Psychoanalysis

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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.