Psychoanalysis is a theory and method resulting from the work conducted by Sigmund Freud (1856-1939) on his patients who did not respond in a satisfactory manner with the cathartic technique (hypnosis) mainly used by his colleague Josef Breuer. The basic principles of psychoanalysis which Freud developed were quite different from those adopted in previous methods of treatment; before Freud, hysteria and the neuroses were generally treated with hypnosis or even electroconvulsive treatment.

Freud introduced many new techniques, amongst which a method of treatment based to a large extent on talking. He invited his patients to lie down and relax on a couch - a technique which was to become one of the most widely-known and distinguishing features of the analytical method - and would then allow them to speak freely, referring whatever thoughts entered their mind. Through this method, Freud attempted to short-circuit the overbearing censorship of traditions, morality and the mores of society that might impede a revelation of the patient’s inner world and an individual’s true thoughts were thus more easily brought out into the open. This method of ‘free association’, which requires that the patient’s thoughts be openly expressed, free from the influence of rational logic, leads to a transformation into words of what is present in the deepest recesses of the mind.

This deepest region of the psyche, which Freud referred to as the unconscious - forming part of a model that was to become perhaps his greatest contribution to modern thought - is the most difficult part of our mind to access. It is generated and continues to develop throughout life by means of the mechanism of repression. This latter defence mechanism removes from our consciousness painful and unacceptable thoughts that are so unbearable the mind eventually bans them altogether, sending them down into a subconscious zone. A person thus loses any awareness of them and the mind is no longer disturbed, or at least temporarily. It may indeed later occur that repressed traumas - although not directly available to the conscious mind but in any case still present and potentially active in the unconscious - generate anxiety and negative feelings, which then come to have a pathological effect on human behaviour.

Sigmund FreudFreud also introduced the concept of transference, which can be described as an emotional bond established between the patient and the analyst and by means of which a patient transfers onto the analyst feelings and thoughts relating to significant former relationships. In Freud’s conception, the relation of transference was indispensable for the cure of his patients as it conferred upon them an active role in the therapeutic process, helping them to discover on their own what the best way might be to solve their traumas. At the time of its introduction this was an astonishing concept as formerly patients were considered as passive elements in the therapeutic process.

The structural model of the human mind which Sigmund Freud developed is made up of three fundamental structural components or functions:

  • The Ego. This is the ‘conscious substrate’. It is what we are aware of. The Ego has the function of acting as an intermediary between the Id, Super-Ego and external reality;

  • The Id. This is the unconscious part, which brings together and maintains an enormous quantity of information removed from early infancy to death. The Id is also the reservoir of both sexual and aggressive drives and instincts;

  • The Super-Ego. This is the  "censor" of the human mind. It is rational and contains all moral norms; it bitterly opposes the content of the Id, which, on the contrary, is irrational and instinctual.

In a normal situation, repressed memories remaining in the Id are blocked by the Super-Ego and are incapable of reaching the Ego, however when any conscious element succeeds in reawakening a repressed object, a conflict develops between the  ‘return’ of the repressed material and the resistance of the Super-Ego.
Freud called such a situation a neurosis, or a psychosis in cases where the alteration of mental functioning is so severe that true contact with reality is utterly compromised and a much more serious condition is engendered.

The classical psychoanalytical method is based on the idea that the neuroses derive from the inability of the Ego to acquire and take command over repressed material; in other words, Freud believed that, in itself, knowledge of the cause of one’s sufferance represents an element of the cure. Of course, the repressed objects are unknown and it is not possible to bring them to the surface unless we use the free-association method, through which the patient acquires a free rein and may speak about anything that passes through his or her mind, now liberated from the yoke of rules, norms or judgement.

In any case, psychoanalysis should not be seen as a school of thought rigidly based on the creeds and dogmas of an academic institution. Following the innovations made by Freud, various other authors carried his ideas forward, developing models which also differ quite considerably from the original concepts, however all of which are based on the fundamental tenets of psychoanalysis as described above. After the death of the great master, Carl Gustav Jung (1875-1961), for a time one of Freud’s pupils, developed Analytical Psychology, which further broadens the concept of the unconscious, introducing the idea of a collective unconscious, a region of subconscious ideas shared by the entire human species, and in which reside the ‘archetypes’ (e.g., the figures of the ‘hero’, of the ‘wise old man’, the ‘good mother’ etc.). As Freud had done before him, Jung also adopted the concept of libido, but while for Freud ‘libido’ was a collective concept of the sexual tendencies of man, for Jung the term was a synonym for psychic energy. Moreover, depending on whether the libido is principally directed outwards or inwards, Jung then distinguished between introverted and extraverted personality types. According to Jung, the final goal of development was represented by self-realization. To reach this end it is necessary that the different structural components of the personality differentiate and fully evolve. A healthy and fully integrated personality can be attained only allowing each component to reach the  highest degree of differentiation and development.

Alfred Adler (1870-1937), the theorist behind what came to be known as Individual Psychology, opened up new horizons within the world of psychoanalysis, introducing into this general school of thought a social element. While Freud restricted his view and area of study to the confines of the organism and the interaction of mainly innate biological mechanisms, Adler felt that social interaction had a central role in the development of the psyche and, consequently, of mental disorders. Adler believed that, since the earliest phases of his or her existence, every individual tends to compensate for insufficiencies and incapacities, structuring and arranging in order to defend and support himself or herself a complex series of opinions and behavioural patterns. This concept lies at the base of the inferiority complex, which in Adler’s view could be overcome through will power.

Psychoanalytical therapy thus consists in a process of gradually delving deeply into the inner recesses of the mind, a task that may be compared to the efforts of an archaeologist. The work of analysis eventually leads to the discovery of the causes of conflicts and then their consequent re-elaboration in non-pathological terms. The strong point of the therapy is that of searching for and, often, of finding the actual causes of psychological sufferance, thereafter intervening to address them and resolving them in a definitive manner. The duration of therapy is variable and will depend on the type of disorder and the characteristics of the personality of the patient. Generally, it may be expected to continue for a few years. However, there are shorter forms of psychoanalytical therapy.

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Psychology and psychotherapy
Jung, Freud, Adler, Psicanalisi
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