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Psychoanalysis

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Psychoanalysis
Concepts
Important figures
Important works
Schools of thought
Training
See also

Psychoanalysis today comprises several interlocking theories concerning the functioning of the mind; the term also refers to a specific type of treatment where the analyst, upon hearing the thoughts of the analysand (analytic patient), formulates and then explains the unconscious bases for the patient's symptoms and character problems. Unconscious functioning was described by Sigmund Freud, who modified his theories several times over a period of almost 50 years of attempting to treat patients who suffered with mental problems. During psychoanalytic treatment, the patient tells the analyst various thoughts and feelings. The analyst listens carefully, formulates, then intervenes to attempt to help the patient develop insight into unconscious factors causing the problems. To be treated with psychoanalysis, the patient must have sufficient abstraction ability and capacity to realistically organize thought. The specifics of the analysts interventions include confronting and clarifying the patient's pathological defenses, wishes and guilt. Through the analysis of resistance (unconscious barriers to treatment), transference onto the person of the analyst of expectations, wishes and emotions, from prior unresolved conflicts, is often unearthed, and can be quite helpful to the patient (cf. James Strachey's famous paper from 1936 on "mutative" interpretations). Proponents of the practice believe that past patterns of relating that are no longer serviceable or that inhibit freedom of choice are thereby relieved.

Although psychoanalysis-bashing has become popular,[1] psychoanalysis has been thriving as a research tool into childhood development (cf. the journal The Psychoanalytic Study of the Child), and has developed into a flexible, effective treatment for certain mental disturbances (see Wallerstein's (2000)Forty-Two Lives in Treatment: A Study of Psychoanalysis and Psychotherapy). In the 1960s, Freud's early (1905) thoughts on the childhood development of female sexuality were challenged; this challenge led to major research in the 1970s and 80s, and then to a reformulation of female sexual development that corrected some of Freud's concepts.[2]

Today, there are approximately 45 accredited training institutes for psychoanalysis in the United States (see www.apsa.org), and there are over 3,000 graduated psychoanalysts practicing in the United States. The International Psychoanalytical Association accredits psychoanalytic training centers throughout the world, including countries such as Serbia, France, Germany, Austria, Italy, Switzerland, and many others, and is a fast-growing organization.

Origins

Psychoanalysis was devised in Vienna in the 1890s by Sigmund Freud, a neurologist interested in finding an effective treatment for patients with neurotic or hysterical symptoms. Freud became sensitized to the existence of mental processes that were not conscious as a result of his neurological consulting job at the Kinderkrankenhaus (Children's Hospital), where he noticed that many aphasic children had no organic cause for their symptoms. (He wrote a monograph about this, called, "On Aphasia.") He also became aware of the experimental treatment (combination of hypnotism and "catharsis" done by "abreaction") his older mentor and colleague, Dr. Josef Breuer, was using to treat the now famous patient, Anna O. In the late 1880s, Freud obtained a grant to study with Jean-Martin Charcot, MD, the famed syphilologist, at the Salpetriere in Paris. Dr. Charcot had become interested in patients who had symptoms that mimicked general paresis, the psychotic illness that occurs due to tertiary syphilis. Charcot had found that many patients experienced paralyses, pains, coughs, and a variety of other symptoms with no demonstrable physical etiology (cause). Prior to Charcot's work, women were thought to have a wandering uterus (the name hysteria means this in Greek). But Freud learned that men could have psychosomatic symptoms as well. As a result of talking with patients, Freud learned that the majority complained of sexual problems (especially coitus interruptus as birth control), which surprised him greatly. He first suspected their problems stemmed from cultural restrictions on sexual expression, and devised what today is called "topographic theory," in 1895. In this theory, which he later more or less discarded (in 1923), unacceptable sexual wishes were repressed into the unconscious due to their clash with "society," and this repression created anxiety. Freud also discovered what most of us take for granted today: that dreams were symbolic and specific to the dreamer. Often, dreams give clues to unconscious conflicts, and for this reason, Freud referred to dreams as the "royal road to the Unconscious." After several theoretical modifications, the discovery of narcissism (1915), and the study of paranoia, masochism, and depression (1917), Freud eventually reorganized his data into what became known as structural theory (in a small book called "The Ego and the Id" 1923). This theory, which addressed the cause of neurotic symptoms (phobias, compulsions, obsessions, depressions, e.g.), suggested that such problems included various wishes, guilt, anxiety, and that to handle the anxiety, the mind forgot (repressed) certain conflictual thoughts. In other words, now he felt that anxiety produced repression, not the other way around.

Theories

The predominant psychoanalytic theories include

  • Conflict Theory, which theorizes that emotional symptoms and character traits are complex solutions to intrapsychic conflict. See Brenner (2006) "Psychoanalysis: Mind and Meaning" NY: Psychoanaltyic Quarterly Press. This revision of Freud's structural theory (Freud, 1923, 1926) dispenses with the concepts of a fixed id, ego and superego, and instead posits unconscious and conscious conflict among wishes (dependant, controlling, sexual, and aggressive), guilt and shame, emotions (especially anxiety and depressive affect), and defensive operations that shut off from consciousness some aspect of the others. Moreover, healthy functioning (adaptive) is also determined, to a great extent, by resolutions of conflict. A major goal of modern conflict theorist analysts is to attempt to change the balance of conflict through making aspects of the less adaptive solutions (also called compromise formations) conscious so that they can be rethought, and more adaptive solutions found. Current theoreticians following Brenner's many suggestions (see especially Brenner's 1982 book, "The Mind in Conflict") include Sandor Abend, MD (Abend, Porder, & Willick, 1983, "Borderline Patients: Clinical Perspectives"), Jacob Arlow, MD (Arlow and Brenner, 1964, "Psychoanalytic Concepts and the Structural Theory"), and Jerome Blackman, MD (2003, "101 Defenses: How the Mind Shields Itself"). Conflict theory is the prevalent analytic theory taught in psychoanalytic intitutes, throughout the United States, accredited by the American Psychoanaltyic Association.
  • Ego Psychology, which has a long history. Begun by Freud in "Inhibitions, Symptoms, and Anxiety," in 1926, the theory was refined by Hartmann, Loewenstein, and Kris in a series of papers and books from 1939 through the late 1960s. Leo Bellak picked up the work from there. This series of constructs, parallelling some of cognitive theory, includes the notions of autonomous ego functions: mental functions not dependant, at least in origin, on intrapsychic conflict. Such functions include: sensory perception, motor control, symbolic thought, logical thought, speech, abstraction, integration (synthesis), orientation, concentration, judgment about danger, reality testing, adaptive ability, executive decision-making, hygiene, and self-preservation. Freud noted inhibition as a way the mind may interfere with any of these functions to avoid painful emotions. Hartmann (1950s) pointed out that there may be delays or deficits in such functions. Frosch (1964) described differences in those people who demonstrated damage to their relationship to reality, but who seemed able to test it. Deficits in the capacity to organize thought are sometimes referred to as blocking or loose associations (Bleuler), and are characteristic of the schizophrenias. Deficits in abstraction ability and self-preservation also suggest psychosis in adults. Deficits in orientation and sensorium are often indicative of a medical illness affecting the brain (and therefore, autonomous ego functions). Deficits in certain ego functions are routinely found in severely sexually or physically abuse children, where powerful affects generated throughout childhood seem to have eroded some functional development. Ego strengths, later described by Kernberg (1975), include the capacities to control oral, sexual and destructive impulses; to tolerate painful affects with falling apart; and to prevent the eruption into consciousness of bizarre symbolic fantasy. Defensive activity, which shuts certain conflictual thoughts,fantasies, and sensations out of consciousness, is also sometimes included here, although defensive operations are different from autonomous functions. Nevertheless, the term "ego defense" has become common.
  • Object relations theory, which stresses the dynamics of one's relationships with internal, fantasized, others; although often attributed to Melanie Klein, actually Sigmund Freud began the work on intrapsychic representations of others with his early concepts of drive theory (1905, "Three Essays on Sexuality"). Freud's 1917 paper, "Mourning and Melancholia", for example, hypothesized that unresolved grief was caused by the survivor's internalized image of the deceased becoming fused with that of the survivor, and then the survivor shifting unacceptable anger toward the deceased onto the now complex self image. Vamik Volkan, MD, in "Linking Objects and Linking Phenomena," expanded on Freud's thoughts on this, describing the syndromes of "Established pathological mourning" vs. "reactive depression" based on similar dynamics. Melanie Klein's hypotheses regarding internalizations during the first year of life, leading to paranoid and depressive positions, were later challenged by Rene Spitz (e.g., The First Year of Life, 1961), who divided the first year of life into a coenesthetic phase of the first 6 months, and then a diacritic phase for the second 6 months. Margaret Mahler, MD (Mahler, Fine, and Bergman, 1975, "The Psychological Birth of the Human Infant") and her group, first in NY, then in Phila, described distinct phases and subphases of child development leading to "separation-individuation" during the first three years of life, stressing the importance of constancy of parental figures, in the face of the child's destructive aggression, to the child's internalizations, stability of affect management, and ability to develop healthy autonomy. Later developers of the theory of self and object constancy as it affects adult psychiatric problems such as psychosis and borderline states have been John Frosch, MD, Otto Kernberg, MD, and Salman Akhtar, MD. Peter Blos, Ph.D. described (1960, in a book called "On Adolescence) how similar separation-individuation struggles occur during adolescence, of course with a different outcome from the first 3 years of life: the teen usually, eventually, leaves the parents' house (this varies with the culture). During adolescence, Erik Erikson (1950, 1960s) described the "identity crisis," that involves identity-diffusion anxiety. In order for an adult to be able to experience "Warm-ETHICS" (warmth, empathy, trust, holding environment (Winnicott), identity, closeness, and stability) in relationships -- [see Blackman, 2003 "101 Defenses: How the Mind Shields Itself"], the teenager must resolve the problems with identity and redevelop self and object constancy.
  • Structural Theory, which breaks the mind up into the id, the ego, and the superego. Actually, in German, the word id means "it." The word ego was coined by Freud's translators; Freud used the term, "ich" meaning "I" in English. Freud called the superego the "Uber-ich." The id was designated as the repository of sexual and aggressive wishes, which Freud called "drives." The ego was composed of those forces that opposed the drives -- defensive operations. The superego was Freud's term for the conscience -- values and ideals, shame and guilt. One problem Brenner (2006) later found with this theory (see above) was that Freud also suggested that forgotten thoughts ("the repressed") were also "located" in the id. However, Freud here realized that drives could be conscious or unconscious, and that consciousness vs. unconsciousness was a quality of any mental operation or any mental conflict. Forgetting things could be done on purpose, or not. People could be aware of guilt, or not aware.
  • Self psychology, which emphasizes the development of a stable sense of self through mutually empathic contacts with other humans, was developed originally by Heinz Kohut, MD, and has been elucidated by the Ornsteins and Arnold Goldberg. Marian Tolpin explicated the need for "transmuting internalizations" (1971) during treatment, to correct what Kohut referred to as a disturbance in the "self-object" internalizations from parents.
  • Interpersonal psychoanalysis, which accents the nuances of interpersonal interactions, was first introduced by Harry Stack Sullivan, MD, and developed further by Frieda Fromm-Reichmann, MD. It is the primary theory, still taught, at the William Alanson White Center.
  • Relational psychoanalysis, which combines interpersonal psychoanalysis with object-relations theory as critical for mental health, was developed primarily by Stephen Mitchell. His suggestions for technique applied to patients who seemed unable to develop trusting, close relationships. Fonagy and Target, in London, have propounded their view of the necessity of helping certain detached, isolated patients, develop the capacity for "mentalization" associated with thinking about relationships and themselves.
  • Modern psychoanalysis, a body of theoretical and clinical knowledge developed by Hyman Spotnitz and his colleagues, extended Freud's theories so as to make them applicable to the full spectrum of emotional disorders. Modern psychoanalytic interventions are primarily intended to provide an emotional-maturational communication to the patient, rather than to promote intellectual insight.

Although these theoretical "schools" differ considerably, most of them continue to stress the strong influence of unconscious elements affecting people's mental lives. There has also been considerable work done on consolidating elements of conflicting theory (cf. the work of Theodore Dorpat, B. Killingmo, and S. Akhtar). As in all fields of medicine (for example, [1]}, there are some persistent conflicts regarding specific causes of some syndromes, and disputes regarding the best treatment techniques.

Today psychoanalytic ideas are embedded in the culture, especially in childcare, education, literary criticism, and in psychiatry, particularly medical and non-medical psychotherapy. Though there is a mainstream of evolved analytic ideas, there are groups who more specifically follow the precepts of one or more of the later theoreticians. It also plays a role in literary analysis. Please see: Archetypal literary criticism

Indications and Contraindications

Using the various analytic theories to assess mental problems, several particular constellations of problems are particularly suited for analytic techniques (see below) whereas other problems respond better to medicines and different interpersonal interventions.

To be treated with psychoanalysis, whatever the presenting problem, the person requesting help must demonstrate 1) good capacity to organize thought (integrative function) 2) good abstraction ability 3) reasonable ability to observe self and others 4) some capacity for trust and empathy 5) some ability to control emotion and urges, and 6) good contact with reality (excludes most psychotic patients) 7) some guilt and shame (excludes most criminals) 8) reasonable self-preservation ability (excludes severely suicidal patients)

If any of the above are faulty, then modifications of techniques, or completely different treatment approaches, must be instituted. The more there are deficits of serious magnitude in any of the above mental operations, the more psychoanalysis as treatment is contraindicated, and the more medication and supportive approaches are indicated. In non-psychotic first-degree criminals, any treatment is often contraindicated.

The problems treatable with analysis include: phobias, compulsions, obsessions, anxiety attacks, depressions, sexual dysfunctions, a wide variety of relationship problems (dating and marital strife, e.g.), and a wide variety of character problems (e.g., painful shyness, meanness, obnoxiousness, workaholism, hyperseductiveness, hyperemotionality, hyperfastidiousness). The fact that many of such patients also demonstrate deficits in numbers 1-8 above makes diagnosis and treatment selection difficult.

Technique

There is what is known among psychonanalysts as "classical technique," although Freud throughout his writings deviated from this considerably, depending on the problems of any given patient. Classical technique was best summarized by Allan Compton, MD, as comprising:

1) instructions (telling the patient to try to say what's on their mind, including interferences) 2) exploration (asking questions) 3) clarification (rephrasing and summarizing what the patient has been describing) 4) confrontation (bringing an aspect of functioning, usually a defense, to the patient's attention) 5) dynamic interpretation (explaining how being too nice guards against guilt, e.g. - defense vs. affect) 6) genetic interpretation (explaining how a past event is influencing the present) 7) resistance interpretation (showing the patient how they are avoiding their problems) 8) transference interpretation (showing the patient ways old conflicts arise in with the analyst) 9) dream interpretation (obtaining the patient's thoughts about their dreams and connecting this with their current problems) 10) reconstruction (estimating what may have happened in the past that created some current day difficulty)

Clearly, these techniques are primarily based on conflict theory (see above). As object relations theory evolved, supplemented by the work of Bowlby, Ainsorth, and Beebe, techniques with patients who had more severe problems with basic trust (Erikson, 1950) and a history of maternal deprivation (see the works of Augusta Alpert) led to new techniques with adults. These have sometimes been called interpersonal, intersubjective (cf. Stolorow), relational, or corrective object relations techniques. These techniques include:

1) expressing an experienced empathic attunement to the patient 2) expressing a certain dosage of warmth 3) exposing a bit of the analyst's personal life or attitudes to the patient 4) allowing the patient autonomy in the form of disagreement with the analyst (cf. I.H. Paul, "Letters to Simon.")

Finally, ego psychological concepts of deficit in functioning led to refinements in supportive therapy. These techniques are particularly applicable to psychotic and near-psychotic (Eric Marcus) patients. They include:

1) discussions of reality 2) encouragement to stay alive (including hospitalization) 3) psychotropic medicines to relieve overwhelming depressive affect 4) psychotropic medicines to relieve overwhelming fantasies (hallucinations and delusions) 5) advice about the meanings of things (to counter abstraction failures)

File:Freud Sofa.JPG
Freud's patients would lie on this couch during psychoanalysis

The basic method of psychoanalysis is interpretation of the analysand's unconscious conflicts that are interfering with current-day functioning, or conflicts that are causing painful symptoms such as phobias, anxiety, depression, and compulstions). Strachey (1936) stressed that figuring out ways the patient distorted perceptions about the analyst led to understanding what may have been forgotten (see Freud's paper, Repeating, Remembering, and Working Through). In particulary, unconscious hostile feelings toward the analyst could be found in symbolic, negative reactions to what Langs later called the "frame" of the therapy -- the setup that included times of the sessions, payment of fees, and necessity of talking. In patients who made mistakes, forgot, or showed other peculiarities regarding time, fees, and talking, various "resistances" to the flow of thoughts -- sometimes called free association.

File:AufderCouch.jpg
"You're born, you deconstruct your childhood, and then you die"

When the patient reclines on a couch with the analyst out of view, the patient tends to remember more, experience more resistance and transference, and be able to reorganize thoughts after the development of insight -- through the interpretive work of the analyst. Although fantasy life can be understood through the examination of Dreams, masturbation fantasies (cf. Marcus, I. and Francis, J. (1975)Masturbation from Infancy to Senescence)are important, the analyst is also interested in how the patient reacts to and avoids such fantasies (cf. Paul Gray (1995) the Ego and the Analysis of Defense. Various memories of early life are generally distorted -- Freud called them "screen memories" -- and in any case, very early experiences—before age 2- can not be remembered (See the child studies of Eleanor Galenson, MD on "evocative memory").

The notion of the "silent analyst" has been made into negative propaganda against analysis. Actually, the analyst listens in a special way (see Arlow's paper on "The Genesis of Interpretation"). Much active intervention is necessary by the analyst to interpret resistances, defenses creating pathology, and fantasies that are being displaced into the current day inappropriately. Silence and non-responsiveness was actually a technique promulgated by Carl Rogers, Ph.D., in his development of so-called "Client Centered Therapy" -- and is not a technique of psychoanalysis (also see the studies and opinion papers of Owen Renik, MD).

"Analytic Neutrality" is a concept that does not mean the analyst is silent. It refers to the analyst's position of not taking sides in the internal struggles of the patient. For example, if a patient feels guilty, the analyst might explore what the patient has been doing or thinking that causes the guilt, but not reassure the patient not to feel guilty. The analyst might also explore the identifications with parents and others that led to the guilt.

Many clinicians hold that psychoanalysis is not recommended in cases of serious psychological disruption, such as psychosis, suicidal depression, or severe untreated alcoholism because of the ego deficits and object relations deficits involved in such pathology. Such patients are often termed "un-analyzable". More typical applications include treatment of clinical depression and personality disorders. Some analysts even attempt to cope with dissociative identity disorder, which is never easy for anyone. There are clinicians and researchers who claim to have used "analysis" for treating psychotic patients (cf. Harold Searles's work, e.g.), although the techniques they actually use do vary some from the "classical" techniques mentioned above.

Some more recent forms of psychoanalysis seek to help patients gain self-esteem through greater trust of the self, overcome the fear of death and its effects on current behavior, and maintain several relationships that appear to be incompatible.

Although single-client sessions remain the norm, psychoanalysis has been adapted as a form of group therapy by Harry Stack Sullivan and others.

Efficacy

Over a hundred years of case reports and studies in the [Psychoanalytic Quarterly], the [International Journal of Psychoanalysis] and the [Journal of the American Psychoanalytic Association] demonstrate the efficacy of analysis in cases of neurosis and with character or personality problems. Psychoanalysis modified by object relations techniques has been shown to be effective in many cases of ingrained problems of intimacy and relationship (cf. the many books of Otto Kernberg, MD). As a therapeutic treatment, psychoanalytic techniques may be useful in a one-session consultation (see Blackman, J (1994) Psychodynamic Technique during Ungent Consultation Interviews in J Psychoth Pract & Research). Psychoanalytic treatment, in other situations, may run from about a year to many years, depending on the severity and complexity of the pathology.

Analysis of previous randomized controlled trials have suggested that psychoanalytic treatment is effective in specific psychiatric disorders. [2]. Empirical research on the efficacy of psychoanalysis and psychoanalytic psychotherapy has also become prominent among psychoanalytic researchers.

Research on psychodynamic treatment of some populations shows mixed results. Research by analysts such as Bertram Karon and colleagues at Michigan State University had suggested that when trained properly, psychodynamic therapists can be effective with schizophrenic patients. More recent research casts doubt on these claims. The Schizophrenia Patient Outcomes Research Team (PORT) report argues in its Recommendaton 22 against the use of psychodynamic therapy in cases of schizophrenia, noting that more trials are necessary to verify its effectiveness. However, the PORT recommendation is based on the opinions of clinicians rather than on empirical data, and empirical data exist that contradict this recommendation (link to abstract). A review of current medical literature in The Cochrane Library, (the updated abstract of which is available online) reached the conclusion that no data exist that demonstrate that psychodynamic psychotherapy is effective in treating schizophrenia. Dr. Hyman Spotnitz and the practitioners of his theory known as Modern Psychoanalysis, a specific sub-specialty, still report (2007) much success in using their enhanced version of psychoanalytic technique in the treatment of schizophrenia.

Further data also suggest that psychoanalysis is not effective (and possibly even detrimental) in the treatment of sex offenders.

Cost and length

The cost of psychoanalytic treatment ranges widely, from as low as ten United States dollars a session (with an analytic candidate in training at an institute) to over US $250 a session with a senior training analyst.

Unlike most kinds of psychotherapy, psychoanalysis generally requires more than one sesssion a week, in order to maintain continuity. Two sessions is minimal, for the early stages; four or five times a week is more usual. In some cases, an analyst will schedule one or two sessions a week and call it psychotherapy, then (after months or years of work) schedule four or five sessions a week and call it psychoanalysis.

Length of treatment varies. Some psychodynamic approaches, such as Brief Relational Therapy (BRT), Brief Psychodynamic Therapy (BPT), and Time-Limited Dynamic Therapy (TLDP) limit treatment to 20-30 sessions. Full-fledged psychoanalysis, however, generally lasts longer, with an average of 5.7 years, according to a recent survey. Which treatment length is optimal depends on the individual's needs. Managed care has placed increased pressure on psychotherapy in general to restrict time devoted to patients: such plans generally don't pay for psychoanalysis. In general, managed-care plans expect a doctor to write a drug prescription during the first appointment, and to see the patient rarely afterwards: they don't want to spend money on talk. They also prefer not to pay for anybody not licensed to write a prescription, like a clinical psychologist or a MFCC. Often, managed-care providers prefer a family doctor to write a prescription for an antidepressant and refill it indefinitely, rather than referring a patient to a psychotherapist or psychoanylist or even a bioogical psychiatrist.

Training

Throughout the history of psychoanalysis, most psychoanalytic organizations have existed outside of the university setting, with a few notable exceptions.

Psychoanalytic training usually occurs at a psychoanalytic institute and may last approximately 4-10 years. Training includes coursework, supervised psychoanalytic treatment of patients, and personal psychoanalysis lasting 4 or more years.

An ongoing debate in professional psychoanalysis concerns the qualifications candidates must have to enter analytic training. Freud believed that applicants from the humanities and many non-medical disciplines are as well prepared as physicians for psychoanalytic training.

Anna Freud described the essential personal qualities in a psychoanalyst being the following [3].

The American Psychoanalytic Association, however, limited access to training to medical doctors (psychiatrists) until quite recently. Later, after extensive debates and legal battles, psychoanalytic training in most institutes was opened to non-medical mental health professionals, such as psychologists and clinical social workers. Currently, access to training by applicants from nonclinical disciplines, such as literary studies and philosophy, is limited to a handful of institutes in the United States. By contrast, many or most institutes in Europe and Latin America admit candidates without formal clinical training.[citation needed]

Although the popularity of psychoanalysis was in decline during the 1980s and early 1990s, prominent psychoanalytic institutes have experienced an increase in the number of applicants in recent years.[3]

Theory

The theories distinctive of classical Freudian psychoanalysis generally include the following hypotheses:

  • Human development is best understood in terms of changing objects of sexual desire.
  • The psychic apparatus habitually represses wishes, usually of a sexual or aggressive nature, whereby they become preserved in one or more unconscious systems of ideas.
  • Unconscious conflicts are the source of neuroses.
  • Neuroses can be treated through bringing the unconscious wishes and repressed memories to consciousness in psychoanalytic treatment.

The unconscious and psychic structures

The unconscious refers to that part of mental functioning of which subjects make themselves unaware. The psychoanalytic unconscious is similar to but not precisely the same as the popular notion of the subconscious. For psychoanalysis, the unconscious does not include all of what is not conscious. It does not include e.g., motor skills, but only what is actively repressed from conscious thought. It does include instances of automatic processing such as stereotypes and the effects of past relationships on the present.

For Freud, the unconscious was a depository for socially unacceptable ideas, wishes or desires, traumatic memories, and painful emotions put out of mind by the mechanism of psychological repression. However, the contents did not necessarily have to be solely negative. In the psychoanalytic view, the unconscious is a force that can only be recognized by its effects—it expresses itself in the symptom.

The ego, super-ego, and id are the divisions of the psyche according to Freud's later "structural theory". The id contains "primitive desires" (hunger, rage, and sex), the super-ego contains internalized norms, morality and taboos, and the ego mediates between the two and may include or give rise to the sense of self.

Roots of neurosis

In his earliest writings on the subject, Freud theorized that all neuroses were rooted in childhood sexual abuse (the so-called seduction theory). Later, Freud came to abandon or de-emphasize this hypothesis, emphasizing instead the importance of unconscious fantasy as the cause of neurosis, particularly fantasy structured according to the Oedipus complex.

The Oedipus complex is a concept developed by Sigmund Freud to explain the origin of certain neuroses in childhood. The Oedipus Complex was seen by Freud to emerge in childhood and, if left unresolved, persists into adulthood in the form of symptomatic interferences with mature sexual relationships. The complex as a whole includes the 'positive' and 'negative' aspects, both of which Freud considered to be universal in development. The positive oedipal longings refer to the child's sexual wishes for and desire to possess the parent of the opposite sex. These feelings engender jealousy and death-wishes towards the rival same-sex parent. The opposite or 'negative' oedipal longings for the parent of the same-sex, and corresponding wishes to eliminate the parent of the opposite sex, are always present to varying degrees, though usually are less predominant, depending on multiple factors, including the sex of the child, other constitutional factors, the point in time during the oedipal phase, as well as external circumstances within the child's environment. The strivings of the Oedipus complex are more or less conscious initially and are sometimes verbalized by children during the oedipal phase of development (roughly between the ages of three and five). Eventually, the developing child's concessions to reality and identifications with parental values impose a relative resolution to the conflicts of the Oedipus complex; unresolved residues are repressed to the unconscious in the course of development and manifest in the form of symptoms and inhibitions. The idea of the Oedipus complex is based on the Greek myth of Oedipus, who unwittingly kills his father Laius and marries his mother Jocasta.

Freud revisited the Oedipal territory in the final essay of Totem and Taboo. There, he combined one of Charles Darwin's more speculative theories about the arrangements of early human societies (a single alpha-male surrounded by a harem of females, similar to the arrangement of gorilla groupings) with the theory of the sacrifice ritual taken from William Robertson Smith. Smith believed he had located the origins of totemism in a singular event, whereby a band of prehistoric brothers expelled from the alpha-male group returned to kill their father, whom they both feared and respected. In this respect, Freud located the beginnings of the Oedipus complex at the origins of human society, and postulated that all religion was in effect an extended and collective solution to the problem of guilt and ambivalence relating to the killing of the father figure (which Freud saw as the true original sin).

The life and death instincts

Freud believed that humans were driven by two conflicting central desires: the life drive (Eros) (incorporating the sex drive) and the death drive. Freud's description of Eros/Libido included all creative, life-producing drives. The death drive of Thanatos(or death instinct) represented an urge inherent in all living things to return to a state of calm, or, ultimately, of non-existence. The presence of the death drive was only recognized in his later years, and the contrast between the two represents a revolution in his manner of thinking.

Post-Freudian schools

  • Object relations theory is the idea that the ego-self exists only in relation to other objects, which may be external or internal. Internal objects are internalized versions of external objects, primarily formed from early interactions with the parents. According to object-relations theory there are three fundamental "affects" that can exist between the self and the other - attachment, frustration, and rejection. These affects are alleged to be universal emotional states that are major building blocks of the personality. Object relations theory was pioneered in the 1920s by the Austrian psychoanalyst Otto Rank, in the 1930s by Melanie Klein and in the 1940s and 1950s by Ronald Fairbairn, D.W. Winnicott, Harry Guntrip, Margaret Mahler and others.
  • Interpersonal psychoanalysis is based on the theories of Harry Stack Sullivan, an American psychiatrist who believed that the details of patient's interpersonal interactions with others provided insight into the causes and cures of mental disorder. Sullivan argued that patients keep many aspects of interpersonal relationships out of their awareness by selective inattention. He felt it to be important for psychotherapists to conduct a detailed inquiry into patient's interactions with others so that patients would become optimally aware of their interpersonal patterns.

Modern adaptations

Cultural adaptations

Psychoanalysis can be adapted to different cultures, as long as the therapist or counseling understands the client’s culture. For example, Tori and Blimes found that defense mechanisms were valid in a normative sample of 2,624 Thais. The use of certain defense mechanisms was related to cultural values. For example Thais value calmness and collectiveness (because of Buddhist beliefs), so they were low on regressive emotionality. Psychoanalysis also applies because Freud used techniques that allowed him to get the subjective perceptions of his patients. He takes an objective approach by not facing his clients during his talk therapy sessions. He met with his patients where ever they were, such as when he used free association—where clients would say whatever came to mind without self-censorship. His treatments had little to no structure for most cultures, especially Asian cultures. Therefore, it is more likely that Freudian constructs will be used in structured therapy (Thompson, et al., 2004). In addition, Corey postulates that it will be necessary for a therapist to help clients develop a cultural identity as well as an ego identity. Since Freud has been criticized for not accounting for external/societal forces, it seems logical that therapists or counselors using his premises will work with the family more. Psychoanalytic constructs fit with constructs of other more structured therapies, and Firestone (2002) thinks psychotherapy should have more depth and involve both psychodynamic and cognitive-behavioral approaches. For example, Corey states, that Ellis, the founder of Rational Emotive Behavioral Therapy (REBT) would allow his clients to experience depression over a loss, such an emotion would be rational—often people will be irrational and deny their feelings.

Adaptations for age and managed care

Play therapy for different ages

Psychoanalytic constructs can be adapted and modified to both age and managed care through the use of play therapy such as art therapy, creative writing, storytelling, bibliotherapy, and psychodrama. In the 1920’s, Anna Freud (Sigmund Freud’s daughter) adapted psychoanalysis for children through play. Using toys and games, she was able to enhance relationship with the child—Freud has been criticized for his, objective and disengaged approach. When children play, they often engage in a make believe world where they can express their fears and fantasies, and they do so without censorship, so it resembles very much the technique of free association. Psychoanalytic play therapy allows the child and the counselor to access material in the unconscious, material that was avoided and forgotten. This material is re-integrated into the conscience, and the counselor is able to work with the child and the family to address the trauma or issue that was forgotten. With adults, the term art therapy is used, instead of play, however they are synonymous. The counselor simply adapts art therapy to the age of the client. With children, a counselor may have a child draw a portrait of his self, and then tell a story about the portrait. The counselor watches for recurring themes — regardless of whether it is with art or toys. With adults, the counselor may work one on one or in a group and have clients do various art activities like painting or clay to express themselves — toys here would probably not be age appropriate, and children stop pretend play as they transition into adolescence. Since play is considered appropriate in Occidental (Western) culture, it allows people to deal with personal/social issues that they would normally avoid—it allows them to drop their defenses without anxiety and fear.

Other play therapy techniques

Bibliocounseling involves selecting stories from books that children can identify with (similar issues). Through this story, a child will be more likely to not feel defensive and will work to find alternative solutions to problems. Storytelling is similar, the counselor may tell a story but not use a name, and instead he may address the child with each new sentence using his name. For example, he may say, “next, Eric, the little boy had dream about a mouse that was not like the other mice…”

Play therapy for managed care

Unlike traditional psychoanalysis, play therapy takes much shorter time span; which allow insurance companies to cover it for their clients. Even more, it provides more structure to the process allowing for specific measurable goals. Psychoanalytic theory will be applied in more preventative ways, such as educating parents on how to best meet the needs of the child and enhance the child’s development and growth. Lastly, more advocates may use homework assignments such as journal writing to save time (Thompson et al., 2004).

Expressive writing for managed care

According to a book,[4] the writing cure provides an analysis of research that supports expressive writing as a way to integrate cognitions and work through trauma. People who write about traumatic events experience more self control. The Writing Cure offers new, cost-effective ways to treat clients; clients can even use expressive writing to work through their own personal/social issues.

Criticisms

Psychoanalysis has been criticized on a variety of grounds by

and others. Exchanges between critics and defenders of psychoanalysis have often been so heated that they have come to be characterized as the Freud Wars.

Popper argues that psychoanalysis is a pseudo-science because its claims are not testable and cannot be refuted, that is, they are not falsifiable.[5] For example, if a client's reaction was not consistent with the psychosexual theory then an alternate explanation would be given (eg. defense mechanisms, reaction formation).

Similarly, Grünbaum argues that psychoanalytic based theories are falsifiable, and in fact are false. Other schools of psychology have produced alternative methods for psychotherapy, including behavior therapy, cognitive therapy, Gestalt therapy and person-centered psychotherapy.

Hans Eysenck determined that improvement was no greater than spontaneous remission. Between 2/3 and 3/4 of “neurotics” would recover naturally; this was no different from therapy clients. Prioleau, Murdock, Brody reviewed several therapy-outcome studies and determined that psychotherapy is no different than placebo controls.

Michel Foucault, and similarly Gilles Deleuze, noted that the institution of psychoanalysis has become a center of power, with its confessional techniques being the same of the Christian tradition.[6]

Due to the wide variety of psychoanalytic theories, varying schools of psychoanalysis often internally criticize each other. One consequence is that some critics offer criticism of specific ideas present only in one or more theories, rather than in all of psychoanalysis while not rejecting other premises of psychoanalysis. Defenders of psychoanalysis argue that many critics (such as feminist critics of Freud) have attempted to offer criticisms of psychoanalysis that were in fact only criticisms of specific ideas present only in one or more theories, rather than in all of psychoanalysis. As the psychoanalytic researcher Drew Westen puts it, "Critics have typically focused on a version of psychoanalytic theory—circa 1920 at best—that few contemporary analysts find compelling...In so doing, however, they have set the terms of the public debate and have led many analysts, I believe mistakenly, down an indefensible path of trying to defend a 75 to 100-year-old version of a theory and therapy that has changed substantially since Freud laid its foundations at the turn of the century." link to Westen article On the other hand, those who criticize psychoanalysis on scientific basis tend to dismiss the entire subject as pseudo science.

Scientific validity

An early and important criticism of psychoanalysis was that its theories were based on little quantitative and experimental research, and instead relied almost exclusively on the clinical case study method. In comparison, brief psychotherapy approaches such as behavior therapy and cognitive therapy have shown much more concern for empirical validation (Morley et al. 1999). Some even accused Freud of fabrication, most famously in the case, and miraculous cure of Anna O. (Borch-Jacobsen 1996).

An increasing amount of empirical research from academic psychologists and psychiatrists has begun to address this criticism.

A survey of scientific research showed that while personality traits corresponding to Freud's oral, anal, Oedipal, and genital phases can be observed, they cannot be observed as stages in the development of children, nor can it be confirmed that such traits in adults result from childhood experiences (Fisher & Greenberg, 1977, p399). However, these stages should not be viewed as crucial to modern psychoanalysis. What is crucial to modern psychoanalytic theory and practice is the power of the unconscious and the transference phenomenon.

Some claim the idea of "unconscious" is contested because human behavior can be observed while human psychology has to be guessed at. However, the unconscious is now a hot topic of study at the undergraduate and graduate level in the fields of experimental and social psychology (e.g., implicit attitude measures, fMRI, and PET scans, and other indirect tests). One would be hard pressed to find scientists who still think of the mind as a "black box". Presently, the field of psychology has embraced the study of things outside one's awareness. Even strict behaviorists acknowledge that a vast amount of classical conditioning is unconscious and that this has profound effects on our emotional life. The idea of unconscious, and the transference phenomenon, have been widely researched and, it is claimed, validated in the fields of cognitive psychology and social psychology, though such claims are also contested. Recent developments in neuroscience have resulted in one side arguing that it has provided a biological basis for unconscious emotional processing in line with psychoanalytic theory, while the other side argues that such findings make psychoanalytic theory obsolete and irrelevant.

E. Fuller Torrey, considered by some to be a leading American psychiatrist, writing in Witchdoctors and Psychiatrists (1986) stated that psychoanalytic theories have no more scientific basis than the theories of traditional native healers, "witchdoctors" or modern "cult" alternatives such as est. In fact, an increasing number of scientists regard psychoanalysis as a pseudoscience (Cioffi, F. 1998).

Among philosophers, Karl Popper argued that Freud's theory of the unconscious was not falsifiable and therefore not scientific.[5] Popper did not object to the idea that some mental processes could be unconscious but to investigations of the mind that were not falsifiable. In other words, if it were possible to connect every conceivable experimental outcome with Freud's theory of the unconscious mind, then no experiment could refute the theory.

Anthropologist Roy Wagner in his classic work The Invention of Culture ridicules psychoanalysis and tries to account for personality and emotional disorder in terms of invention and convention.[7]

Some proponents of psychoanalysis suggest that its concepts and theories are more akin to those found in the humanities than those proper to the physical and biological/medical sciences, though Freud himself tried to base his clinical formulations on a hypothetical neurophysiology of energy transformations. For example, the philosopher Paul Ricoeur argued that psychoanalysis can be considered a type of textual interpretation or hermeneutics. Like cultural critics and literary scholars, Ricoeur contended, psychoanalysts spend their time interpreting the nuances of language — the language of their patients. Ricoeur claimed that psychoanalysis emphasizes the polyvocal or many-voiced qualities of language, focusing on utterances that mean more than one thing. Ricoeur classified psychoanalysis as a hermeneutics of suspicion. By this he meant that psychoanalysis searches for deception in language, and thereby destabilizes our usual reliance on clear, obvious meanings.

Controversy over efficacy

Psychoanalysts, for most of their history, have relied on the clinical case report as the chief method of evaluating the efficacy of treatment. In comparison, brief psychotherapy approaches such as behavior therapy and cognitive therapy have shown much more concern for empirical validation from broad-based studies modeled after randomized pharmaceutical trials. (see, e.g., Morley and al. 1999).

At least in the United States, psychoanalysis has usually been perceived as a form of insight-based therapy, with the goal of bringing unconscious thoughts or memories into consciousness. Some studies, however, throw doubt on whether insight is a necessary or sufficient means for improving a person's behavior or increasing their level of functioning (Fisher & Greenberg, 1977, pp. 411-412).

There is even a great controversy among psychologists as to whether repressed memories actually exist. The whole recovered memory movement, which has flourished in the United States in the last decade, is now highly criticized by the advocates of the false memory syndrome (Loftus & Ketcham, 1994).

Theoretical criticism

Psychoanalysts have often complained about the significant lack of theoretical agreement among analysts of different schools. Many authors have attempted to integrate the various theories, with limited success. However, with the publication of the Psychodynamic Diagnostic Manual much of this lack of cohesion has been resolved.

The philosopher Jacques Derrida incorporated certain aspects of psychoanalytic theory into his practice of deconstruction in order to question what he called the 'metaphysics of presence' or 'self-presence'. This was the defining trait (for Derrida) of traditional metaphysics, namely its assumption that the meaning of utterances can be pinned down and made fully evident to consciousness, perhaps most evident in Descartes' conception of 'clear and distinct ideas'. Derrida is here influenced by Freud (among others such as Marx and Nietzsche.) For instance, Freud's insistence, in the first chapter of The Ego and the Id, that philosophers will recoil from his theory of the unconscious is clearly a forbearer to Derrida's understanding of metaphysical 'self-presence'. However, Derrida goes on to turn certain of these practices against Freud himself, in order (in Derrida's typical manner) to reveal tensions and contradictions in Freud's work which are nonetheless the very conditions upon which it can operate - its simultaneous conditions of possibility and impossibility. For instance, although Freud will define religion and metaphysics as a displacement of the identification with the father in the resolution of the Oedipal complex (e.g. in 'The Ego and The Id' and 'Totem and Taboo') Derrida will insist (for instance in 'The Postcard') that the prominence of the father in Freud's own analysis is at the same time indebted to and an example of the prominence given to the father in Western metaphysics and theology since Plato. Thus, (in a similar manner to that in which Levi-Strauss reads Freud's understanding of the Oedipal complex as but another version of the Oedipus myth,) Derrida understands Freud as remaining partly within that theologico-metaphysical tradition ('phallologocentrism' Derrida helpfully calls it) which Freud nonetheless criticizes. However, the purpose of Derrida's analysis is not to refute Freud per se, (which would only be to reaffirm traditional metaphysics) but rather to reveal an aporia (an undecidability) at the very heart of Freud's project. Such a 'deconstruction' (or indeed psychoanalysis) of Freud does tend to cast doubt upon the possibilty of delimiting psychoanalysis as a rigorous science. However, in doing so it celebrates and pledges a critical alliegance to that side of Freud which emphasises the open-ended and improvisatory nature of psychoanalysis, and its (methodical and ethical) demand (for instance in the opening chapters of the 'Interpretaion of Dreams,') that the testimony of the analysand should be given prominence in the practice of analysis.

Psychoanalysis, or at least the dominant version of it, has been denounced as patriarchal or phallocentric by proponents of feminist theory.[citation needed] Other feminist scholars appreciate how Freud opened up society to female sexuality.

List of psychoanalytical theorists

A few of the most influential psychoanalysts and theorists, philosophers and literary critics who were or are influenced by psychoanlaysis include:

References

Specific
  1. ^ Tallis, R.C. (1996). Burying Freud. Lancet, 347, 669-671. PMID 8596386.
  2. ^ Cf. Blum, Harold P. (Ed.) (1977). Female Psychology. New York: International Universities Press. Also see the various works of Eleanor Galenson, Nancy Chodorow, and others.
  3. ^ Tuhus-Dubrow, Rebecca (2005, April 12). Head case. The Village Voice.
  4. ^ Review by Berman (2003).
  5. ^ a b Popper KR "Science: Conjectures and Refutations", reprinted in Grim P (1990) Philosophy of Science and the Occult, Albany, pp. 104-110. See also, Conjectures and Refutations.
  6. ^ Weeks, Jeffrey. Sexuality and its Discontents; Meanings, Myths, and Modern Sexualities. New York: Routledge. ISBN 0-415-04503-7. p.176
  7. ^ John M. Ingham [Simplicity and complexity in anthropology]. On the Horizon 2007 Volume: 15 Issue: 1 Page: 7 - 14
General
  • International dictionary of psychoanalysis : [enhanced American version], ed. by Alain de Mijolla, 3 vls., Detroit [etc.] : Thomson/Gale, 2005
  • Jean Laplanche et J.B. Pontalis: "The Language of Psycho-Analysis", Editeur: W. W. Norton & Company, 1974, ISBN 0-393-01105-4
  • John Kafka: "Multiple Realities in Clinical Practice", Publisher: Yale University Press, 1989, ISBN 0-300-04350-3
  • Pierre Fédida: "Dictionary of Psychoanalysis", Publisher: French & European Pubns; 2nd edition 1988, Language: English, ISBN 0-8288-2215-8
  • Berman, J. (2003). [Review of the book The writing cure: How expressive writing promotes health and well-being.] Psychoanalytic psychology, 20(3), 575-578.
  • Brenner, C. (1954). An elementary textbook of psychoanalysis.
  • John Steiner: Psychic Retreats, Publisher: Routledge; 1993, ISBN 0-415-09924-2
  • Corey, G. (2001). Theory and practice of counseling and psychotherapy. (6th ed.). Belmont, CA: Brooks/Cole Thompson Learning
  • Hanna Segal : "The Work of Hanna Segal: A Kleinian Approach to Clinical Practice (Classical Psychoanalysis and Its Applications) " Publisher: Jason Aronson, 1993), ISBN 0-87668-422-3
  • Seymour Fisher, The Scientific Credibility of Freud's Theories and Therapy, Columbia University Press (1985), trade paperback, ISBN 0-231-06215-X
  • Sabina Spielrein : "Destruction as cause of becoming", 1993, OCLC 44450080
  • Robert Stoller : "Presentations of Gender", Yale University Press, 1992, ISBN 0-300-05474-2
  • Edith Jacobson : "Depression; Comparative Studies of Normal, Neurotic, and Psychotic Conditions", Publisher: International Universities Press, 1976, ISBN 0-8236-1195-7
  • Firestone, R.W. (2002). "The death of psychoanalysis and depth therapy." [Electronic version]. Psychotherapy: Theory, Research, Practice, and Training, 39(3), 223-232.
  • Rene Spitz : "The First Year of Life: Psychoanalytic Study of Normal and Deviant Development of Object Relations", Publisher: International Universities Press, 2006, ISBN 0-8236-8056-8
  • Otto Kernberg : "Severe Personality Disorders: Psychotherapeutic", Publisher: Yale University Press; edition 1993, ISBN 0-300-05349-5
  • Kramer, Peter D., Listening to Prozac: A Psychiatrist Explores Antidepressant Drugs and the Remaking of the Self ISBN 0-670-84183-8.
  • Herbert A Rosenfeld: * "Impasse and Interpretation: Therapeutic and Anti-Therapeutic Factors in the Psycho-Analytic Treatment of Psychotic, Borderline, and Neurotic Patients", Publisher: Tavistock Publications, 1987, ISBN 0-422-61010-0
  • Luhrmann, T.M., Of Two Minds: The Growing Disorder in American Psychiatry ISBN 0-679-42191-2.
  • André Green : "Psychoanalysis: A Paradigm For Clinical Thinking" Publisher: Free Association Books, 2005, ISBN 1-85343-773-5
  • Thomson, C.L, Rudolph L.B., & Henderson, D. (2004). Counseling children. (6th ed.). Belmont, CA: Brooks/Cole Thompson.
  • Tori, C.D. & Blimes, M. (Fall 2002). Cross-cultural and Psychoanalytic Psychology: The Validation of defense measure in an Asian population. [Electronic version]. Psychoanalytic psychology, 19(4), 701-421.
  • Jose Bleger "Symbiosis and Ambiguity: The Psychoanalysis of Very Early Development", Publisher: Free Association Books, 1990, ISBN 1-85343-134-6
  • Psychoanalytic Theory: An Introduction, by Anthony Elliott, an introduction that explains psychoanalytic theory with interpretations of major theorists [4]
  • Harold F Searles : "Collected Papers on Schizophrenia and Related Subjects", Publisher: International Universities Press, 1966, ISBN 0-8236-0980-4
  • Heinz Kohut : "Analysis of the Self: Systematic Approach to Treatment of Narcissistic Personality Disorders", Publisher: International Universities Press, 2000, ISBN 0-8236-8002-9
  • The Psychoanalytic Movement: The Cunning of Unreason, by Ernest Gellner. A critical view of Freudian theory. ISBN 0-8101-1370-8
  • Mitchell, S. & Black, M. (1995). Freud and Beyond: A History of Modern Psychoanalytic Thought (ISBN 0-465-01405-4)
  • Donald Meltzer "The Kleinian Development (New edition)", Publisher: Karnac Books; Reprint edition 1998, ISBN 1-85575-194-1
  • Donald Meltzer : "Dream-Life: A Re-Examination of the Psycho-Analytical Theory and Technique" Publisher: Karnac Books, 1983, ISBN 0-902965-17-4
  • Heinrich Racker : "Transference and Counter-Transference", Publisher: International Universities Press, 2001, ISBN 0-8236-8323-0
  • Donald Winnicott : "Playing and Reality", Publisher: Routledge; edition 2005, ISBN 0-415-34546-4
  • Walter Bromberg, M.D.
    • "The Mind of Man: The Story of Man's Conquest of Mental Illness", 1938.
    • "The The Mind of Man. A History of Psychotherapy and Psychoanalysis", 1954.
    • "From Shaman to Psychotherapist: A History of the Treatment of Mental Illness", 1976.
  • Stefano Bolognini: "Like wind, like wave - An Italian psychoanalyst and raconteur reflects insightfully on life and the common experiences that make us human", Other Press Books, 2006, ISBN 1-59051-179-4
  • Stefano Bolognini: "Psychoanalytic Empathy", Free Association Books, London, 2004
  • George Devereux, [ed.], "Psychoanalysis and the Occult", New York, International Universities Press, 1953.
  • Calvin S. Hall, A Primer of Freudian Psychology, Publisher: The World Publishing Company; and Mentor Books via The New American Library, 1954

Critiques of psychoanalysis

  • Aziz, Robert (2007). The Syndetic Paradigm: The Untrodden Path Beyond Freud and Jung. Albany: State University of New York Press. ISBN 978-0-7914-6982-8.
  • Borch-Jacobsen, M (1996). Remembering Anna O: A century of mystification London: Routledge. ISBN 0-415-91777-8
  • Cioffi, F. (1998). Freud and the Question of Pseudoscience, Open Court Publishing Company. ISBN 0-8126-9385-X
  • Erwin, Edward, A Final Accounting: Philosophical and Empirical Issues in Freudian Psychology ISBN 0-262-05050-1
  • Fisher S., Greenberg RP. (1977), The Scientific Credibility of Freud’s Theories and Therapy. New York: Basic Books.
  • Fisher S, Greenberg RP. (1996), Freud Scientifically Reappraised: Testing the Theories and Therapy. New York: John Wiley.
  • Gellner, Ernest, The Psychoanalytic Movement: The Cunning of Unreason. A critical view of Freudian theory, ISBN 0-8101-1370-8
  • Grünbaum, Adolf (1979), Is Freudian Psychoanalytic Theory Pseudo-Scientific by Karl Popper's Criterion of Demarcation? American Philosophical Quarterly, 16, 131-141.
  • Grünbaum, Adolf (1985) The Foundations of Psychoanalysis: A Philosophical Critique ISBN 0-520-05017-7
  • Loftus, Elizabeth F. & Ketcham, K. (1994) The Myth of Repressed Memory. New York: St. Martin's Press.
  • Macmillan, Malcolm, Freud Evaluated: The Completed Arc ISBN 0-262-63171-7
  • Morley S, Eccleston C, Williams A. (1999) Systematic review and meta-analysis of randomized controlled trials of cognitive behaviour therapy and behaviour therapy for chronic pain in adults, excluding headache. Pain, 80(1-2), 1-13.
  • Webster R. (1995). Why Freud was wrong, New York: Basic Books, Harper Collins. ISBN 0-465-09128-8
  • [5] Skeptic's dictionary entry on psychoanalysis
  • [6] Skeptic's dictionary entry on repressed memory
Look up psychoanalysis in Wiktionary, the free dictionary.

Online papers about psychoanalytic theory

History of Psychoanalysis and New York City

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