This is the 2007 version. Click here for the 2017 chapter 13 table of contents.


The word psychoanalysis refers specifically to Freud's approach to conducting therapy. Freud was trained as a medical doctor before turning his attention to psychological disorders, and to this day a psychoanalyst is typically a psychiatrist—an MD who has taken a residency in psychiatry after completing medical school. Psychoanalysts without medical degrees are called lay analysts.

In psychoanalysis, an individual's life is reviewed and the individual's personality is interpreted in accordance with Freud's theory.

To what does the word "psychoanalysis" refer?

Where is the emphasis placed, in classic psychoanalysis?

In classic psychoanalysis, considerable emphasis is placed on the "family drama" of sexual conflicts and other Freudian theoretical constructs, described in Chapter 11. For example, the individual's problems are likely to be traced to difficulties in one of the psychosexual stages.

Psychoanalysis has always been associated more with psychiatry than psychology.

When psychoanalysis first arrived in the United States, most psychologists ignored it. By the 1920's, however, psychoanalysis had so captured the public imagination that it threatened to eclipse experimental psychology entirely. (Hornstein, 1992)

As Hornstein indicates, despite the negative opinions of most psychologists, psychoanalysis caught on with the public. By World War II it was the dominant type of psychotherapy.

When did psychoanalysis have its heyday?

Psychoanalysis had its heyday in the United States from 1940 to 1960 during which it was hailed as the inspired hope for dealing with most, if not all, of the problems in mental health. (Wolberg,1989)

Where is psychoanalysis still a dominant therapy?

Psychoanalysis could not live up to such inflated promises. It suffered a decrease in popularity from the 1960s onward. Today relatively few therapists in the United States practice psychoanalysis. It is still a dominant mode of therapy in some European countries such as France and Belgium. Variations of cathartic therapy, not necessarily Freudian in outlook, are still common in the United States.

What are common features of psychoanalysis as a therapy?

Psychoanalysis as a therapy is typically very time-consuming, sometimes requiring many years. During this time, all facets of a patient's childhood are explored in detail, especially the relationship with the parents. Techniques such as dream interpretation, free association, or inkblot interpretation may be used to explore unconscious conflicts. If the analyst accepts Freud's formulations, most of those conflicts are thought to involve repressed sexual urges of childhood.

Psychoanalytic therapy is usually quite expensive. The total cost may exceed $30,000 after years of therapy. Freud claimed the high cost of psychoanalysis was actually therapeutic, because it symbolized a commitment to change and a serious desire to expose the truth.

What is transference and how is it used in psychoanalysis? What do critics point out?

Psychoanalysts expect the phenomenon of transference to occur in therapy. Transference is a tendency to put the psychoanalyst in the same role as an important othersuch as a parent or a spouse. Transference results in intensely positive or negative feelings about the therapist (called positive and negative transference, respectively). Freud thought transference was useful for (1) understanding how the patient interacted with important others, and (2) achieving a certain power or social influence over the patient. Critics of psychoanalysis point out the negative aspects of transference, such as the formation of an emotional attachment to the therapist that may add complications to a patient's life.

Why is it simple-minded to render a global judgment about psychoanalysis?

Many variations of the psychoanalytic technique exist. Some therapists sit face-to-face with their patients and emphasize problem-solving in the present, rather than analysis of childhood problems. Some use hypnosis; some do not. Some agree with much of Freud's original theory, others accept only parts of it.

Research on psychotherapy shows that most forms of therapy work equally well, if success is measured by the percentage of clients who report improvement. That would appear to give an advantage to briefer and less expensive therapies. But there is no such thing as an average person, so in the final analysis (so to speak) each person must make an individual judgment about which therapy is preferred.

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Copyright © 2007-2011 Russ Dewey