Psychoanalysis

Saul McLeod published 2007, updated 2014

Psychoanalysis was founded by Sigmund Freud (1856-1939). Freud believed that people could
be cured by making conscious their unconscious thoughts and motivations, thus gaining insight.

The aim of psychoanalysis therapy is to release repressed emotions and experiences, i.e., make
the unconscious conscious. It is only having a cathartic (i.e., healing) experience can the person
be helped and "cured."

Psychoanalysis Assumptions
 Psychoanalytic psychologists see psychological problems as rooted in the unconscious
mind.
 Manifest symptoms are caused by latent (hidden) disturbances.
 Typical causes include unresolved issues during development or repressed trauma.
 Treatment focuses on bringing the repressed conflict to consciousness, where the client
can deal with it.

How can we understand the unconscious mind?

Remember, psychoanalysis is a therapy as well as a theory. Psychoanalysis is commonly used to
treat depression and anxiety disorders.

In psychoanalysis (therapy) Freud would have a patient lie on a couch to relax, and he would sit
behind them taking notes while they told him about their dreams and childhood memories.
Psychoanalysis would be a lengthy process, involving many sessions with the psychoanalyst.
Due to the nature of defense mechanisms and the inaccessibility of the deterministic forces
operating in the unconscious, psychoanalysis in its classic form is a lengthy process often
involving 2 to 5 sessions per week for several years.

This approach assumes that the reduction of symptoms alone is relatively inconsequential as if
the underlying conflict is not resolved, more neurotic symptoms will simply be substituted. The
analyst typically is a 'blank screen,' disclosing very little about themselves in order that the client
can use the space in the relationship to work on their unconscious without interference from
outside.

The psychoanalyst uses various techniques as encouragement for the client to develop insights
into their behavior and the meanings of symptoms, including ink blots, parapraxes, free
association, interpretation (including dream analysis), resistance analysis and transference
analysis.
1) Rorschach ink blots

Due to the nature of defense mechanisms and the inaccessibility of the deterministic forces
operating in the unconscious,

The ink blot itself doesn't mean anything, it's ambiguous (i.e., unclear). It is what you read into it
that is important. Different people will see different things depending on what unconscious
connections they make.

The ink blot is known as a projective test as the patient 'projects' information from their
unconscious mind to interpret the ink blot.

However, behavioral psychologists such as B.F. Skinner have criticized this method as being
subjective and unscientific.

Click here to analyze your unconscious mind using ink blots.

2) Freudian Slip
Unconscious thoughts and feelings can transfer to the conscious mind in the form of parapraxes,
popularly known as Freudian slips or slips of the tongue. We reveal what is really on our mind by
saying something we didn't mean to.

For example, a nutritionist giving a lecture intended to say we should always demand the best in
bread, but instead said bed. Another example is where a person may call a friend's new partner
by the name of a previous one, whom we liked better.

Freud believed that slips of the tongue provided an insight into the unconscious mind and that
there were no accidents, every behavior (including slips of the tongue) was significant (i.e., all
behavior is determined).
3) Free Association
A simple technique of psychodynamic therapy, is free association, in which a patient talks of
whatever comes into their mind. This technique involves a therapist reading a list of words (e.g..
mother, childhood, etc.) and the patient immediately responds with the first word that comes to
mind. It is hoped that fragments of repressed memories will emerge in the course of free
association.

Free association may not prove useful if the client shows resistance, and is reluctant to say what
he or she is thinking. On the other hand, the presence of resistance (e.g., an excessively long
pause) often provides a strong clue that the client is getting close to some important repressed
idea in his or her thinking, and that further probing by the therapist is called for.

Freud reported that his free associating patients occasionally experienced such an emotionally
intense and vivid memory that they almost relived the experience. This is like a "flashback"
from a war or a rape experience. Such a stressful memory, so real it feels like it is happening
again, is called an abreaction. If such a disturbing memory occurred in therapy or with a
supportive friend and one felt better--relieved or cleansed--later, it would be called a catharsis.

Frequently, these intense emotional experiences provided Freud a valuable insight into the
patient's problems.
Dream Analysis
According to Freud the analysis of dreams is "the royal road to the unconscious." He argued that
the conscious mind is like a censor, but it is less vigilant when we are asleep. As a result,
repressed ideas come to the surface - though what we remember may well have been altered
during the dream process.

As a result, we need to distinguish between the manifest content and the latent content of a
dream. The former is what we actually remember. The latter is what it really means. Freud
believed that very often the real meaning of a dream had a sexual significance and in his theory
of sexual symbolism he speculates on the underlying meaning of common dream themes.

Clinical Applications
Psychoanalysis (along with Rogerian humanistic counseling) is an example of a global therapy
(Comer, 1995, p. 143) which has the aim of helping clients to bring about a major change in their
whole perspective on life.

This rests on the assumption that the current maladaptive perspective is tied to deep-seated
personality factors. Global therapies stand in contrast to approaches which focus mainly on a
reduction of symptoms, such as cognitive and behavioral approaches, so-called problem-based
therapies.

Anxiety disorders such as phobias, panic attacks, obsessive-compulsive disorders and post-
traumatic stress disorder are obvious areas where psychoanalysis might be assumed to work. The
aim is to assist the client in coming to terms with their own id impulses or to recognize the origin
of their current anxiety in childhood relationships that are being relived in adulthood. Svartberg
and Stiles (1991) and Prochaska and DiClemente (1984) point out that the evidence for its
effectiveness is equivocal.

Salzman (1980) suggests that psychodynamic therapies generally are of little help to clients with
specific anxiety disorders such as phobias or OCDs but may be of more help with general
anxiety disorders. Salzman (1980) in fact expresses concerns that psychoanalysis may increase
the symptoms of OCDs because of the tendency of such clients to be overly concerned with their
actions and to ruminate on their plight (Noonan, 1971).

Depression may be treated with a psychoanalytic approach to some extent. Psychoanalysts

relate depression back to the loss every child experiences when realizing our separateness from
our parents early in childhood. An inability to come to terms with this may leave the person
prone to depression or depressive episodes in later life.

Treatment then involves encouraging the client to recall that early experience and to untangle the
fixations that have built up around it. Particular care is taken with transference when working
with depressed clients due to their overwhelming need to be dependent on others. The aim is for
clients to become less dependent and to develop a more functional way of understanding and
accepting loss/rejection/change in their lives.

Shapiro and Emde (1991) report that psychodynamic therapies have been successful only
occasionally. One reason might be that depressed people may be too inactive or unmotivated to
participate in the session. In such cases a more directive, challenging approach might be
beneficial.

Another reason might be that depressives may expect a quick cure and as psychoanalysis does
not offer this, the client may leave or become overly involved in devising strategies to maintain a
dependent transference relationship with the analyst.

Critical Evaluation
- Therapy is very time-consuming and is unlikely to provide answers quickly.

- People must be prepared to invest a lot of time and money into the therapy; they must be
motivated.

- They might discover some painful and unpleasant memories that had been repressed, which
causes them more distress.

- This type of therapy does not work for all people and all types of disorders.

- The nature of Psychoanalysis creates a power imbalance between therapist and client that could
raise ethical issues.

Fisher and Greenberg (1977), in a review of the literature, conclude that psychoanalytic theory
cannot be accepted or rejected as a package, 'it is a complete structure consisting of many parts,
some of which should be accepted, others rejected and the others at least partially reshaped.'

Fonagy (1981) questions whether attempts to validate Freud's approach through laboratory tests
have any validity themselves. Freud's theory questions the very basis of a rationalist, scientific
approach and could well be seen as a critique of science, rather than science rejecting
psychoanalysis because it is not susceptible to refutation.

The case study method is criticized as it is doubtful that generalizations can be valid since the
method is open to many kinds of bias (e.g., Little Hans).

However, psychoanalysis is concerned with offering interpretations to the current client, rather
than devising abstract dehumanized principles. Anthony Storr (1987), the well-know
psychoanalyst appearing on TV and Radio 4's 'All in the Mind', holds the view that whilst a great
many psychoanalysts have a wealth of 'data' at their fingertips from cases, these observations are
bound to be contaminated with subjective personal opinion and should not be considered
scientific.
References

Comer, R. J. (1995). Abnormal psychology (2nd ed.). New York: W. H. Freeman.

Fisher, S., & Greenberg, R. P. (1977). The scientific credibility of Freud's theories and therapy.
Columbia University Press.

Fonagy, P. (1981). Several entries in the area of psycho-analysis and clinical psychology.

Freud, S. (1916-1917). Introductory lectures on psychoanalysis. SE, 22: 1-182.

Freud, A. (1937). The Ego and the mechanisms of defense. London: Hogarth Press and Institute
of Psycho-Analysis.

Noonan, J. R. (1971). An obsessive-compulsive reaction treated by induced anxiety. American

Journal of Psychotherapy, 25(2), 293.

Prochaska, J., & C. DiClemente (1984). The transtheoretical approach: Crossing traditional
boundaries of therapy. Homewood, Ill., Dow Jones-Irwin.

Salzman, L. (1980). Treatment of the obsessive personality. Jason Aronson Inc. Publishers.

Shapiro, T., & Emde, R. N. (1991). Introduction: Some Empirical Approaches To

Psychoanalysis. Journal of the American Psychoanalytic Association, 39, 1-3.

Storr, A. (1987). Why psychoanalysis is not a science. Mind-waves.

Svartberg, M., & Stiles, T. C. (1991). Comparative effects of short-term psychodynamic

psychotherapy: a meta-analysis. Journal of consulting and clinical psychology, 59(5), 704.
Learning Check: You are the Therapist

Read through the notes below. Identify the methods the therapist is using. What do you think
Albert's problem is?

A young man, 18 years old, is referred to a psychoanalyst by his family doctor. It seems that, for
the past year, the young man (Albert) has been experiencing a variety of symptoms such as
headaches, dizziness, palpitations, sleep disturbances - all associated with extreme anxiety. The
symptoms are accompanied by a constant, but periodically overwhelming fear of death. He
believes that he has a brain tumor and is, therefore, going to die. However, in spite of exhaustive
medical tests, no physical basis for the symptoms can be identified. The doctor finally concludes
that Albert's symptoms are probably psychologically based.

Albert arrives at the analyst's office accompanied by his parents. He describes his problems and
depicts his relationship with his parents as 'rosy' - though admitting that his father may be 'a little
on the strict side.' It emerges that his father will not permit Albert to go out during the week, and
he must be home by 11 pm at weekends.

Additionally, he successfully broke up a relationship between Albert and a girlfriend because he

thought they were getting 'too close.' In describing this, Albert shows no conscious resentment,
recounting the events in an emotional, matter of fact manner.

During one session, in which Albert is encouraged to free associate, he demonstrated a degree of
resistance in the following example:

'I remember one day when I was a little kid, and my mother and I were planning to go out
shopping together. My father came home early, and instead of my mother taking me out, the two
of them went out together leaving me with a neighbor. I felt... ...for some reason my mind has
gone completely blank.'
This passage is fairly typical of Albert's recollections.

Occasionally, Albert is late for his appointments with the therapist, and less often he misses an
appointment, claiming to have forgotten.

ALBERT'S DREAM

During one session Albert reports a dream in which his father is leaving on a train, while Albert
remains on the platform holding hands with both his mother and his girlfriend. He feels both
happy and guilty at the same time.

Sometime later, after the therapy sessions have been going on for several months, the analyst
takes a two weeks holiday. During a session soon afterward Albert speaks angrily to the
therapist.

'Why the hell did you decide to take a holiday with your damned wife just as we were beginning
to get somewhere with my analysis.'
How to reference this article:

McLeod, S. A. (2007). Psychoanalysis. Retrieved from

www.simplypsychology.org/psychoanalysis.html

https://www.simplypsychology.org/psychoanalysis.html