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This essay will examine psychoanalytic theory and its associated therapy in terms of the question posed. It will present arguments for and against the statement backed by examples from course materials. After presenting the contrasting arguments the essay will focus towards a conclusion. Source materials used in this essay are course books and course materials. Please see bibliography for details.
The writer believes that psychoanalytic theory and its associated therapy does have a place in today’s society as the same unconscious defence mechanisms still exist, and that derivatives, which are conscious or pre-conscious ideas associatively linked with the unconscious, still play a part in neuroses and society.

By eliminating the element of suggestion and pursuing the expression of deeply
entrenched conflicts which so far have been avoided, psychoanalytical theory
used specifically and in accordance with the client’s needs can go a very great
distance towards helping the client understand himself more fully and lead to an
insight to his current symptoms which otherwise would remain repressed. “The
aim of psychoanalytic intervention is to make the unconscious conscious
through the dissolution of resistances…Using the strict interpretation of the rule
of neutrality there are only three types of interventions available to the Freudian
therapist; silence, management of the environment, and interpretation.” (David L Smith – Individual Therapy, p31).
Sigmund Freud (1856 – 1939) developed the psychoanalytic theory of personality. As a child he saw himself as a general or a statesman, but studied medicine in the pursuit of veneration. After qualifying as a research biologist and neurologist he studied hypnosis with Jean-Martin Charcot and found that hysterical symptoms could be replicated with the use of hypnosis. This was an extremely important breakthrough as hysteria had been viewed as organic in origin. As one surgeon protested to Freud “But, my dear sir, how can you talk such nonsense?

Hysteria means the uterus. So how can a man be hysterical?” (David Stafford-Clark – What Freud Really Said, p18). This view of hysteria reflected the culture of the period. Women suffering from hysteria were viewed as weak silly people. Freud challenged this saying that hysteria was a real sickness.
On returning to Vienna from Paris Freud worked with fellow physician Josef Breuer and started to develop psychoanalysis. One of the most significant discoveries they made was that when hysteria was replicated with hypnosis it was never remembered by the patient or recalled by him through introspection.  This emotionally charged material was buried into the unconscious mind – repression. Freud believed that the real force in peoples behaviour was submerged in the unconscious. By re-living, recalling and releasing the original stuck emotions from the unconscious to the conscious mind abreaction was achieved, but memories and the way they associated with past suffering may continue to dominate.

The consistent theme in the cases studied was repressed sexuality. These
conclusions sparked violent hostility from the medical profession. Breuer
himself, failing to appreciate Freud’s belief that there was a connection between
neuroses and early traumatic events in childhood, eventually split from Freud. In
a letter to his friend, Dr Fliess, Freud wrote “Not long ago Breuer made a big
speech about me at the Doktorenkollegium, in which he announced his
conversion to belief in the sexual aetiology (of the neuroses). When I took him
on one side to thank him for it, he destroyed my pleasure by saying; ‘all the same
I don’t believe it.’ Can you understand that? I can’t.” (David Stafford-Clark – What Freud Really Said, p34).

Breuer’s break from Freud was also exasperated by the sexual attachment which
one of the female patients – Anna O – had for him. From this Freud developed
his theory of transference in which he stated that the concepts of unconscious
mental activity, repression, resistance and transference were the fundamental
pillars of psychoanalysis. Transference is a strange mixture of hostility,
suspicion, affection and jealousy. The client tends to react towards the therapist
in ways in which he reacted to other important figures in his life – positive transference. If dislike or hate are present, then it is termed negative transference. When emotions are projected from the therapist to the client it is counter transference.

As Freud’s work proceeded more and more cases concerning sexual seduction of
the client’s infant years by a parent of the opposite sex were revealed. At first
Freud believed these memories to be real. It was not until later on in his work that he came to the belief that they were in fact fantasies of what the patient feared or wished might happen. These he called screen memories.
Freud eventually stopped using hypnosis saying that it was “too capricious.” The
new approach was known as free-association (freier einfall). Where the client
would lie on a couch with the therapist sitting behind him – to allow unconscious
expression – the patient was encouraged to “let himself go” in what he said, as
you would do in a conversation in which you were rambling on quite
disconnectedly and at random “…He insists that they must include in it whatever
comes into their heads, even if they think it unimportant or irrelevant or nonsensical; he lay special stress in their not emitting any thought or idea…  because to relate it would be embarrassing or distressing to them.” (David L Smith – Individual Therapy, p30).

In association with this Freud also used dream analysis. He believed that all
dreams have a psychological meaning, but the true meaning is disguised wish
fulfilment. The manifest content is the distorted surface of the dream. The latent
part, which contains the real meaning, is that which is unacceptable to the person’s consciousness. Freud said dreams were the “Royal Road” to a knowledge of the unconscious. “You should bear in mind that the dreams which we produce at night have, on the one hand, the greatest external similarity and internal kinship with the creations of insanity, and are, on the other hand compatible with complete health in waking life.” (David Stafford-Clark – What Freud Really Said, p52). With recurring dreams the unconscious was sending unconscious messages to the ego which can be described as disguised fulfilment of repressed wishes. This is known as dream-work. The image carries the meaning – condensation – but is moved from the original object or person onto another – displacement. This is a defence mechanism.
Freud believed there were four ways a dream may begin. They can represent the emotional state of people, including wish fulfilment. Many different and important ideas can be included in a dream. A number of recent or important events may be included in a dream but represented by an impartial memory.

An important or buried memory of an event or idea may occur. This is usually concurrent with someone who is experiencing emotional difficulties.
Symbolism occurs when a latent object appears in a different guise. Some of the
symbols of dreams are connected to sexual desires. Male genitals may be
represented as umbrellas, trees, watering cans, knives, rifles etc., and they may
appear in anxiety dreams. Female genitalia may be represented by boxes, doorways, tunnels etc. In our dreams we ignore the acquired standards of thoughts and behaviour imposed on us by society, so that on waking the dreamer may try to understand what the meanings are – secondary elaboration; or when the dreamer remembers his visual images – dramatisation.
Symbolism indicates more directly as to what the meaning of the dream really
is, as it has not been distorted by the dreamers’ critical factor. “The more the
dream-work succeeds in separating manifest and latent content, the more
incomprehensible will the manifest dream be and, therefore, the more
indispensable the reversal or undoing of the dream-work becomes. The
technique of this reversal is simply free-association to each separate item of the
dream. And the understanding of the specific symbolic language common in varying degree to all dreams.” (David Stafford-Clark – What Freud really Said, p76).

Freud viewed the personality as having three parts or forces. The id – the it – is
the biological foundation and is present from birth and focuses entirely on its
own gratification. Sex and aggression. Freud called it the true psychic reality as
it represents the inner world of subjective experience and no knowledge of
objective reality. The id reduces tensions in the body by operating on the
pleasure principle. In order to do this it has the reflex reaction (ie sneezing and
blinking) and the primary process where it may form a mental picture of food in the form of a memory image. Freud described the libido as the basic unconscious mental energy derived from the id. He felt it was predominantly sexual although he modified this later and the meaning he gave to it was more of life energy or procreation instinct (Eros). The death instinct being known as Thanatos. “In its economic aspects, libido in an individual is regarded as a closed energy system regulated by the physical law of energy conservation, so the libido withdrawn from one area must inevitably produce effects elsewhere.  Hence the psychoanalyst’s conviction that any symptom removed by suggestion (i.e. without release of the energy maintaining it) will make its appearance in some other form; e.g. cessation of smoking may be replaced by over-eating, cessation of habitual masturbation or intercourse by anxiety.” (J. A. C. Brown – Freud and the Post-Freudians, p22).

The ego (the I) begins to develop in the first year of life. This is the part that
must make the external adaptation to reality for the person to go and acquire the
food to sustain the life force. The ego works on the reality principle and so
operates by the way of the secondary process. The reality principle holds the
pleasure principle in abeyance until the food is found – reality testing. Since the
ego is part of the id, its task is to further the ways in which the id receives pleasure by interacting with the external environment.

The super ego (the above I) is the voice if civilisation and restraint, it is the
moral part of the personality representing the ideal as opposed to the real. It
seeks perfection rather than pleasure. It is the conscience, the internalised moral
arbiter of conduct conditioned by parents. This conditioning is introjected into its ego ideal, thus making him feel guilty if he fails at what he “ought to do.” The super ego tried to block the id’s gratification permanently, since sexual expression is condemned by society this can lead to a precarious balancing act by the ego.

Ego defence mechanisms.
Repression:     Forgetting disturbing memories by burying them in the unconscious.
Disavowal/Denial:      Refusing to acknowledge the existence of something which hurts us. May form an irrational idea that it does not exist.
Projection:      Attributing one’s own thoughts or feelings onto someone else, but mirroring the feelings for oneself. At its most extreme this could be paranoia.
Introjection:    This is when a person may unconsciously emulate someone else.
Reversal:         Turning back an attitude or belief onto oneself instead of directing it at the person it was intended for.
Displacement: Redirecting of intense emotions onto someone or something which reminds oneself of the original emotion.
Isolation:         Depriving an emotion of real significance by detaching oneself from it.
Reaction Formation:  This when the person behaves in the opposite way to the way they feel because their real feelings may frighten them.
Rationalisation:          False reasons are made to justify unacceptable attitudes.
Conversion:    Transforming a psychological disturbance into a physical disorder.
Sublimation:   A powerful constructive force which involves repressing the libidinal desires which are later channelled into more socially acceptable pursuits.

After many years of research work Freud believed that the root cause in adult neurotic symptoms stemmed from childhood. This led him to study child psychology. He eventually came to the conclusion that a group of interrelated emotions, aspirations and fantasies were significant. Freud was extremely well read and came across the Oedipus Complex which comes from an ancient Greek legend. Oedipus was the son of King Laius and Queen Jocasta of Thebes.  Because it was predicted that the King would have a son who would kill him Oedipus was sent away to be killed. He escaped and was brought up by another king and queen.

When he grew up Oedipus consulted an oracle who told him that he was fated to
kill his father and marry his mother. He naturally assumed that his foster parents
were his own. He then left. On his travels in Greece he killed a man at a
crossroads arguing about rights of way. This man was his natural father. He then
arrived in the city of his birth and correctly answered a riddle, thus saving the
city from a sphinx. In reward for this he married the queen, his natural mother.  Many years later, after investigating the death of her husband, Oedipus found out that he killed him. He then blinded himself and Queen Jocasta committed suicide.
From the twin themes of incest and patricide Freud believed that children as well as adults have erotic desires in the guise of incestuous fantasies and anxieties.

The pre-genital stages are where an individual may become fixated, thus
affecting adult life. The stages in the first five years of life are the oral stage, the
anal stage and the phallic stage.

The Oral stage. In the early months the infant finds, in order to survive, that he
will need to seek the pleasure of feeding. Sexual instinct is turned inward and pleasure is derived from the mouth – oral satisfaction – this predisposition may well play an important part in life (ie thumb sucking, nail biting, compulsive eating, and biting). If the infant is deprived of mother love he may carry this feeling of deprivation throughout his adult life.

The anal stage. The passing of faeces may be pleasurable and the embryo of anal
eroticism is born. If the mother is strict the child may hold back its passing of
faeces. He may develop a retentive character, being obstinate, mean, destructive,
throw tantrums or be disorderly. However if the child is encouraged and pleaded with to pass faeces this “activity of great importance” may be the launching pad for creativity and productivity.
The phallic stage. Aggressive and sexual feelings to do with the genital organs
come to prominence at this stage. The boy child directs his attentions towards
the mother. He wishes to take his father’s place in his mother’s affections, but is
fearful that the father will castrate him because he is aware that females do not
possess a penis and this may have already happened to them. Castration anxiety
is the force which represses the sexual desire for the mother. Displacing his
sexual impulses towards the mother by identifying with the father, the super ego
benefits by then defending against both incest and aggression. The girl child,
who’s attentions are directed towards the mother, believes that father will punish
her for this. She thinks her clitoris is a stunted penis so then envies the male
genitals – penis envy. She blames her mother for not giving her a penis and
relations between mother and daughter become hostile. Unconsciously the girl
wishes for a baby to compensate for the lack of a penis, and because there is no
castration anxiety she incestuously lusts after the father. Excessive attachment to
either parent, especially one of the opposite sex, may result in narcissistic tendencies which the child in later life may try to duplicate in homosexuality.

Freud felt that the symptoms people suffered from were substitutes for repressed ideas – primary gain. The discomfort is more tolerable that the upset cause by unpalatable conflicts entering consciousness from the unconscious. Secondary gain is the pay-off for avoiding situations. When these conflicts threaten to overwhelm the ego and its defence mechanisms, anxiety occurs.
Freud listed three types:

Reality anxiety is when the danger actual – ie when the person’s life is in imminent danger.
Neurotic anxiety (psychoneurosis) is the fear that control will be lost over
instinct and will cause the person to do something he will be punished for. It is a
fear of the punishment, not of the actions.

Moral anxiety is a well developed super ego which will make the person feel anxious if they have violated their moral code.
Common examples of anxiety include “people who are generally apprehensive,
constantly in a state of fear whose origin they can give no account, or who
develop specific fears, which they know to be absurd, in relation to quite trivial
and ordinary everyday events, such as going out by themselves or remaining
alone in the house, travelling in public transport or sitting other than in the aisle
seat in the theatre. Such patients also suffer characteristic disturbances of
physiological equilibrium including increased heart rate, respiration and blood
pressure; and disturbances of digestive capacity and sleep rhythm.” (David
Stafford Clark – What Freud Really Said, p120). Freud termed this free floating
anxiety. Long standing anxiety may lead to depression, obsession, lack of
confidence, suggestibility, and a feeling of personality disintegration. A phobia
is when the anxiety is projected onto an external thing or situation.  A persistent
irrational thought.

Conclusion
The writer feels that the length of time needed for analysis is in itself a drawback. The client looking for a speedy solution will be disappointed, and the longer analysis continues the greater the chance there is of the client making things up to bring the therapy to a conclusion. This is dangerous. At face value psychoanalysis offers a realistic answer to a lot of problems, but it is very doubtful that it cures. Freud himself said that neurotic misery can only be replaced with ordinary unhappiness.

Many anxiety states are kept alive by the fear of fear. Sensitization is the key to
understanding the anxiety state. When the body is aroused it is in a state in which emotions and nervous responses are greatly intensified. These come with unusual alarming swiftness. Most of us feel it mildly at the end of a day when nerves are on edge. A severely sensitized person feels the symptoms of stress so intensely that an ordinary spasm of fear may be registered as an anxiety attack, Reverberated circuits in the nervous system produce a heightened response usually initiated by fear. The heightened responses of which the sensitized person complains are the usual symptoms of stress and these panic spasms themselves sensitize. Fear – adrenalin – fear. “It is the intensity of these established nervous responses that prevent simple explanation of any deep-seated cause being enough to cure a sufferer, because so often the patient’s recurring anxiety concerns the nervous symptoms themselves, concerning the whipping lash of panic.” (Dr Claire Weekes – Simple Effective Treatment of Agoraphobia, p13). Understanding, support and knowledge of anxiety are vitally important in helping to cure the sufferer.

The strict stance taken by the Freudian therapist represents the Edwardian attitude of it’s origin, whereas the openess of today’s society requires a more humanistic approach. A person-centred approach would be of much more benefit to the lonely, depressed individual who would need the time and space to rediscover himself and, more importantly, see the world in a new light, and hopefully rediscover faith in his fellow man through the therapist’s empathy.  Freud viewed the unconscious mind as a seething cauldron of repressed emotions and sexual desires. The writer however believes the unconscious to be a source of great wisdom and knowledge which is there to protect and help us.
It is widely recognised that Freud did not keep thorough records of what his
patients said and did during therapy, and would work from notes made several
hours after the session had ended, so it is very difficult to determine the truth
with his analysis. To attribute perverted wishes on all human beings, particularly
in the Edwardian era where sex was a taboo subject, indicates that Freud himself may have been obsessed with sex. “The name most frequently connected with interview therapy is, of course, that of Sigmund Freud. Psychoanalysis has since been modified, expanded or variously transformed, particularly by auxiliary techniques which go far beyond what was available in the early years.” (Perls et al – Gestalt Therapy, p11)

The writer believes that in today’s society there is a great number of therapies
which deal purely with the symptoms of the person from meditation,
behaviourism through to inappropriate issuing of anti-depressants. the great
majority of people who have had good health and then experience some form of
neurotic suffering will wish to know why this has come about. It would be
wrong to be dismissive of the sexual element as a causal factor in a great many
peoples problems. Many phobias can be a displacement from the original
anxiety provoking incident. Freud initially got it wrong when he suspected
widespread incest, but the fact does remain that in today’s society there is a great
deal of sexual abuse, usually in the family circle. It would without this
knowledge be very easy to be superficially dogmatic in dismissing
psychoanalysis and its theories and to feel that they never did have, or do have,
any place in the “real world.” Of course Freud would argue that this is an ego
defence mechanism and, as with Freudian theory in general, it would be very
difficult to disprove. T

he same avoidance of not wanting to face the basic
instincts of sexual gratification and procreation are as taboo a subject now as
they were in Viennese society. Sexual abuse can affect anyone and although it
may be slightly more recognised it is still treated with disdain. How many times
does a person think about sex in the course of a day, and how many times do
they talk about it? “Dirty” jokes are either looked upon disparagingly or tittered
at with a touch of hypocrisy.

The writer is of the opinion that Freud’s concept of repression is brilliant.
Psychotherapists do not have to go looking for the sexual element in their case
histories. The broad minded eclective therapist with an understanding and
knowledge that everything is possible will get the desired results for his clients.

Dream analysis and hypno-analysis have extreme relevance on today’s society. It
is not so much Freud’s theories which are wrong, but the reaction with which
they have been greeted. Freud was before his time, it is doubtful if he would
ever be allowed to be ahead of his time. “Freud himself was a sincere and
generous man, as well as a genius. All his life he had looked upon human frailty
without revulsion and without contempt. He had struggled to help man find a
way to elevate himself above the savage beast, which, through no fault of his
own, is always part of him…But just as he accepted man as he was, and strove to
make him more free, more responsible, and therefore more noble, so Freud would never accept that man’s inherent guilt should be a reason for blaming him.” (David Stafford Clark – What Freud Really Said, p201).

 

Robin Thorburn