What is Psychoanalysis? An Overview


Psychoanalysis is the psychotherapeutic theory established by Austrian neurologist Sigmund Freud in the late 1890s, gaining popularity throughout the early 20th century. The basic proponents of psychoanalysis include the following:
(1) Personality is determined by early childhood development, (2) human experience, cognition, and behavior are determined by unconscious irrational inner drives, (3) any effort to bring unconscious drives to conscious awareness is met with defense mechanisms which resist this effort, (4) conflicts between the unconscious and conscious can result in mental pathology or disturbances (neurosis, obsessions, anxiety etc.), (6) bringing unconscious material to the conscious mind with the assistance of a skilled therapist can relieve an individual of their mental disturbances (Atkinson, Mitchell, Muir, Passer & Smith, 2008).

Psychoanalysis in the research context has much to do with the study of child development and identifying the early determiners of neurosis. Psychoanalysis in the clinical or treatment context refers to a type of therapy in which the patient verbalizes thoughts as they come to mind, rather than repeating ideas or answering questions of the analysts, a technique called free-association. The analyzer interprets what was said during free-association for sources of unconscious and conscious conflicts- the cause of the mental disturbances. The theory states that unconscious symbols found in the sessions of free association are directly related to life events. These events are often negative and are repressed by the patient causing the mental disorder. Insight is presented to the patient so he or she can confront the issues and resolve the problem, a process called “transference” (Freud, 2005).
Sigmund Freud
Sigmund Freud

History of Pseudoscience

Hysteria, Neurosis and Repression

Sigmund Freud, the father of psychoanalysis, was born in Freidberg, Moravia in 1856 to a Jewish family. His family moved to Vienna when we has young. Freud studied medicine at the University of Vienna and specialized in neurology. In the 1880s, early in his practicing career, Freud was inspired by his colleague Dr. Joseph Breuer. Breur was using the technique of hypnosis to cure hysteria patients. Patients were hypnotized, and led to talk freely throughout the session. Herein lies the birth of psychoanalysis with the introduction of the free-association technique to treatment. Shortly thereafter Freud went to France to study at La Salpetriere Hospital with Jean-Martin Charcot, a famous French psychiatrist. Freud and Charcot worked together investigating the use of psychoanalysis on patients with aphasia and cerebral palsy. It wasn’t until later that Freud began researching hysteria and memory repression. It 1896 he published his first theory of repression and seduction with the assistance of Breur in his book Studies on Hysteria. While working at the Bernheim’s Clinic in Nancy, France, Freud learned that he could prompt people to recall forgotten memories. (Freud, 1917). His research here led him to believe that hysteria was a particular type of neurosis in which the person is experiencing symptoms due to some inescapable repressed trauma. Despite the repression, the negative essence continues to exist and pushes into the conscious realm. Due to the struggle, these feelings manifest themselves as psychotic symptoms (hysteria) and sometimes even physical disease (blindness, paralysis etc). These repressed traumatic memories, Freud suggests, are often sexual fantasies of early childhood. Suppressed libido can also creates the symptoms of hysteria (LaCapra, 1987). This theory is also used to explain female hysteria which was believed to be the result of “penis envy” where women unconsciously desire the power associated with being a man. After discovering that he himself has little skill in hypnotism, Freud abandoned this technique all together. He began exclusively using the free association, talk-therapy technique psychoanalysis is most famous for (Beeley, 1931).

Interpretation of Dreams

In 1900, Freud became increasingly interested in the significance of symbols in dreams, and that same year he published his book The Interpretation of Dreams. This theory was centered around the idea that the unconscious presented symbols to the individual during dreams, symbols had mean subjective to the dreamer. Frequently these symbols were related to suppressed sexual feelings. He proposed that the mind was separated into the consciousness, pre-consciousness, and unconsciousness, a theory he called “topographic theory” (Lear, 2005).

Psychosexual Phases
Psychosexual Stages of Development
Psychosexual Stages of Development

In 1905 Freud formulated his theory of child development, which involve different phases of perseverations. He called the stages the “psychosexual phases” of development. They included, the oral, anal, phallic-oedipal, latency and mature genital stages. Perseverating too long in one phase, or failing to move onto the next, he believed, could cause disorder in adulthood (Tauber, 2010). Freud’s theory of child development was not widely accepted.

Structural Theory

Freud’s topographic theory was replaced by his structural theory in 1915, when he wrote the book The Ego and the Id. This new theory divides the mind or psyche into the id, the ego and the superego. The id is the first of the three to develop in an individual and consists of primal drives and instinctual urges. The ego is the more later developing, logical and rational part of the psyche and deals with the real world and suppressing the primal urges of the id. Lastly, the superego is the moral part of the psyche, dictating what the individual ought to be doing. When the urges from the three parts of the psyche are misaligned (i.e what the individual is doing in real life, the ego, does not match what he feels he ought to be doing, the superego) anxiety results. This theory is also used to explain narcissism where aggression is turned inwards towards the self and the poorly developed ego is unable to cope with these demands. It is believed that self-hate and self-directed hostility can lead to depression, neurosis and schizophrenia (Lear, 2005).

Freud, the 40s and Forward

Freud began to develop a following, while at the same time being the subject of harsh critique. His theories were especially popular with the European elitists. Following his death in 1939, his work was picked up by a group of Austrian psychiatrists led by Heinz Hartmann. This group was interested in Freud’s The Ego and the Id, particularly the function of the ego and the effects of discordant psyche on memory, attention and intelligence. Despite strong criticism, child psychoanalysis was further researched and used in a therapy environment. It is still used to account for some child mental disorders and past traumas. In the mid 1960s, with the rise of the women’s revolution and feminist movement, modern Freudians abandoned the theories of female hysteria, neurosis and penis envy. Similarly, theories related to homosexuals were abandoned shortly thereafter with the gay-rights movement . Many of Freud theories continue to be influential in psychology today, particularly those involving unconscious influences (Lear, 2005). Current psychoanalysts practice modified theories based on the work of Freud on account of the harsh critiques associated with his original works. Freud's original theories are not widely perceived as reputable today with more biological theories of child development and mental illness existing. However, the practice of talk-therapy is still wide spread in its use, with the therapist taking less of a symbolic interpreter or analyzer position (Pigliucci, 2012). In 2010 the International Psychoanalytical Association (IPA) celebrated it’s 100 year anniversary with its 12 000 members. The IPA continues to train professionals at their institutes around the world (International Psychoanalytic Association, n.d.).

The video below summarizes a brief history of the IPA.








But is Psychoanalysis Based on Science?

Psychoanalysts believe that they are genuine scientists and that psychoanalysis is based on science. They claim that there are methods of testing psychoanalytic theories. For example, the interpreter or analyst can test the validity of a free-association interpretation by observing the reaction of the client. For a correct interpretation, the client may open up and provide additional details or they may get aggravated and deny the interpretation, perhaps even resisting further treatment. The key is that there is some reaction. With an incorrect interpretation neither of the two will happen (Mathers, 1986). This demonstrates some element of falsifiability according to the psychoanalysts. The transcendental realism model of science stemming from Kantian philosophy has attracted considerable interest among psychologists and psychiatrists. This theory contains three principles. The first states that there exist a world apart from men which goes beyond the limits of human consciousness. Secondly, science tries to understand that which makes up the real world. Thirdly, all natural laws are true, they are not just hypothesis that explain common patterns. Scientific activity develops first with the “empirical identification of a phenomenon using existing cognitive materials; second, a plausible explanation of the phenomenon is invented in the form of a possible generative mechanism; third, the reality of this imagined generative mechanism is tested empirically” (Mathers, 1986, p. 103). Thus, psychoanalysts believe that Freudian theories follow this scientific model. A therapist observes a certain behavior in a client. Using evidence found in session, the therapist makes a hypothesis as to the cause of this behavior. This hypothesis is tested in the following session and client outcomes are observed. However, the transcendental realist model fails to take into account the problem of objectivity. The therapist's interpretation of the client outcome is largely subjective, and the phenomenon of “transference” is by no means measurable (Mathers, 1986).
With this is mind, psychoanalysts appeal to other empirical support that demonstrates that their therapeutic interventions are effective. They bring forth the many cases of symptom remission in their patients. Remission is evident in cases which demonstrate increases self-esteem, finding more pleasure in life, building more fulfilling relationships etc. However, it is important to note that there are discrepancies between what is and what is not perceived as evidence. Similarly there lacks evidence between the effectiveness of psychotherapy therapy versus other forms of therapy or a placebo (Shelder, 2010).

Why Psychoanalysis is a Pseudoscience


The purpose of demarcation is to distinguish between what is scientific and non-scientific. In the research context demarcation guides scientific advances, the interpretation of data and the allocation of funding. Socially, demarcation is important because it allows consumers to make informed decisions based on evidence provided and dictates what can be taught in school. Science is granted a significant amount of respect within society, thus it is important to determine what evidence is deemed scientific. Delimiting science continues to be a topic of debate (Bortolotti, 2008).

The local positivists of the Vienna Circle believed that verifiability was the criteria for demarcation. They proposed that a scientific statement could be differentiated from non-scientific (specifically metaphysical) statements if the statement could be verified (Stanford Encyclopedia of Philosophy, 2008). Karl Popper, a British Philosopher rejected the idea of verifiability as the criteria for demarcation, and claimed that it is falsifiability that makes science distinct. According to Popper, science is governed by hypothesis and testing, two vital components that make up his theory of falsification (1963). Popper rejected verifiability because it relies on the process of induction which is frequently used by pseudosciences to argue the case of scientific consideration. Psychoanalysts are known to appeal to the verifiability criterion. Consider the following example:

A male patient with severe depression comes to a clinic. A psychoanalyst leads a session of free-association. The patients describes how he has not had a real relationship in years and how he feels like he is not worthy of the love of others. The analyst prompts him to describe his most recent dreams, and the patient talks about being trapped in a cave. The analyst interprets the cave to represent his mothers womb and tells the patient that he is depressed because he is repressing sexual feelings that he had for his mother as a child. The patient is enraged and storms out, yet he returns to the next session.

Psychoanalysts would take the patients response to be evidence of verifiability. Yet the same enraged reaction could result from any number of interpretations. Note that the analyst is subjectively interpreting the session. Psychoanalysis is highly subject to bias. The same case study could be interpreted in various ways, all of which could be correct. Verifiability could support numerous theories for depression, even if these theories were unscientific (Pope, 1998).

Karl Popper
Karl Popper

Popper states that falsification demarcates scientific theories from pseudoscience. He claims that a hypothesis must, in some way, have a method of falsification if it is to be considered science. Any statement, theory or hypothesis which can not be falsified is non-scientific. This is key, because if a theory can not be falsified, it can not be tested, and thus the theory can not evolve. The terms falsifiable and testable are used interchangeably, thus any attempts to test a theory is an attempt to falsify (1963).

A summary of Popper’s criteria for falsifiability are as follows (1963):
  1. If sought, verifications can be easily obtained for almost any theory.
  2. Verification should only count if they are the product of “risky predictions”.
  3. Good scientific theories have restrictions, they prohibit something. The more it prohibits the better.
  4. A theory that is not refutable is non-scientific.
  5. Every attempt to test a theory is an attempt to falsify it. Some theories may be more testable than others.
  6. Confirming evidence should only count if it is the product of a genuine test of the theory.
  7. Some theories, despite being tested and found false are still upheld by their believers. These theories use auxiliary assumptions to maintain their theory, and as such posses a lower scientific value.

Why Psychoanalysis Fail to Meet These Criteria

Karl Popper argues that psychoanalysis is unfalsifiable and therefore a pseudoscience. He believes that there is no conceivable way to test any psychoanalytic theories. Moreover, Popper refutes Freud’s structural theory of the mind: “as for Freud's epic of the Ego, the Super-ego, and the Id, no substantially stronger claim to scientific status can be made for it than for Homer's collected stories from Olympus. These theories describe some facts, but in the manner of myths. They contain most interesting psychological suggestions, but not in a testable form” (Popper, 1963, p. 33-39). The structural theory, he concludes is utter nonsense.

Freud is also guilty of using terms in a much broader sense than the literal definition understood by the general public. For example Freud uses the term “sex” in an ambiguous fashion in many of his theories. Sex, he argues, does not always have to include the physical act of intercourse. In his interpretations it can mean anything from “love” to “libido”. This ambiguous definition makes it difficult to test his data in any formal manner (Pigliucci, 2012).

Freud’s theory of the psychosexual phases of development is also highly criticized as being non-science. When forming his theory of development, Freud did not actually observe or study children. His theory was based off of his case studies with his adult patients. Concepts within this theory are unmeasurable, thus untestable, such as the concept of libido. While some argue that aspects of this theory are verifiable, it fails to meet criterion (2) of Popper’s criteria for falsifiability. Freud’s psychosexual phases of development fails to make risky predictions, in fact it can be argued that future predictions can not be made at all. Too much of his theory is open to interpretation, with many of the outcomes being vague in nature (“this could happen”, “this may result”) (Robinson, 1993). The failure to generate genuine psychoanalytic predictions demonstrates its lack of predictive power and qualification as a pseudoscience.

Frank Cioffi- Procedures

Frank Cioffi argues that a pseudoscience is “not constituted merely by formally defective theses but by methodologically defective procedures” (1998, p. 115). He believes that falsifiability is not altogether a sufficient criterion for demarcation. Cioffi argues that if refutability were the only principle with which to demarcate science from non-science, astrology and homeopathic medicine would escape their pseudoscience status. He argues that both astrology and homeopathic medicine can easily be falsified, yet they are both largely accepted as pseudoscience. Instead, he proposes that a new criterion should be used to demarcate science from non-science. His suggestion: “To claim that an enterprise is pseudoscientific is to claim that it involves the habitual and willful employment of methodologically deceptive procedures (in a sense of willful which encompasses refined self-deception).” (1998, 116). He then gives an example of a scientific study in which the researcher fails to use a placebo control group. With current scientific standards, he argues, the failure to employ controls in a study would demonstrate that the researcher was attempting to avoid discovering that his theory was wrong. He believes this is sufficient to grant this study the status of pseudoscience. He believes that the psychoanalysis hypothesis generation process does not produce genuine theories. Examinations of psychoanalytical interpretations demonstrate that the researcher typically processes by beginning with “whatever content his theoretical preconceptions compel him to maintain underlies the symptoms, and then, by working back and forth between it and the explanandum, constructing persuasive but spurious links between them” (Cioffi, 1998, p. 139). He states that psychoanalysts do not interpret fantasies and dreams because they are meaningful, but rather lend meaning so that these phenomena can be interpreted. This evidence demonstrates deceptive procedures in the generation of a hypothesis and theory, and for this reason psychoanalysis is a pseudoscience.

Kipper Williams in the Sunday Times (October 1995) on Why Freud Was Wrong by Richard Webster
Kipper Williams in the Sunday Times (October 1995) on Why Freud Was Wrong by Richard Webster



Potential Harm

The most harming aspect in psychoanalysis is the the potential for memory recovery associated with the free-association technique in therapy. For example, recovering memories of child sex abuse can cause further psychological damage to the patient. Moreover, some patients claim that these memories are untrue, that the therapy caused false memories to be implanted into their minds. Scientists are unable to determine if these memories are repressions that have emerged into the consciousness or if these were formed during the therapy process. By examining patient histories, it can be verified that some of these are examples of repressed memories. Yet not all claims can be verified (Pope, 1998). Case studies have demonstrated that the result of memory recovery has torn apart families, prompted court cases and even pushed patient further into their disorder. Some patients have felt that they were bullied or forced to reproduce memories of sexual abuse (Webster, 1995).

Below is a video of a lecture by University of California Professor, Elizabeth Loftus, where she discusses the science behind implanting false memories.










Conclusion

Psychoanalysis is a form of psychotherapy grounded in theories proposed by Austrian neurologist Sigmund Freud. The practice of psychoanalysis involves interpreting free-association therapy sessions for instances of unconscious and conscious conflict. Correct interpretations can relieve patients of their mental disturbances, a process called “transference”. Psychoanalysis was founded in 1890 and gained considerable popularity in the early 1900s. Despite criticism, components of psychoanalysis are still used today. Demarcation criteria presented by Karl Popper and Frank Cioffi demonstrate that psychoanalysis is in fact not a science, but a pseudoscience. While psychoanalysts argue that psychoanalysis is a testable science, their claims fall short when bias is taken into consideration. Psychoanalysis has significantly declined in popularity since the 1940s, with biological theories of mental health and child development becoming more widespread. Today the International Psychoanalytical Association continues to promote and research psychoanalysis, though with a diminishing presence in the psychological community.


References


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