In the last century, psychoanalysis has incorporated itself as one of the paramount disciplines within the field of psychiatry. The father of psychoanalysis is unequivocally Sigmund Freud; and while the science of psychoanalysis has advanced far beyond Freud, and his basic principles, his influence is still strong and pervasive.
Freud’s basic principles are central in the practice of psychiatry and in psychotherapeutic practice; namely, psychic determination, unconscious mental activity, and the effects on childhood on the development of our adult psyche (Semple, Smyth, Burns, Darjee, & McIntosh, 2005). Freud also focused on the role of meaning in his vision of psychoanalysis. In his opinion, symptoms, thoughts, feelings, and behaviors were all common end points in psychological processes, many of which he believed were part of the unconscious. Besides the effect that biology has on the pathogenesis of a disease, the disease may still have a psychological component for the patient; for example, while a disorder may manifest with auditory hallucinations, the specifics of what he hears and the voice telling it to him is specific to his psychological characteristics (Sadock & Sadock, 2007). In psychoanalysis, unconscious factors play an important role in shaping symptoms and their true meaning.
During his time in Vienna, Freud began to work with Josef Bauer, and together they collaborated on a study of patients with hysteria, with the culmination of the published work “Studies in Hysteria”. Bauer described a patient he was treating that developed various symptoms associated with her hysteria, which included: paralysis, cough, vision loss, and sudden personality changes; these symptoms started when her father was diagnosed as terminally ill. Bauer observed that the symptoms went away when he put her under hypnosis, but they would recur following the sessions ending. When the sessions were completely terminated, she suffered a full-blown relapse. In “Studies of Hysteria” they described that trauma is repressed from a patient’s conscious memory because it is conceived as undesirable (Sadock & Sadock, 2007). The repression activates the nervous system and leads to the development of hysteria; because there is a residual conscious component, the symptoms can be resolved during hypnosis.
While Freud was expanding on his ideas of repressed memories, and the possibilities in uncovering these memories, he developed the technique of free association (Semple, Smyth, Burns, Darjee, & McIntosh, 2005), where patients were told to just say whatever came to their mind. He recognized the patients either did not follow his instructions or stayed silent. This technique known as resistance, among other techniques such as, transference, where patients developed feelings towards him, and counter transference are at the core of treatment in psychoanalysis. This idea of resistance, Freud realized was an unconscious behavior, and activities such as forgetting to fill a prescription, or missing an appointment all reflected unconscious resistance.
In Freud’s pivotal work, Interpretation of Dreams, originally published in 1913, he described how to analyze the content of the dream, described defense mechanisms, and included his topographical model of the mind, which divided the mind into three distinct regions: the conscious, preconscious, and unconscious; each is unique, and has its own function (Semple, Smyth, Burns, Darjee, & McIntosh, 2005). The basic drives of a person, which include, the libido, which is the mental manifestation of the sexual drive, the eros, and thanatos, were described by Freud in his “Drive Theory”. He described the pleasure principle, where one tries to avoid pain and experience pleasure, and its connection with the reality principle (Freud, S., 1922/2010). Jung later expanded Freud’s drive theory to include instinctual drives other then sexual ones.
Freud’s Three essays on the Theory of Sexuality, originally publish in 1905, he described his views regarding childhood development and the developmental phases including, the oral, anal, urethral, phallic, latency, and genital stages, as well as sexual perversions such as the Oedipal complex, where the child has sexual feelings towards the parent of the opposite sex (Rycroft, 1995), and their association with adult psychosis.
The oral stage is the earliest psychosexual stage of development. All interactions and expressions are centered and associated with the mouth, such as breastfeeding. It controls the psyche of the infant until approximately 18 months of age. Excessive oral fulfillment or deprivation can lead to pathological traits such as: optimism, narcissism, pessimism, and demandingness. Oral characteristics are found in people that are dependent on others. Envy and jealousy are also associated with oral characteristics (Freud, 1920).
The anal stage is marked by the progressive self-control of the sphincters; it extends from approximately 1 year of age until about 3 years of age. The fixation on anal functions brings about: orderliness, obstinacy, willfulness, frugality, and stubbornness. Anal characteristics are most often seen with OCD (Freud, 1920).
The phallic stage is characterized by a focus on the, and the stimulation of, genital areas; it follows the anal stage and is found between the ages of three through five years old. Interest in the penis is found in both sexes. Associated with increased genital masturbation. Finally, the genital stage is associated with the onset of puberty and continues on through early adulthood. Successful resolution of this stage of development leads to the development of a person that has a consistent sense of identity (Freud, S. 1920).
Freud’s point of view transitioned from the topographical model of the mind to the structural model of the mind with the publication of “The Ego and the Id”; where he described the ego, id, and superego (Sadock & Sadock, 2007). This change in thinking came about because Freud recognized that the unconscious and a person’s instinct did not have as definite a connection as he once thought they did. The Ego is part of all three structural models of the mind; complex thought processes and verbal expression are conscious and preconscious parts of the ego, while ones defense mechanisms are part of the unconscious (Sadock & Sadock, 2007). The ego is the control center of the psyche and controls contact with reality; the defense mechanisms available adjust they way we connect with reality.
Our earliest wants and needs are controlled by the id; it is the basic instinctual drive that we are born with (Rycroft, 1995). The id functions under the pleasure principle and therefore, as mentioned previously, seeks to avoid pain. The superego functions as the persons moral conscious, it provides the morals by which the ego functions (Sadock & Sadock, 2007).
When Freud died in 1939, his daughter continued to publish and refine his work. Following Freud’s “creation” of psychoanalysis as a field, many schools of thought developed. Carl Jung developed analytical psychology. He proposed and developed the idea of the extraverted personality, which describes a typical outgoing, talkative, and energetic personality, and the introverted personality, which is the polar opposite. He also developed the idea of archetypes, which were “archaic” images of the unconscious; he thought them to be distinct from instincts (Feist & Feist, 2007).
Erik Erikson was a psychologist and psychoanalyst who described his theories of psychosocial development. Where Freud looked at the internal aspects of a person, Erikson focused on the boundaries between a child and his environment (Erikson, 1968), and explained the how the maturing ego relates to its expanding environment. His theories were based on the principles of epigenetics, where just like in embryology, where the term was taken from, development occurs in sequential steps, and that each step must be fulfilled before smooth transition to the next one can occur, and if it does not occur the successive stages reflect this, and in the case of Erikson described that they would be either, socially, cognitively, physically, or emotionally underdeveloped (McLeod, 2008). Erikson accepted Freud’s theories on instinct and infant sexuality; for each of the stages that Freud developed (oral, anal, and phallic), Erikson described similar stages with their own specific pattern of behavior. He also developed on Freud’s theory of the ego; instead of only being the result of inner wants, Erikson explained that it was also associated with the person’s surroundings.
The center of his work revolved around the development of what he called the eight stages of the life cycle (Erikson, 1968). The first stage is found in infancy and is known as trust vs. mistrust. Because the emphasis in this early part of life is on nurturing and care by the caregiver; there develops a sense of trust between these two for proper development. Therefore a child will develop trust and confidence if nurtured properly (Erikson, 1968).
The next stage of development is found in the toddler years and is known as autonomy vs. shame. During this period of life, the child learns the difference between right and wrong, and is able to build self-esteem and autonomy. Properly nurtured the child learns to feel confident and carries him- or her-self with a sense of pride. Neglected in this stage, the child will feel shame and unconfident in his capabilities. This stage of development is also very vulnerable; this is because with great number of new skills learned at this point of life, it is easy to feel shame, if one is unable to learn a new skill. In the pre-school years the stage of initiative vs. guilt comes about. During this stage children tend to copy adults and their surroundings, and use their imaginations to create games (Erikson, 1968). These games tend to revolve around what we think it means to be an adult (e.g. playing house). This stage is associated with the Oedipal complex described by Freud.
Industry vs. Inferiority found in school aged children is associated with they ability to learn and understand new concepts; it is inherently a very social stage, and problems with development may lead to low self – esteem. The following four stages, Identity vs. confusion, intimacy vs. isolation, generativity vs. self, and finally integrity vs. despair, are found from late teenage years through old age respectively. During the stage identity vs. confusion we are trying to identify who we are. During Intimacy vs. isolation we are concerned with finding companions and true love. A middle age person battles generativity vs. self. Erikson described generativity as the want to produced something or be the reason for the development of some major change for the betterment of society. The final stage of life, integrity vs. despair, is characterized by reflecting on our lives, and how we choose to leave this world.
Each stage had what he called a “virtue” which essentially was the favorable outcome for that corresponding stage of development. Erikson’s work culminating in the understanding of the theories of the creation of ones identity. They seemed to stem from the fact that he himself had problems identifying his own identity. Freud and Erikson seem to have made the biggest and longest lasting impressions in the field of psychoanalysis.
Other schools of thought in psychoanalysis include, Donald Winnicott who developed object relations theory, which describes that people relate to other people and situations based on ones early experience (Greenberg & Mitchell, 1983); and he developed the idea of a “good enough mother.” Melanie Klein developed theories regarding childhood and the development of the innate defense mechanism; her work incorporated Freud’s theories on the eros and thanatos; she had a great impact in the field of child psychiatry (Melanie Klein, n.d).
Psychoanalysis is both a method of describing human behavior and a method of treatment. It is influenced by the biological and social sciences as well as group behavior, philosophy and literature. The subject itself contributes to psychology and psychiatry, law, and family studies. Besides its association with the body and mind, psychoanalysis also serves as the method of understanding the role emotions have in physical and mental health.
Works Cited
Rycroft, C. (1995). A Critical Dictionary of Psychoanalysis (2nd ed.) London:Puffin
Freud,S (1922). Beyond the Pleasure Principle; (C. J. M. Hubback trans.) London, Vienna: International Psycho-Analytical; Retrieved from: Bartleby.com, 2010. www.bartleby.com/276/
Freud, S. (1920) Three contributions to the theory of sex (A.A. Brill trans.)
Retrieved from: http://www.gutenberg.org/files/14969/14969-h/14969-h.htm
Freud, S. (1913). Interpretation of Dreams (3rd ed.) (A.A Brill trans.) New York: The Macmillan Company. Retrieved from: Bartleby.com, 2010. www.bartleby.com/285/
Sadock,B., & Sadock,V (2007). Kaplan & Sadock’s Synopsis of Psychiatry (10th ed.) Philadelphia:Lippincott, Williams & Wilkins
Semple, D., Smyth, R., Burns, J., Darjee, R., McIntosh, A. (2005) Oxford Handbook of Psychiatry (1st ed.) New York :Oxford University Press
Fiest J, Fiest G, (2009) Theories of Personality. New York New York; McGraw-Hill
Superego (n.d) In Encyclopedia Britannica Online. Retrieved from: http://www.britannica.com/EBchecked/topic/574274/superego
McLeod, S. (2008) Erik Erikson. Retrieved from: http://www.simplypsychology.org/Erik-Erikson.html
Erikson, E.H. (1968) Identity: Youth and Crisis. New York: Norton
Grenber, J. & Mitchell, S. (1983). Object Relations in psychoanalytic theory. Massachusetts and London: Harvard University Press
Melanie Klein (n.d) In Encyclopedia Britannica Online. Retrieved from: http://www.britannica.com/EBchecked/topic/574274/superego
