When You Don't Know Where to Turn / A Self-Diagnosing Guide to Counseling and Therapy

by Steven J. Bartlett

For wide-range improvements in individuals
who are not severely impaired and who are
articulate, reflective, patient, self-disciplined,
and able to make a potentially long-term
commitment to therapy.

The past hides but is present....
Bernard Malamud, A New Life

Psychoanalysis is the root from which the large family of different theories of psychotherapy and counseling has grown. Sigmund Freud's first efforts to develop psychoanalysis began in the 1880s. He lived a long life and was active into his eighties; he died in 1939. Freud left behind one of the most important contributions to the field of mental and emotional health. It formed the historical basis for the diversity of approaches that would follow. Even when later thinkers took issue with Freud, their work in different ways relied on the foundation of his pioneering work.

Many of Freud's ideas have worked their way into our everyday vocabulary: the unconscious, the ego, repression, the Oedipus complex, and so forth. His work has influenced the study of anthropology, sociology, history, philosophy, and literature.

FREUD'S THEORY

During Freud's early medical training, he went to Paris to study with a well-known neurologist, J. M. Charcot. Charcot had begun to use hypnosis to treat patients with certain physical disorders—paralysis, for example—for which there was no apparent physical cause (so-called hysterical symptoms). Working with Charcot, and later with a physician, Joseph Breuer, Freud began to suspect that these symptoms were motivated by earlier traumatic experiences that so distressed the patients that they were forgotten (repressed).

Freud's theory of emotional and mental illness began then to take shape around this central idea that neurotic behavior has a purpose: there is an underlying motive, the motive itself is very upsetting to the person, and so it is repressed from awareness. But it continues to gnaw away below the level of conscious awareness and eventually leads to the disturbance that brings the patient to the point at which he or she is in need of professional help. Freud believed that recovery would occur if a patient could be helped to gain insight into these painful events and feelings that had been forgotten or suppressed. In a moment, we will look at two real examples.

Freud's theory has several dimensions. First, his theory offers an explanation of how the mind operates through its defense mechanisms: as we have noted, excessively painful feelings and memories are repressed. Second, his theory tries to identify the different psychologically critical stages children go through on their way to adulthood: the oral, anal, and genital stages. And third, his theory seeks to distinguish the parts of the psyche, which together underlie an individual's personality: the ego (the rational portion of the mind that deals with reality), the id (made up of basic instincts that press for gratification), and the superego (formed from parental influences that have been internalized).

HOW PSYCHOANALYSIS IS DONE

Together, these three so-called dynamic, developmental, and intrapsychic dimensions of Freud's theory make up the general framework of psychoanalysis. The central technique of psychoanalysis is to help the patient become aware of motives that are unconscious. Psychoanalysis, or analysis for short, is basically an attempt to extend self-control, bringing disturbing feelings and behavior under a person's conscious management.