Cross Currents: Chapter 11
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Welcome back. He wanted to pursue a career as a research scientist in neuroanatomy and neurophysiology, did laboratory work in Vienna after his medical training and wrote many purely scientific papers. Indeed, his first extensive treatise unpublished was an attempt to express psychology in neurological terms, and his first book, On Aphasia , was a neurological treatise. But a Jew could not make a living in neurological research, so Freud turned to clinical work, taking on the cases other doctors could not help.
He and his mentor, Josef Breuer, applied various nostrums, including hypnosis and electrotherapy, but mostly they listened and began to make interpretations about the sexual fantasies of their patients. This material proved too much for Breuer or, more accurately, for Mrs Breuer , who abandoned this line of work. Freud persevered, eventually coming to attribute neuroses to unconscious sexual impulses and conflicts. He initially stressed sexual abuse but moved on to attribute neuroses to both actual and fantasied sexual distress.
Freud also wrote some popular works— The Psychopathology of Everyday Life and Jokes and Their Relation to the Unconscious— and was not above the odd populist potboiler to help the psychoanalytic press keep solvent. His complete psychological works make up 24 volumes, but at the heart of it all is the role of sexuality, interpreted very broadly, in human nature and of the unconscious in human motivation.
He argued that by far the largest portion of our thought processes are unconscious, and that unconscious motivation is by far the most determinate part of our minds. His discoveries in this area place him in the tradition of ideas that diminish human arrogance and status. In this his work follows the Copernican dethronement of the Earth from the centre of the solar system, the Darwinian removal of humankind from a special place at the peak of living nature, and the Marxist assertion that economic causation lies at the heart of human arrangements and culture.
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The claims about the role of the unconscious have also been broadened to say that the inner world is more determinate than the outer world of who we are and how we act. This is not to say that the outer world is ineffectual, but rather that our early experiences of care and upbringing set the tone of how we feel and react for the rest of our lives.
Psychoanalytic training schools and institutes were set up all over the world and continue to train psychoanalysts, while psychotherapy trainings have also prospered. He won the Goethe prize for his writings, and he was made a corresponding member of the Royal Society of London when he immigrated to Hampstead just before he died. When I was a university student in the s, psychoanalysis was at the peak of its influence, and many posts in medical schools were held by psychoanalysts.
Self and Other : Object Relations in Psychoanalysis and Literature
But Freud and psychoanalysis have always had their detractors, particularly among traditional psychiatrists or the new generation of psychopharmacologists who aspired to treat mental illness by drugs. There was a concerted counterattack on psychoanalysis by the traditional psychiatrists in the s that centred on the editorship of the Diagnostic and Statistical Manual of the American Psychiatric Association, the main textbook of student psychiatrists and reference work for practitioners throughout the world. A professor at Columbia, Robert Spitzer, was approached to edit a revision of the manual.
He said he would accept on the condition that he could determine the board of editors and that they could expunge all trace of psychoanalytic and psychodynamic thinking from the revised edition. And so it came to pass. There was a standing ovation at the meeting when this coup was announced. This period saw another institutional attack on psychodynamic therapies. The insurance companies that pay for psychotherapy became reluctant to fund open-ended psychological treatments, preferring short-term interventions and ongoing drug regimes. Even though prolonged drug treatments have since been discredited for most conditions, this view remains to the present day.
Most people cannot afford private psychotherapy, much less psychoanalysis four or five times a week. Some countries, like Germany and Canada, enjoy state funding of such treatments. The latest appeal in Britain, by Richard Layard, an LSE economist and adviser to No 10, calls for 10, more therapists to treat the large number of people suffering from depression and anxiety, but Layard advocates the use of cognitive behavioural therapy CBT , decidedly un-psychodynamic. CBT is useful in its place, but it is psychoanalytic psychotherapy that reaches the parts other therapists do not reach. Marxism had been another traditional source of critiques of psychoanalysis—most Marxists mocked psychoanalysis as subjectivist, accusing it of ignoring material conditions.
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Reich believed that neurosis could be eliminated by removing sexual repression, as described in his The Mass Psychology of Fascism and The Function of the Orgasm. He believed that repression was necessary for civility but distinguished biologically necessary repression from that which was specific to different historical periods, like the capitalist era. More recently, Victor Wolfenstein, who is both a political scientist and a psychoanalyst, has made imaginative integrations of psychoanalysis and Marxism in his The Victims of Democracy: Malcolm X and the Black Revolution , which I consider to be the best psychobiography there is, and Psychoanalytic-Marxism: Groundwork.
And it is Plato and Shakespeare, Proust, Nietzsche and, most recently, Freud who complicated the issue by insisting that there are deep currents of meaning, often cross-currents, running through the human soul which can at best be glimpsed through a glass darkly. But for the most part, the psychoanalytic community has not given a very good account of itself.
I find this failure to rebut the critics of psychoanalysis somewhat odd. Behaviourists and Darwinian psychologists share a contempt for explanations in terms of unconscious motivation and opt instead for habits and genes as the determinants of human behaviour. And yet it is psychoanalysis, with its dynamic view of the complexities of human motivation, that resonates with literature, drama, fine art, film and music, including folk, country and pop.
There is a shrinkage of patients, trainees and practitioners, though all agree that the amount of psychological distress remains high and is growing.
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The elite psychoanalytic training institutes have put their wagons in a circle and have created a caste hierarchy.