Freudian & Psycho-analytical therapies: An enduring paradigm
Psycho-analytical and Freudian therapies often represent in the layman’s mind, what psychology and psychotherapy are at large. The reason for this enduring reign is that Freud may well have been the single biggest contributor psychotherapy as a field. This is does not mean that he was alone in that, or even that his work was perfect or purely scientific. It does mean though that the concepts he coined and the structured approach to psycho-analysis he founded have proven extremely resilient to time and critic.
Freud in so many words aimed to “throw light upon the unusual, abnormal, or pathological manifestations of the mind”. To do so he proposed to explore deeper, find the underlying causes and beliefs that lead to specific behaviour. He was one of the first to openly question the “content” of what people consciously say, to posit that “deep down” they may think or want something else.
He defined the “unconscious” and why it is so vital to get a more conscious understanding of it. Others had before described similar concepts to the unconscious some from time immemorial in mythology, others from theology. But it was Freud who spoke of the Unconscious fully, what feeds it, how it filters, how it affects our behaviour.
Freudian & Psychoanalytical therapies – An Overview
Before we explore Freudian tools and principles, it is worth remembering the historical and cultural context of the time. Freudian thought has survived admirably well on the whole which can make us forget the hue of the times of its inception. Rationality was at its peak, sciences and the industrial revolution in full swing. Only the human mind remained “terra incognita” the unknown continent. Charcot had done interesting work on “hysterics”, Mesmer had convinced a feverish middle-class of the merits of hypnosis. The brilliant Josef Breuer was laying interesting foundations in neuropsychology (he was also the real life doctor of the famous Anna O. a case that would form much basis in Freud’s theory). There were promising, but isolated signs of deeper understanding of the mind, of its ability for non-linear thinking. But no structured, self-standing method until Freud laid out his framework for pscyhotherapeutic work over 30 years or so. He published his first opus in 1899, the watershed “Interpretation of dreams” all the way to his 1930 “Society and its discontents.
Freud has been accused of many things, with varying accuracy over the years, from fraud to lunatic, from plagiarist to poor scientist. Others point out that much of his work has been informed by his work on “neurotics” not necessarily in this sense, research applicable to society at large. That also, he feigned complete objectivity in his own self-analysis but clearly was, like anyone else, a product of his time and culture (white, male, Jewish, scientist, Austrian, bourgeois, etc.) casting further down on the universality of his “science”.
Thankfully he also practiced with more common patients showing lapses of behaviour or character seen in most. And it is fortunate because it is in the benign-looking but odd actions, that he saw clues as to the deep and unexpressed causes. The net result between the push of an unconscious drive, and the repression of a “censor” could look like a small, odd action or word. He was one of the first ones to be able to imagine a whole world of non-obvious, answering non-conscious rules, beyond that of what people say and how they outwardly behave. Yet without falling in to the trap of the soothsaying divine, whilst keeping a somewhat scientific approach in mind.
What a miracle of the human mind.
One can wonder if Freud’s inspiration was not somewhat anchored in the reality of his existence, of his family. He was born in Moravia and only came to Vienna aged 3, in what was the latest episode of family diaspora relocation. His family recent ancestry went back to Ukraine, and later on closer yet, to Poland, until he himself spent most of his life in Austria. Can experiencing directly religious persecution engrain a high level of awareness in families and individuals who go through that experience? Can they instill a hypervigilant ability to read much from little at any time? Could the Talmudian concept of miracle have helped Freud break through everyday awareness?
Key symptoms of Freudian interest
Freud identified a set of actions and expressions that were most likely to bear (unconscious) meaning:
- Vivid dreams, dreams laden with “psychic energy”
- Human phenomena seemingly impossible to explain by reason alone (humour, religion)
- Everyday oddities such as “déjà-vu” and “uncanniness”
- Obvious “errors” and/or lapses of the human mind, such Freudian slips, slips of the tongue, stuttering.
The Freudian model of the mind hinges on a few basic elements/rules no further reducible:
- The relationship between the pre-conscious, conscious and unconscious/subconscious mind
- The tripartite division of the mind: ego, id; superego. Their interactions; filtering effects (the “censor”).
- Psychosexual development: how childhood experience shapes personality and life choices and predisposes the individual to
- Health and Dis-ease
- Eros & Thanatos
Obviously some of his views and principles were influenced by his specific context, the Zeitgeist around which he operated. A litany of psychoanalysts and researchers have spent colossal lengths critiquing his world view, and how his method was heavily influenced by his environment. Freud was Jewish Austrian, male, bourgeois and single till 30 , age at which he married happily though is wife always resented his “porn”. He was someone too, subject to fairly usual blind spots himself, and had to deal with his own personal pressures, relations and challenges. There is likely merit in pointing these out and to debate the “definiteness” of Freudian approaches. A Freudian type therapy is fairly “hierarchical” in nature, with the doctor presiding over a patient. Freudian thought can sometimes feel as unquestionable cannons or principles dictated from a moral mountain top. Freudian therapies (depending on the practitioner obviously) can feel overly conceptual and nerdy in nature at the detriment of connection, emotion or energy found humanistic type therapies for ex. Many psychotherapists in modern times see more, faster therapeutic gain in other approaches (CBT, Gestalt, Person-Centered, etc.) Freudian psychologists on their end accuse many such frameworks of not being enough “depth” therapy, to only address symptoms not underlying causes and unconscious reality.
Whilst there is merit re-examining his work through sociological and psychological lenses, the fact stubbornly remains: His approach is still very current, and echoes through a wide variety of other therapies. Key concepts such as ego, id and superego, or conscious/unconscious are expressed similarly in PCT (Real self, congruence, Ideal sefl) and Transactional Analysis (Parent, Adult, Child) to name but two.
Freudian therapy & Childhood
As another common principle shared with PCT, Freud long established that most current questions and issues can be reduced to childhood experience. It was so vitally important in his view because childhood is a unique experience (compared to later stages) that produces:
a) Particularly lasting impressions on people
b) Made these impressions particularly inaccessible to consciousness in later life.
Of critical importance is “unconscious mentation” that occurs early on in babies, the unconscious mind that goes to basic functions. This lack of consciousness inherited at birth according to Freud may carry on in later life for many, unaware of it and the impact it has on their life.
Freud posits that many unpleasant experiences may in time be “repressed” into that unconscious “zone” of the brain. Not forgotten, unalleviated, waiting for an event to express, if oddly.
The famous case of Anna O which he managed with his close colleague and boss Josef Breuer is indicative of that kind of therapeutic intervention. The simplicity of such anecdotes greatly facilitated the adoption and vulgarisation of Freudian thought at the time but may have been more complex in truth.
But here you have it, at the time it was a major victory for psychotherapy, a brand new, structured model of investigation, to make new sense from an apparently odd outward behaviour. The patient becomes aware of the source experience, and that awareness alone is enough to cure her of her concrete ailment (the inability to drink).
The case of Anna O did not just serve to popularize the nascent discipline. It also confirmed Freud it his investigative approach. He shared increasing amounts of his research and collaboration with Breuer in “Studies on Hysteria” (1895). In it he expounds his model, still groping in the dark but taking shape. By now accepting in full that patients usually revealed themselves best when unconsciously, outside of deliberate communication, he forged on. He defined that “unconscious” more clearly as a fundamental aspect of the human mind, end result of countless impressions from real life. Never openly expressed or processed because unconscious, these thoughts were repressed from consciousness since childhood.
Staying in the unconscious for extended periods of time, these thoughts were unable to evolve or be expressed so as to be examined. Unable to discharge they stay somewhat “stuck” in the unconscious. The psychic effort of repression however means that these thoughts remain “on alert” waiting for a moment to manifest.
Since their manifestation borrows more to the inner life of the patient, than anything else that would legitimately justify them, they appear odd, accidental, out of place. Their cryptic nature acting as a very last line of defense of the tortured mind, desperate to express itself whilst afraid of the consequences attached to owning and expressing the thought.
It is why Freudian psychoanalysis places so much attention to the interpretation of dreams, the non-obvious, the tic, the Freudian slip, as well as a variety of paradoxical or nebulous everyday actions.
Transference & Counter-transference
Freud was also one of the first ones to document and analyse the lens and feelings themselves that can form between a therapist and a patient. Transference is a phenomenon where a person redirects and projects feelings about someone on to someone else (it is often what we take for granted, what we unconsciously resonate with in someone else, etc.) Freud went to great lengths to talk of that phenomenon as part of the pscyhoanalytical method, a key component of the method itself. The real world is effectively in his view, also simply, a patient transfering on a therapist, and a therapist counter-transfering. Or vice-versa.
Transference is a psychotherapeutic concept focusing on the relationship between therapist and client, sometimes erotic in nature, it can also take the form of rage, distrust, hatred, profound dependency, disgust, and panoply of others. It is part and parcel of any psychoanalyst to express openly with the client what they understand is happening around the therapy.
Transference is also an every reality: We can all relate to meeting someone who reminds us of someone else, and automatically assuming that they will behave and think somewhat similarly. That body of research alone has been extensively studied and will be for years to come: How do we really form relations? What do we really look for and project in our partner?
Freud originally stumbled upon the concept through a patient, who stolidly refused to engage in a free-association game. Freud commonly used those to start “digging” through the outter layers of consciousness of his patients. This one clearly was embarrassed at the thought of being “exposed” through such a game where the conscious mind cannot keep its full “guardianship” role.
Initially Freud considered that to be patient “resistance” another concept he worked on but soon realised the difference, the specific meaning of a transference and how it held profound clues by itself.
“Counter-transference” soon followed, as the symmetrical term, describing this time the therapist’s transference on the patient, or the general “entanglement” of the therapist. Freud himself looked forward to studying both transference and counter-transference as a key tool in therapeutic terms: Whether attraction or repulsion, what was in the patient’s speech or behaviour that led the therapist to feel this way? What lies behind that behaviour? etc.
Resistance
Another key concept of Freudian psychoanalytical therapies is that of resistance. Resistance if often shown by patients who seem to “cling on to their disease” as he writes. It was a common scenario that Freud ran into enough times to dedicate specific research into.
How and why do some patients exhibit resistance and stubborn relapses into unhelpful behaviours where others do not and change durably as soon as they become more aware of their mind map and experience?
The answer according to Freud was in “trade-offs”. If you see deeper than the obvious (a patient suffering psychosomatic block for ex.)
“In civil life illness can be used as a screen to gloss over incompetence in one’s profession or in competition with other people; while in the family it can serve as a means for the other members and extorting proofs of their love or for imposing one’s will upon them … we sum it up in the term ‘gain from illness’ … But there are other motives, that lie still deeper, for holding on to being ill … these cannot be understood without a fresh journey into psychological theory
By exposing and studying the nature of the resistance, as well as secondary trade-offs involved in “healing” Freud added a potent tool to his investigative bag of tricks. Many Freudian schools of thought now look at both transference and resistance as the central starting point of a psychoanalytical therapy.
Relevance and indications of Freudian psychodynamic approaches
Does this mean that psychoanalysis is the best in class?
Absolutely not.
Firstly, psychoanalysis is somewhat victim of its own success in the sense that many patients believe they understand it, but fail to grasp it crisply and/or as a holistic approach. It can therefore be difficult to discuss with patients. Many patients will avoid for their entire lives, going to a therapist as they imagine they will be forced to discuss their most intimate dreams or have to lay on a couch awkwardly. Which is really not how most therapies proceed.
Others may delay seeing a psychotherapist for years, for fear that they need an enormous sum of money before reaching any psychotherapeutic benefit, another hangover from the (often expensive) Freudian psychoanalysis view.
In the end it depends a lot on the patient themselves. What symptoms are they showing and how pressing are they? If the patient seems on the cusp of losing their job say, it will most likely be a better idea to choose a quick acting therapy model as “handbrake” before they incur increasing personal loss (of employment, of finances, of health, etc.) Cognitive Behavioural Therapy for example would seem a better choice. It does not have the depth of psychoanalysis but is fast acting.
In the end choosing will come down to personal preference, therapist qualifications and patient finances. Psychoanalysis is profound but long. Some patients imagine any therapy would follow psychoanalysis cannon and so actively request it. Others exhibit typical symptoms and issues congruent with Freudian investigation (Freudian slips, vivid or stressful dreams, etc.)
In any case, Freudian psychodynamic and psychoanalytical thought has accomplished the wondrous feat of arming anyone with a basic understanding of the human mind. Of mapping out with elemental concepts the surprising workings of our inner mind. Of helping us all re-examine our thoughts and behaviours, our values and trade-offs in a radically new light.
