for feminism is meant to destroy this pleasurable experience through the act of analyzing it. Here again, psychoanalytic theory is inseparable from the specific political program it serves.

REDISCOVERING THE GAZE

Due in large part to the impact of Mulvey's essay, psychoanalytic film theory grew so popular in the 1980s that it became identified, especially in the minds of its detractors, with film theory as such. In the 1990s, however, psychoanalytic film theory almost ceased to be practiced and was reduced to being an idea to refute in the process of introducing another way of thinking about film. Its demise led to a general retreat from theory to empirical research within the film studies field. But psychoanalytic film theory did not completely die out. Acknowledging twenty years of critiques of psychoanalytic film theory focused on spectator identification, a new manifestation of psychoanalytic film theory developed through an act of self-criticism. In Read My Desire: Lacan Against the Historicists (1994), Joan Copjec completely revolutionized psychoanalytic film theory. Copjec pointed out that psychoanalytic film theory had based itself on a radical misunderstanding of Lacan's concept of the gaze, which he does not develop in his essay on the mirror stage but in a later seminar translated as The Four FundamentalConcepts of Psycho-Analysis (1978). The gaze, as Copjec explains it, is not on the side of the looking subject; it is an objective gaze, a point on—or, rather, absent from—the film screen. Rather than being the spectator's look of (illusory and deceptive) mastery, it is the point in the film image where this mastery fails. Instead of reducing the film screen to the mirror in which spectators can identify themselves, Copjec understands the screen as the site of the gaze, which is the object motivating the spectator's desire.

Psychoanalytic film theory had been too eager to think in terms of spectator identification and thus forgot about the role of spectator desire. According to psycho-analysis, desire is triggered by a missing object—an absence. Though the camera has the effect of rendering everything it photographs visible, it cannot create a field of unlimited visibility. Though films may work to dis-guise the limits of visibility, these limits are actually necessary for engaging the spectator's desire. The spectator desires to see a film only if it remains absent from the field of vision. It is this absence, not the illusion of gaining visual omnipotence, that draws the spectator into the events on the screen. The spectator thus seeks an object in the filmic image that remains irreducible to that image and irretrievable there. The encounter with this absence is traumatic for the spectator, shattering the ego and dislodging the spectator from her or his position of illusory safety. As films often make us aware, we as spectators are not separate from the screen but present there as an absence. When films push us toward the recognition of this unconscious involvement, we confront the public elaboration of our unconscious desire.

Though there is an implicit political valence to this turn in psychoanalytic film theory, it breaks from previous versions by refusing to place psychoanalytic insights in the service of a pre-formulated political program. Instead, Copjec's psychoanalytic film theory takes unconscious desire—the founding idea of psychoanalysis—as its starting point for understanding the cinema. In this sense, there is a homology between the emergence of Lynch's filmmaking and this innovation in psychoanalytic film theory. Both focus on the role of unconscious desire in film rather than on the process of identification. It is not coincidental that film theorists such as Slavoj Žižek, following in Copjec's wake, have turned their attention to the films of David Lynch.

With her revision of the traditional understanding of the gaze, Copjec authored a revolution in psychoanalytic film theory. It now becomes clear that the link between psychoanalysis and the cinema is even tighter than it initially seemed. No longer do we need to use psycho-analysis exclusively to help us decode cinematic manipulation and ideological control. Instead, psychoanalysis and cinema become locatable as part of a shared project that emerges out of a recognition of the power of the unconscious. Both psychoanalysis and cinema, in their best manifestations, represent attempts to embrace the trauma that constitutes us as subjects. In doing so, one discovers that this trauma is at once the source of our enjoyment as well. Psychoanalytic film theory can now look at films in terms of the way in which they relate to the gaze and thereby recognize how they mobilize spectators' desires and appeal to their fantasies. This allows psychoanalytic film theory to finally arrive at the fundamental questions that the cinema poses for us as individual subjects and for culture at large.

SEE ALSO Criticism;Feminism;Film Studies;Spectatorship and Audiences

FURTHER READING

Baudry, Jean-Louis. "Ideological Effects of the Basic Cinematographic Apparatus." In Movies and Methods: An Anthology, edited by Bill Nichols, vol. 2, 531–548. Berkeley: University of California Press, 1985.

Copjec, Joan. Read My Desire: Lacan Against the Historicists. Cambridge, MA: MIT Press, 1994.

Freud, Sigmund. Beyond the Pleasure Principle. Translated by James Strachey. New York: Norton, 1961.

——. The Interpretation of Dreams. Translated by James Strachey. New York: Avon, 1965.

Gabbard, Glenn O. Psychoanalysis and Film. London: Karnac Books, 2001.

Lacan, Jacques. The Four Fundamental Concepts of Psycho-Analysis. Translated by Alan Sheridan. New York: Norton, 1978.

——. "The Mirror Stage as Formative of the Function of the I as Revealed in Psychoanalytic Experience." In Écrits: A Selection, translated by Bruce Fink, 3–9. New York: Norton, 2002.

Metz, Christian. The Imaginary Signifier: Psychoanalysis and Cinema. Translated by Celia Britton et al. Bloomington: Indiana University Press, 1982.

Mulvey, Laura. "Visual Pleasure and Narrative Cinema." In Visual and Other Pleasures, 14–26. Bloomington: Indiana University Press, 1989.

Oudart, Jean-Pierre. "Cinema and Suture." Screen 18, no. 4 (1977–1978): 35–47.

Žižek, Slavoj. The Art of the Ridiculous Sublime: On David Lynch's "Lost Highway." Seattle: University of Washington Press, 2000.

——. The Fright of Real Tears: Krzysztof Kieslowski Between Theory and Post-Theory. London: British Film Institute, 2001.

Todd McGowan

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Psychoanalysis

Psychoanalysis

Definition

Description

Normal results

Abnormal results

Resources

Definition

Psychoanalysis, as a form of therapy, is based on the understanding that human beings are largely unaware of the mental processes that determine their thoughts, feelings, and behavior, and that psychological suffering can be alleviated by making those processes known to the individual.

Sigmund Freud originally developed the theory and technique of psychoanalysis in the 1890s. Freud’s ideas are still used in contemporary practice; however, many have been further developed or refined, and some even abandoned. The theory and technique of psychoanalysis continues to integrate new insights about human development and behavior based on psychoanalytic research and discoveries from related fields. Different schools of psychoanalytic theory have evolved out of the original Freudian one, reflecting a variety of ideas and perspectives. Psychoanalysis is practiced by a trained psychoanalyst, also referred to as an analyst.

Purpose

Primary goals of psychoanalysis include symptom relief, increased self-awareness, and a more objective capacity for self-observation. Other aims might include improved relationships with others and the capacity to live a more deeply satisfying life. Typically, an individual seeks treatment in order to alleviate some difficulty, such as unhappiness in work or love, disturbances in mood or self-esteem, or troubling personality traits. With the exception of those that are physically based, psychoanalysis views such symptoms as related to unconscious mental processes, and because these mental forces are not within the individual’s awareness, symptoms cannot be relieved with perseverance or with the help of friends or family. Through a slowly unfolding process, psychoanalysis demonstrates to the individual how unconscious mental processes affect current modes of thinking, feeling and interacting with others. It also demonstrates that these processes can be traced back to early experiences and relationships with caregivers and family members. This kind of insight enables individuals to identify the sources of their sometimes troubling thoughts, feelings and behavior and, as a result, gives new meaning to current modes of functioning. This kind of transformation of character takes several years to accomplish due to the intense nature of the process. It requires a sacrifice of time, money, and mental energy. The resulting transformation offers the means for adaptive, enduring changes in personality. These are changes that enable the individual to live a more productive, satisfying, and pleasurable life.

Precautions

The term “psychoanalyst” can be used by anyone, so it is important to know the credentials of an analyst prior to beginning treatment.

CREDENTIALS

In addition to having received advanced degrees in mental health (psychiatry, psychology, social work), trained psychoanalysts have also graduated from psychoanalytic training institutes. Institute training consists of three parts: course work on psychoanalytic theory and technique; supervised analyses (meaning that the candidate conducts analyses while being supervised by a seasoned psychoanalyst); and, third, candidates undergo a personal psychoanalysis. A personal analysis is considered a vital part of the training, as it enables candidates to learn about their own psychological processes. In turn, the knowledge enhances their capacity to treat others. This type of training program takes a minimum of four years to complete. Psychoanalysts also practice psychoanalytic psychotherapy, a less intensive form of treatment. It relies on the same theory of human development and a similar technique.

Description

In psychoanalysis, an individual in treatment is seen four to five times per week for 45- to 50-minute sessions. The individual lies comfortably on a couch while the analyst sits in a chair behind the person, out of view. The person is then asked to say whatever comes into his or her mind. Although this structure varies depending on the theory and style of the analyst, this is the most typical and traditional manner in which sessions are conducted. These conditions are maintained consistently, making it possible for thoughts and feelings to emerge that had once been outside of the person’s awareness. The process of free associating, or saying whatever comes to mind, is challenging because people are taught at a young age to keep many ideas and feelings to themselves. When the analyst is out of view, it removes the possibility for eye contact, making it easier to speak spontaneously. Free association is also made easier by the analyst’s nonjudgmental attitude—in listening to the individual, in the attention and interest given to seemingly unimportant details, and in the objective and caring attitude with which the analyst understands the individual.

As the person speaks, unconscious sources of present-day difficulties gradually emerge. Specifically,

ERICH FROMM (1900-1980)

Erich Fromm was born in Frankfurt-am-Main, Germany, the son of Naphtali Fromm, a wine merchant, and Rosa Krause. Throughout his career Fromm strove toward an understanding of human existence based upon the breaking down of barriers–between individuals as well as between schools of thought.In a Los Angeles Times obituary article of the famous psychologist, a reviewer summarizes: “Fromm’s lifelong concern was how people could come to terms with their isolation, insignificance and doubts about life’s meaning.” As his theories developed over the decades into what would later be collectively labeled “social humanism,” he incorporated knowledge and information culled from such diverse fields as Marxist socialism and Freudian psychology. The psychologist used these schools of thought as building blocks for developing original theories which, like his idiosyncratic life, often ran against popular beliefs. As a psychologist, he diverged from the Freudian school, in which the unconscious was the main factor in understanding human actions, by pointing out the importance of the influence of social and economic factors.

Most of Fromm’s work was an application of psychoanalysis, sociology philosophy, and religion to the peculiar problems of man in modern industrialize society. In Escape from Freedom he postulated that “modern man, freed from the bonds of pre-individualistic society, which simultaneously gave him security and limited him, has not gained

freedom in the positive sense of the realization of his individual self; that is, the expression of his intellectual, emotional and sensuous potentialities. Freedom, though it has brought him independence and rationality, has made him isolated and, thereby, anxious and powerless.” This problem, the individual’s tenuous relationship to institutions and society, became the core of such later works as Man for Himself: An Enquiry into the Psychology of Ethics and The Sane Society.

Fromm’s penultimate book, To Have or To Be?, presents “the viewpoint and challenge of radical humanistic psychoanalysis,”’ explains Paul Roazen in Nation. The volume has been seen as the culmination of Fromm’s work at that time and maintains, according to a publisher’s note, “that two modes of existence are struggling for the spirit of humankind; the having mode, which concentrates on material possession, acquisitiveness, power, and aggression and is the basis of such universal evils as greed, envy, and violence; and the being mode, which is based in love, in the pleasure of sharing, and in meaningful and productive rather than wasteful activity. Dr. Fromm sees the having mode bringing the world to the brink of psychological and ecological disaster, and he outlines a program for socio-economic change [to] turn the world away from its catastrophic course.”

the analyst begins to notice repetitive aspects of behavior. Some of them may include particular subjects about which the person finds it hard to speak, as well as habitual ways in which the person relates to the psychoanalyst. The analyst begins to reveal these to the person in a gradual and thoughtful manner. Sometimes these revelations are accepted as correct and helpful. At other times they are rejected, corrected, or refined.

During the years of an analysis, the individual will grapple with new insights repeatedly, each time comprehending them in new ways. There will be an enhanced emotional and intellectual understanding, in addition to seeing matters from the perspective of different periods of life. As in all worthwhile learning processes, this one includes times of deep satisfaction and great frustration, periods of growth and regression. Overall, the analyst and individual work together to modify debilitating life patterns, to ameliorate troubling symptoms, and to release emotional and intellectual resources bound up in unconscious psychological processes. A transformation will occur eventually, and be one in which the person’s understanding of themselves and of others, along with their productivity in work and capacity to love, changes in profound and enduring ways.

Who can benefit from psychoanalysis?

Anyone interested should seek a consultation with a psychoanalyst in order to determine if this treatment is appropriate. People often begin psychoanalysis also after having participated in psychoanalytic psychotherapy, which is a less intense form of treatment.

Individuals who are the most suited for psychoanalysis are those who have experienced satisfactions in work, with friends, in marriage, but who nonetheless experience a general dissatisfaction with their life— suffering from long-standing depression, anxiety, sexual difficulties, physical symptoms without physical basis, or typically feel isolated or alone. Some people need analysis because their habitual ways of living interfere with experiencing greater pleasure or productivity in life. Individuals need to be psychologically minded with an interest in becoming more self-aware, and a determination to forgo quick symptom relief in favor of a more gradual therapeutic process.

KEY TERMS

Psychoanalysis —A form of therapy based on the understanding that human beings are largely unaware of the mental processes that determine their thoughts, feelings, and behavior, and that psychological suffering can be alleviated by making those processes known to the individual.

Psychotherapy —A form of therapy that involves discussion of mental problems in order to treat them.

Psychoanalysis is also practiced with children and adolescents, with some variation in technique. Specifically, fantasy play and drawings are used with children in addition to verbal communication. During the treatment of children and young adolescents, parents are consulted on a regular basis so that the analyst can develop a more holistic understanding of the youngster’s world. The goal of child and adolescent psychoanalysis is to alleviate symptoms and to remove any obstacles that interfere with normal development.

Use with other treatments

Psychoanalysis is used at times with other forms of treatment. Medication may be warranted in selected situations—if an individual suffers from a severe mood disturbance which interferes with his or her capacity to participate in treatment, for example. In general, medication is used as a tool that allows the individual to benefit from the psychoanalytic process; it is an adjunct therapy, while psychoanalysis is the primary curative one. There are also occasions in which psychoanalysis is provided concurrently with couples therapy or family therapy or with group therapy. Treatment recommendations, whether for psychoanalysis alone or in combination with couples, family, or group therapy, are based both on the individual’s particular needs and the practice of the treating psychoanalyst.

Finally, psychoanalysis is not only a type of therapy. It is also a theory of human development from infancy to old age, amethod for understanding thought processes. It offers a way of thinking about aspects of society and culture such as religion, prejudice, and war.

Normal results

Normal results include symptom relief and an enduring, adaptive change in personality.

Abnormal results

Some individuals do not benefit from this in-depth form of treatment. They instead experience increased distress, or do not progress after a sufficient amount of treatment sessions. In these cases, people are typically transitioned to a less intensive form of treatment such as psychoanalytic psychotherapy.

Resources

BOOKS

Freud, Sigmund. The Origin and Development of Psychoanalysis. Whitefish, MT: Kessinger Publishing, 2004.

Galatzer-Levy, Robert, MD. Does Psychoanalysis Work? New Haven: Yale University Press, 2000.

Kandel, Eric. Psychiatry, Psychoanalysis, and the New Biology of Mind. Arlington, VA: American Psychiatric Publishing, 2005.

Person, Ethel S., Arnold M. Cooper and Glen O. Gabbard, eds. The American Psychiatric Publishing Textbook of Psychoanalysis. Arlington, VA: American Psychiatric Publishing, 2005.

ORGANIZATIONS

American Psychoanalytic Association. 309 East 49th Street, New York, NY 10017-1601. (212) 752-0450. http://www.apsa.org

International Psychoanalytical Association. Broomhills, Woodside Lane, London N12 8UD. http://www.ipa.org.uk

Susan Fine, Psy.D

Stephanie N. Watson

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Psychoanalysis

Psychoanalysis

History

Personality theory

Personality organization

Personality development

Psychoanalytic therapy

Treatment styles

Resources

Psychoanalysis is a form of psychotherapy used by qualified psychotherapists to treat patients who have a range of mild to moderate chronic life problems. It is related to a specific body of theories about the relationships between conscious and unconscious mental processes. However, it should not be used as a synonym for psychotherapy in general. Psychoanalysis is done one on one with the patient and the analyst; it is not appropriate for group work. The term psychoanalysis has three meanings: 1) a theory of personality with an emphasis on motivation, or why humans behave the way they do; 2) a method of treatment for various psychological problems; and 3) a group of techniques used to explore human nature or the mind.

History

Psychoanalysis is the most intensive form of an approach to treatment called psychodynamic therapy. Psychodynamic refers to a view of human personality that comes about from interactions between conscious and unconscious factors. The purpose of all forms of psychodynamic treatment is to bring unconscious mental material and processes into full consciousness so that the patient can gain more control over his or her life.

Classical psychoanalysis has become the least commonly practiced form of psychodynamic therapy because of its demands on the patients time, as well as on his or her emotional and financial resources. It is, however, the oldest form of psychodynamic treatment.

The theories that underlie psychoanalysis were worked out by Austrian physiologist, medical doctor, psychologist Sigmund Freud (18561939) during the early years of the twentieth century. Freud lived in an era rich with groundbreaking scientific discoveries in physics, biology, and medicine. He studied medicine with the goal of being a scientist and doing research, not of seeing patients, and as a medical student he performed laboratory research on the nervous system. For financial reasons Freud was forced to practice medicine and see patients, and because of his research background he began specializing in the treatment of nervous disorders or psychological problems. To improve his treatment skills he studied with French psychiatrist and neurologist Jean-Martin Charcot (18251893) who was using hypnosis as a treatment method. But, Freud felt hypnosis did not provide long term cures, and it did not get to the sources of his patients problems. Next, Freud tried a method being used by Josef Breuer (1842 1925), a Viennese physician, whereby patients symptoms were cured by talking about them. It was through using the talking cure with his own modifications and revisions to it that Freud formed his theories of personality and psychoanalytic therapy.

Personality theory

Over Freuds long life, his thinking evolved and he continually revised his theories. Since Freuds death, psychoanalytic theory and therapy have been modified by numerous psychoanalysts, psychologists, and psychiatrists.

One of Freuds most significant contributions to psychology and the world at large was his view of the unconscious. To Freud the unconscious is the seat of all of human impulses, instincts, wishes, and desires, which people are usually unaware, or not conscious of. It is irrational and yet it is just this part of human nature that controls most behavior.

Personality organization

Personality is composed of three interacting systemsid, ego, and superego. They are not structures or things; they are simply names for different psychological processes, and in normal circumstances they work together harmoniously.

The id, present at birth, is the foundation of personality containing all of the instincts and receiving its energy from bodily processes. Id operates according to the pleasure principle, meaning it avoids pain and seeks pleasure using two processesreflex actions and primary process. Reflexes are inborn actions that reduce discomfort immediately, like a sneeze. Primary process is very simply forming a wish-fulfilling image of what is desired. For example, if one was hungry the person might start imagining a favorite meal. Imagining of course will not satisfy hunger, or most other needs, and the ego develops to deal with reality and satisfy the ids demands because the id cannot tell the difference between what exists in reality and what is in the mind.

The ego, on the other hand, can make that distinction and it operates according to the reality principle, mediating between the desires of the id and the realities of the outside world. Ego tries to satisfy the ids urges in the most appropriate and effective ways. For example, the id might urge the person to go to sleep immediately, no matter where they are. The ego would delay sleep until a convenient time and an appropriate place were found.

The superego is the third and last system of personality to develop. It represents traditional values of society as learned by the child through its parents. It is concerned with morals and tells us what is right and wrong, punishing people with guilt feelings if they do something that was taught to be wrong. Both the ego and superego derive their energy from the id.

Personality development

Freud believed human behavior and thought are ruled by numerous instincts that fall into two groupsthose that further life and those that further death. Scientists know little about the death instincts, but aggression and destructiveness come from them. Life instincts further survival and reproduction. Sexual instincts are the main life instincts and they are very important in the psychoanalytic theory of development. Freud believed humans pass through five stages of psychosexual development: the oral, anal, phallic, latent, and genital.

In the oral stage infants find pleasure in using their mouths to eat and suck. In the anal stage, from about age two to four years, pleasure is found in the tension reducing release of waste products. During the phallic stage children become preoccupied with their genitals, and they begin to develop an attraction to their opposite sex parent, which is called the oedipus complex. How the child and his or her parents deal with the oedipus complex can have a great impact on the individuals personality. During the latency period, roughly from ages five to 12 years, the sexual instincts are subdued until physiological changes in the reproductive system at puberty reawaken them. With puberty the genital stage begins, wherein the individual develops attraction to the opposite sex and becomes interested in forming a loving union with another. This is the longest of the stages, lasting from puberty until senility. It is characterized by socialization, vocational planning, and decisions about marriage and raising a family.

Psychoanalytic therapy

Freud believed the foundation of personality is formed during early childhood and mental illness occurs when unpleasant childhood experiences are repressed, or kept from consciousness, because they are painful. Psychoanalytic therapy tries to uncover these repressed thoughts; in this way the patient is cured.

Freuds primary method of treatment was free association, in which the patient is instructed to say anything and everything that comes to mind. Freud found that patients would eventually start talking about dreams and painful early childhood memories. Freud found dreams especially informative about the persons unconscious wishes and desires. In fact, he called dreams the royal road to the unconscious. The patient and analyst then try to understand what these memories, feelings, and associations mean to the patient.

Treatment styles

People considered best suited to psychoanalytic treatment include those with depression, character disorders, neurotic conflicts, and chronic relationship problems. When the patients conflicts are long-standing and deeply entrenched in his or her personality, psychoanalysis may be preferable to psychoanalytic psychotherapy, because of its greater depth.

Psychoanalysis is not suitable for patients suffering from severe depression or psychotic disorders such as schizophrenia. It is also not appropriate for people with addictions or substance dependency, disorders of aggression or impulse control, or acute crises; some of these people may benefit from psychoanalysis after the crisis has been resolved.

In both psychoanalysis and psychoanalytic psychotherapy, the therapist does not tell the patient how to solve problems or offer moral judgments. The focus of treatment is exploration of the patients mind and habitual thought patterns. Such therapy is termed non-directed. It is also insight-oriented, meaning that the goal of treatment is increased understanding of the sources of ones inner conflicts and emotional problems. The basic techniques of psychoanalytical treatment include: neutrality, free association, and transference.

Neutrality means that the analyst does not take sides in the patients conflicts, express feelings about the patient, or talk about his or her own life. Therapist neutrality is intended to help the patient stay focused on issues rather than be concerned with the therapists reactions. In psychoanalysis, the patient lies on a couch facing away from the therapist. In psychodynamic psychotherapy, however, the patient and therapist usually sit in comfortable chairs facing each other.

Free association means that the patient talks about whatever comes into mind without censoring or editing the flow of ideas or memories. Free association allows the patient to return to earlier or more childlike emotional states (regress). Regression is sometimes necessary in the formation of the therapeutic alliance. It also helps the analyst to understand the recurrent patterns of conflict in the patients life.

Transference is the name that psychoanalysts use for the patients repetition of childlike ways of relating that were learned in early life. If the therapeutic alliance has been well established, the patient will begin to transfer thoughts and feelings connected with siblings, parents, or other influential figures to the therapist. Discussing the transference helps the patient gain insight into the ways in which he or she misreads or misperceives other people in present life.

In psychoanalytic treatment, the analyst is silent as much as possible, in order to encourage the patients free association. However, the analyst offers judiciously timed interpretations, in the form of verbal comments about the material that emerges in the sessions. The therapist uses interpretations in order to uncover the patients resistance to treatment, to discuss the patients transference feelings, or to confront the patient with inconsistencies. Interpretations may be either focused on present issues (dynamic) or intended to draw connections between the patients past and the present (genetic). The patient is also often encouraged to describe dreams and fantasies as sources of material for interpretation.

Working through occupies most of the work in psychoanalytic treatment after the transference has

KEY TERMS

Ego Mental processes that deal with reality and try to mediate between the id and the environment.

Free association Method used in psychoanalytic therapy to bring unconscious memories to awareness. The patient tells the psychoanalyst everything he or she thinks of.

Id Unconscious mental processes containing instincts that dominate personality.

Instincts Mental representations of bodily needs that direct thought.

Pleasure principle The avoidance of pain and seeking of pleasure which the id performs. Primary processWish-fulfilling images formed by the id.

Psychoanalysis A theory of personality, method of psychotherapy, and approach to studying human nature, begun by Sigmund Freud.

Psychosexual development Five stages of development humans pass through: oral, anal, phallic, latent, and genital.

Reality principle Rational, realistic thinking the ego operates according to.

Superego Mental processes concerned with morality as taught by parents.

Unconscious That which humans are unaware of. Ruler of behavior containing all instincts and thoughts people are unaware of.

been formed and the patient has begun to acquire insights into his or her problems. Working through is a process in which the new awareness is repeatedly tested and tried on for size in other areas of the patients life. It allows the patient to understand the influence of the past on his or her present situation, to accept it emotionally as well as intellectually, and to use the new understanding to make changes in present life. Working through thus helps the patient to gain some measure of control over inner conflicts and to resolve them or minimize their power.

Although psychoanalytic treatment is primarily verbal, medications are sometimes used to stabilize patients with severe anxiety, depression, or other mood disorders during the analysis.

According to the American Psychoanalytic Association (APsaA), psychoanalysis is becoming more popular around the world, in spite of the development of new anti-depression drugs and the growing sector of managed health care. Statistics show that the majority of patients in the United States take psychoanalysis for a little over five years, where most of the cost is passed to the patient. In Canada, with most of the expenses are covered with insurance, most patients take psychoanalysis for a little less than five years. Surveys researched by the APsaA show that 60 to 90% of the outcomes of psychoanalysis are positive for the patient. In addition, over 80% of patients try psychoanalysis only after responding favorably to other forms of treatment.

Resources

BOOKS

Campbell, Jan. Psychoanalysis and the Time of Life: Durations of the Unconscious Self. London, UK: Routledge, 2006.

Canestri, Jorge, ed. Psychoanalysis: From Practice to Theory. Chichester, UK: John Wiley and Sons, 2006.

Ferro, Antonino (translated by Philip Slotkin). Psychoanalysis as Therapy and Storytelling. London, UK: Routledge, 2006.

Gedo, John E. Psychoanalysis as Biological Science: A Comprehensive Theory. Baltimore, MD: Johns Hopkins University Press, 2005.

Kandel, Eric R. Psychiatry, Psychoanalysis, and the New Biology of Mind. Washington, DC: American Psychiatric Pub., 2005.

Marie Doorey

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Psychoanalysis

Psychoanalysis

Psychoanalysis is both a theory of the psyche and a method of treating psychological disorders. The word psyche, a term borrowed from the Greek psyche, meaning soul, refers to the human mind. Most psychoanalytic theories understand the mind as a dynamic, organized system that connects to the entire body. The psyche is a complex, multilayered apparatus that operates according to certain processes that react to and reflect an individual's experiences and environment. The psyche is often envisioned as a space with layers, one of which—the unconscious—an individual cannot directly know. The techniques of psychoanalysis are designed to reveal the contents and operations of the unconscious, many of them sexual, to cure physical and nervous symptoms that have no physical cause.

The basic premise of psychoanalysis is that certain mental conditions are the effects of the mind repressing memories, experiences, sexual wishes and desires, and traumatic events. When such material is repressed—or kept away from consciousness as if it had never happened—the mind finds other ways to express and react to such material. These other ways constitute symptoms, which represent indirect, often symbolic or metaphorical, responses to the repressed material. The goal of psychoanalysis is to stop such symptoms by tracing and revealing the repressed material that such symptoms express. The theory is that when repressed material is brought to light, the symptoms by which it is otherwise expressed will stop.

Psychoanalysis also conceives of the mind as having multiple layers, some of which are conscious and accessible and others of which are not. It also assumes that the body often reflects through symptoms what the mind hides from itself, that the layers of the mind and the body work together in certain predictable ways, and that experiences and traumas will partially contribute to shape an individual's psyche. Concepts of how the layers of the mind work together are often mechanistic and dynamic, but they also interact with and are formed by relationships and events from the outside world, such as the family, encounters with other people, and traumas.

Methods for discerning and understanding the unconscious have included mesmerism; hypnosis; categorizing hysterical states as revealed by the body; listening to and analyzing what a patient says (the talking cure); analyzing dreams, slips of the tongue, and other manifestations of the unconscious; and analyzing stories and case histories of psychotic behavior. Psychoanalysis began as an offshoot of medical practice, but it operates in the early twenty-first century more as an aspect of psychological treatment as opposed to medical interventions made by psychiatrists, which often include the use of drugs.

PSYCHOANALYSIS BEFORE FREUD

Although Sigmund Freud (1856–1939) is probably the most famous as well as the most influential psychoanalyst, psychoanalysis as known in the early twenty-first century started a century before Freud began his work. In the late eighteenth century, Franz Anton Mesmer (1734–1815), a Viennese medical doctor, believed that individuals had what he called animal magnetism, which was quite literally a magnetic fluid in the body. If the fluid became disorganized, individuals suffered symptoms that could be cured by using magnets or the laying on of the physician's hands to realign the magnetic elements of the fluid. Mesmer believed that for healing to occur, patients needed to have an intense rapport with the doctor, who, by stimulating crises in a patient, could understand and control the symptoms.

Mesmerism seems a far cry from the more sophisticated theories of psychoanalysis, but Mesmer's ideas opened up a field of inquiry in which the mind and body are linked and disorders are treated through the relationship between doctor and patient. Two French physicians, neurologists Jean-Martin Charcot (1825–1893) and Pierre Janet (1859–1947), continued to develop modes of defining and analyzing patients with physical symptoms that seemed to have no physical cause. Having been assigned to the Salpêtrière, an old Paris hospital crowded with impoverished patients—many of them prostitutes and women afflicted with hysteria, or various uncontrollable symptoms thought to be caused by a wandering womb—Charcot began working to categorize his patients' maladies. He determined that the illnesses of some of the patients were mental rather than physical, and he used hypnosis to alleviate symptoms. Charcot also took photographs of female patients with hysteria to demonstrate what he thought were definitive stages of the disease. Janet, who followed Charcot at the Salpêtrière, further developed modes of analyzing patients, providing empirical proof of the existence of the unconscious, and beginning to theorize that hysteria and other conditions were effects of the flow of psychic energies. The idea of the psyche as a system that worked around the disposition of energy provided the basis for Freud's ideas about repression, symptoms, and the treatment of psychical disorders.

FREUD'S THEORIES

Freud, who began as a neurologist and studied with Charcot in Paris, offered what became the most far-reaching and influential model of psychic functioning. Beginning his studies with hysterical female patients, Freud developed a talking cure, in which patients talked to him, narrating dreams, feelings, and experiences. By listening to and analyzing how a patient related thoughts and feelings, the analyst could deduce what the repressed material was that produced symptoms. In The Interpretation of Dreams (1899), Freud suggested that dreams represent not only the expression of unconscious thoughts but also wish fulfillment, and that dream expressions follow specific rules—a dream grammar—which also indicates the general ways the unconscious itself works. According to Freud material in dreams is often condensed; that is, figures and events are combined in a composite figure. Or they are displaced—that is, they are expressed through material typically associated with other material in the unconscious. By tracing these logics back from the dream material, the analyst could discern the basis for the dream.

Freud believed that sexual impulses and desires constitute much unconscious and repressed material, including both the idea that children have sexual feelings and that their relations with others are formed through desire and prohibitions enforced in the family. The Oedipus complex results from the father's prohibition of the son's desire for his mother. The prohibition takes the form of a threat of castration. Freud believed that many of his hysterical adult female patients were reacting to an early seduction by adults, a theory he later altered by suggesting that fantasies of such seduction might function in a similar fashion.

Freud also developed a theory of mental functioning that worked around desire, the libido (or sexual energy), and the alleviation of excitement. Believing that the psyche seeks levels of lowest excitement, Freud saw mental functioning as an effort to balance and discharge the various excitements that occur in the course of living. The psyche also works as the interrelation of different functions such as the ego, which is formed in relation to others, as a defense against prohibitions, and as a sense of agency for the individual. For Freud most people are neurotic, which means their behaviors in some way constitute a symbolic expression of early childhood psychical conflicts.

OTHER THEORISTS AND FOLLOWING FIGURES

Freud's work was joined by a burgeoning number of analysts, including Alfred Adler (1870–1937), who developed an individual psychology, a radically different set of assumptions that derive from the individual's relation to the community. Adler's thought developed in contradistinction to that of Freud. Although Adler agreed that infantile experience is important to individual development, he thought that psychology is derived from two opposing drives: the desire for community and belonging and a desire for individual superiority. Adler's emphasis on interpersonal relationship would form the basis of a psychoanalysis based on the analysis of the effects of those relationships. This mode of analysis, which deemphasized the sexual in favor of the relational, was later known as object relations analysis. Its practitioners included Harry Stack Sullivan (1892–1949), Karen Horney (1885–1952), Erik Erikson (1902–1994), and Erich Fromm (1900–1980).

At the same time, another acquaintance of Freud's, Carl Gustav Jung (1875–1961), developed his own complex system of psychoanalysis. Called analytic psychoanalysis, Jung's theory set out the ideas of psychic totality and energism as the basis for the organization of the psyche. He invented the concepts of introverted and extroverted personality types. For Jung the unconscious had two aspects: a personal dimension and a dimension comprised of archetypes derived from a collective unconscious. The goal of Jungian psychoanalysis was wholeness composed of a harmony between an individual's consciousness and the two aspects of the unconscious. Because of Jung's insistence on the collective character of the unconscious and his rejection of sexual trauma as the basis for mental disease, he and Freud parted ways.

Followers of Freud and Adler continued to develop the precepts of psychoanalysis, some such as Otto Rank (1884–1939) and Anna Freud (1895–1982) working through Freudian ideas, and others such as Melanie Klein (1882–1960) and D. W. Winnicott (1896–1971) developing Adler's insights about the importance of an infant's early relations with other people. Rank worked closely with Sigmund Freud but focused on early infancy, including birth trauma. Rank explored the various cultural manifestations of what he dubbed the pre-Oedipal, or the period of separation before the Oedipus complex. He differed from Freud in that Freud believed all neuroses derived from the Oedipus complex.

Freud's youngest daughter, Anna Freud, focused on a study of the ego as it struggles to navigate through desires, conflicts, and the necessities of living, forming defense mechanisms. She concentrated her studies on the psychology of children, developing techniques for treating them, and showing that children manifest similar personality traits and disorders as adults. Child psychology was also the field of Klein, an object relations analyst who adapted Freud's idea that life is governed by the opposing dynamics of the desire to live and the desire to stop living.

Object relations psychoanalysis continued to evolve with the work of Winnicott, a British psychoanalyst who further developed Klein's theories. Focusing on the idea that the psyche is formed in its relations with other people, particularly the mother, Winnicott theorized that a mother who functions as a good enough mother must allow the infant to use her to gain a sense of its own omnipotence. This holding environment enables the infant to become autonomous. Infants without good enough mothers develop frustrations and false self disorders. Like Adler, Winnicott de-emphasizes the sexual in favor of the relational.

Winnicott's work anticipates Heinz Kohut's (1913–1981) later formulations of self psychology, which emphasize self states, such as one's sense of worth. Kohut thought that to combat the emotional costs of others' negative judgments, individuals continue to need positive and nurturing relationships throughout life.

THE THEORIES OF JACQUES LACAN

Perhaps the most influential of Freud's followers, however, was Jacques Lacan (1901–1981), a French psychiatrist who took up Freud's ideas. Working with psychotic patients, Lacan reinterpreted Freud's work through the insights of philosophy and more contemporary theories of language. Lacan saw the individual as a flexive system that, inevitably suffering the trauma of separation from the fullness of its pre-Oedipal existence, develops language, desire, and drives as ways to fill in for the lack-in-being precipitated by the inevitable recognition that one is separate and alone. Lacan used the analogy of the insight of individual separateness gained by seeing oneself in a mirror to characterize the stage at which infants begin to understand that they, too, will become separate human beings.

Lacan theorized that individuals are formed in relation to how they process this separation or symbolic castration, part of which becomes the process by which individuals take on a sex. He showed that all individuals are formed by prohibitions deriving from the recognition that they are not whole. This lack produces desire, which is itself temporarily fulfilled by objects or people in the world. If individuals have not internalized this basic prohibition, they may become psychotic, which means that they know no limit. As did Freud, Lacan worked through a transferential relationship between the analyst and the analysand (the person being analyzed) in which the analysand projects feelings about others onto the analyst and thereby works through the problems. Lacan also formulated such concepts as the gaze, or the sense individuals have of being seen, as well as the idea that all existence occurs through the knotted registers of the symbolic, or the realm of law, language, and rules; the imaginary, or the realm of images and representations; and the real, or the realm of unmediated material existence.

CONTEMPORARY PRACTICES

Psychoanalysis continues as a practice in the early twenty-first century, no longer necessarily attached to the medical practice of psychiatry. Different schools of analysis are practiced throughout the Europe and America, though one mode or another may dominate in specific places. While still practiced in the United States, psychoanalysis has increasingly given way to the psychiatric medical treatment of mental illness; by contrast, in Europe and South America, psychoanalysis is a more often practiced alternative to psychiatric care. Psychoanalysis has become an intrinsic part of literary and cultural criticism, especially in the ways some psychoanalytic theories such as those of Freud, Lacan, and Jung emphasize the importance of literature, myth, and visual representations and provide a language by which critics can understand the operations of desire and sexuality.

see also Freud, Sigmund; Lacan, Jacques; Psychiatry.

BIBLIOGRAPHY

Ellenberger, Henri F. 1970. The Discovery of the Unconscious: The History and Evolution of Dynamic Psychiatry. New York: Basic.

Gay, Peter. 1988. Freud: A Life for Our Time. New York: Norton.

Mitchell, Stephen A., and Margaret J. Black. 1995. Freud and Beyond: A History of Modern Psychoanalytic Thought. New York: Basic.

Ragland-Sullivan, Ellie. 1986. Jacques Lacan and the Philosophy of Psychoanalysis. Urbana: University of Illinois Press.

                                                 Judith Roof

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Psychoanalysis

Psychoanalysis

The term psychoanalysis has three meanings: 1) a theory of personality with an emphasis on motivation, or why we behave the way we do; 2) a method of treatment for various psychological problems; and 3) a group of techniques used to explore human nature or the mind.


History

Sigmund Freud (1856-1939) lived in an era rich with groundbreaking scientific discoveries in physics , biology , and medicine. He studied medicine with the goal of being a scientist and doing research, not of seeing patients, and as a medical student he performed laboratory research on the nervous system . For financial reasons Freud was forced to practice medicine and see patients, and because of his research background he began specializing in the treatment of nervous disorders or psychological problems. To improve his treatment skills he studied with the famous French psychiatrist Jean Charcot who was using hypnosis as a treatment method. But Freud felt hypnosis did not provide long term cures, and it did not get to the sources of his patients' problems. Next, Freud tried a method being used by Joseph Breuer, a Viennese physician, whereby patients' symptoms were cured by talking about them. It was through using the "talking cure" with his own modifications and revisions to it that Freud formed his theories of personality and psychoanalytic therapy.


Personality theory

Over Freud's long life, his thinking evolved and he continually revised his theories. Since Freud's death, psychoanalytic theory and therapy have been modified by numerous psychoanalysts, psychologists, and psychiatrists. We will look at Freud's final version of psychoanalysis.

One of Freud's most significant contributions to psychology and the world at large was his view of the unconscious. To Freud the unconscious is the seat of all of our impulses, instincts, wishes, and desires, which we are usually unaware, or not conscious of. It is irrational and yet it is just this part of ourselves that controls most behavior .


Personality organization

Personality is composed of three interacting systems—id, ego, and superego. They are not structures or things; they are simply names for different psychological processes, and in normal circumstances they work together harmoniously.

The id, present at birth , is the foundation of personality containing all of the instincts and receiving its energy from bodily processes. Id operates according to the pleasure principle, meaning it avoids pain and seeks pleasure using two processes—reflex actions and primary process. Reflexes are inborn actions that reduce discomfort immediately, like a sneeze. Primary process is very simply forming a wish-fulfilling image of what is desired. For example, if you were hungry you might start imagining your favorite meal. Imagining of course will not satisfy hunger, or most other needs, and the ego develops to deal with reality and satisfy the id's demands because the id cannot tell the difference between what exists in reality and what is in the mind.

The ego, on the other hand, can make that distinction and it operates according to the reality principle, mediating between the desires of the id and the realities of the outside world. Ego tries to satisfy the id's urges in the most appropriate and effective ways. For example, the id might urge the person to go to sleep immediately, no matter where they are. The ego would delay sleep until a convenient time and an appropriate place were found.

The superego is the third and last system of personality to develop. It represents traditional values of society as learned by the child through its parents. It is concerned with morals and tells us what is right and wrong, punishing us with guilt feelings if we do something we were taught was wrong. Both the ego and superego derive their energy from the id.


Personality development

Freud believed human behavior and thought are ruled by numerous instincts that fall into two groups—those that further life and those that further death. We know little about the death instincts, but aggression and destructiveness come from them. Life instincts further survival and reproduction. Sexual instincts are the main life instincts and they are very important in the psychoanalytic theory of development. Freud believed we pass through five stages of psychosexual development: the oral, anal, phallic, latent, and genital.

In the oral stage infants find pleasure in using their mouths to eat and suck. In the anal stage, from about age two to four, pleasure is found in the tension reducing release of waste products. During the phallic stage children become preoccupied with their genitals, and they begin to develop an attraction to their opposite sex parent, which is called the oedipus complex. How the child and his or her parents deal with the oedipus complex can have a great impact on the individual's personality. During the latency period, roughly from ages five to 12, the sexual instincts are subdued until physiological changes in the reproductive system at puberty reawaken them. With puberty the genital stage begins, wherein the individual develops attraction to the opposite sex and becomes interested in forming a loving union with another. This is the longest of the stages, lasting from puberty until senility. It is characterized by socialization, vocational planning, and decisions about marriage and raising a family.


Psychoanalytic therapy

Freud believed the foundation of personality is formed during early childhood and mental illness occurs when unpleasant childhood experiences are repressed, or kept from consciousness, because they are painful. Psychoanalytic therapy tries to uncover these repressed thoughts; in this way the patient is cured.

Freud's primary method of treatment was free association, in which the patient is instructed to say anything and everything that comes to mind. Freud found that patients would eventually start talking about dreams and painful early childhood memories. Freud found dreams especially informative about the person's unconscious wishes and desires. In fact he called dreams the "royal road to the unconscious." The patient and analyst then try to understand what these memories, feelings, and associations mean to the patient.


Resources

books

Barron, James W., Morris H. Eagle, and David L. Wolitzky, eds. Interface of Psychoanalysis and Psychology. Washington, DC: American Psychological Association, 1992.

Greenberg, Jay R., and Stephen A. Mitchell. Object Relations in Psychoanalytic Theory. Cambridge, MA: Harvard University Press, 1983.

periodicals

Hyman, S.E. "The Genetics of Mental Illness: Implications for Practice." Bulletin of the World Health Organization 78 (April 2000): 455-463.


Marie Doorey

KEY TERMS

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Ego

—Mental processes that deal with reality and try to mediate between the id and the environment.

Free association

—Method used in psychoanalytic therapy to bring unconscious memories to awareness. The patient tells the psychoanalyst everything he or she thinks of.

Id

—Unconscious mental processes containing instincts that dominate personality.

Instincts

—Mental representations of bodily needs that direct thought.

Pleasure principle

—The avoidance of pain and seeking of pleasure which the id performs.

Primary process

—Wish-fulfilling images formed by the id.

Psychoanalysis

—A theory of personality, method of psychotherapy, and approach to studying human nature, begun by Sigmund Freud.

Psychosexual development

—Five stages of development humans pass through: oral, anal, phallic, latent, and genital.

Reality principle

—Rational, realistic thinking the ego operates according to.

Superego

—Mental processes concerned with morality as taught by parents.

Unconscious

—That which we are unaware of. Ruler of behavior containing all instincts and thoughts we are unaware of.

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Psychoanalysis

PSYCHOANALYSIS

In an encyclopedia article published in 1924, its founder 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." Within the theory there were four fundamental concepts on which the entire intellectual edifice was built: (1) the unconscious as a domain or a property of ideas (representations); (2) repression (and more generally a range of defenses that define the mind as a field of dynamic conflict); (3) the drives (or instincts), the basic elements that motivate the mind; (4) transference—the repetition or reenactment of early intense experiences, such as the "Oedipus complex," the ambivalent relation of the child to its parents—as the fundamental discovery and distinguishing feature of its therapeutic practice.

Freud was born on 6 May 1856 in Freiberg (now Príbor) in Moravia, a small town at the eastern end of what was then the Austro-Hungarian Empire and is now the Czech Republic, not far from the Polish and Slovakian borders. Freud's family moved when he was three to Vienna, where he would live until he was forced by the unification of Austria and Germany in 1938 to emigrate to London that year; he died there three weeks after Britain's declaration of war on Germany. An outstanding student at school and later at the University of Vienna, Freud trained as a doctor; he was enamored of Darwinism, positivism, and the grand ambitions of experimental science in the 1870s, but was also a serious student of philosophy, taking courses with Franz Brentano (1838–1917), to whom key developments in twentieth-century logic and phenomenology can be traced. Freud's scientific training made him an exemplary exponent of experimental laboratory science and the histological study of the brain, under the leadership of Theodor Meynert (1833–1892), one of the most important brain anatomists of the period. Freud's intention to pursue a research career in brain science was, however, deflected when he met, fell in love with, and quickly became engaged to Martha Bernays in 1882. By 1884 he knew that he would have to go into general medical practice if he wished to marry in the near future. Envisaging a career specializing in the nervous diseases, in 1885–1886 he spent four and a half months on a scholarship to Paris, working with the world-famous neurologist Jean-Martin Charcot (1825–1893). He opened his medical practice in April 1886, married in September, and over the next nine years Martha gave birth to six children, the last of whom, Anna (1895–1982), would become her father's nurse, the protector of her father's work, and a great psychoanalyst in her own right.

Freud encountered Charcot when his work on the rehabilitation of hysteria employing hypnosis was at its height; Freud joined the large numbers of European and American physicians intent on finding psychological cures for the common nervous diseases, at times employing hypnotic suggestion. It was certainly Charcot who, perhaps inadvertently, turned Freud away from his anatomo-physiological orientation toward the psychological, where he would thereafter remain. But an old friend and colleague in Vienna, Josef Breuer (1842–1925), supplied Freud with his distinctive starting point: Breuer's exhaustive eighteen-month treatment of Bertha Pappenheim (1859–1936, called "Anna O." in Freud's writings) in 1880–1882. The therapy Bertha invented, her "talking cure," consisted of tracing, in speech and in a cathartic reliving, the numerous occasions of the appearance of her symptoms. In 1893, Breuer and Freud put forward the thesis that "hysterics suffer mainly from reminiscences"; they developed this argument in Studies on Hysteria of 1895, affirming the psychological causation of the neuroses and the efficacy of Freud's method of exhuming the past through the technique of "free association": the instruction to the patient to say whatever entered her mind. Throughout the 1890s, Freud sought the underlying causes of the disposition to neurosis, becoming convinced that he would find them in the domain of sexuality and the traumas of early life; this did not prevent him from elaborating materialistic brain-based models of the neuroses, which, when transposed into mentalistic language, would constitute his high-level theory.

Psychoanalysis came fully into existence with the publication in late 1899 of Freud's most important book, Die Traumdeutung (The interpretation of dreams), the fruit of several years of the practice of interpreting his own and his patients' dreams as part of a search for the fundamental mechanisms of unconscious mental activity and the sources of the repressed memories that led to neurotic symptoms. It was dream analysis that became the model for "self-analysis" and the extension of his theories to normal mental life. Freud set out the key theses of his work: the distinction between "latent" and "manifest" in mental life, particularly in dreams; the principle of psychic determinism, for Freud the guarantee of the possibility of a properly scientific study of the mind; the distinction between the unconscious, the preconscious, and the conscious, with the related distinction between primary and secondary modes of psychic functioning; the significance of early experience and memories for all aspects of mental life, and in particular the all-pervasiveness of sexuality, including childhood sexual experience, as causal factors in psychopathology.

In 1905 Freud published three major works: a case history ("Fragment of an Analysis of a Case of Hysteria: 'Dora"'), Jokes and their Relation to the Unconscious, and the fundamental Three Essays on the Theory of Sexuality, in which he outlined the theory of infantile sexuality that underpinned his account of the variety of forms of human sexuality and of the causality of neuroses. As he acquired an audience and followers in the ensuing years, he produced major works in the anthropology of kinship and religion, psychobiography (on Leonardo da Vinci), sociology and social psychology, alongside clinical and theoretical studies of the neuroses and the structure of the normal and abnormal mind. It was undoubtedly the fluency, cogency, and sheer variety of Freud's writing that made him and his movement so influential, both within professional circles and for the mass readership that he, like others such as Thomas Mann (1875–1955) and H. G. Wells (1866–1946), created in the postwar era. From very early on, Freud had a wide readership outside professional circles; but it was within professional circles that he would begin to build a visible movement.

The first of Freud's followers were outsiders—independent-mindedly Jewish physicians like him. However, from 1904 on, Freud was contacted by the respected psychiatrist Eugen Bleuler (1857–1939) and his young assistant, Carl Jung (1875–1961), at the famous Burghölzli Hospital, Zurich, who were interested in his dream theories, his claims about the meaningfulness of psychical symptoms, and the possibility of using the psychoanalytic method of treatment as both therapy and research tool. From this contact with the world of psychiatry in 1907–1908 came some of Freud's most important and enduring younger disciples: Karl Abraham (1877–1925), later the founder of psychoanalysis in Berlin; Max Eitingon (1881–1953), later also based in Berlin and a crucial figure in the institutional development of psychoanalytic clinical training in the 1920s; Abraham Arden Brill (1874–1948), a young American psychiatrist who would become the linchpin of psychoanalysis in New York; and Ernest Jones (1879–1958), who helped found psychoanalysis in North America and then became the key figure in its institutional development in the United Kingdom from 1912 to the 1940s. These younger men, in particular Jung, became belligerent proponents of Freud's views in heated debates among German-speaking neurologists and psychiatrists in the period from 1907 on. In the years before World War I, Freud's psychoanalytic movement founded branch societies in Vienna, Zurich, and Berlin, set up an International Psychoanalytic Association (IPA) in 1910 and was riven by internal strife, with the departure of Alfred Adler (1870–1937), Wilhelm Stekel (1868–1940), and finally Jung himself, the president of the IPA.

Before 1914, psychoanalysis had already become a cause célèbre for modernists, Bohemians, and progressive professionals concerned with reforming sexual mores; undertaking the inner journey that would result in the literary modernism of Marcel Proust (1871–1922), Virginia Woolf (1882–1941), and James Joyce (1882–1941); and in applying these insights to the nervous diseases. Its impact on artistic and literary figures as well as "progressive" scientists and doctors was already considerable in the principal cities of Central Europe and in addition in circumscribed circles in New York and London.

The First World War unexpectedly became the turning-point for the expansion and reception of psychoanalysis, in two principal modes: firstly, a growing number of the mobilized physicians treating the tens of thousands of cases of "war neuroses" or "shell shock" became sympathetic to Freudian views concerning the psychogenic nature of these cases, and the use of psychoanalytic methods among other psychological therapies in their treatment. Secondly, the catastrophe of the war led to a sea change in cultural sensibility with which key psychoanalytic themes were resonant: its emphasis on the overwhelming power of instinctual forces and on the irrational forces determining human action. Psychoanalysis offered a powerful theory and therapy, alongside other psychotherapies that developed in the period, for doctors and other clinicians to deploy; it offered individuals—scientists, artists, politicians, ordinarily unhappy citizens—a description of the forces at work in the irrational mind that resonated with the times; and it offered a promise of a science of the mind, in reach of everyone, that could match the miseries and mysteries of a whole life and its history. The early 1920s became, in Germany, Britain, and the United States, the era of great new scientific discoveries, chief among which, alongside the theory of relativity, was psychoanalysis.

With psychoanalysis all the rage among modernist artists and with an expanding clientele of patients, the 1920s saw its professionalization: across Europe, following the model of Berlin, training institutes and clinics were established, centered on the obligatory training analysis; these training systems were independent of both universities and medical schools. They were also, in Europe, open to nonmedical ("lay") students. What was a movement before the First World War was rapidly becoming in addition an independent profession. But its independence—of academia, of medical schools—was both strength and weakness. Alliances between psychoanalysis and other disciplines drawn to its challenging and powerful ideas were manifold, often undisciplined, yet overall fitful. Psychoanalysis was taken up by maverick sociologists and anthropologists, relatively few academic psychologists, writers, and artists, some medical scientists (for instance, in psychosomatic medicine and general practice) in addition to its considerable (though exceedingly variable from country to country) influence on psychiatry in the mid-twentieth-century. A full consideration of the complex developments and manifold influences of psychoanalysis belongs to a history of the twentieth century rather than the long nineteenth century; but psychoanalysis was undoubtedly a product of that long nineteenth century, a part of the emergence of psychology as a discipline and practice, a part of the emergence of positivist science and Darwinist critiques of religion that accompanied the development of the novel profession of scientist. Nor was the emergence of psychoanalysis conceivable without the social transformations of groups that constituted its core clientele and practitioners: the Jews who, since the opening up of the Central European ghettos and their emigration westward to Vienna, Berlin, and the New World, were becoming a significant proportion of the medical, scientific, and professional sectors; and the emancipated New Woman, for whom psychoanalysis, with its emphasis on the significance of sexuality and the rigors of the emotional life of the private sphere, would provide both ideology and novel professional practice. For these groups and many others, psychoanalysis offered a secular scientific alternative to traditional religious and ethical doctrines.

See alsoAdler, Alfred; Brentano, Franz; Darwin, Charles; Freud, Sigmund; Jews and Judaism; Jung, Carl Gustav; Modernism; Rank, Otto; Vienna.

bibliography

Primary Sources

Freud, Sigmund. The Standard Edition of the Complete Psychological Works of Sigmund Freud. Edited by James Strachey in collaboration with Anna Freud, assisted by Alix Strachey and Alan Tyson. 24 vols. London, 1953–1974.

Secondary Sources

Appignanesi, Lisa, and John Forrester. Freud's Women. New York, 1992.

Ellenberger, Henri F. The Discovery of the Unconscious: The History and Evolution of Dynamic Psychiatry. London, 1970. A monumental historical survey.

Gay, Peter. Freud. A Life for Our Time. London, 1988. A superbly researched and finely judged biography.

Roudinesco, Élisabeth. Jacques Lacan & Co:. A History of Psychoanalysis in France, 1925–1985. Translated by Jeffrey Mehlman. London, 1990.

Roudinesco, Élisabeth, and Michel Plon. Dictionnaire de la Psychanalyse. Paris, 1997. The most reliable and comprehensive starting-point for all researches in the history of psychoanalysis.

Schorske, Carl E. Fin de Siècle Vienna: Politics and Culture. New York, 1979.

John Forrester

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Psychoanalysis

PSYCHOANALYSIS.

WORLD WAR I AND THE INTERWAR YEARS
WORLD WAR II AND THE IMMEDIATE POSTWAR YEARS
THE CRISIS OF THE 1960S
BIBLIOGRAPHY

Europe—both east and west—gave birth to psychoanalysis, but psychoanalysis eventually traveled through the whole world, and much of its history was determined by events in the United States. European psychoanalysis does have its own history, however, one that was interrupted at least three times: by World War I, by World War II, and by the 1960s.

WORLD WAR I AND THE INTERWAR YEARS

To Sigmund Freud, the Austrian neurologist and founder of psychoanalysis, it appeared as if World War I might end the psychoanalytic movement. "What [Carl] Jung and [Alfred] Adler have left intact of the movement is now perishing in the strife among nations—science sleeps" he wrote Ernest Jones, a British associate (Paskauskas, 1993; letter of 25 December 1914). Yet, the war itself provided a great inspiration to psychoanalysis in the form of the shell shock crisis. Analysis—only a decade or so old when the war broke out, and riven by schisms in the years preceding the war—nonetheless appeared vastly superior to its neurologically based rivals; above all, it accepted the reality of shell shock and provided some means of treatment. In addition, the apparent irrationality of the war, the widespread sense that events were out of conscious control, gave a new encouragement to psychoanalysis. As a result, in the last years of the war it gained both public attention and internal strength.

In 1918 the first postwar analytic congress was held in Budapest, Hungary, at the invitation of Béla Kun's communist regime, which planned to build a clinic to treat war neuroses. The Budapest Congress adopted two resolutions that shaped the postwar history of analysis: first, to prepare for "mass," that is, publicly financed, therapy, and second, to require that every analyst be analyzed. Both resolutions arose from the crisis provoked by the war. The first was based on the idea that psychotherapy should be considered an entitlement, like health care in general. As the analytic congress passed a resolution to prepare for publicly financed therapy, Freud explained: "the poor man should have just as much right to assistance for his mind as he now has to the life-saving help offered by surgery … the neuroses threaten public health no less than tuberculosis" (Freud, vol. 17, p. 167). At the same time, analytically oriented outpatient clinics, such as the Tavistock in London and Bellevue in New York, which were aimed at patients unable to afford private fees, were being founded abroad.

As a result of the resolution on mass analysis, European analysis had a socially oriented cast throughout the 1920s and 1930s. February 1920 saw the opening of the Berlin outpatient Polyclinic on Potsdamerstrasse, financed by Max Eitingon, housed in a building renovated by Freud's son Ernst, and offering low-cost, government-supported psychotherapy. Mass analysis also meant that analysts would play an educative role as part of the social-democratic culture of the time. In England and Austria, for example, the term applied analysis described analytic work in nursery schools, child guidance clinics, teenage consultations, and social work.

In addition to endorsing public clinics, the Budapest Congress also endorsed the requirement of a training analysis for every analyst. The purpose of the resolution was to secure the independence of analysis by gaining control over training and licensing. It aimed to distinguish analysis both from popular techniques, for which no training was necessary, and from psychiatry, which required a medical degree. The prerequisites for becoming an analyst, according to Freud, were "psychological instruction and a free human outlook." Many analysts had no medical degree, including Oskar Pfister (minister); Hermine Hug-Hellmuth, Anna Freud, and Barbara Low (teachers); Lou Andreas-Salomé and Otto Rank (writers); Hans Sachs (lawyer); Ella Freeman Sharpe (literature professor); August Aichhorn and Siegfried Bernfeld (social workers); and Ernst Kris (art historian).

As the war ended, interest in psychoanalysis exploded. Before the war, psychoanalysis had been effectively a Männerbund, an all-male circle centered around a charismatic father figure. (The first female analyst, Margarete Hilferding, had been admitted in 1910.) After the war, the "psychoanalytic movement," a diverse collection of national societies all seeking to turn the circle around Freud into a discipline or profession, replaced the Männerbund. The size and diversity of the movement is suggested by the first postwar congress, held in The Hague in September 1920, a meeting with the character of a reunion. Participating were 112 individuals: 62 from Austria and Hungary, 16 from Holland, 15 from Britain, 11 from Germany, 7 from Switzerland, and 1 from Poland. Four years later, the International Psychoanalytic Association (IPA) had a total membership of 263.

Stymied in their efforts to win legitimacy from the university, and capitalizing on the popularity of analytic practice, postwar analysts created a separate profession, developing a core curriculum, standardized forms of practice, and regularized mechanisms of succession to replace the committee that had been formed around Freud before World War I. To this end, they established "institutes," all-purpose centers that combined a society, a clinic, and formal training through course work, supervised clinical practice, and didactic or "training" analyses. Although an inner circle centered on Freud persisted, it became increasingly peripheral to the main thrust toward professionalization. Substantial control passed to a new generation distinguished from the Männerbund in terms of age, gender, sexuality, and political orientation.

The age differences were dramatic. Whereas Freud had been born in 1856, Melanie Klein was born in 1882, Otto Rank and Helene Deutsch in 1884, Karen Horney in 1885, Franz Alexander in 1891, and Wilhelm Reich, a prodigy, in 1897. They were all still young in the 1920s and recognizably "modern" in their sensibilities and values. Freud, by contrast, had negative feelings about such exemplary products of modernity as the radio, the telephone, film, feminism, abstract art, and U.S. culture. The distinction between old and young inflected many debates of the period, including those over brief therapy, female sexuality, and the place of the United States in the analytic movement.

The gender composition also shifted dramatically. The number of female analysts rose from two before World War I to approximately fifty in the immediate postwar period. By 1929 the majority of new trainees were women. Many had been teachers, and many were mothers. The changing gender composition of the movement encouraged a dramatic shift in its preoccupations to the mother–infant relationship, the mother–daughter relationship, and female sexuality.

The shift concerning sexuality is more difficult to trace, but two incidents of the immediate post-war period are revealing. In 1920 an openly homosexual doctor applied for membership in the Dutch Psychoanalytic Association. Its members turned to Jones for advice, and he counseled against admittance. Sachs, Karl Abraham, and Eitingon urged from Berlin that this was a matter for the individual society to determine, although they added, there should be a presumption that any homosexual was neurotic, unless analysis demonstrated otherwise. Even Sándor Ferenczi, long a champion of legalization of homosexuality, insisted that "these people are too abnormal" to be analysts. Freud, in contrast, recommended acceptance, but conceded that the matter was ultimately to be determined by the local society. In 1921, in another incident, Jones wrote Freud informing him that he was refusing psychoanalytic training to a homosexual. Freud again disagreed: "we cannot exclude such persons without other sufficient reasons, as we cannot agree with their legal persecution.… [A] decision in such cases should depend upon a thorough examination of the other qualities of the candidate" (Jones, p. 9).

Politically, the ethos of the analytic movement became more democratic. Whereas in 1910 Freud had argued for an elite "along the lines of Plato's republic," by the 1920s he advocated local autonomy, as just noted. After World War I, moreover, disagreements did not necessarily provoke schisms. Rank and Ferenczi left the analytic movement voluntarily, albeit amidst turmoil; they were not excluded. In 1927, when the International Training Commission tried to impose lay analysis on the New York Psychoanalytic Society, Anna Freud led the opposition, calling it an obvious injustice.

Before the war, psychoanalysis had been mixed up with many other forms of psychotherapy, such as mind cure, Jungianism, Adlerianism, and mental hygiene, as psychiatry was increasingly called. The revisions sparked by the shell shock experience—the theory of the ego, the idea of the death instinct, a revised theory of anxiety, a new orientation to the mother—led to a sharp distinction between psychoanalysis and the rest. While there were many ways to characterize this distinction, Freud drew the line with his assertion that the ego was the locus of resistance. Deeply rooted in his thought, this idea became central to modernist culture, as well as to the practice of psychoanalysis itself. If, as is often said in the early twenty-first century, psychoanalysis is "pluralistic" or "polycentric," that it has no agreed-upon core theory, until the end of the 1960s, it did have a core theory: it was the theory of the analysis of the resistance or negative transference. No other therapy did this, at least not in a systematic fashion. This was why there was psychoanalysis at all, and not just psychotherapy.

After the rise of the Nazis, refugees took the analytic theories of the 1920s and 1930s—the so-called structural theory—to the United States where it was termed "ego psychology." But the true beginnings of ego psychology were in postwar Europe. There were several different centers, each with different variations.

Supported by government funds and recognized by the medical community, the Berlin Psychoanalytic Institute, run by Abraham, Eitingon, and Ernst Simmel, was the flagship for the entire movement. Benefiting both from proximity to and distance from Vienna, and sponsoring the influential Kinderseminar, the discussion group of younger analysts such as Otto Fenichel, Käte Friedländer, Edith Jacobson, and Georg Gerö, the institute pioneered in ego psychology. Berlin also housed the Verlag (the psychoanalytic publishing house) and the Internationale Zeitschrift für Psychoanalyse (International Journal of Psychoanalysis), edited by Sándor Radó.

Along with Berlin, international analytic politics took shape around the London and Vienna Societies. The British Psychoanalytic Society, with about fifty-five members, housed Jones, a central figure in the IPA who maintained close relations not only with Sigmund and Anna Freud, but also with the far-flung parts of the ex–British Empire, especially the United States. It benefited from a relatively democratic and woman-friendly environment and was also associated with a substantial publishing effort: Leonard and Virginia Woolf's Hogarth Press, which published the English edition of the International Journal of Psychoanalysis, the English translations of Freud, and the International Psychoanalytical Library. Reflecting its inaugural place in the history of psychoanalysis, Vienna produced ego psychology's definitive formulation, Anna Freud's The Ego and the Mechanisms of Defense (1936).

Alongside Berlin and Vienna three important variations of European ego psychology emerged in London, Paris, and Budapest. In London, Klein proposed an object-relational view of the ego. Developing an ethic of responsibility, rather than an ethic of justice, providing what some have called a feminine alternative to Freud, Klein's thought resonated with a new, middle-class orientation to the problem of building up and sustaining personal relations, as opposed to the problem of autonomy implicit in the theory of the Oedipus complex. In Paris, Jacques Lacan developed a second alternative to ego psychology in his famous "mirror stage" article. According to Freud, "where id was there shall be ego" defined analysis, but Lacan insisted (cf. Ercits) that the ego or "I" was a defensive response to the traumatic discovery of emptiness, an imaginary "crystallization or sedimentation of images of an individual's own body and of self-images reflected back to him or her by others." Finally, in Budapest, Ferenczi argued that the original state of the neonate was one of expecting to receive without having to give anything in return. Passive receptivity, not agency, was the driving force of development, and a "corrective emotional experience," not insight, was the means of cure.

The great debates over female psychology in the interwar years also were debates over the development of the ego. Ego psychology, beginning during World War I and marked especially by Otto Rank's The Trauma of Birth (1923), took psychology back before the Oedipus complex to the early relationship with the mother, what later came to be called the pre-Oedipal stage. This raised the question of what difference the early mother–child relationship made to sexual development—especially to object choice—in both sexes. For the boy, it was clear that the early relationship to the mother generally preceded a female object choice. How, however, did the girl come to form a male object choice, given that her earliest relations were with the mother? All the debates over "penis envy," and over whether females followed an "autonomous" line of sexual development were efforts to answer this question. Autonomy—the goal of analytic ego psychology—also rested on the relationship to the mother.

WORLD WAR II AND THE IMMEDIATE POSTWAR YEARS

Psychoanalysis thrived in the interwar years until, in 1933, the rise of the Nazis destroyed its main society—in Berlin—and much of its self-confidence. As fascism triumphed, psychoanalysis crumbled. The Paris Psychoanalytic Society was abolished when the Nazis entered Paris. Italian analysis was put out of business by the anti-Semitic laws of 1938. In the Soviet Union, Stalin had condemned analysis in 1927, but after the Nazi victory analysis was banned. Hungarian analysis passed into "non-Jewish" hands; meetings had to be reported to the police in advance. In the Netherlands, training continued in secret. Only in neutral Switzerland did analytic societies continue to operate openly.

Most poignant, certainly, were the experiences of analysts and analysands in concentration camps. Some struggled to maintain an analytic perspective even there, thus testifying to the ability of the analytically oriented to suspend consideration of the immediate environment. Many analysts perished. After the Germans invaded Hungary in 1944, Jószef Mihály Eisler (a member of the Hungarian Psychoanalytic Society since 1919), Miklos Gimes, Zsigmond Pfeifer, and Geza Dukes died in the camps. The Yugoslav analyst Nikola Sugar, also a member of the Hungarian society, died at Theresienstadt. David Oppenheim, a classics teacher with whom Freud had cowritten his first piece on folklore and who left Freud over the Adler controversy, was murdered in a camp. Auguste Watermann had fled Hamburg in 1933, but was never fully accepted by the Dutch Psychoanalytic Association. After the Germans invaded Holland, he was arrested with his wife and child and deported to Vreemdelingen at Westerbork, then to Theresienstadt, then to Auschwitz, where all three were killed. Ernst Hoffman, a Jew from Vienna, had fled to Antwerp in 1933 and trained the future founders of the Belgian Psychoanalytic Society before he was deported in 1942 to a camp in Gurs, France, dying soon after. Sabina Spielrein was shot to death during a forced march, along with her two daughters, in a ravine outside Rostov. Fugitives from German occupation forces included Leo Eitinger in Norway and Hans Keilson in the Netherlands. Camp survivors included Eddy DeWind, Elie Cohen, and Viktor Frankl. Leopold Szondi, who coined the term destiny analysis, survived Belsen and lived until 1986. Raoul Wallenberg's intervention saved the Hungarian-Jewish analyst István Hollós. Gottfried R. Bloch, a Czech analyst, survived Auschwitz and later lived in Los Angeles. John Rittmeister, a communist psychoanalyst and member of the Resistance, executed by the Gestapo in Berlin in 1943, was remembered by East Germans as a hero and by West German analysts as a Bolshevik spy. Nevertheless, it should be said that while Nazism destroyed many analytic societies, its refugees also created new ones—in Palestine, South Africa, and Argentina and ultimately throughout Latin America.

World War II moved the center of gravity to the United States. Nevertheless, one European society had prospered during the 1930s and had survived the war: the British Psychoanalytic Society into which Klein introduced her pioneering innovations and to which Anna Freud and many other analysts had fled in 1938.

Klein was born in 1882 in Vienna, was analyzed by Ferenczi in Budapest, and studied with Abraham in Berlin. There she had been one of the first to practice analysis on children, whose "presenting symptoms" were typically problems at school. Viewing early learning as directed at the mother, she interpreted inhibitions on learning as resulting from the child's fear of retaliation for what the child perceived as its hostile wishes. From this Klein concluded that the mother, not the father, was the original authority figure. In the late 1920s, Klein began developing an alternative to the Freudian paradigm.

Klein's key move was her insistence, contra Freud, that the superego originated in early representations of the mother, long prior to the Oedipus complex. This innovation had far-reaching implications. First, it implied that the conflicts that were formative for the individual were often very primitive, closely tied to biological survival. This represented a major departure from Freud, for whom material frustrations became meaningful only later, after they had been reconfigured as moral imperatives.

Second, Klein's view of the inner object world was strikingly different from Freud's. In Freud's, there was always a third term—the superego—that stood apart from the ego and judged it. For Klein, in contrast, all relations were saturated with ethical and moral content, but there was no independent or impersonal viewpoint. Rather, the Kleinian inner world was a complex, three-dimensional, differentiated landscape of gratifying and frustrating, rivalrous and supportive, "part" and "whole" objects. The result, Klein claimed, would be "a new understanding of the unconscious and of internal relationships as they have never been understood before apart from the poets."

Finally, Klein's view implied a different diagnosis of the fundamental problem facing modern men and women. For Freud, the key problem had been to strengthen the ego so as to give the individual some freedom from the superego, from the demands of the id, and from society. For Klein, in contrast, the problem was to build up an internal world of whole objects, that is, to forge and sustain personal connections.

The predominance of the U.S. analysts after 1945, and the intolerance with which they treated Klein, meant that her thought remained isolated for a long time. After World War II, the Americans sponsored a revival of analysis in Europe, more or less as part of the Marshall Plan. Ego psychology, now understood as an American innovation, returned to Europe—an example of what has been termed the "pizza effect," the invention of some item or idea in Europe, its export to the United States, and its return to Europe as if it were American. The new or rebuilt European societies often followed the American lead, although there were many exceptions. In Germany, the real successor to psychoanalysis was the Frankfurt School critical theorists, especially Alexander Mitscherlich, whose The Inability to Mourn (with Margarete Mitscherlich; 1967) applied analysis to Nazism and German nationalism. The most important exception, however, was Lacan, who emerged with Sacha Nacht and Daniel Lagache as one of a troika that ran the reconstituted Paris Psychoanalytic Society and who found a way to make Freud a major figure in French thought.

Freud had described the ego as a psychical agency, originating in the systems of perception and consciousness, and serving the drives toward self-preservation and sexual release. Beginning with his famous "mirror stage" lecture, delivered to the IPA's Marienbad Congress in 1936, Lacan rejected Freud's characterization of the ego as an agent. Psychical development, Lacan argued, began not with agency but with primal lack, terror, or the emptiness of nonexistence. The "ego of narcissism," as Lacan called the "I," was a defensive response to the traumatic discovery of this emptiness, an imaginary construction, a "crystallization of images." Having no basis in the organism's instinctual drives, it was better thought of as an object than an agent.

Deriving his basic orientation from surrealism, which characterized the unconscious in linguistic and imagistic rather than instinctual terms, Lacan described the ego of narcissism as born into discourses, meaning unconscious, multivoiced, streams of associations governed by their own rules of exclusion, prohibition, and privilege. Examples of discourse include the "name of the father," the "desire of the mother," and larger, social discourses such as those of religion, nationality, and politics. Seeking to rescue the unconscious from the prevailing "confused, unitary, naturalistic conception of man," Lacan defended Freud's death instinct hypothesis as a reminder that "in man, there's already a crack, a profound perturbation of the regulation of life."

In his 1953 "Rome Discourse," a private lecture given to friends and associates in the midst of an official analytic congress, Lacan contrasted his notion of an ego adrift in discourse to both American ego psychology and British object relations. Emigration to America and "the absence of the social 'resistances' in which the psychoanalytic group used to find reassurance," he argued, had led ego psychologists to repress the "living terms" of analytic experience; they had become obsessionally preoccupied with technique, "handed on in a cheerless manner." And while the Kleinians had opened up important new areas, such as "the function of the imaginary" (phantasy), object relations (existential phenomenology), and countertransference (the analyst's transference), the naturalistic British emphasis on dependency and maternal care also vitiated Freud's discovery.

THE CRISIS OF THE 1960S

After the two world wars, the 1960s represented the third great crisis in the history of European psychoanalysis. The cultural revolutions of the 1960s—the New Left, the women's movement, gay liberation—were really attempts to act out and to politicize many of the questions of sexuality and personal identity that psychoanalysis restricted to the consulting room. Many attempts were made to combine psychoanalysis with Marxism; others criticized psychoanalysis for its sexism, homophobia, and medicalizing authoritarianism; and a host of new psychotherapies arose that promised to replace psychoanalysis, often drawing on its theories.

Lacan was the main European figure to survive the upheavals of the 1960s. Preaching a "return to Freud" he rejected the U.S.-dominated analytic establishment arguing that "l'analyste ne s'autorise que de lui-même" (the analyst does not authorize himself). One result was le champ freudien, the freeing of psychoanalysis from medicine, and its integration into the social, cultural, and lifestyle changes that characterized the 1960s. Claiming to replace René Descartes's cogito, or "I think," with ça parle, where ça meant language, Lacanianism articulated the growing sense that it was through media images and discourse, rather than the work-place, that social domination was secured; in other words, Lacan believed that language determined human actions, and not the reverse. By 1974, there were three important French analytic groups, each with its own journal: the official Société Psychanalytique de Paris (the aforementioned Paris Psychoanalytic Society; publisher of Études freudiennes), with nearly five hundred members, among the largest analytic societies in the world; Lacan's École freudienne (publisher of Scilicet); and the French Association for Psychoanalysis centered around Jean LaPlanche and Jean-Bertrand Pontalis (publisher of the Nouvelle revue de psychanalyse). New thinkers, such as Didier Anzieu, Piera Aulagnier, Janine Chasseguet-Smirgel, and André Green, expanded the parameters of both analysis and philosophy. In 1994, when official membership in the IPA was less than nine thousand, about three thousand of whom were North Americans, France boasted about five thousand non-IPA analysts, four-fifths of them Lacanian. Much of Lacan's influence was in the Catholic world—such as Italy, Spain, and Portugal—where the clerical establishment had successfully resisted the influence of analysis earlier.

The British Psychoanalytic Society also survived the 1960s but with nothing like the influence of the French. At the end of the war, the members had mooted their differences by forming three training paths taught by associates respectively of Klein (Group A), Anna Freud (Group B), and a Middle or Independent Group, which included such figures as D. W. Winnicott, Michael Balint, and W. R. D. Fairbairn. Often touted as a triumph of English rationality, moderation, and compromise, the solution had the effect of further marginalizing Klein's thought. The same centripetal tendencies that brought the society's members into a powerful but short-lived alliance during the war propelled them into disparate, centrifugal orbits afterward, its leading members turning to criminology, ethology, psychiatry, and the writing of memoirs. By the end of the century the still-vital British society had 405 members out of a population of 60 million: one of the thinnest ratios in the developed world.

The 1960s also produced a kind of normalization of the Jewish origins of and influence on psychoanalysis. For one thing, Jewish analysts had always refused to allow the IPA to meet in Germany. In 1985 they relented. An exhibit illustrating the history of the Göring Institute dominated the meeting, held at Hamburg. A German analyst remarked, "Thank God that you have been willing to come; for forty years we have been living alone with our shame." Even so, the Jewish question remained symptomatic for some. Thus the English/Punjabi analyst Masud Khan's 1988 autobiography, The Long Wait, describes Khan exulting at throwing off his "Yiddish shackles," and complaining that the "Judaic-Yiddish-Jewish bias of psychoanalysis" had always cramped his "personal ethnic style."

Normalization progressed in other senses as well. In 1979 the profession founded an internal historical organization led by Alain de Mijolla, even as its larger history was being written by outsiders, such as Paul Roazen, Henri Ellenberger, Peter Gay, Michael Molnar, Elisabeth Roudinesco, Frank Sulloway, Alexander Etkind, and Carl Schorske. New journals, notably Psychoanalysis and History (first published in 1988), replaced hagiography with established methods of historical research. The British, French, and German societies built major research collections.

But what, actually, is meant by normalization? Perhaps more than many other histories, the history of psychoanalysis is punctuated by traumas: that is, by catastrophes that remain "actively vital and yet incapable of resolution." These include personal violations, misshapen lives, wasted years, destroyed documents, secret archives, forgotten lapses, and ruptures. Normalization has not unfolded smoothly. The most explosive example of this has been the attempt to understand the weak response of analysts to the Nazis and, indeed, to the Holocaust itself.

Prior to the 1960s, acceptance by the IPA had been taken as proof of a "place among the persecuted" for German analysts, thus allowing them "to escape from the burden of [their] national past." When activists of the late 1960s became analysts, however, that cover became subject to critical scrutiny. In 1980, at a conference at Bamberg, Germany the younger analysts exploded: "Who was your analyst?," "What were you doing?," "From what has come this feeling of mysteries, lies, the pathology of the reality sense?" Helmut Dahmer, Regine Lockot, Geoffrey Cocks, and others unearthed the history of the Göring Institute and the exclusion of Reich. In 1997 a leading German analyst, Werner Bohleber, explained the absence of important theoretical developments in post-1960s German psychoanalysis by the fact that German analysts remained so utterly preoccupied with their past.

The samizdat and other anticommunist movements that triumphed in 1989 allowed another broken cord of analytic history to be picked up. In the Soviet Union in 1979 Aron Belkin drew on analysis to explain the national malaise, suggesting that "identification with the Supreme Guide [Stalin] had crushed the family father figure, forced the individual to regard as diabolical any alternative … and eventually caused the death of thought." Eugen Kogan described "the obsessive identification with the father who had disappeared, the feeling of shame towards the father who had been deported or eliminated as an enemy of the people, and the solitude and wanderings of the son." Under Mikhail Gorbachev's program of glasnost (openness) starting in the mid-1980s, Freud's works were published in Russian for the first time since the early 1930s. Andrei Zagdansky's 1989 film The Interpretation of Dreams celebrated the event by counterposing readings from Freud's texts with archival film from Soviet history.

In its great days, European psychoanalysis had stood at the confluence of two distinct currents. One was scientific. Its most important point of reference was the Darwinian vision of the human being as an organism driven by internal needs that it sought to satisfy in specific environmental settings. This current expressed itself in the close relations between psychoanalysis and neurophysiology, for example, in the idea that the instincts were on the "border" between the soma and the psyche, or in the idea that the mind discharged tension or acted reflexively in ways that were similar to the nervous system. It also led to the view that such characteristics of the psyche as the developmental stages of sexuality, or the functions of the ego, were the product of a long evolutionary history, the continual adaptation of inner and outer realities.

The other stream was humanistic. Its most important expression had been the analytic focus on the moral struggle of the human being, a struggle that arose in relation to the parents and that ended in the confrontation with death. This stream drew on literary sources such as the Hebrew Bible and the Greek tragedians, on William Shakespeare, Johann Wolfgang von Goethe, and Fyodor Dostoyevsky, and on modernist literature and philosophy, even when psychoanalysis disavowed them; and it also responded to the need for an everyday or "folk" understanding of psychological life. Freud fused these two currents into an extraordinary new synthesis, neither wholly scientific nor wholly humanistic. What made this synthesis both coherent and compelling was the discovery of a new object: the idiosyncratic, meaning-saturated, morally inflected psychical life of the human being.

Always embattled, the psychoanalytic conception of the human subject had been drastically weakened during the 1960s. That project had drawn its strength from its ability to integrate its scientific and its humanistic currents. In the 1970s these currents parted ways. Psychoanalysis divided into two divergent projects, a quasi-medical therapeutic practice aimed at treating mental and emotional disorders and a set of new approaches to the study of culture. The two new projects—the "therapeutic" and the "hermeneutic"—underwent separate development. The scientific lineage of psychoanalysis gave way to neuroscience, brain research, and psychopharmacology, at first in the United States and then, more slowly, elsewhere. The humanistic and literary lineage gave way to cultural studies, feminist theory, "queer" theory, and to the study of identity, narrative, and representation. The ethic of self-reflection fell away entirely, as new versions of mind-cure "empowerment" triumphed. At the beginning of the twenty-first century, the future of analysis remained in doubt.

See alsoFreud, Sigmund; War Neuroses.

BIBLIOGRAPHY

Brecht, Karen, Volker Friedrich, Ludger M. Hermanns, Isidor J. Kaminer, and Dierk H. Juelich. "Here Life Goes on in a Most Peculiar Way": Psychoanalysis Before and After 1933. Hamburg, Germany, n.d.

Cocks, Geoffrey. Psychotherapy in the Third Reich: The Göring Institute. 2nd ed. New Brunswick, N.J., 1997.

Etkind, Alexander. Eros of the Impossible: The History of Psychoanalysis in Russia. Translated by Noah and Maria Rubins. Boulder, Colo., 1997.

Freud, Sigmund. The Standard Edition of the Complete Psychological Works of Sigmund Freud. Translated from the German under the general editorship of James Strachey in collaboration with Anna Freud. 24 vols. London, 1953–1974.

Gay, Peter. Freud: A Life for Our Time. New York, 1988.

Grosskurth, Phyllis. Melanie Klein: Her World and Her Work. New York, 1986.

Jones, Ernest. Body Politic. Toronto, 1977.

King, Pearl, and Riccardo Steiner, eds. The Freud–Klein Controversies, 1941–1945. London, 1991.

Lacan, Jacques. Ecrits. Translated by Alan Sheridan. London, 2001.

Lieberman, E. James. Acts of Will: The Life and Work of Otto Rank. New York, 1985.

Paskauskas, Andrew R., ed. The Complete Correspondence of Sigmund Freud and Ernest Jones, 1908–1939. Cambridge, Mass., 1993.

Roudinesco, Elisabeth. Histoire de la psychanalyse en France. 2 vols. Rev. ed. Paris, 1994.

Sharaf, Myron. Fury on Earth: A Biography of Wilhelm Reich. New York, 1983.

Young-Bruehl, Elisabeth. Anna Freud: A Biography. New York, 1988.

Eli Zaretsky

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