Of Freud’s many contributions to Psychology, his idea that the unconscious mind is a driving force behind personality and development is perhaps his most enduring. The field he created, called Psychoanalysis, is both a theory of the human mind and a method of treatment for psychological disorders. In Freud’s view, unconscious impulses exist in constant conflict with conscious thoughts, and this is the root cause of neurotic symptoms. These conflicts may stem from difficulties during childhood development, producing a fixation or unresolved emotion which the conscious ego now works to repress in adulthood.
As Psychoanalysis has evolved, Freud’s early ideas about the role of sexual impulses within the unconscious have been lessened by his successors while the techniques of the psychoanalyst have been adapted and refined. Modern psychoanalysis, however, remains centered on the unconscious impulses, fixations, repressions and ego-defenses that play out over a series of developmental stages and into adult life.
Despite a century of debate and substantial derision of psychoanalysis, Freud’s school of thought continues to be a key topic within the field of Psychology. Remarkably, many of its concepts have since been observed in empirical studies of more recent therapeutic approaches like cognitive behavioral research and neuropsychology. However, scholarship produced in recent decades reveals an understanding of psychoanalysis that differs somewhat from where it all began in Freud’s writings and on his couch.
The first is that, despite Freud’s assertions, psychoanalysis is not a true science. The second is that psychoanalysis is a process that depends on a therapeutic relationship between the analyst and the analysand (the psychoanalytic word for patient), which is shaped by the unconscious drives and ego-defenses of both participants. Third, it is the patient, not the analyst, who ultimately holds the keys to unlocking the unconscious and ideally achieving self-discovery.
Results may vary
Unlike a scientific field of study, which would seek objective, measurable and repeatable results that could be applied to broader populations of people, psychoanalysis is mainly focused on addressing the individual patient. Freud believed that the unique context provided by a patent’s biographical stories shaped the psychoanalytic approach and should therefore replace objective methods.
In this regard, psychoanalysis can best be likened to a study of personal history that attempts to determine not only what happened in a patient’s life but what motivated those events and how the patient wished to interpret them, then and now. In other words, what is gleaned from a patient’s history – and interpreted from a person’s unconscious – will differ in each case, and so then must the technique of the analyst.
Because of the individualized nature of psychoanalytic practice, results may vary as well. This has led to the frequent criticism of psychoanalysis from medical and academic communities that have long viewed Freudian psychology with skepticism for a lack of empirical evidence to support its many claims. When challenged, psychoanalysts have typically resisted efforts to examine the psychoanalytic process in action, leading to an external reputation for defensiveness and secrecy, as well as internal division within the field itself.
This resistance to more rigorous study is not necessarily born out of fear that psychoanalysis will fail to measure up under scientific scrutiny. Instead, some Freudians believe that such examination of the psychoanalytic process would influence or taint the technique. Again, this points to the reality that psychoanalysis is not grounded in science. By definition, a science must involve defined methods that are repeatable. If a process cannot be observed, or its results cannot be measured, then it cannot be considered scientific.
This is a truth that would have greatly upset Freud, who was trained as a medical doctor and specialized in neurology. As the founder of psychoanalysis, he vehemently maintained the scientific underpinnings of his work until his death.
A Shared Experience
If not a scientific method, then what is psychoanalysis and how does it work? One answer lies in Freud’s theory of transference, or the unconscious projection of emotions between analyst and patient. Transference takes place as interactions trigger ego-defense mechanisms in both individuals. The patient may, for example, project relational issues with a parent onto the therapist who is now taking on the role of a caregiver. In turn, the therapist may inadvertently respond to the patient’s behaviors or thoughts through an unconscious lens of their own, which is known more specifically as countertransference.
This effect is natural and common, but likely to produce ruptures in the therapeutic relationship which must be recognized and repaired. This phenomenon can be observed not only in psychoanalysis, but also in empirically tested techniques where it has been demonstrated that the strength of the transference relationship actually predicts the success of therapy.
In this light, it is clear that the practice of psychoanalysis is not simply an examination of the patient, or a corrective procedure akin to a medical surgery or physical therapy. Psychoanalysis is a shared experience in which both the patient and the analyst provide the context for interpretation, which in turn guides the process toward deeper understanding. For this reason, Freud insisted that the psychoanalyst and the patient embark on a journey together.
As a practitioner, Freud saw his role as something of an observer, or more accurately an investigator, along for the ride and helping the patient work through the experience. This process can have a profound effect on both the patient and the analyst. Here again is recognition that psychoanalysis is a technique dependent on a relationship, and the analyst must be able to recognize and adapt to ego-defense mechanisms in both the patient and himself in order to achieve therapeutic results.
We Are the Dreamers of Dreams
As Willy Wonka once told the guests at his chocolate factory, “We are the music makers, and we are the dreamers of dreams.” This quote has special significance in regard to psychoanalysis, which depends critically on the patient for interpretive material and associations. Freud believed that his role as a psychoanalyst was to interpret the unconscious wishes of the analysand and bring them to light, and his favored method of exploring the unconscious was dream interpretation.
In this technique, recalled dreams and subsequent associations with dream images provided by the patient are key to discerning their hidden meanings. While Freud believed that he needed to take an active role to interpret the symbols of his patients’ dreams, psychoanalysts have since observed that it is actually the dreamer who does most of the work to decipher their dreams. Therefore, there can be no master list of dream images and their meanings which would apply to all people or situations, for example. This highlights once again the unscientific and individualized practice of psychoanalysis, but also the extent to which effort from the analysand is necessary to provide the context for analysis.
A modern view to psychoanalysis grows out of these observations which differs from Freud’s initial, hands-on approach. Dream interpretation remains of interest to psychoanalysts, but some therapists have found greater success with this method by lessening the role of the analyst as interpreter or judge of dream symbols and associations. While the analyst may still need to act as a guide during the process, directing focus and navigating the transference relationship as it unfolds, it may not be necessary for the analyst to directly decipher on behalf of the patient as Freud initially believed.
Indeed, empirical evidence suggests that fewer interpretations made by the analyst will result in more effective therapy, particularly in less disturbed patients. Therefore, the purpose of dream interpretation is less to unlock a specific truth from a dream image and more about allowing the free associations offered by the patient to provide a path toward deeper and more meaningful understanding.
Modern Relevance of Freudian Psychoanalysis
Freud's theories, like anything that's been through the shredder of media and pop culture, is often oversimplified. In addition to the pop-psych understanding of his work, there is also the issue that he deals with sex. As Freud rightly noted, people are obsessed with sex, and so there is rarely any deeper discussion of Freud beyond the more titillating things he said. This characterization doesn't do him justice.
I find Freud much more applicable when not taken literally. If one considers what he was trying to say, rather than how he said it, it becomes clear that he had some useful insight into what makes people neurotic, obsessed, and otherwise anxious. There's no doubt that his ideas about the unconscious, repression, defense mechanisms, and transference were pretty solid concepts. Not only can these be observed in everyday life, but some of these theories, such as transference, have been seen in empirical research since Freud first popularized them.
That said, I'm not so sure that psychoanalysis is the most useful method for dealing with people with debilitating mental disorders. The "talking cure" of psychoanalysis, which depends on interpretation of unconscious associations, is probably not well suited for the schizophrenic, for example, or those who may not be able to fully engage in the process. In less-severe cases of mental illness, whether depression or obsessive-compulsive disorder, there is a chance psychoanalysis could work but it's likely to take a long time. Many people simply don't have the time and money to see it through to the end, which is why a combination approach with other types of behavioral therapies and medications is often chosen.
In my view, Psychoanalysis is most useful in dealing with people in general. In many ways, what Freud was addressing as "neurosis" is often symptoms of being human, and especially in modern society. Everyone is experiencing these phenomena to some degree, and most are not crippled with anxiety over their unconscious impulses or ego defenses -- but they are still there, and they still play a role, and they still make us unsettled and maladjusted sometimes.
Understanding Freud can be helpful in understanding people in the most basic way -- in realizing that everyone has something more going on under the surface.