What are the main features of psychoanalysis

Historical

Freud’s discovery and development of psychoanalysis as theory and therapy of psychological disorders was historically ground breaking. The psychodynamic psychotherapies derive from psychoanalysis. There are differences, but there are significant similarities.

Clinical

1. Therapeutic situation. Patients in analysis lie on a couch with the analyst seated behind out of the patient’s field of vision. In psychoanalytic psychotherapy, patients and analysts are seated face-to-face.
2. Basic rule. Both psychoanalysis and psychoanalytic psychotherapy employ the basic rule of free association whereas, for example, counselling does not. Patients are asked to communicate whatever thoughts, imaginings, memories occur to them and whatever feelings may be aroused in them during each session.
3. Frequency. Psychoanalysis has a frequency of three to five sessions per week. Psychoanalytic psychotherapy has a frequency of one to three sessions per week. Frequency is a function of the depth and intensity of the therapeutic work needed.
4. Transference. Transference consists of the repetition of neurosis generating conflicts with parents and siblings in the patient’s relation to the therapist. It occurs in and is useful therapeutically in both psychoanalysis and psychoanalytic psychotherapy.
5. Non-judgemental evenly suspended attention. Analysts and psychoanalytic psychotherapists are non-judgemental. Their orientation is one of attentive listening to the patient no matter where the patient’s associations may lead and whatever the patient’s transference thoughts and feelings may be. The patient’s sexual and aggressive feelings and emotions are especially important.
6. Interpretation. Analysts and psychoanalytic psychotherapists seek to improve their patient’s self-understanding by interpreting psychological defences that inhibit their ability to become aware of the motivations of their attitudes, beliefs, relations and actions – the inner sources of their symptoms, inhibitions and moods. Analysts and psychoanalytic psychotherapists interpret these motivations to facilitate their becoming less conflicted and more maturation.

Theoretical

There are currently several psychoanalytic theoretical orientations which overlap but with differences:

• Classical Freudian theory is the mainstream orientation albeit modified (for example, using Freud’s earlier rather than later theory of aggression),
• Kleinian theory retains Freud’s theory of aggression as a death instinct,
• Self-psychology and the primacy of narcissism rather than object love,
• Relational psychology without or with a modified classical drive theory.

 
The theoretical differences involved are significant but adherents of these theories employ them equally in both psychoanalysis and psychoanalytic psychotherapy and share the elements of the clinical technique enumerated above. These theoretical differences do not alter the basic clinical similarities between psychoanalytic psychotherapy and psychoanalysis: free associations, transference, non-judgemental attention and their interpretation. The differences have to do with frequency, duration and the therapeutic set-up.

Psychoanalysis is a method of therapy in which the patient talks about experiences, early childhood, and dreams.

Psychoanalysis refers to both a theory and a type of therapy based on the belief that all people possess unconscious thoughts, feelings, desires, and memories.

According to the American Psychoanalytic Association (APA), psychoanalysis can help people understand themselves by exploring their unrecognized impulses hidden in the unconscious.

In psychotherapy, people are able to feel safe as they explore feelings, desires, memories, and stressors that can lead to psychological difficulties. Research has demonstrated that the self-examination utilized in the psychoanalytic process can contribute to long-term emotional growth.

Psychoanalysis Theories

Psychoanalysis is based on Freud’s theory that people can experience catharsis and gain insight into their state of mind by bringing the content of the unconscious into conscious awareness. Through this process, a person can find relief from psychological distress.

Psychoanalysis also suggests that:

• A person’s behavior is influenced by their unconscious drives.
• Emotional and psychological problems such as depression and anxiety are often rooted in conflicts between the conscious and unconscious mind.
• Personality development is heavily influenced by the events of early childhood (Freud suggested that personality was largely set in stone by the age of five).
• People use defense mechanisms to protect themselves from information contained in the unconscious.

Skilled analysts can help a person bring certain aspects of their unconscious mind into their conscious awareness by using psychoanalytic strategies such as dream analysis and free association.

History of Psychoanalysis

Many of Freud’s observations and theories were based on clinical cases and case studies. This made his findings difficult to generalize to the larger population. Still, Freud’s theories changed how we think about the human mind and behavior and left a lasting mark on psychology and culture.

Freud’s theories of psychosexual stages, the unconscious, and dream symbolism are still popular among both psychologists and laypeople, but others view his work with skepticism.

Today, psychoanalysis encompasses:

• Applied psychoanalysis (which applies psychoanalytic principles to the study of art, literature, and real-world settings and situations)
• Neuro-psychoanalysis (which applies neuroscience to psychoanalytic topics such as dreams and repression)
• Psychoanalytic therapy

Although traditional Freudian approaches have fallen out of favor, modern approaches to psychoanalytic therapy emphasize a non-judgmental, empathetic approach.

Important Milestones

• 1856 – Sigmund Freud was born
• 1882 – Josef Breuer described the case of Anna O to Freud
• 1886 – Freud first began providing therapy
• 1895 – Anna Freud was born
• 1900 – Sigmund Freud published his book The Interpretation of Dreams
• 1896 – Sigmund Freud first coined the term psychoanalysis
• 1908 – The Vienna Psychoanalytic Society was formed and the first international meeting of psychoanalysts was held
• 1909 – Freud made his first and only trip to the United States
• 1910 – The International Psychoanalytic Association was formed
• 1913 – Jung broke from Freud and psychoanalysis
• 1938 – The Vienna Psychoanalytic Society was dissolved
• 1939 – Sigmund Freud died in London following a long battle with oral cancer

Psychoanalysis Theorists

Sigmund Freud was the founder of psychoanalysis and the psychodynamic approach to psychology. Freud believed that the human mind was composed of three elements: the id, the ego, and the superego.

Other thinkers—including his own daughter, Anna Freud—also left a significant mark on the field. Among the most prominent names in psychoanalysis were Erik Erikson, Erich Fromm, and Carl Jung

Erik Erikson expanded on Freud’s theories and stressed the importance of lifelong growth. Erikson’s psychosocial stage theory of personality remains influential today in our understanding of human development.

Karl Abraham, Otto Rank, John Bowlby, Melanie Klein, Karen Horney, and Sabina Spielrein were also key contributors to the evolution of psychoanalytic theory.

Key Ideas

Psychoanalysis also involves a number of different terms and ideas related to the mind, personality, and treatment.

Case Studies

A case study is defined as an in-depth study of one person, group, or event. Some of Freud’s most famous case studies include Dora, Little Hans, and Anna O. These cases had a powerful influence on the development of his psychoanalytic theory.

In a case study, the researcher attempts to intensely examine every aspect of an individual’s life. By closely studying a person, a researcher can gain insight into how an individual’s history contributes to their current behavior.

Although the hope is that the insights gained from a single case study could apply to others, it is difficult to generalize the results, because case studies tend to be highly subjective. In some instances, the factors involved in a particular case are so individualized that they may not apply to others.

The Conscious and Unconscious Mind

The unconscious mind includes all of the things that are outside of our conscious awareness, such as early childhood memories, secret desires, and hidden drives. According to Freud, the unconscious contains things that we might consider to be unpleasant or even socially unacceptable. We bury these things in our unconscious because they might bring us pain or conflict.

While these thoughts, memories, and urges are outside of our awareness, they still influence how we think and behave. In some cases, the things that are outside of our awareness can influence behavior in negative ways and lead to psychological distress. 

The conscious mind, on the other hand, includes everything that is inside of our awareness. The contents of the conscious mind are the things we are aware of or can easily bring into awareness.

Unconscious Mind

• Thoughts, urges, or feelings that are unpleasant, difficult, or even socially unacceptable.

• Buried because they can bring about pain or conflict.

• Can sometimes be brought into awareness using certain techniques.

Conscious Mind

• Thoughts, feelings, and urges that we are aware of or can easily bring into awareness.

• Not hidden or suppressed.

• May be influenced by unconscious thoughts, feelings, or memories.

The Id, Ego, and Superego

Freud believed that an individual’s personality had three components: the id, the ego, and the superego.

Id

The first of the key elements of personality to emerge is known as the id. The id contains all of the unconscious, basic, and primal urges.

Ego

The second aspect of personality to emerge is known as the ego. This is the part of the personality that must deal with the demands of reality. It helps control the urges of the id and makes us behave in ways that are both realistic and acceptable.

Rather than engaging in behaviors that are designed to satisfy our desires and needs, the ego forces us to fulfill our needs in ways that are socially acceptable and realistic. In addition to controlling the demands of the id, the ego also helps strike a balance between our basic urges, our ideals, and reality.

Superego

The superego is the final aspect of personality to emerge, and it contains our ideals and values. The values and beliefs that our parents and society instill in us are the guiding force of the superego and it strives to make us behave according to these morals.

The Ego’s Defense Mechanisms

Defense mechanisms are strategies that the ego uses to protect itself from anxiety. These defensive tools act as a safeguard to keep unpleasant or distressing aspects of the unconscious from entering our awareness. When something is experienced as overwhelming or even inappropriate, defense mechanisms keep the information from entering our consciousness, which minimizes our distress.

Strengths and Weaknesses

Over the course of the early 20th century, the influence of psychoanalysis grew. However, it was not without critics. Despite its flaws, psychoanalysis continued to play a key role in the development of psychology. It influenced our approach to treating mental health conditions and continues to exert an influence on psychology today. 

Strengths

• Even though most psychodynamic theories did not rely on experimental research, the methods and theories of psychoanalytic thinking contributed to the development of experimental psychology.
• Many of the theories of personality developed by psychodynamic thinkers, such as Erikson’s theory of psychosocial stages and Freud’s psychosexual stage theory, continue to influence the field today.
• Psychoanalysis opened up a new view on mental illness, particularly that talking through problems with a psychoanalytic professional could help alleviate a person’s psychological distress. 

Weaknesses

• Freud’s theories overemphasized the unconscious mind, sex, aggression, and childhood experiences.
• Many of the concepts proposed by psychoanalytic theorists are difficult to measure and quantify.
• Most of Freud’s ideas were based on case studies and clinical observations rather than empirical, scientific research.

Support and Criticism

Many of the criticisms of psychodynamic approaches are based on the earlier Freudian approaches to treatment. Many people are skeptical of psychoanalysis because the evidence supporting its effectiveness has often been viewed as weak. One of the critics’ main arguments is that it’s not as effective as other treatments.

More recently, however, research has demonstrated that this approach can have a number of benefits. One systematic review of previous studies concluded that psychoanalytic therapy was an effective treatment that resulted in the reduction of symptoms and long-term changes that persisted for years after treatment ended.

A 2015 review found that psychodynamic therapy could be effective in the treatment of a number of conditions include:

• Depression
• Eating disorders
• Somatic disorders
• Some anxiety disorders

Another critique is that psychoanalysis often requires an investment of time, money, and effort. Psychoanalysis is also generally a long-term proposition. In the world we live in today, people are usually seeking fast results and approaches that yield an effect in days, weeks, or months. Psychoanalytic therapy typically involves a client and therapist exploring issues over a period of years.

Susan Krauss Whitbourne, PhD

Using the criteria established for evidence-based treatment, traditional psychoanalysis alone does not, in fact, pass muster as a method of therapy for the large majority of psychological disorders. However, to dismiss Freud’s contributions as irrelevant to psychology…is an oversimplification.

— Susan Krauss Whitbourne, PhD

Past and Present

Many of Freud’s ideas have fallen out of favor in psychology, but that certainly does not mean that his work is without merit. Research also supports at least some of Freud’s original ideas.

His approach to therapy (specifically, the suggestion that mental illness was treatable and that talking about problems could bring relief) was a revolutionary concept that changed how we approach the treatment of mental illness.

“Reviews of neuroscientific work confirm that many of Freud’s original observations, not least the pervasive influence of non-conscious processes and the organizing function of emotions for thinking, have found confirmation in laboratory studies,” explained Peter Fonagy in an article published in World Psychiatry.

Sigmund Freud was also very much a product of his time. Although he was known for his audacious theories (which were considered especially shocking in the Victorian period), his view of the world was colored by the time in which he lived. If Freud were alive today, his ideas might be regarded very differently—and his own work would likely take a different direction.

Some have suggested that if Freud were alive today, he would likely be interested in topics related to brain functioning. Prior to the development of psychoanalysis, Freud’s interests had centered on developing a neural model of behavior. Researchers today also suggest that the neurobiological underpinnings of psychoanalysis are worth further exploration.

Susan Krauss Whitbourne, PhD

Psychologists today talk about the psychodynamic, not the psychoanalytic perspective. As such, this perspective refers to the dynamic forces within our personalities whose shifting movements underlie much of the basis for our observable behavior. Psychoanalysis is a much narrower term referring to the Freudian-based notion that to understand, and treat, abnormal behavior, our unconscious conflicts must be worked through.

— Susan Krauss Whitbourne, PhD

Psychoanalysis as Freud conceived it might be on the decline, but that does not mean that the psychodynamic perspective has disappeared or that it will be going anywhere soon.

Psychoanalysis Today

If you ask someone what comes to mind when they think of psychology, Sigmund Freud and psychoanalysis are likely to be common responses. There is no question that psychoanalysis—both as a therapeutic approach and theoretical outlook—has left its mark on psychology.

Most psychologists today employ a more eclectic approach to the field of psychology, though there are some professionals who still take a purely psychoanalytical point of view on human behavior.

Many contemporary psychologists view psychoanalysis with skepticism. Some even feel derision toward Freud’s school of thought. In a world of psychology where cognitive processes, neuroscience, and biopsychology dominate, is there still room for psychoanalysis?

In general, there is a perceived decline in traditional psychoanalysis. A report published by the APsaA in 2008 found that psychology departments typically treat psychoanalysis as a purely historical artifact, while subjects such as art, literature, history, and other humanities were more likely to teach psychoanalysis as an ongoing and relevant topic.

Some suggest that psychoanalysis has fallen by the wayside as an academic topic within psychology partly because of its failure to test the validity of its therapeutic approach and earlier failures to ground the discipline in evidence-based practices.

The Future of Psychoanalysis

There are a few things that psychoanalysis as a field can do to ensure its continued relevance in the world of psychology. Some things that can help improve the legitimacy and relevance of psychoanalytic methods include:

• Place a greater emphasis on scientific research and empirical evidence.
• Explore evidence-based treatments in greater depth.
• Improve data-gathering methods.
• Give greater consideration of other possible explanations for behavior.
• Collaborate actively with other mental health professionals.

Some current efforts to revitalize psychoanalysis focus on psychoanalytic concepts that are more evidence-based (such as attachment theory) or on connecting Freud’s idea of the unconscious to modern neuroscience.

A Word From Verywell

Freud’s mark on psychology is still felt today. Talk therapy is most often associated with psychoanalysis, but therapists also use the technique in other approaches to treatment, including client-centered therapy and group therapy.

Psychoanalysis might not be the force it was back in 1910, but Freud’s theories have had a lasting influence on both popular culture and psychology.