Psychoanalysis had its beginning with the discovery that a person in complete physical health could experience an illness with physical symptoms that stemmed from things trapped in the subconscious known as hysteria. Charcot, a French neurologist tried to liberate the mind through hypnosis. A Viennese physician, Josef Breuer, carried this purging further with a process based on his patient, Anna O. , revealing her thoughts and feelings to him. Sigmund Freud took Breuer’s method and made generalizations that grew into conceptualizations and eventually into the theories of psychoanalysis.
Freud would listen to his patients, and then use these thoughts to interpret what was happening in the unconscious part of their mind. This was explained as bringing the unconscious to consciousness so it could be dealt with through therapy. Breuer and Freud’s successes with this method led to the foundational publication of Studies in Hysteria in 1895. Freud continued his practice of theory until it became the system of psychology known as psychoanalysis, a system that is the single most influential theory of psychotherapy in our time.
A brief look into psychoanalysis is seen through the foundations of Freud’s theory. Freud began with his study of the three forces of the psyche: the id, the ego, and the superego. The id is the unconscious and contains most things inherited and the all-encompassing instincts. The ego is the conscious and must control the ever-demanding id by serving as its link to the external world. The ego is a regulator and responds to a stimulus by adapting or fleeing, regulating, and seeking pleasure while avoiding displeasure. The superego is actually managed by the id.
It carries the responsibility of the limitation of satisfactions and the representation of other persons’ influence, especially the influence of parents, teachers, and other role models. It also represents the impact of racial, cultural, and societal traditions. The instincts, which are mostly a part of the id, are the cause of every human behavior. Behavior is further made up of two basic instincts that are Eros (love) and Death (destructive and aggressive). Eros is responsible for establishing and preserving the unity of relationships.
The Death or destructive instinct carries the purpose of undoing connections and unity through aggression or destruction. They either work together to form attraction or in competition to create repulsion. Simply put one may be bashful or impotent or aggressive to the extreme of being a sex murderer. To carry his study further, Freud considered the sexuality of an individual. Through this particular study, Freud contends that one must go back to birth, which is the manifestation of an individual’s sexuality.
The oral phase is where life begins and that is why babies explore everything with their mouth, the center of all sensations. The following phase is the anal or sadistic-anal phase where excretory functions are the center of everything. Pleasures are experienced in the anus during bowel movements. Finally these erotically tinged pleasures are experienced when the sexual organ is manipulated. Thus psychosexual development progresses from the oral through the anal to the phallic (in psychoanalytic theory phallic refers to both male and female sexual organs) stage.
During the height of the phallic phase, about the ages of three to six, these libidinous forces focus on the parent of the opposite sex and lend an erotic cast to the relationship between parent and child (son/mother or daughter/father). This focus is known as the Oedipus phase for boys and the Electra phase for girls. The phallic phase is followed by a period of latency where sexual drives lay dormant until puberty when they are reawakened and individuals become more aware of the sexual roles they will play as an adult. The further structure comes with Freud’s description of the conscious, preconscious, and unconscious.
The conscious is driven by pleasure and is locked away from the conscious. Repression, as well as similar disorders, forms the barrier between the conscious and unconscious. The preconscious can be accessed by the conscious even though it is no longer being thought about. The psychoanalyst must find the line between what is merely a part of preconscious and what is part of the unconscious. Freud’s dream analysis was determined the gateway to the unconscious. The preconscious and unconscious had to be unlocked and evaluated in the beginning cases known as hysteria and in a multitude of psychological disorders.
As the disorders become neuroses treatment became necessary for a mentally healthy life. This treatment is used on patients that seek psychoanalytic treatment because they suffer from one or more of a variety of psychological symptoms such as anxiety, depression, sexual and other inhibitions, obsessive thoughts, compulsive actions, irrational angers, shyness and timidity, phobias, inability to get along with friends or spouses or co-workers, low self-esteem, a sense of feeling unfulfilled, nervous irritability, and blocked creativity.
The defects and repressed conflicts that cause these symptoms are usually indicative of a psychoneurosis or a narcissistic personality disorder. Normal ego functioning and the job of life that comes with easy relationship to others is seriously interfered with or sometimes lost altogether. Psychoanalysis does not promise a quick cure but holds out the hope that through the better understanding of oneself and of others one can achieve an amelioration of symptoms as well as a smoother and more effective socialization of one’s behavior.
Psychological maladaptations usually originate from painful misunderstandings or outright failures in the child’s relationship to his or her parents. Sometimes parents lack the appropriate and attuned empathic understanding that children need. Sometimes severe physical or mental illness or the death of a parent or sibling causes serious psychic wounds. Consequently, even in adults, they remain ever-[resent though usually unconscious fears that the early hurtful experiences will now be repeated again with others.
Transference is the unconscious expectation that the old injuries and insults will now again be suffered, only this time at the hand of friends, spouses, children, bosses, etc. as if transferred from the past into the present. Transference makes one have irrational expectations from the people with whom one lives and works. For example, one may feel a need for the approval of a supervisor similar to the same feeling of need a child has towards his parents. Frustration of these expectations may evoke immature rage or other immature behavior.
Transference causes great distress, but it also makes treatment possible. The method of treatment seems simple at first. The patient reclines on a comfortable couch in the analyst’s office with the analyst seated behind the patient. The recumbent position, as well as not being able to see the analyst, minimizes distraction and allows concentration on inner experiences, thoughts, wishes, fantasies, and feelings. The patient is instructed to say absolutely everything that comes to mind without censoring anything, a technique that is called free association.
This brings about a state of regression in which long-forgotten events and painful encounters are remembered, often with great clarity and intense emotions. At the same time, because of transference, the patient experiences the analyst as well, as if he or she were a figure from the past, perhaps resembling a parent. The analyst often can trace the connection between the patient’s current fantasies and feelings about the analyst and the origin of these thoughts and emotions in childhood experiences.
The analyst then interprets the re-experienced conflicts and traumas, together with the accompanying fears and feelings. The patient learns to recognize the connections between the experiences during the regressed state brought about by the analytic method which causes a reorganization of the psychological structures into more healthfully adaptive patterns . The analyst’s friendly and calmly explaining attitude that is generally devoid of any moralizing or other biases creates an atmosphere in which, most of the time, all human failings and foibles can be looked at, talked about, and finally resolved.
Typically, an analysis lasts for a few years, with four to five sessions per week of about 45 minutes each. In this way the psychoneuroses and the narcissistic personality disorders can be treated successfully in a majority of patients. Serious mental illnesses such as schizophrenia, manic-depressive illness, and the psychoses caused by organ malfunctioning of the brain cannot be cured by psychoanalytic treatment, though the patient can often benefit from psycho-pharmacological treatment – sedatives, tranquilizers, anti-depressants– in combinations with psychotherapy.
The longevity of success using psychoanalysis becomes a testimony to Freud’s in-depth study of the human mind. His forty plus years of work in the field were spent on the development of the main principles of psychoanalysis along with the techniques and methods used by the analyst. His work was furthered by his daughter and later adopted then adapted by Erikson. What seemed so revolutionary in the 1890’s and beyond has now become widely accepted by most all schools of psychological thought and its study.