Essentials Of Psychoanalysis

Herbert S. Strean

• Publisher: Routledge
• Year: 2013
• eBook ISBN: 9781135063603
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

Presents the fundamentals of theory and technique of psychoanalytic treatment, valuable for psychotherapists and students. Begins with a review of Freud's theory of personality and its modifications, and discusses transference and countertransference reactions; unconscious meanings of problems and

1

FREUD AND HIS THEORY OF PERSONALITY

Just as psychoanalysis as a personality theory, treatment method, and research perspective has been steeped in controversy ever since its inception, Sigmund Freud, the founder of the art and science, may be regarded as one of the most controversial figures of the 20th century. Highly esteemed for his monumental discoveries, he is severely derogated for his alleged prejudices. Some aver that he is more influential than any other human being in civilization in acquainting us with the child in ourselves, while others blame him as a prime source of modern sexual libertinism and for many of the other ills of contemporary life (Roazen, 1975).

Those who regard Freud as a genius compare him to Darwin, Einstein, or Galileo (Jones, 1957). They point to his many creative contributions such as the dynamics of the unconscious, infantile sexuality and psychosexual development, the interpretation of dreams, the role of fantasies, the process of free association, the crucial importance of transference in and out of the therapeutic situation, the inevitability of human resistance to change, and many more discoveries (Freeman & Strean, 1987).

Those who condemn Freud view him as a male chauvinist who was a preserver of the status quo. They contend that he exaggerated the importance of the penis, erroneously postulated a death instinct, naively assumed that children inherit acquired characteristics, and incorrectly averred that women have weaker superegos than men (Masson, 1984, 1990).

Even among psychoanalysts and other mental health professionals there is only limited consensus on Freud's findings. During the last two decades classical Freudians have been severely criticized by object-relations experts and proponents of self psychology, to name just two dissenting groups of psychoanalysts who fault Freud for many of his positions on personality formation and treatment. Yet, there are other clinicians who claim nothing much has been discovered about personality theory or treatment since Freud entered on the psychotherapeutic stage (Malcolm, 1981).

In A History of Psychoanalysis, Reuben Fine (1979) points out that Freud knew little about the oral stage of development, particularly the infant's hostility toward the mother, maternal rejection, the ego and its autonomous functions, narcissism, and psychosis. Some therapists believe Freud overemphasized the importance of sexuality in the development of neuroses, while others maintain he ascribed too much to the role of aggression (Sulloway, 1979). A number of therapists suggest that Freud was too subjective as a psychoanalyst, became at times too emotionally involved with patients, while others accuse him of lacking empathy. Therapists of many persuasions regard Freud's perspective as too deterministic and his philosophy as too gloomy (Corsini, 1973).

As one reads the many biographies on Sigmund Freud (Clark, 1980; Freeman & Strean, 1987; Gay, 1988; Jones, 1957; Masson, 1985; Roazen, 1975; Sulloway, 1979), he or she learns that few remain neutral about Freud. He was and is adored and abhorred, acclaimed and disdained. Although Freud died over 50 years ago, biographies on him continue to flourish. His theories also continue to be evaluated and re-evaluated (Fine, 1962, 1979). Even his favorite jokes have been the subject of a book (Oring, 1984). Masson's (1985) publication of Freud's letters to Wilhelm Fliess, a physician who was both a collaborator and father confessor of Freud's, was a bestseller. There are currently many individuals who call themselves Freudian scholars, Freudian philosophers, Freudians, neo-Freudians, and anti-Freudians (Wollheim, 1977).

What about Sigmund Freud, the person? He was born on May 6, 1856, in Freiberg, a small town in Moravia, where his father was a businessman. For financial reasons, when Sigmund was 4 years old, his family moved to Vienna where he lived and practiced until 1938 when Austria was occupied by Hitler (Wyss, 1973).

Freud wrote little about his personal life, reluctant to have it made public. He also contended that biographers have a propensity to distort their subject. Nonetheless, a lot is known about Freud. He did say he inherited his passionate nature and temperament from his mother and his sense of humor, shrewd skepticism, liberalism, and free thinking from his father. Freud described his father as possessing a gentle disposition, loved by his children, and an optimist who was always hopefully expecting something to turn up, which unfortunately for the family finances, rarely did. Freud said he was the duplicate of his father physically and to some extent mentally. His father would often take him for walks in the dense forests of the foothills of the Carpathian Mountains half a mile from Freiberg, as Freud would later take his own children for walks in the Austrian Alps. From Jakob, Freud absorbed a love of trees, plants, and flowers (Clark, 1980; Freeman & Strean, 1987; Gay, 1988; Jones, 1957). After the death of his father, when Freud was 40, he wrote Fliess that he valued his father highly and understood him very well. He also said that nothing upsets a man more than the death of his father (Masson, 1985).

But it was Freud's mother who played the dominant role in his early life. As Freud was later to say, the mother is a child's original love, and all future loves are modeled after this first love experience. He acquired from his mother, Amalie, a lasting sense of self-confidence that enabled him to make discoveries that disturbed the sleep of the world. He felt that he was a valued human being without having to be told so. His self-esteem allowed him to endure the most vituperative criticisms of his theories when they were introduced to the skeptical medical profession of Vienna (Jones, 1957).

Though Freud was his mother's indisputable favorite, he had to contend with newcomers almost continually during the first 10 years of life. The arrival of these infants aroused intense jealousy in him. Sigmund was followed by a brother, Julius, who died at 8 months when Freud was 19 months old. Anna was born when Freud was 2 1/2. Then came Rosa, Marie (Mitzi), Pauline (Paula), Adolfine (Dolfi), and Alexander, 10 years younger than Freud (Clark, 1980; Jones, 1957).

It has been suggested that because Freud had so much hostility toward his mother for having so many children, the role of the mother in the development of the child was neglected by him (Stolorow & Atwood, 1979) and left to a later generation of psychoanalysts to explain. In his famous case of Little Hans, a 5-year-old-boy who suffered from a horse phobia, Freud excluded the mother from the treatment plan. Only Freud, Hans, and Hans's father participated in the first child guidance case in history (Strean, 1970).

Freud always excelled as a student and scholar. He left the Gymnasium in Vienna where he had been “top boy” for 7 years and passed his University Entrance at the age of 17. Practical research and subjects ranging from archeology to literature and philosophy were all attractive to him. Although he decided to study medicine, he found limited satisfaction in the field until Ernst Bruke took him on as an assistant in the Physiological Laboratory where Freud became fascinated with physiological problems. He worked in this institute from 1876 to 1882 but was obliged to give up the idea of a career in physiological research because his financial situation would not permit it. After leaving the institute he became an assistant in the General Hospital to prepare for the practice of medicine but he continued his interest in physiological and histological investigations into the central nervous system in human beings. As a young physician he published a large number of neuropathological works on the course of the fibrous tissue in the medulla oblongata and the spinal cord (Jones, 1957; Wyss, 1973).

By 1885 Freud was appointed a lecturer in neuropathology. While studying neuropathology he became interested in nervous disorders, later called anxiety hysteria and conversion hysteria. Influenced by Charcot, one of the leading neurologists and neuropathologists of Europe, Freud concerned himself with hypnosis as a therapeutic instrument in the treatment of hysteria. Freud was able to demonstrate how some paralyses and other disorders could be overcome through hypnosis. Collaborating later with Breuer, he demonstrated that abreaction and catharsis could cure hysteria. However, when he reported his observations to his colleagues of the Viennese medical fraternity, they held him up to ridicule and did not take him seriously (Jones, 1957).

Freud's persistence and intensity never wavered and despite much opposition he refused to budge from his positions. Whether it was his notions on hypnosis, the unconscious, sexuality, aggression, free association, transference, or dreams, all notions essentially rejected by most of his colleagues, he felt strong in his aloneness and contended that his findings were based on the scientific objectivity to which he had disciplined himself. The hard struggle for existence that Freud was required to wage and endure perhaps accounted for some of his authoritarianism. He was not very tolerant of dissenters such as Adler, Jung, and Rank (Clark, 1980) and he acknowledged to his mentor Fliess that he always needed a hated enemy and an intimate friend (Masson, 1985), suggesting perhaps that he had not resolved his ambivalence toward his father.

According to Jones (1957) Freud confessed to him that he was not really a man of science, not an observer, nor an experimenter, and not a thinker. He felt that by temperament he was “a conquistador”—an adventurer with the curiosity, boldness, and tenacity that belongs to that type of being.

Freud's intensity and passionate interest are qualities that all of his biographers (Clark, 1980; Gay, 1988; Jones, 1957) note. His intense love for his mother and ambivalence toward his father helped him to discover the Oedipus complex. This intensity is also noted in his lifelong devotion to his wife Martha Bernays and his 6 children, one of whom, Anna, followed in her father's footsteps.

From his self-analysis Freud found in his own personality those conflicts, contradictions, and irrationalities he had observed in his patients, and this experience helped him gain more conviction about the essential correctness of his views. Freud was reluctant to accept the validity of any hypothesis until he had tested it out on himself. He continued his self-analysis throughout his life, reserving the last half hour of each day for this activity (Jones, 1957).

FREUD'S MAJOR CONCEPTS ON PERSONALITY FORMATION

No conceptualization of the human personality is as complex nor as comprehensive as Freud's. Basic to understanding it is the notion of psychic determinism (Freud, 1939). This principle holds that in mental functioning nothing happens by chance. Everything a person feels, thinks, fantasizes, dreams, and does has a psychological motive. How individuals earn a living, whom they choose to love and marry, whom they hate, the quality and quantity of their attachments are all motivated by inner unconscious forces (Freud, 1905).

Although external factors are always impinging on the human being, the notions of psychic determinism and the unconscious help the mental health professional appreciate that the behaviors of individuals, couples, families, groups, institutions, and societies are not only reactions to situational variables but are also influenced and shaped by instinctual wishes, ego functions such as defenses and superego admonitions, and other idiosyncratic, internal forces. For example, two individuals working in the same plant are both fired the same day. One of them can become anxious, depressed, and suicidal while the other can feel relieved, pleased, and welcome a respite from working. The reasons for these two different responses are complex and are influenced in part by the individual's history, fantasy and dream life, self-image, and other ego functions, superego mandates, transferences toward bosses and peers, and a host of other internal factors.

A psychoanalytic perspective with its emphasis on determinism and the unconscious can help the clinician gain a better understanding of the patient's presenting problems. For example, when a prospective patient complains about a rejecting spouse or a disturbed son or daughter, a psychoanalytic perspective suggests that the complainer is deriving unconscious protection and gratification from his or her complaints. The fault-finding serves unconscious purposes.

When the mental health professional recognizes that patients are not saints or sinners, neither complete victims nor vicious perpetrators, but are vulnerable and imperfect human beings trying to discharge instinctual wishes, erect defenses against anxiety, and obey superego commands—and all almost completely unconsciously—they become less judgmental, less punitive, and more objective, trying less to impose solutions on patients, but more to understand how and why the patient has written a good part of this psychological script. Thus, when the clinician meets a husband who constantly complains his wife is sexually unresponsive, the clinician may infer that the husband unconsciously wants her to be that way. Similarly, a parent's constant complaining about a son's or daughter's belligerent behavior may reflect the parent's unconscious wish to have the child behave belligerently.

A minister. Reverend Arnold, came to a child guidance clinic and discussed his profound shame and guilt about his son stealing automobiles. In his sixth session with a social worker. Reverend Arnold was obviously deriving much pleasure and excitement about his son's escapades as he described them in detail with a glow on his face.

In conjoint marital treatment when Mr. Brown complained that his wife never wanted to have sex, the clinician turned to Mrs. Brown and asked about it. She confessed that she had been somewhat reluctant to have sex, but she would that night. On hearing this, Mr. Brown said anxiously, “We can wait.”

Calling a mental health clinic for an intake interview, Mr. Cole, a depressed, suicidal man who had delusions that his wife was having a series of extramarital affairs, made an interesting slip over the phone saying, “I'm desperately in need of trouble.”

Freud viewed the human personality from five distinct but intermeshing points of view: the structural, topographic, genetic, dynamic, and economic. These points of view, when combined, are called the metapsychological approach (Freud, 1938).

THE STRUCTURAL POINT OF VIEW

According To Freud (1923), the human mind is composed of id, ego, and superego. The most primitive part of the mind is the id, which is totally unconscious. The id is the repository of the drives (sex and aggression) and is concerned with their gratification. The ego, although having capacities at birth, generally develops out of experience and is the executive of the personality, mediating between the inner world of id drives, superego commands, and the demands of the external world. Some of the functions of the ego are judgment, reality testing, frustration tolerance, impulse control, and interpersonal relationships (frequently called “object relations”). The ego also erects defenses against anxiety, such as repression, denial, and reaction formation. Anxiety is the h...

Table of contents

• Front Cover
• Half Title
• BRUNNER/MAZEL BASIC PRINCIPLES INTO PRACTICE SERIES
• Title Page
• Copyright
• Dedication
• CONTENTS
• PREFACE
• ESSENTIALS OF PSYCHOANALYSIS
• 1. FREUD AND HIS THEORY OF PERSONALITY
• 2. MODIFIERS OF FREUD’S PERSONALITY THEORY
• 3. A PSYCHOANALYTIC PERSPECTIVE ON PSYCHOPATHOLOGY
• 4. A PSYCHOANALYTIC VIEW OF PSYCHOTHERAPY
• 5. PSYCHOANALYSIS AND RESEARCH
• BIBLIOGRAPHY
• INDEX