An Introduction To Freudian Psychoanalytic Therapy English Literature Essay

Introduction

The purpose of this essay is to examine and evaluate Freud’s claim that his theories are supported by his case histories.

Introduction to Psychoanalytic Therapy

Prior to Psychoanalysis it was presumed that psychological disturbances and even behaviour were simply ‘just the way we were’, and that there was little, if anything that could be done about it.

Freud’s concepts were that there are unconscious factors that influence our thought processes and behaviour.

Freud theorised that positive results could be obtained with a better understanding of how our minds function and in doing so we need to accept certain theories about how these issues originated.

According to Freud, there are three levels of consciousness.

Conscious, this is the part of the mind that holds what we’re aware of. We can verbalise about our conscious experiences and can think about it in logical ways.

Preconscious, this is ordinary memory. Although things stored here aren’t in the conscious, they can be readily brought into conscious awareness.

Unconscious, Freud felt that this part of the mind was not directly accessible to awareness. In part, he saw it as a hiding place for urges, feelings and ideas that are linked to anxiety, conflict and pain. These feelings and thoughts have not disappeared and according to Freud, they are there, exerting influence on our actions and our conscious awareness.

Material passes easily back and forth between the conscious and the preconscious. Material from these two areas can slip into the unconscious.

Freud theorised that unconscious material can’t be made available voluntarily, but could be coaxed by analysing dreams and through techniques within Psychoanalysis such as free association.

Freud used the metaphor of an iceberg to help in understanding his topographical hypothesis.

Only a small proportion of the iceberg is visible (conscious) whereas the rest is beneath the water (preconscious and unconscious).

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In An Outline of Psychoanalysis, Freud (1949), explains his principles, firstly with an explanation of the tripartite structure of the mind.

Id

The id has the quality of being unconscious and contains everything that is inherited, everything that is present at birth, and the instincts (Freud, 1949, p. 14).

The key features of The Id are the sexual and aggressive desires as well as The Pleasure Principal, a demand for instant gratification of basic needs but without any consideration for morality. The power of the Id does not begin to subside until the child recognises the need for patience and develops more effective ways of satisfying basic urges and needs.

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In Freud’s own words the Id is “… the dark, inaccessible part of our personality; what little we know of it we have learnt from our study of dreamwork and the construction of neurotic symptoms, and most of that is of a negative character and can be described only as a contrast to the Ego…we call it a chaos, a cauldron full of seething excitations” Freud (1933).

Ego

” … we might say that the Ego stands for reason and good sense, while the id stands for the untamed passions … The Ego’s relationship to the id might be compared with that of a rider to his horse” Freud (1933) .

The Ego develops during the first year of life and does so in order to find more realistic and effective ways of satisfying the urges of the Id.

No longer governed by The Pleasure Principle of early life, the Ego obeys The Reality Principle and begins to learn the necessity to endure pain and to defer gratification because of the obstacles of reality.

The Ego acts as a go between not just with the Id and the real world, but also the Id and the Superego.

In striving to achieve pleasure and avoid pain the Ego may develop defence mechanisms, processes that ultimately become unconscious that are designed to maintain the status quo by satisfying the Superego.

Superego

Developing from the age of 5 or 6 the Superego is representative of our morals.

It learns from the external world what is good and bad and what is expected of us. In doing so it develops 2 components, Conscience and Ego-Ideal.

The Conscience controls what we should not do, often in the respect of the urges of the Id, but also in respect of what our parents ideas of bad behaviour is.

The Ego-Ideal controls what we should do, based usually on the parents ideas as to what is deemed good.

Adherence to the rules of the Superego can ensure feelings of pride and self esteem, but failure to adhere can create guilt and shame.

Defence mechanisms

As the Id, Ego and Superego often conflict it can result in anxiety, and to protect the Ego from experiencing anxiety Defence mechanisms are deployed.

These can be either Primary or Secondary or Behaviour channelling defence mechanisms.

Primary defence mechanisms would make the person unaware of the threat in order to completely hide anxiety from consciousness and Secondary defence mechanisms disguise the feelings that anxiety brings with an alternative.

Behaviour channelling defence mechanisms offer an alternative behaviour to satisfy the urge.

Repression

A Primary defence mechanism that is totally unconscious, unacceptable urges or experiences that result in severe trauma or anxiety become completely hidden from consciousness.

Denial

A primary defence mechanism where an accurate perception of an unacceptable event is blocked from consciousness.

Displacement

A Behaviour channelling defence mechanism that redirects the target of the impulse to a safer alternative, a common example would be shouting at a spouse instead of shouting at the boss.

Sublimation

A Behaviour channelling defence mechanism where a socially unacceptable urge is redirected into behaviour that is more socially acceptable, such as aggression into sport.

Projection

A Secondary defence mechanism that combines denial and displacement. When a person is unable to recognise their own behaviour and projects their faults onto another.

Rationalisation

A Secondary defence mechanism that will find an acceptable excuse for unacceptable behaviour.

Psychosexual stages of development

Originally written as “Three Essays on the Theory of Sexuality” and reproduced and translated with the help of Peter Gay in “The Freud Reader”, Freud proposed that sexuality was evident from a very early age, even from birth, and that 3 specific areas of the body became particularly sensitive at different ages as the child grows.

He believed that treatment of the child at each specific stage of their life was crucial. Both over-gratification at a stage and under-gratification would lead to a fixation on that stage, creating a reference point to return to in times of stress.

Oral

During the first 12 months of life the child associates gratification with the mouth, from sucking nipples and teats to growing teeth and biting.

It is proposed that a fixation at this stage would lead to gullibility and oral dependency, such as smoking.

Anal

Following the Oral stage it coincides with potty training and lasts until around the age of 3. Freud proposed that it is at this point where the child feels that love from parents is no longer unconditional. The child becomes obsessed by the retention or expulsion of faeces. Fixation on expulsion at this stage is often linked to adults who are disorganised, reckless or anti social, while those who are retentive are often linked to compulsively neat and tidy adults.

Phallic

Between the ages of 3 and 6 the focus of pleasure is moved to the genitals, and masturbation becomes a source of gratification.

The child becomes increasingly aware of gender differences and Freud proposed this led to a conflict in boys that he labelled The Oedipus complex, Jung later proposed a similar complex in girls that he labelled the Electra complex.

Oedipus complex

Named after the Greek tragedy Oedipus Rex, where Oedipus unknowingly kills his own Father and marries his mother, it begins with the conflict of the boy’s attraction to his mother and hostility towards his Father due to jealousy. Fearing punishment from his Father, which Freud proposed was a fear of castration, the desire for his mother is repressed and instead the boy begins to identify with the Father.

In doing so the boy acquires his Superego, comprising of values introjected from parents.

Electra complex.

In the same way that the Oedipus complex begins with an attraction to the mother and hostility towards the Father, so does the Electra complex.

But due to the lack of a penis the girl feels already punished and blames her mother. Penis envy develops and because of this an attraction to the Father increases until in order to identify with the mother the girl must give up her Father as a love object, and in doing so acquires her Superego.

Latency period and Genital Stage

The latency period takes place between 6 and puberty, where no new desires take place and previous urges are either repressed or redirected into the development of new skills.

Once the physiological changes of puberty begin so develops the Genital stage, this is the final stage of psychosexual development and leads to a breaking away from parents and a desire for a relationship with the opposite sex.

Free Association and Dream Analysis

As dreams occur when we are asleep the conscious mind tends to be in a relaxed state allowing us to peek at the unconscious mind. The two different states of mind also bring about two different states of dream content.

The manifest content is the part of the dream that is consciously remembered and the latent content, the part of the dream that is not consciously remembered.

The latent part of the dream is often thought of as the important part of the dream as it contains the real hidden meanings of the dream comprising of repressed desires that are unacceptable to the Ego.

In The Interpretation Of Dreams Freud said that, “the interpretation of dreams is the royal road to knowledge of the unconscious activities of the mind” (1900 / 1953).

For a short while Freud used Hypnosis in is practice to encourage conscious relaxation, so as to glimpse at the unconscious.

He had little success and one issue in particular was problematic for Freud. His patients would deny the things they had spoken about during hypnosis claiming not to remember them and so disabling the chance for rational discussion afterwards. Which is why he is quoted in Seven Psychologies by Edna Heidbreder as saying that true psychoanalysis started only when hypnosis had been discarded (1933).

Refining his techniques Freud found he could replicate any successes of Hypnosis but with full conscious awareness by asking his patients to simply lie down to encourage relaxation and to ramble, with the idea that repressed information becomes more and more accessible through a succession of associated thoughts.

Freud recorded notes on very few of his patients, in fact only 12 patients are reported about in any great detail (Stevens, 1995), so there is little evidence to support his theories. But we do have details about a handful of them.

Little Hans (Herbert Graf)

The full title of Freud’s publication was ‘Analysis of a Phobia in a Five-year-old Boy’, first published in 1909 and more recently in The ‘Wolfman’ and Other Cases. The analysis lasted for about two months (March-May 1908).

Hans developed a fear of horses, specifically being bitten and around the same time began creating fantasies on which he was married to his Mother.

Little Hans’ Father was a follower of Freud’s and conducted most of the analysis himself under Freud’s supervision.

Freud had already been following Hans’ development from an early age as Hans’ Father had been assisting Freud in developing his sexual development theories.

Hans had made comments about specific horses with black around their mouths, not unlike Hans’ Fathers moustache, and so Freud interpreted Hans’ fear of being bitten by a horse as part of the Oedipal complex with a repression of the feelings towards his Father leading him to displace the feelings onto something that could be avoided, such as horses, with being bitten a representation of castration anxiety.

Dora

Ida Bauer (named as Dora in Freud’s case study Fragments of an Analysis of a Case of Hysteria and republished in The Penguin Freud Library) began developing problems as a girl of 15; a chronic cough and a loss of voice, but refused to see Freud until she was 18 in 1900 when her thoughts had turned suicidal.

Freud’s first diagnosis was “merely a case of petit hysteria … not worth recording”.

Ida’s parents were very close to another couple named as Frau and Herr K, and according to Ida, Frau K began an affair with Ida’s Father. Shortly afterwards and at around the same time that she began losing her voice, Herr K had sexually propositioned her on a number of occasions.

During some brief analysis, of only 11 weeks, Freud proposed that her hysteria was as a result of a combination of her being jealous of her father’s relationship with Frau K and of her confused feelings towards Herr K’s advances.

Ida broke off her therapy, much to Freud’s disappointment, and resolved the issue herself after confronting her father and the K’s.

Freud was disappointed with the results at first, but considered the case to be important as it raised his awareness of transference.

Daniel Schreber

Published in The ‘Wolfman’ and Other Cases Freud writes about Daniel Paul Schreber, a German Judge who began to experience schizophrenia during middle age, and wrote about his experiences in a book, Memoirs of My Nervous Illness. Freud never met Judge Schreber, but drew his conclusions from reading his memoirs.

Schreber awoke one day with thoughts of having sexual intercourse as a woman, he soon became psychotic blaming at first his doctor and then God.

Freud’s conclusion was that Schreber must have wanted to be a woman in order to be the sole object of God’s desires, with God representing Schrebers father.

Wolf Man

Sergei Pankejeff was suffering with severe depression when he came to Freud. Freud’s treatment centred on a dream that Sergei had as a child in which 6 or 7 white wolves were outside his bedroom window ready to eat him. Freud’s interpretation of it was that he had witnessed his parents having sex from behind one afternoon, although later on Freud changes his theory to having seen sheepdogs copulating whilst visiting a farm with his father and thus transposing the sheepdogs for his parents. Although Sergei complained of being worse than ever despite over 50 years of therapy, with various Freudian disciples Freud used The Wolf Man as his main case to prove the validity of psychoanalysis. (Trans. Louise Adey Huish), (2002)

Rat Man

Rat Man was the name given by Freud to Ernst Lanzer in a case study published in 1909 under the name ‘Notes Upon A Case Of Obsessional Neurosis’ and again in The ‘Wolfman’ and Other Cases.

Ernst was suffering with a superstitious attitude that prevented him from being happy. He had obsessive thoughts about people he cared for, in particular Ernst would imagine his father or his fiancée being subjected to a form of torture described to Ernst whilst in the Army. In which a pot is placed on the buttocks and rats are placed into the bucket and allowed to burrow into the anus. Ernst’s father had already died by this point but the guilt of these thoughts would continue to haunt Ernst. As would the guilt of a fleeting thought as a 12 year old boy in which Ernst wished his father dead so that he could inherit his money to impress a girl. Also whilst in the Army Ernst is overwhelmed with guilt when he discovers he owes someone money, bringing the intrusive thoughts of rat torture back into his awareness.

Freud believed that a conflict of aggressive and loving impulses relating to his fiancée and his father were producing the thoughts, and that these impulses had begun in infancy during the development of his sexuality.

Evaluation and Conclusion

As previously mentioned Freud left very little in terms of patient records, he made no notes during sessions and so any notes made were based on his memories of what was said, so there is not much first hand evidence that supports his theories.

What we do know though is that the majority of his patients were women from middle class Jewish families, (Shorter, 1997) which is not representative of the human population. In fact in his work Sex and Repression in Savage Society (1927), the anthropologist Bronislaw Malinowski discovered that in the Trobriand Isles they have an avuncular society and the boys are disciplined by their maternal uncles rather than fathers. Because of this boys had dreams where the target of their anxieties was their uncle and not their father.

Based on this, Malinowski proposed that power, rather than sexual jealousy, is the base for the Oedipal complex.

Freud proposed that without a male role model a boy would become homosexual, however in a longitudinal study by Fiona Tasker and Susan Golombok they found that children raised by lesbian parents don’t differ from those raised by heterosexual parents in terms of gender role and sexual orientation, merely in their acceptance of homosexuality.

Although Little Hans was widely quoted as evidence for the Oedipal complex, Freud had already developed his theories at least 4 years previous, so it can certainly be argued that Freud’s interpretation was used to justify his theory not develop it. (Fisher & Greenberg 1996). An unnerving quote by Freud published by Eysenck and Wilson in 1973 concerning Little Hans was “It is true that during analysis Hans had to be told many things which he could not say himself that he had to be presented with thoughts which he had so far shown no signs of possessing and that his attention had to be turned in the direction from which his father was expecting something to come.”

Hans was certainly being led, either by Freud or by Hans’ father.

Behaviourists would certainly argue that the sight of seeing a horse have a heart attack and fall on someone, killing them, could certainly cause Hans’ phobic response. An incident that did indeed happen prior to Hans developing his issue.

With regards to Freud’s technique of Free Association Gellner (1985) argued that the requirement that patients free associate while the analyst listens in silence, is an important ingredient in fostering a state of disorientation that causes the patient to mistrust their own thoughts “The analyst’s silence does indeed constitute or engender, not so much sensory, as conceptual deprivation. The patient is not allowed to erect and maintain patterns of his own (that would not be free association), and he is initially denied any patterns by the prestigious therapist.” Softened-up by a month or two of such treatment, Gellner says the patient becomes so hungry for explanations that when finally one is offered by the analyst, it is grabbed at uncritically. Does free association provide the answers for patients or does it simply create further questions that would ordinarily have been pointless?

Another question that needs answering I feel, is how much of Freud’s theories came from his experiences with his patients and how much came from his own self analysis? During the 1890’s Freud began recalling his own feelings towards his parents including the sexual feelings for his mother. Was Freud developing these theories merely to explain his own issues or were his theories really about the population as a whole?

That’s not to say that everything Freud said must be wrong though, there is great evidence to support Freud’s proposal of Oral and Anal personality traits. As well as the development of our Ego and existence of Id urges.

Although it does seem inadequately supported that all issues derive from sexual desires.

Freud’s revolutionary proposals and the effect he had on those who followed him clearly establish that his theories have had a huge impact in the field of Psychotherapy. However, with the way we understand clinical, empirical evidence today I have to agree with Adolf Grunbaum, (1984) that although there are elements of science in Freud’s approach to his theories there is no evidence to support it as being the truth.

After reading through Freud’s case studies I do not feel that there is significant evidence in them to establish his theories as wholly accurate. But as Stephen Frosh (1997) says with regard to psychoanalysis “It offers nothing, but at least it does not run away.”