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Psychoanalysis

Chapter Overview

Learning Objectives

Introduction

Setting the Stage: Antecedent Influences on Psychoanalysis

The History of Attitudes/Ideas Concerning Psychopathology

Sigmund Freud (1856–1939)

Early Life

The Development of Psychoanalysis

Breuer and the Case of Anna O., Studies on Hysteria

Freud’s Seduction Theory

The Interpretation of Dreams

The Psychopathology of Everyday Life

Building a Legacy: Freud and His “Naughty Boys”

Freud in America

Theory of Personality Development

Freud in Exile

The Last Year

Following in Freud’s Footsteps

Anna Freud: Child Psychoanalysis

Ernest Jones

Carl Jung (1875–1961)

The Final Break

Psychological Types

Personality Structure

Alfred Adler (1870–1937)

Individual Psychology

Summary

Chapter Overview

In this chapter, we break away from our discussion of the more experimentally focused areas of scientific psychology to explore the school of psychoanalysis. Psychoanalysis, the early framework of which was the inspiration and life’s work of Sigmund Freud (1856–1939), was influenced by earlier ideas on the nature of psychopathology.

As a means of providing a conceptual framework for a systematic discussion of psychoanalysis, we begin with an overview of the history of attitudes and ideas concerning psychopathology including pre-Hippocratic mystical and surgical approaches to the treatment of pathological behavior. Our discussion of the history of psychopathology then progresses through the Middle Ages where we make note of the first mental asylums. With the institutionalization of the mentally ill there also developed the first systematic study and categorization of types of psychopathological behavior leading to two divergent theoretical views of the etiology of psychopathology, namely, the psychic view and the somatic view.

Hysteria, a common disorder of the 1800s, characterized by sensory and/or motor disability not attributable to an actual physiological dysfunction, provided a proving ground from which to test out and further develop the conflicting ideas and theories of the psychics and the somatics. The somatic model argued that abnormal behavior had a physical cause such as a brain lesion or impaired nerve function whereas the psychic model argued that mental or psychological causes gave rise to abnormal behavior. Sigmund Freud’s theory of psychoanalysis emerged initially from his pursuit of a psychic explanation for the development of hysteric symptoms and developed further into a general theory of personality development.

We proceed to identify the significant ideas and accomplishments of Sigmund Freud, including, his first published work on hysteria, co-authored by Josef Breuer and titled Studies on Hysteria. This inaugural book introduced the technique of having the patient talk about experiences surrounding the onset of symptoms and the patient’s resultant experience of catharsis. Freud published The Interpretation of Dreams which was a self-analysis through the technique of dream analysis. Throughout the course of his professional career, Freud emerges as an often uncompromising and controlling individual. We discuss the work of some of Freud’s followers who further developed psychoanalysis, some of whom proceeded with their own theoretical contributions while maintaining a strict adherence to the theoretical framework established by Freud (such as Sigmund Freud’s daughter Anna Freud and Freud’s biographer Ernest Jones), while others (including Carl Jung, Alfred Adler, and Karen Horney) developed ideas divergent from those of Sigmund Freud.

We conclude this chapter with the contributions of another follower of Freud, namely, Alfred Adler (1870–1937), who ultimately diverged from Freud to develop his individual psychology, which included the concept of the inferiority complex. Adler’s individual psychology, unlike Freudian psychoanalysis, de-emphasized the unconscious mind and instead focused on the conscious and on the role of social urges in determining human behavior.

Learning Objectives

When you finish studying this chapter, you will be prepared to:

Introduction

Psychoanalysis differs in several important ways from the other schools of psychology discussed previously in this text. These schools of psychology arose within universities with the emphasis upon scientific practices including the centrality of laboratory and field-based research. In contrast, psychoanalysis developed and continues to exist primarily in the clinical setting with some ties to academia, although not closely bound. Another key difference between psychoanalysis and other schools of psychology is their primary focus.

Previously described schools of psychology such as behaviorism were focused on explanations of behavior in general, and emphasized quantification of phenomena and experimentation. The scope of some of these schools of psychology was quite broad and encompassed both normal and abnormal behavior of humans as well as infrahumans. In contrast, psychoanalysis, at least in its initial development, was more narrowly focused on the causes and treatments of abnormal human behavior.

While other schools of psychology have waxed and waned in popularity, few have experienced the intensely divisive debate that has characterized psychoanalysis from its inception right up to the present. Psychoanalysis gives rise to intense responses ranging from dogmatic devotion to critical castigation. Regardless of what any individual may think or feel concerning psychoanalysis, the impact of psychoanalysis and its founder Sigmund Freud (1865–1939) on psychology and on popular culture is undeniable, pervasive, and enduring. Psychoanalysis has become an integral part of Western culture and many of its terms and ideas, often in poorly understood and misinterpreted form, have filtered into daily usage. Id, ego, superego, regression, repression, anal retention, Freudian slip, catharsis, free association, wish-fulfillment, and Oedipus complex are only a few of the ideas attaining the status of common usage that have their roots in psychoanalysis.

Setting the Stage: Antecedent Influences on Psychoanalysis

While Sigmund Freud is credited as the founder of the psychoanalytic school, he did not give birth to psychoanalysis from within a void. Indeed, there are many antecedent practices and theorists whose influence is evident in Freud’s creation. Given the focus on abnormal human behavior, psychoanalysis was particularly influenced by earlier ideas about the nature of psychopathology.

Psychopathology or mental illness is a term that can be quite difficult to define, and while at first one might think that it could be defined by purely objective criteria, upon further analysis it becomes evident that psychopathology is determined by social factors as much as it is by physiology. While no perfect criteria have as yet been devised for determining that a behavior is psychopathological, several currently agreed-upon criteria include the following: statistical infrequency, unexpectedness, violation of norms, personal distress for the sufferer, or resulting in disability or dysfunction (Neale, Davison, & Haaga, 1996).

The History of Attitudes/Ideas Concerning Psychopathology

Since the dawn of time humankind has made subjective judgments concerning normative human behavior, but over time such judgments have varied considerably regarding what constitutes normal versus abnormal behavior as well as both the cause(s) and the treatment for abnormal behavior. At times, possession by demons or evil spirits was considered to be the cause and there is evidence that as early as prehistoric times a form of primitive psycho-surgery called trephining, which involved cutting a hole in the skull, may have been performed for the purpose of releasing these demons or spirits (Maher & Maher, 1985). In addition to such early surgical interventions, a variety of treatments including physical torture and administration of potions or tonics were attempted with the common aim of all such treatments to make the human “host” an uncomfortable environment for the demon or spirit.

Hippocrates (c. 470–410 B.C.) attributed all illness, physical as well as mental, to natural rather than metaphysical causes and prescribed remedies involving rest as well as moderation in both diet and physical activity. This approach was accepted by both Greek and Roman practitioners at least until the time of Galen (A.D. 129–210). During the middle ages, treatment of mental illness in Europe in some cases was more reminiscent of pre-Hippocratic practices. While less violent than earlier treatments for “demonic possession,” medieval attempts to remedy dysfunctional behaviors were often times conducted by members of the clergy and involved prayer and the application of holy water and religious relics, and, in some cases, ritualistic insults or threats.

“Therapeutic” practices changed somewhat by the mid-13th century, during the Inquisition, when the mentally ill were frequently caught up in campaigns conducted by the church to root out heresy and the practice of witchcraft. Again abnormal behavior was thought to have been the result of demonic possession but with a new element in that the person possessed by a demon was considered to be the victim of witchcraft (Thorne & Henley, 1997). Accordingly, the focus was then shifted more toward finding the guilty witch who had cursed the victim rather than on treating the afflicted individual.

In general, the common perceptions of medieval treatment of the mentally ill often paint a bleak and brutal portrait; however, the reality of medieval practices may be considerably different. Neugebauer (1978), in reviewing manuscripts from medieval and early modern England, found evidence that mental illness may have been measured during this time period in terms of the practical impact of abnormal behavior on the community.

The collectivization of the mentally ill into asylums was an essentially unknown practice until around the 15th century when many of the first asylums emerged from institutions that had previously been used to house people with leprosy. As the disease of leprosy gradually disappeared from Europe, leprosariums were re-tooled to house the mentally ill. The function of these early asylums, however, was frequently not the treatment or improvement of the mentally ill but rather their segregation from society. The conditions in the earliest institutions were often filthy, brutal, and degrading. One of the worst of such asylums was at St. Mary of Bethlehem in London, which achieved such a level of notoriety that its name was later shortened colloquially to Bedlam, a word that became synonymous with madness and uproar. The existence of these early asylums may well have represented the first systematized stigmatization of the mentally ill.

Toward the end of the 18th century the mentally ill began to experience more humane treatment, most notably as a result of the actions of Philippe Pinel (1745–1826). One of the first to advocate for the possible treatment of mental illness, Pinel radically improved the care of individuals at Bicêtre asylum in Paris in 1793 and a year later at Salpêtrière, another renowned Parisian public hospital. Similar improvements in the treatment of the mentally ill were made in England by the English Quaker, William Tuke (1732–1822) and in the United States by Benjamin Rush (1745–1813). Years later Dorothea Dix (1802–1887) inspired massive changes in attitude and practice for the treatment of the institutionalized mentally ill. See Chapter 14 for further discussion.

Changes in treatment of the mentally ill were accompanied by changing ideas concerning the etiology or basis of mental illness. Two different models of thought, the somatic and the psychic, began to emerge in psychiatry during the 19th century. The somatic model argued that abnormal behavior had a physical cause such as a brain lesion or impaired nerve function. In the mid-19th century, the German physician Wilhelm Griesinger suggested that mental illness was indicative of an underlying physiological problem, an idea proposed earlier by Hippocrates (Thorne & Henley, 1997). Emil Kraepelin (1856–1926), one of the most famous of Wilhelm Wundt’s students, further subdivided mental illness into two major categories, dementia praecox or schizophrenia and manic-depressive psychosis, attributing different physiologic causes, chemical imbalance, or metabolic disorder, respectively, to these two categories (Thorne & Henley, 1997).

In contrast, the psychic model of thought argued that mental or psychological causes gave rise to abnormal behavior. Practitioners of the psychic model began to explore the role of emotional factors instead of physiological problems as a possible cause of abnormal behavior. Psychoanalysis evolved initially as a part of this exploration into the role of emotional or psychic factors, particularly in the disorder known as hysteria.

The term hysteria was used as a label for one of the most common disorders in late 19th- and early 20th-century Europe. The major symptoms of hysteria included sensory or motor problems such as a lack of sensation in a limb or impaired sight or hearing without a known anatomical cause. The famous Parisian neurologist, Jean Martin Charcot (1825–1893) initially believed the cause of hysteria to be physiologic in nature, but after experimenting with the response of the symptoms of hysteria to treatment with hypnosis, Charcot came to believe in a psychic or emotional origin instead. The work of Charcot on the use of hypnosis in cases of hysteria is further described in Chapter 6, Phrenology, Mesmerism, and Hypnosis.

Building on the foundation of earlier theorists such as Charcot, Sigmund Freud began in the late 19th century to build his school of psychoanalysis initially to address treatment of individuals exhibiting symptoms of hysteria. From this limited initial focus, Freud’s psychoanalytic theory and techniques have grown to encompass the full range of human behavior and have revolutionized psychotherapy as well as our understanding of human behavior to a degree not unlike the impact of Einstein’s Theory of Relativity on our understanding of the universe.

Sigmund Freud (1856–1939)

Early Life

Sigmund Freud was born in the town of Freiberg, Moravia (now known as Pribor and part of the Czech Republic), the son of a Jewish wool merchant Jacob Freud and his third wife Amalie. Freud’s father was forced by financial and business setbacks to move the family to Leipzig, and later, when Sigmund was four years old, to Vienna. Freud remained in Vienna for the majority of his life before he was forced to leave Austria to escape Nazi persecution in 1938.

Early on, Sigmund Freud demonstrated great intellectual abilities and his academic efforts and ambitions were strongly encouraged by his parents. Although not the eldest of his father’s eight children, Sigmund was Amalie’s firstborn and her favorite, a position which secured him certain privileges in the household. Freud was first in his class at school for several years in a row and graduated with distinction from the local Gymnasium (high school) a year earlier than normal, at the age of 17. His exposure during his high school years to the work of Charles Darwin (1809–1882) awakened in Freud an interest in biological science. In 1873, Freud began to study medicine at the University of Vienna, not with the intention of becoming a practicing physician but instead as a way of pursuing a career in scientific research.

Freud’s earliest work in the experimental sciences was in the fields of biology, dissecting the genital structure of eels, and physiology, conducting a detailed examination of the spinal cord of fish. While studying medicine in Vienna, Freud began to experiment with the drug cocaine. In addition to using it himself to treat his own enduring problem with depression, Freud became a cocaine enthusiast, advocating its use to his fiancée and family as a cure-all for a variety of complaints. A medical colleague of Freud’s, overhearing Freud’s enthusiastic endorsement of the drug, conducted experiments on the use of cocaine as an anesthetic to facilitate eye surgery and thus introduced the use of cocaine into medical practice.

Freud published six papers on the benefits of cocaine in the period between 1884 and 1886. Following their publication, the use of cocaine became popular in both Europe and the United States and Freud was criticized by his professional peers for his role in introducing the drug along with its negative physiological and social side effects to the world. Although his personal papers reveal continued use of the drug for several years, over time Freud became less vocal in his advocacy of cocaine to the extent of omitting reference to his papers on cocaine’s benefits from his own bibliography. Freud’s decreasing advocacy of the use of cocaine may have been in part related to the tragic death of his friend Ernst von Fleischl in 1891, from cocaine addiction; Freud had initially prescribed the drug ironically as a treatment for Fleischl’s addiction to morphine (Breger, 2000).

Although Freud’s earliest ambition was to become a scientific researcher, his medical professor Ernst Brücke (1819–1892), the director of the physiological institute where Freud worked, discouraged Freud from pursuing his goal because of financial concerns. To begin with, few academic positions were available to scientific researchers in general and Freud’s ambitions were likely to be hampered even further by his Jewish heritage, due to the growing anti-Semitism in Europe and particularly in Austria.

Finances were much on Freud’s mind at this time since he had become engaged to an attractive young woman named Martha Bernays, whom he met while visiting one of his sisters. Some measure of financial security was essential if Freud was ever to establish the kind of respectable bourgeois household that he believed would be acceptable to Martha Bernays’ family. Reluctantly, Freud put aside his dreams for more practical and potentially lucrative pursuits and completed his medical examinations in 1881, taking a post at the Vienna General Hospital a year later. Freud left this post four years later to open a private practice as a clinical neurologist. Freud and Martha Bernays married about five months later.

The Development of Psychoanalysis

For a brief period prior to his marriage, from October 1885 to February 1886, Freud traveled to Paris to work with the French neurologist Jean-Martin Charcot (1825–1893). His acquaintance with Charcot, and his observation of Charcot’s use of hypnosis to treat symptoms of hysteria, stimulated Freud’s interest in the study and treatment of mental illness. Freud saw in the treatment of mental illness a possible road to greatness, which was something that always appealed to him. Previously, Freud thought his discovery of the “miracle drug” cocaine might give him the fame he sought, but when controversy over cocaine’s effects made it more likely cocaine would lead to Freud’s infamy, he moved on to other interests. Freud’s interest in mental illness was developed through his acquaintance and correspondence with two individuals who later became his close personal friends and exerted a major influence on his career, two nose-and-throat specialists, Wilhelm Fliess (1858–1928) from Berlin and another physician, Josef Breuer (1842–1925).

Breuer and the Case of Anna O., Studies on Hysteria

Josef Breuer was a well-respected Viennese physician who first met Freud in the late 1870s. In late 1882, Breuer told Freud of his work with a young woman from a wealthy family named Bertha Pappenheim. Pappenheim suffered from a variety of strange physical symptoms which she first experienced while caring for her gravely ill father. These symptoms included a nervous cough, which first brought her to Breuer as a nose-and-throat specialist, in addition to limb paralysis, impaired tactile sensation, distorted vision, anorexia, vivid hallucinations, and a bizarre language disorder. At one point, Pappenheim was only able to speak English and not her native German language, although she appeared able to understand when addressed in German. Since no physiological basis could be determined for her symptoms, Breuer’s diagnosis was hysterical neurosis.

Throughout the period of her treatment, from November 1880 to the summer of 1882, Breuer found that Pappenheim’s symptoms were improved after getting her to talk about the subject matter of her various symptoms. Pappenheim called this process her “talking cure” or “chimney-sweeping” (Freud & Breuer, 2000). Each evening, the two would meet to discuss her symptoms, focusing in particular on Pappenheim’s memories of when each symptom first appeared, with hypnosis often used to assist Pappenheim’s recall. While frequently a very difficult and emotional process, Pappenheim would usually feel calm and her symptoms improved as a result of this release of tension, a process Breuer referred to as catharsis, which was a term first employed by Aristotle (Hothersall, 1995).

According to Freud, as Breuer’s treatment of Pappenheim continued, Breuer’s wife became increasingly concerned about the relationship between her husband and Bertha Pappenheim and she insisted that Breuer end his treatment of her. Breuer acceded to his wife’s wishes and Pappenheim responded to Breuer’s termination of treatment by going into hysterical childbirth, crying out that she was “Giving birth to Dr. Breuer’s baby” (Breger, 2000).

Another Freudian myth concerning Anna O. is the presentation of Breuer’s treatment of her resulting ultimately in a permanent cure of her symptoms. In actuality, Pappenheim was institutionalized for a year following her therapy with Breuer. However, Pappenheim fell in love with the superintendent of the institution, causing her mother to remove her from the institution and take her back to Germany. She later recovered and returned to public life, going on to a successful career as Germany’s first social worker, an author of short stories, a playwright, and as a champion of women’s rights (Ellenberger, 1972). Later in life Pappenheim was reticent to comment on her relationship with Breuer and, out of respect for her privacy and for the fact that she was a friend of Freud’s fiancée, Breuer always referred to her in discussions with Freud as Fraulein Anna O. This was the name later used by Freud and Breuer when in 1895 they published her case as part of their work Studien über Hysterie (Studies on Hysteria).

Freud had been intrigued by Breuer’s discussion of the case of Anna O. and increasingly his own private medical practice became specialized in the treatment of hysteria. Initially, Freud used conventional methods including baths, massage, electrotherapy, and rest, but by 1889 he had found these methods to be ineffective and turned instead to hypnosis. After returning to France to study hypnotic techniques of Liebault and Bernheim at the Nancy School of hypnosis, Freud came back to Vienna and began to incorporate the use of hypnosis in his treatment of hysteric patients.

Freud, however, became increasingly dissatisfied with hypnosis as a therapeutic technique due to his discovery that not all patients were even susceptible to hypnotic suggestion and those who could be hypnotized were susceptible to different degrees. Some patients were totally unaffected by the use of hypnosis while others were only temporarily relieved of their symptoms. As a result, Freud concluded that the patient–therapist relationship was more important than the actual technique used in therapy.

Inspired by Breuer’s work with Anna O., Freud began to treat his patients by engaging them in a dialogue during which Freud instructed them to try to recall events associated with the first appearance of hysterical symptoms. As was the case with Pappenheim, Freud found that his patients often were able to recall and describe memories of events they had apparently repressed for years. Freud gradually developed the use of a process involving free association, in which he asked patients to describe everything that came to mind during their session. He first referred to his new therapeutic process as “Breuer’s method,” while later describing it as “physical analysis,” and finally “psychoanalysis.”

After using this method with several patients, Freud implored Breuer to collaborate with him in publishing the case of Anna O. Initially reluctant, Breuer was finally convinced and Studies on Hysteria came to fruition, presenting the “talking cure” and catharsis as described and analyzed in the context of case studies of five hysteria patients including Anna O. In the process of writing Studies on Hysteria, Freud and Breuer increasingly began to disagree on key points in the treatment of hysteria, particularly Freud’s emphasis upon the patient–therapist relationship. As described by Christopher Monte in Beneath the Mask (1980):

Breuer could not have known, but his patient viewed him, as all future analytic patients were to view their therapists, as father, lover, confessor, friend, rival, villain, and hero, calling up emotions for these changing perceptions of the therapist from previous relationships to important people in her life.

(Monte, 1980, pp. 44–45)

Freud coined the term transference in reference to this process of the patient projecting emotions and images from past relationships onto the therapist, and later developed the term counter-transference in reference to a similar process occurring in the therapist’s response to the patient. Freud described the presence of both transference and counter-transference in Breuer’s relationship with Anna O., stating that Anna O. had transferred her feelings for her father to Breuer and that Breuer in turn had counter-transferred his love to her. According to Ernest Jones, Freud’s biographer, Freud attributed Breuer’s inability to accept Freud’s analysis of his relationship with Anna O. as the cause of the permanent rift between these two formerly close colleagues (Breger, 2000; Jones, 1953). Freud may have suggested this as the cause of the rift as a means of presenting himself in a more favorable light regarding the dissolution of their relationship. The real reasons for the break are doubtless more complicated as is true of most intense relationships be they personal, professional, or both.

Despite the break in their professional relationship, Freud always acknowledged Breuer’s influence on his development of psychoanalysis and Breuer in turn referred to Freud with both admiration and awe. This pattern of intensely close relationships ending in permanent and irreparable disaffections appeared frequently in Freud’s life. However, Freud’s break with Breuer may have been one of the most amicable of the many subsequent separations between Freud and some of his key future colleagues.

Freud’s Seduction Theory

In addition to his focus on the patient–therapist relationship, Freud was increasingly convinced of the importance of sex in the development of neuroses. Although he was the first to popularize such a theory, Freud was not the first to suggest a sexual etiology for mental disorder. Indeed, Freud later claimed to have been inspired in this belief after hearing both Breuer and Charcot discuss their observations that neuroses could always be traced to sexual problems. Freud took this idea even further when, in an 1896 address to the Viennese Society of Psychiatry and Neurology titled “The Etiology of Hysteria,” Freud first acquainted the psychiatric community with his seduction theory, namely, the idea that neuroses are the result of childhood sexual abuse. Freud was influenced in this belief by observations that the majority of his neurotic patients reported traumatic sexual experiences in childhood often involving a family member. In his 1896 address, Freud reported that such experiences appeared to involve some form of seduction, usually by an older relative, often the patient’s father.

Freud’s seduction theory proved controversial and was received with some skepticism, revealing another personal tendency of Freud’s that appeared repeatedly throughout his career, namely, his intense and often heated response to criticism. In the case of his seduction theory, when the president of the Society of Psychiatry and Neurology, Krafft-Ebing, was quoted as saying it sounded like a “scientific fairy tale,” Freud responded by saying that his critics were asses and could all go to hell (Jones, 1953).

A year later, however, Freud was himself questioning or at least modifying his earlier claims of childhood sexual abuse in the experiences of his patients. He instead felt that in the majority of these cases the childhood seduction experiences described were not real but rather his patients were actually reporting fantasies. This new stance appeared to be a compromise between Freud’s earlier seduction theory and a complete rejection of any sexual basis of neurosis. Freud stated that, while not based in reality, such sexual fantasies were indeed quite real to these patients, and since such fantasies focused on sex, sex still lay at the root of their neuroses.

Historians have voiced differing opinions regarding the reason for this seeming reversal on Freud’s part regarding this critical feature of his theory of the etiology of neuroses. Most notably, Jeffrey Masson, one-time director of the Freud Archives, claimed in 1984 that Freud lied about the reality of his patients’ experience of childhood sexual abuse. Masson claimed the reports of abuse from Freud’s patients were real and that Freud knowingly decided to promote his sexual fantasy theory so as to make his system more acceptable to his peers and to the public who would have been reluctant to believe in the possibility of the widespread childhood sexual abuse implied in Freud’s earlier seduction theory (Masson, 1985).

Most Freudian scholars have refuted Masson’s claims citing evidence that Freud never denied that childhood sexual abuse sometimes took place but only stated that it had not actually occurred as frequently as reported by many of his patients. As Freud stated in a letter to his friend Fliess in 1897, “I no longer believe in my neurotica [the seduction theory],” giving as his reasons his inability to cure his patients with interpretations based on this theory, and the belief that “there are no indications of reality in the unconscious” and that too many respectable fathers would have to be accused of being perverse (Breger, 2000). In addition, Masson’s critics stress Freud’s own self-analysis as a significant contributing factor for his changing views on childhood sexual abuse as it related to his seduction theory (Storr, 2001). More recent analyses have suggested a more complicated scenario, namely, that Freud did not deliberately suppress the truth as Masson claimed, but that he instead underestimated the true incidence of childhood sexual abuse and that “more of Freud’s patients were telling the truth about their childhood experiences than he was ultimately prepared to believe” (Crewsdon, 1988, p. 41; Krüll, 1986).

The Interpretation of Dreams

Sex may have continued to play a prominent role in Freud’s theories regarding psycho-pathology due, in part, to his own difficulties and issues around sex. While emphasizing the role of sex in determining the behavior of others, Freud seemed to go to great pains to emphasize his own ability to rise above his personal sexual needs, stating that we should try to rise above such a “common animal need” and that “Sexual excitation is of no more use to a person like me” (Freud, 1954, p. 227).

Many of Freud’s personal sexual difficulties appear related to his concerns about birth control and his dislike of both condoms and coitus interruptus. Freud, in a 1908 essay titled “‘Civilized’ Sexual Morality and Modern Nervous Illness,” related his personal belief that all known methods of birth control impair sexual enjoyment and that contraceptive devices can “even actually cause illness.” There is evidence that the Freuds practiced abstinence periodically as a means of preventing pregnancy. During one such period of abstinence, Sigmund Freud developed a number of symptoms, migraine headaches, urinary problems, spastic colon; and anxiety about travel, heart disease, and death, all of which he diagnosed as anxiety neurosis resulting from accumulated sexual tension.

Freud undertook his own treatment through a process of self-analysis focused primarily on the method of dream analysis. He was inspired to attempt dream analysis by his observation that a patient’s dreams often provided significant clues to underlying emotional causes for disturbed behavior. He did not believe that standard free association would be possible in a self-analysis due to the difficulty of splitting into the roles of patient and therapist simultaneously. Accordingly, because he believed that events in dreams must have meaning that reflect something from within a person’s unconscious mind, Freud saw dream analysis as a means of accessing his own unconscious.

Each morning, Freud would write down any remembered content from his dreams of the night before and would then free-associate about the recalled context of these dream stories. This self-analysis was one of the lengthiest analyses undertaken by Freud and lasted for two years. The entire self-analysis was published in 1900 as The Interpretation of Dreams and is considered by many to be Freud’s most influential and groundbreaking work; it was the first published work in which Freud introduced a psycho-developmental process that he later termed the Oedipus complex.

In the course of his self-analysis, Freud discovered what he sensed was a universal process in child development in which children feel sexual attraction for the parent of the opposite sex coupled with fear of the same-sex parent who is now perceived in the role of rival. He later called this the Oedipus complex in reference to the Greek legend in which Oedipus, separated early in life from his birth parents, as an adult unwittingly kills his father and marries his own mother.

Although it took a while for the full impact of The Interpretation of Dreams to be realized, and Freud in his correspondence with his friend and biographer Ernest Jones expressed his belief that the book had been unfairly overlooked or poorly perceived by his professional peers, the actual evidence reveals that the book was in fact extensively and quite favorably reviewed in Germany and was well known to educated Germans (Decker, 1971). One individual greatly influenced by this book was a young physician from Zurich, Switzerland, named Carl Jung.

The Psychopathology of Everyday Life

While The Interpretation of Dreams introduced many of the key ideas in his developing psychoanalytic theory, the theoretical portrait was incomplete. Freud expanded his psychoanalytic theory with another book called The Psychopathology of Everyday Life (1904), which was published a year after The Interpretation of Dreams. In this new work, Freud suggested that in the course of our everyday lives our behavior is modified by the influence of unconscious ideas struggling to be expressed. The term Freudian slip was coined to describe “mistakes” such as slips of the tongue or the pen, the inability to remember a name, or forgetting a task. Freud considered such “mistakes” to be reflective of some unconscious idea struggling for expression and believed them to be a source of information to be analyzed as a means of understanding the unconscious mind of the patient. Freud’s proposition, that one’s behavior could be potentially outside of one’s conscious control and that one might instead be following the dictates of a sometimes almost primal unconscious mind, was revolutionary. Other previous theorists had touched on the possible existence of the unconscious mind, but none had delved into it as deeply or with such frankness as Freud.

Building a Legacy: Freud and His “Naughty Boys”

With the publication of The Interpretation of Dreams and The Psychopathology of Everyday Life, Freud’s reputation began to grow and he found himself at the center of an expanding circle of admiring individuals, mostly young doctors, all interested in learning how to practice this new psychotherapy called psychoanalysis. By 1902, a small group of men including Freud, Alfred Adler, Rudolf Reitler, and Wilhelm Stekel had begun meeting on a regular basis every Wednesday evening in the waiting room of Freud’s office at Berggasse 19 in Vienna, which was also the location of Freud’s private residence and is now a museum open to the public. This group came to be known as the Wednesday Psychoanalytical Society. By 1908, it had expanded to 20 members and had changed its name to the Vienna Psychoanalytical Society.

While Freud continued to develop his psychoanalytic theories and technique he also became increasingly rigid and controlling concerning the developmental path of psyho-analysis. His attitude toward the Vienna Psychoanalytical Society was that of master to disciples and Freud was intolerant of challenges from even his most favored followers. What resulted from this developing Freudian orthodoxy was a series of bitter defections and estrangements of former Freud supporters. Two of the first to defect were Wilhelm Stekel and Alfred Adler. Adler resigned from the Vienna Psychoanalytical Society in 1911, taking nine of the then 35 members with him, after bitter disagreements with Freud over Adler’s critique of Freud’s sexual theory of hysteria. Stekel left the Society in 1912. The most bitter defection, however, was yet to come.

In 1906, Carl Jung had sent a copy of one of his papers to Freud and there followed a friendship and correspondence that lasted seven years. At first Jung was, at least on the surface, just another eager and unquestioning student, but Freud soon recognized the potential to expand interest in psychoanalysis beyond his mostly Jewish circle of Viennese adherents by fostering the interest of the Christian-Swiss Jung. The Freud–Jung correspondence became increasingly intimate and intense and by 1909, Freud was referring to Jung as “my dear friend and heir.” In a letter to Jung written in April of 1909, Freud wrote of the time, “when I formally adopted you as eldest son and anointed you, in the land of the unbelievers, as my successor and crown prince” (Breger, 2000). However, by 1912, Jung and Freud were disagreeing more and more as Jung began to immerse himself in studies of mythology and in the development of what he called a collective unconscious, pursuits that were deemed unacceptable to Freud. Finally, in 1914 the two split irrevocably and Freud expelled Jung, along with a number of Swiss colleagues he had enticed into the Vienna Society, from membership.

Freud in America

During this same period between 1900 and 1914, in which Freud was establishing and maintaining his position of unquestioned authority within the Viennese psychoanalytical community, his reputation was spreading beyond Vienna. In 1909, he achieved international recognition after accepting an invitation from G. Stanley Hall to speak at Clark University in Massachusetts, where Freud was awarded an honorary doctorate in psychology. Freud’s trip to America proved to be a tremendous success and he found himself warmly received by such eminent American psychologists as William James, E. B. Titchener, and James McKeen Cattell. His lectures presented a clear and concise discussion of psychoanalysis and Freud’s conception of the existence and nature of an unconscious mind fell on fertile ground. Some of this reception had been cultivated by the writings of Canadian psychologist H. Addington Bruce who, between 1903 and 1917, had written numerous books and magazine articles on the subject of the unconscious (Dennis, 1991).

Despite the overall success of Freud’s appearance at Clark University in engendering an interest in psychoanalysis within the American psychological community, he did not look favorably on this trip. Freud was not fond of traveling and on his trip to America he was particularly plagued by a variety of physical complaints, mostly digestive, as well as general complaints about the quality of American cooking, the lack of sufficient public toilets, and his distaste for the American tendency toward informality. He never returned to the United States and was quoted by his biographer Ernest Jones as having said that “America is a mistake; a gigantic mistake, it is true, but nonetheless a mistake” and “is it not sad that we are materially dependent on these savages, who are not a better class of human beings?” (Gay, 1988, pp. 563–566; Jones, 1955, p. 60).

Even though Freud never returned to America, his first and only trip established a psychoanalytic presence in the new world that continued to survive and thrive despite, or perhaps because of, the absence of his personal influence. For example, A. A. Brill and Ernest Jones began planning psychoanalytical societies in the United States—Brill founded the New York Psychoanalytic Society and Jones founded the American Psychoanalytic Society, both in 1911.

Theory of Personality Development

Over the period between 1895 and 1940, Freud published numerous books and papers developing and explaining his ideas about the unconscious and about the development of personality. He was a prolific and engaging author as evidenced by a 1929 initiative of several of his supporters to nominate Freud for a Nobel Prize in literature, although he never received this award.

A number of key psychoanalytical concepts were proposed and explained by Freud in his impressive body of written works. Throughout all of his writings he reiterated his belief in the operation of unconscious dynamic forces within an individual personality and more and more saw himself as an explorer of this unconscious. At first, Freud described personality as comprised of the unconscious (the locus of material not easily accessible to the awareness of an individual often as a result of repression), the preconscious (the locus of material more readily accessible to conscious perception but still at the border of full consciousness), and the conscious (that level of mind of which we are readily aware). He later shifted his explanations of personality from a focus on levels of consciousness to the separation of consciousness into three subsystems: the id, ego, and superego. The nature and details of these three subsystems are described in Table 12.1.

Table 12.1 Freud's Three Subsystems of Personality

Sub-System Description and Features

Id
  • Only system present at birth


  • Satisfies the first principle of life which Freud called the pleasure principle -“the goal of the pleasure principle is to eliminate tension or to at least reduce it to acceptable levels -”tension causes discomfort whereas relief from tension is satisfying and pleasurable


  • Function is to discharge psychic energy released in the organism in response to external or internal stimuli


  • Primitive reservoir of energy, undifferentiated and derived from instincts (for example, hunger, thirst, and sex)


  • Completely unconscious

Ego
  • Functions according to the reality principle-“the goal of which is to prevent discharge of psychic energy until the source of tension reduction is accessible (the hungry child learns to postpone eating until it can find food)


  • Develops as the result of the Id's growing inability to deal effectively with the external environment


  • To be effective, must function on all three levels of consciousness (unconscious, preconscious, conscious)

Superego
  • The moral component of personality


  • Develops from the ego through the incorporation of parental and societal standards of behavior


  • Primarily unconscious, like the Id


  • Exerts control over the ego by rewarding or punishing it

Freud considered the mind of the healthy individual as exhibiting an effective and adaptive working balance and interchange in the three subsystems. An imbalance or discord between subsystems would result in the kind of maladjusted behavior that would interfere with the individual’s ability to lead a happy and productive existence in society. In his theorizing on the subject of personality development, Freud continued to give center stage to the importance of sexuality. He believed that all aspects of our lives are driven by the psychic energy that derives from our deepest animal instincts.

Freud described the evolution of an individual’s sexuality over the course of childhood development by advocating the radical idea that sexual development, began not with puberty but rather much earlier, in infancy. The concept of an infant as a sexual being was one of Freud’s most controversial proposals, particularly given the social mores prevalent in Europe during the early years of the 20th century. It is important to appreciate that through his sexual theory of personality development Freud expanded the concept of sexuality from the purely reproductive functions that had been the focus of earlier theorists. Freud’s “sexual instinct” was in many ways more of a “sensual instinct” in that he considered not only the genitals but rather any part of the body where sensations could be focused, creating psychic tension that could somehow be relieved through an action such as stroking or suckling, to be an erogenous or sexual zone.

Freud proposed that all children proceed through stages in their psychosexual development in which the sexual instinct is focused at each stage within a different bodily erogenous zone. Freud gave each of these stages a name reflecting the bodily area he considered to be central at each stage of psychosexual development: the oral stage, the anal stage, the phallic stage, and the genital stage. The details of each stage are described in Table 12.2. Critics of Freud often point to his stages of psychosexual development as incorrect or incomplete due to their focus primarily on male sexuality. See Karen Horney’s (1885–1952) work in Chapter 14 on psychosexual development including female sexuality.

Table 12.2 Freud's Stages of Psychosexual Development

Phases Stage Description

Oral Stage (~ birth to age 2 years)
  • Stage of infant sexuality in which all the infant's energy is centered around obtaining satisfaction through the oral zone

  • Five modes of satisfying orally include: taking in, holding on, biting, spitting out, and closing. These five modes are prototypes for different personality traits

  • Frustration or overindulgence of any functional mode may result in fixation of the personality into one of these prototypes with resultant consequences for later adult behavior. Ex.: biting is the prototype for adult "biting" behavior in the form of sarcasm and cynicism

  • Adult manifestation may take the form of the opposite of what would be dictated by the prototype

Pre-Genital (Sexual gratification is self-directed and not focused on reproduction) Anal Stage (~ age 2-4 years)
  • Becomes central at about the age of 2 and lasts until end of the 3rd or beginning of 4th year of life

  • Satisfaction is derived from pressure on the anal sphincter and its release through defecation

  • Toilet training represents the child's experience of external authority. Overly harsh or overly lax toilet training can result in fixation at the anal stage of development

Phallic Stage (~age 4-6 years)
  • Satisfaction is focused on the genitals

  • Beginning development of Oedipus complex

  • Ends typically around age 6

Latency (~age 5-6 years to 12 years)
  • Temporary period during which sexual development is static or regresses to earlier stages

Genital Stage (~age 12 years onward)
  • Focus of sexual gratification begins to turn outward and becomes centered on reproductive functions

  • Period of socialization and of social activities such as marriage and starting a family, which support reproductive functions

Genital
  • Activities that were satisfiers in previous stages are all incorporated into adult behavior. For example, sexual gratification may be derived from kissing even though it does not lead to reproduction because it stimulates the erogenous zone that was the focus in the oral stage

Interestingly, Freud admitted to his lack of understanding of female sexuality. He had progressed no further in his understanding by 1926 when he described female sexuality as “the dark continent” in psychology (Freud, 1926).

Freud in Exile

In 1923, Freud who had been a long-time tobacco addict was diagnosed with cancer of the mouth. Although he lived for another 16 years, he was plagued throughout the remainder of his life by almost constant pain as a result of the cancer and the numerous operations required to remove portions of his palate and upper jaw.

In addition to his physical suffering, Freud’s life was also marred by the increasingly hostile environment surrounding him in Vienna as a result of the Nazis’ rise to power. In 1933, the Nazis officially condemned psychoanalysis as signaled by a rally in Berlin in May of that year during which Freud’s books were publicly burned. Freud’s comment on the event was to say, “What progress we are making. In the Middle Ages they would have burnt me; nowadays they are content with burning my books” (Freud as quoted in Jones, 1957, p. 182). This was an ironic comment given the acts of genocide committed by the Nazis in their concentration camps, but at the time of his comment, Freud was not aware of these events, which were yet to come.

Freud remained in Vienna until March of 1938 when German troops arrested and detained his daughter Anna. After intervention by the American government, Nazi officials agreed to allow Freud and members of his immediate family, including his wife and daughter, to leave Vienna and travel to London. He unfortunately was forced to leave other members of his family behind including four of his sisters, all of whom died in Nazi concentration camps.

The Last Year

Freud’s final year spent in England was marked by his increasingly failing health as a consequence of his spreading cancer, although he remained mentally alert and continued working to his last days with the help of others, including most of all his daughter Anna. Finally, on September 21, 1939, Freud could no longer stand the pain and requested that his physician Max Schur put an end to his suffering. Schur fulfilled Freud’s wish by administering an overdose of morphine over a 24-hour period. The father of psychoanalysis was gone.

Following in Freud’s Footsteps

Freud’s tight control over the development of psychoanalysis during his lifetime led to a schism in the school’s development. Freud’s followers in general took one of two paths, strict adherence or strong divergence from a purely Freudian psychoanalysis. One of the strongest of Freud’s adherents was his daughter Anna.

Anna Freud: Child Psychoanalysis

Anna (1895–1982) was the youngest of Freud’s six children and the one most involved in her father’s work. As Freud began his long battle with cancer, he became increasingly reliant on Anna’s support. Anna often would be responsible for reading Freud’s papers for him at international professional meetings, and later, as his health progressively failed, she became his private nurse.

During his lifetime, Anna remained much in her father’s shadow, her main contribution to psychoanalysis deriving from her role as supporter of the “Great Man.” Freud’s death in a sense freed Anna to take a more active role in developing her own contributions to the discipline. Her theoretical developments, in particular her development of child analysis and her explication of the ego and its mechanisms of defense, were Anna’s own inspiration. Her contributions are described in detail in Chapter 14, Women in Psychology.

Perhaps one of the most controversial elements of Freud’s relationship with his daughter Anna was his psychoanalysis of her. Her formal analysis as conducted by her own father, began when Anna was 23 years old and lasted a full four years. For some reason Anna’s analysis was not publicized, whether to preserve his daughter’s privacy or because of concerns about public perceptions of a father’s analysis of his own daughter, especially his analysis of her sexuality. Reference to this father–daughter analysis was made in disguised form in Freud’s 1919 paper, “A Child Is Being Beaten,” and again in Anna’s own 1922 paper, “Beating Fantasies and Daydreams”; however, the fact of their patient–therapist relationship was not publicly revealed until the 1960s.

After emigrating to England with her father in 1938, Anna was instrumental in building a British branch of the school of psychoanalysis that over time developed its own unique flavor much in the same way American psychoanalysis developed in ways that distinguished it from its European cousin. Anna, together with Freud’s disciple Ernest Jones, also contributed a great deal to the Freud legend and mythology. Jones at one time was rumored to have been interested in marrying Anna, possibly as a means of achieving his ambition to become Freud’s acknowledged successor (Breger, 2000; Ferris, 1997).

Ernest Jones

Jones (1879–1958) was born in Wales and received a medical degree from the University College Hospital in London. He was very interested in neurological research and initially encountered Freud’s work as a result of this interest. The two developed a friendship beginning in 1908 and Jones became increasingly involved in facilitating the spread of psychoanalysis beyond Vienna. He was the first to introduce psychoanalysis to Great Britain and founded the British Psychoanalytical Society in 1913. He also brought psychoanalysis to North America while teaching there as a professor of psychiatry at the University of Toronto from 1909 to 1912.

Jones wrote a three-volume biography of Freud that was considered for a long time to be the definitive text on Freud’s life and works. A great deal of this biography presented Jones’ secondhand account of the version of events as presented to Jones by Freud through their conversations and correspondence. Jones’ biography of Freud, however, may be more of a testament to the old adage that “history is written by the victors.” In many instances, the Jones/Freud account of events tended to present Freud in the most favorable light possible, particularly in recounting his disagreements with former friends and disciples.

In addition to writing Freud’s biography, Jones and Anna were both in control of editing and censoring the release of Freud’s personal papers after his death. Scholars attempting an analysis of Freud’s life and his work are now able to benefit from greater access to some of Freud’s personal correspondence.

Carl Jung (1875–1961)

Carl Gustav Jung was born in Kesswil, Switzerland, the son of a minister of the Swiss Reformed Church who married a minister’s daughter. Most of his early childhood was spent in the town of Klein-Hüningen, where he attended the local school until he was 11 years old. At that time, he transferred to the Gymnasium in the nearby town of Basel.

As a child, Jung was deeply impacted by his mother’s mental illness. She had been hospitalized for several months in a mental institution when Jung was only three years old. This separation was a defining moment for Jung, who was deeply troubled by his mother’s being away. From then on, he always felt mistrustful when the word “love” was spoken. The feeling he associated with “women” was for a long time that of innate unreliability. “Father,” on the other hand, meant reliability and—powerlessness (Breger, 2000). Jung described his mother as an uncanny creature with two different personalities. By day she appeared to him a seemingly ordinary village woman, by night a “strange and mysterious” creature (Hayman, 1999, p. 8). She exposed her son at an early age to her interest in spiritualism and claimed that she could see ghosts and communicate with the dead.

Jung went on to study medicine at the local University of Basel from 1895 to 1900. In 1900, after reading a textbook of psychiatry written by Krafft-Ebing, Jung became interested in psychopathology. In studying the human mind, Jung saw the potential to blend his dual interests in objective science and in philosophy. He also, perhaps, saw an opportunity to better understand both himself and his mother.

Later that year, Jung moved to Zurich to become the assistant of Dr. Eugen Bleuler at the Burghölzli mental hospital where he later rose to the position of Senior Staff Physician. Bleuler was a student of Charcot and was regarded as an expert on schizophrenia. From 1902 to 1903, Jung studied psychopathology at the Salpêtriére in Paris under the tutelage of Pierre Janet. While there Jung wrote a paper on his experimental research with word association in addition to his doctoral dissertation, “On the Psychology and Pathology of So-Called Occult Phenomena” (1902). Jung’s life progressed on a personal as well as a professional level. In 1903, he married a very wealthy young woman named Emma Rauschenbach with whom he went on to have five children.

While working with Bleuler, Jung was asked to review Freud’s The Interpretation of Dreams. Reading this book was Jung’s first introduction to the concept of repression, and to the potential existence of an unconscious. Freud’s ideas struck a chord with Jung as a result of observations he had been making while conducting research, at Bleuler’s request, in the use of word association. Using the method earlier introduced by Galton, Jung asked individuals to respond to words presented singly with the first word that came to mind (Thorne & Henley, 1997). Jung then recorded both the content of their response as well as the latency between presented word and a subject’s response. Jung believed that a slower than average response to a given word indicated that the word had special significance for the person. This special meaning could be found in a unified cluster of ideas in the unconscious, which Jung referred to as a “complex.” These complexes were relegated to the unconscious as a result of repression.

In 1906, struck by the similarity between his conclusions and those of Freud, Jung sent a paper he wrote on his word association work to Freud. A year later he also sent Freud a copy of his book on schizophrenia, titled The Psychology of Dementia Praecox. On the basis of Jung’s friendly overture, the two embarked on a seven-year correspondence that included over 300 letters. Their first face-to-face meeting occurred in 1907 and Jung reported that the two “met at one o’clock in the afternoon and talked virtually without a pause for thirteen hours” (Jung, 1961, p. 149).

Jung differed from the majority of Freud’s disciples in two very important ways: he was not Jewish and he was also an established physician with ideas of his own concerning psychopathology that pre-dated his first exposure to Freud’s work. For many of Freud’s other disciples, their exposure to Freud’s psychoanalysis represented their first serious involvement in the study of psychopathology. Instead of impeding any relationship between Jung and Freud, these differences were central to its development. In reading Jung and Freud’s correspondence, as well as letters written by Freud to others such as Ernest Jones, Freud reveals political motives in cultivating his relationship with Jung. Namely, Freud saw “winning the Swiss” and bringing “Zurich” into his camp as important to the advancement of psychoanalysis (Breger, 2000).

Despite their differences, in 1911, Freud established Jung as the first president of the International Psychoanalytic Association, against the objections of many of its Viennese members who were jealous and distrustful of Jung and accused Jung of being anti-Semitic. The cracks in Freud and Jung’s splintering relationship grew following Jung’s lecture tour to America in 1912, during which Jung presented his own theories, disagreeing with Freud on several points, most particularly on the definition of libido.

Jung believed that Freud overly defined libido in sexual terms, whereas Jung regarded libido as more generalized life energy, only a part of which was sexual. To a great extent, the differences in opinion between Freud and Jung regarding sexuality no doubt stemmed from the differences in their respective relationships with their mothers and their differing personal attitudes toward sex. While Freud, during his self-analysis, found evidence within himself of his own sexual attraction to his mother, Jung’s own self-analysis revealed no such tendency. Jung described his mother as both fat and unattractive and expressed his inability to believe in Freud’s persistent claim that every little boy harbors sexual desire for his mother. His objections to Freud’s focus on sexuality were also partly a result of the differences between the types of patients typically seen by the two men. In his general practice, Freud saw primarily highly functional neurotics whereas Jung’s patients were more commonly hospitalized schizophrenics. In one letter to Freud, Jung wrote, “The loss of reality function in schizophrenia cannot be reduced to repression of libido—defined as sexual hunger. Not by me at any rate” (Jung, as cited in Breger, 2000, p. 227).

Jung also did not share Freud’s slightly prudish attitude toward sex. In addition to his active sexual relations with his wife Emma, Jung indulged what he called his “polygamous nature,” engaging in a number of affairs with other women including at least two documented affairs with female patients (Breger, 2000).

The Final Break

In 1912, Jung published The Psychology of the Unconscious in which he openly expressed opinions that were divergent from those of his mentor, Freud. While writing this book, Jung expressed in his correspondence to friends and colleagues his concern that when this book was published it would damage his standing with Freud. He in fact delayed publication of this book for several months because of his concerns about Freud’s reaction. His concerns proved to be well founded as their correspondence thereafter became increasingly angry. After Freud criticized Jung for his differing opinions, Jung replied in one letter by quoting Nietzsche: “One repays a teacher badly if one remains only a pupil” (Breger, 2000). In November of 1912, the two met at the Park Hotel in Munich, Germany, to attempt a reconciliation. Their reconciliation was short-lived. A few weeks later, Jung expressed anger over Freud’s refusal to consider any of Jung’s ideas on the basis of their merits as well as his feelings of always being diagnosed and interpreted by Freud.

Freud responded to this criticism by doing exactly what Jung accused him of, that is, diagnosing him:

One who while behaving abnormally keeps shouting that he is normal gives ground for the suspicion that he lacks insight into his illness. Accordingly, I propose that we abandon our personal relations entirely. I shall lose nothing by it, for my only emotional tie with you has long been a thin thread—the lingering effect of past disappointments.

To which Jung replied, “I accede to your wish that we abandon our personal relations, for I never thrust my friendship on anyone. You yourself are the best judge of what this moment means to you. ‘The rest is silence.’”

Jung was devastated by the break. As he wrote later in his autobiography: “After the parting of the ways with Freud, a period of inner uncertainty began for me…. It would be no exaggeration to call it a state of disorientation” (Jung, 1961, p. 170). In much the same way that his personal struggles had prompted Freud to undertake his own self-analysis, Jung also began a period of intense self-analysis that led to the development of his own personality theory, later known as analytical psychology. After this period of mental turmoil, Jung published Psychological Types or the Psychology of Individuation (1921).

Psychological Types

Rejecting Freud’s restrictive presentation of libido as purely sexual in nature, Jung further depicted libido as potentially directed by a person in two ways, either inward or outward. Jung called the tendency of inwardly directing libido introversion and outwardly directing it extroversion. The introvert is focused on the inner subjective world of ideas and tends to be self-sufficient, whereas the extrovert is focused on the external objective world of objects and people and needs to have people around. Jung stated that while both tendencies were present in everyone, one tendency is usually more dominant for a given individual. Jung also identified four psychological functions, each utilized to differing degrees in a given individual: thinking, feeling, sensation, and intuition. The Myers–Briggs Type Indicator (MBTI) was developed years later as a personality assessment device and incorporated Jung’s personality type theory (Thorne & Henley, 1997).

Personality Structure

Jung rejected Freud’s division of personality into the three structures of id, ego, and superego. For Jung, the major part of personality consisted of three different structures, which he called the ego, the personal unconscious, and the collective unconscious.

In Jung’s system, the ego was comprised of the conscious mind including all of perception, thought, feeling, and memory. The personal unconscious was the superficial layer of the unconscious and contained experiences at one time conscious that have been repressed, suppressed, or forgotten as well as experiences too insignificant to affect the ego. The personal unconscious was the realm of complexes, which Jung described as “autonomous groups of associations that have a tendency to move by themselves, to live their own life apart from our intentions” (Jung, 1968, p. 81).

The final structure of personality as described by Jung was probably the most radical departure from Freud’s work and it reflected, in part, Jung’s long interests in both archeology and mysticism. Jung called this structure the collective unconscious. Jung believed that the collective unconscious existed at a deeper level than did the personal unconscious and that it was composed of “contents and modes of behavior that are more or less the same everywhere and in all individuals” (Jung, 1939, pp. 52–53).

The collective unconscious contained so-called archetypes, universal thought-forms that transcend the individual’s experience; archetypes are unconscious and inherited predispositions to perceive or respond in certain ways (Thorne & Henley, 1997). Jung, as a result of his travels and readings in anthropology, which compared different cultures around the world, found that all cultures included what appeared to be universal symbols and that their rituals often seemed similar in terms of the experienced thoughts and emotions. For example, a family’s and community’s great joy and hope expressed directly and symbolically at the time of a birth and their sadness and loss surrounding someone’s death. Accordingly, it is the similar underlying emotional and cognitive experiences across disconnected and even isolated cultures that Jung believed were a reflection of inherited dispositions for all humans.

Table 12.3 Jung's Higher-Level Archetypes

Archetype Description

Persona
  • The role a person assumes in society for public consumption, which may or may not reveal a person's true nature.

Shadow
  • The residue of our animal nature. The dark side of human nature assumed to be responsible for socially unacceptable thoughts, feelings, and actions. A source of creative energy.

Anima/Animus
  • Recognizes the importance of human sexual duality. The anima represents the feminine aspects existing within a man while the animus represents male aspects existing within a woman.

Jung reasoned that archetypes revealed themselves symbolically in a variety of ways in myths, fables, dreams, visions, and even works of art. Examples of such archetypes include birth, death, power, magic, God, and the hero. In addition, Jung felt that some archetypes are so developed that they function as separate systems within the personality. These higher-level archetypes include: the persona, the shadow, and the anima and animus, all of which are described in Table 12.3.

Jung also proposed an overall integrating archetype, which he called the “self.” His “self” arises through individuation, the process that makes a person a unique entity (Thorne & Henley, 1997). According to Jung, the ultimate goal of life is self-realization or the full development of the “self.”

Until his death in 1961, Jung wrote extensively on his system of personality development; however, he did not achieve the same level of influence within psychology as his mentor Freud. This may be due in part to the difficulty of his writing style. Freud was a highly skilled writer with the ability to communicate difficult concepts both clearly and concisely. In contrast, Jung’s writing was not as logically structured and could be very difficult to understand. Jung also tended to deal with concepts from such diverse and often mystical sources as religion, astrology, and alchemy, all of which would have been viewed with a jaundiced eye by most of his professional peers. These same mystical overtones, however, were responsible for a brief resurgent interest in Jung’s work during the 1970s and 1980s.

Alfred Adler (1870–1937)

Alfred Adler was born in a suburb of Vienna, the second child of a wealthy grain merchant. Adler suffered from a series of physical complaints including rickets and pneumonia, which prevented him from competing successfully with his older brother and also inspired his early determination to pursue a career in medicine.

Adler attended the University of Vienna and received his medical degree in 1895. Two years after graduation, he married a young Russian woman named Raissa Timofejewna. At first Adler specialized in ophthalmology, but later moved on to practice general medicine before developing an interest in psychiatry. This was due in part to the difficulty he experienced in coping with the death of his patients, particularly younger ones. By this time, Adler had children of his own, three girls and a boy.

In the autumn of 1902, Freud invited Adler, along with Reitler and Stekel, to join him in forming the Vienna Psychoanalytic Society. Adler succeeded Freud as president of the society in 1910. Although during the early years of the Vienna Psychoanalytic Society the majority of its members appeared to express an almost total agreement with Freud, their meetings featured frequent personal attacks and squabbles over hierarchy within the society. Interestingly, such attacks often took the form of psychoanalytic interpretations of one anothers’ behaviors and hidden motivations.

By early 1908, Adler was sufficiently discontented with such behavior to propose a reorganization of the meetings to devote more time to free and open discussion, the abolishment of the rule requiring that everyone speak, as well as the proposal that all new members be elected by secret ballot. His intention was to make the society both more open and more democratic. His proposal was only partly accepted by the group because of Freud’s concern that a more open membership process might dilute his control of the society.

As early as 1906, Adler had also begun to express ideas that diverged from Freud’s. In his 1907 book, titled Study of Organ Inferiority and Its Psychical Compensation, Adler began to develop his concept of the inferiority complex based on the idea that persons with inferior organs or physical disability—poor eyesight, impaired locomotion, deafness, speech defects—were driven to overcome their handicaps in compensation for the disability and that this compensatory mechanism explained both healthy development as well as neurosis (Breger, 2000). Adler further developed this theory to include what he called an “aggressive drive” defined as: “Fighting, wrestling, beating, biting and cruelties … [the refinement of which] lead to sports, competition, dueling, war, thirst for dominance, and religious, social, national and race struggles” (Breger, 2000, p. 199). Adler also reasoned that this aggressive drive could be turned inward as shown by a subject exhibiting traits of humility, submission and devotion, subordination, self-flagellation, and masochism (Breger, 2000).

Adler spoke, in a 1908 paper, of what he termed the “need for affection” as a basic drive. He felt that this drive was exhibited in childhood through a child’s desire to be fondled and praised, and a child’s tendency to want physical closeness to loved ones. Later in life, Adler saw evidence of this same drive in adults striving for loving relationships and friendship. While Freud also left room for the concept of love in his system, it was always intertwined with the sexual instinct. Freud did not look favorably on what he perceived to be Adler’s rejection of the importance of the sexual instinct.

Tensions were further heightened between the two when Adler introduced his concept of the “masculine protest” as an extension of his “aggressive drive.” This masculine protest was defined by Adler as the wish to be strong and powerful in reaction to things that make one feel “unmanly,” manliness being imbued with qualities of power, strength, and aggression, and femininity being equated with weakness. Adler made it very clear that these concepts were not reflective of fixed biological characteristics, but instead arose from the way in which men and women were treated in European society (Breger, 2000).

Adler also began to differ from Freud in his methodological approach to psychotherapy. Abandoning what had become by this time “classical Freudian” psychotherapy, with its focus on the analysis of transference reactions, Adler would first strive to diagnose the individual’s “life plan” or “personal myth,” the patient’s personal style, conflicts, and “mistaken” neurotic path, and then communicate this to the individual as a means of helping him or her to gain understanding and insight (Breger, 2000). Treatment was usually brief, results being expected as quickly as within three months, in contrast to more traditional Freudian psychoanalysis that often lasted years.

By the end of 1910, members of the Vienna Psychoanalytical Society were openly critical of Adler’s theories, claiming that he had diverged too far from “the Professor”; a view apparently shared by Freud who, in his private correspondence, was beginning to refer to Adler as “paranoid,” “neurotic,” and a danger to psychoanalysis (Breger, 2000). Four meetings of the Vienna Psychoanalytical Society were devoted to a discussion of Adler’s ideas between January and February of 1911. During these meetings, Adler tried to communicate what he saw as evidence that underlying what Freud and his followers perceived as a purely sexual instinct were much more important connections, namely, the “masculine protest” (Breger, 2000). Freud was very critical in his response, formulating his critique in a personal attack in which he attempted to discredit Adler’s ideas by interpreting them as symptoms of Adler’s ambition to step out from behind Freud’s shadow. As Freud, Adler, and the other members of the society became further embroiled in the debate, the climate became increasingly tense for Adler. He survived it for about four months before resigning to form his own group, originally called “The Society for Free Psychoanalytic Research,” and later named “The Society of Individual Psychology.” Nine other members of the Vienna Psychoanalytical Society resigned in support of Adler and joined his new organization.

Individual Psychology

The key differences between Adler’s personality theory and that of Freud include the following: Adler de-emphasized sexuality and in particular rejected the idea of infantile sexuality; Adler’s psychology was ego-oriented and made consciousness, not the unconscious, the center of personality; Adler also stressed human social urges as playing an important role in molding personality. Also, unlike Freud, who oftentimes was perceived as having little actual interest in his patients as anything more than subjects for study, Adler was concerned with improving the lives of his patients and evidenced an interest in combating some of the basic problems of existence. Freud also treated mostly upper-class patients whereas Adler worked with the middle class and working poor.

After World War I, Adler became interested in attempting the early prevention of neurosis and established child-guidance centers in Vienna’s public schools. Individual psychology attracted a growing number of followers before reaching the height of its popularity in the early 1930s. Adler wrote and lectured extensively on individual psychology, making regular trips to America before moving there permanently in 1932 to become Professor of Medical Psychology at the Long Island College of Medicine in New York City. Adler died of a heart attack in 1937, while on a lecture tour to Aberdeen, Scotland.

Summary

In this chapter, we discussed the development of the school of psychoanalysis, which differs from other schools described previously in this text in a number of key ways, that is, psychoanalysis was clinically based and focused on explaining and treating abnormal human behavior while other schools were laboratory- and/or academically based and focused on experimentation and on explanation of general human and infrahuman behavior. In as much as psychoanalysis was initially developed as an exploration of abnormal human behavior, we began this chapter with an overview of the history of attitudes and ideas concerning psychopathology, beginning with pre-Hippocratic approaches to the treatment of pathological behavior, proceeding with Hippocrates’ more holistic approach incorporating prescriptions for physical activity as well as dietary recommendations, followed by our discussion of the Middle Ages and the reemergence of practices reminiscent of pre-Hippocratic belief systems along with the post-Middle Ages emergence of the first mental asylums.

We then discussed the impact of institutionalization of the mentally ill with the concomitant development of the first systematic study and categorization of types of psychopathological behavior, leading to two divergent theoretical views of the etiology of psychopathology, namely, the psychic model and the somatic model. We also discussed the ideas and accomplishments of some of the psychic and somatic models’ earliest respective proponents, including Wilhelm Griesinger, Emil Kraepelin, and Jean-Martin Charcot.

Hysteria, a common disorder of the late 1800s and early 1900s, characterized by sensory and/or motor disability not attributable to an actual physiological cause, was frequently the subject of study for these early theorists and provided the initial inspiration for Sigmund Freud’s development of psychoanalysis. Sigmund Freud’s theory of psychoanalysis emerged initially from his pursuit of a psychic explanation for the development of hysteric symptoms and developed further into a general theory of personality development.

We discussed many of the significant ideas and accomplishments of Sigmund Freud including: his work with Josef Breuer in using first hypnosis and later “the talking cure” for the treatment of hysteric symptoms; his proposal of the seduction theory, which attributed the development of neuroses to the experience of childhood sexual abuse, later modified by Freud to focus on childhood sexual fantasy as opposed to the real experience of childhood sexual abuse; Freud’s self-analysis through the technique of dream analysis and his early emphasis on the unconscious mind as a major influence on behavior; his expansion of psychoanalytic theory from the focus on hysteria and psychoneuroses to a more general behavior theory; and his conceptualization of a psychosexual theory of human development.

Throughout the course of his professional career and his work and efforts in developing psychoanalysis and his founding of the Vienna Psychoanalytical Society, Freud emerges as an often uncompromising and controlling individual, which influenced heavily both his personal and his professional relationships. We discussed the work of some of Freud’s followers who further developed psychoanalysis either in strict adherence to Freud’s original psychoanalytic framework or in conflict with and divergent from Freud’s ideas. We also discussed the work of two individuals who diverged radically from Freud in the development of their own ideas, namely, Carl Jung and Alfred Adler.

Discussion Questions