Theories: Psychoanalysis and Beyond
Adrianne L. Johnson and Anthony Zazzarino
The concepts of psychoanalysis have become interwoven into the fabric of U.S. culture, with terms such as Freudian slip, repression, and denial appearing regularly in everyday language. These concepts originated with the examination of unconscious pain, which manifests into maladaptive behaviors in psychoanalysis. Psychoanalytic theory suggests that early life experiences shape one’s social interactions and relationships in adulthood and is based on the concept that individuals are unaware of the many factors, including childhood trauma, that contribute to their maladaptive behaviors and discomforting emotions.
To accommodate contemporary mental health practices, and to meet the unique needs of diverse client populations, traditional psychoanalytic techniques have evolved into a dynamic inclusion of other theories, which increases its efficacy in fostering client self-awareness through modified application of classical techniques. This evolution has birthed other rapidly emerging approaches, including psychodynamic interpersonal therapy, transactional analysis, object relations theory, and brief psychodynamic theory. These distinctive theoretical approaches utilize original psychoanalytic concepts such as unconscious thoughts, instinctual drives, and psychological defenses formed early in life, but each approach features specific techniques that distinguish each in their application toward problem resolution.
The aim of this chapter is to help counselors gain a brief understanding of classical psychoanalytic theory and its influence on current practices and applications in contemporary mental health treatment. The goals of this chapter are to help counselors meet the following objectives: (a) gain a basic understanding of the foundation, history, and development of psychoanalytic theory; (b) gain a basic understanding of the implications of psychoanalytic theory across populations and contexts; and (c) gain a basic understanding of how to apply psychoanalytic and psychodynamic techniques in counseling practice for the most effective therapeutic outcomes.
BACKGROUND
Understanding the Language: Psychoanalytic, Psychoanalysis, and Psychodynamic
The terms psychoanalytic, psychoanalysis, and psychodynamic are often used interchangeably, often without differentiation. Psychoanalytic refers to the larger theoretical framework that was initially popularized by Sigmund Freud and later enhanced and evolved by other theorists like Carl Jung and Alfred Adler (Corey, 2021). Psychoanalysis may be viewed by many as a theory or an intensive psychotherapy involving long-term treatment, often for years (American Psychological Association [APA], 2017). Psychoanalysis is often the technique most closely associated with Freud that involves clients sitting on a couch talking through their problems (Corey, 2021). Psychodynamic theory continues to conceptualize how a person’s mind works from a psychoanalytic perspective. However, psychodynamic theory differentiates itself from psychoanalysis by being brief, once a week, face-to-face, and on average about 15 sessions (APA, 2017). Modern psychodynamic theory encompasses some of the main proponents of traditional psychoanalytic practices while attempting to apply them to current-day issues and contemporary constructs.
Early Psychoanalytic Theory
Psychoanalytic theory was an enormously influential force during the first half of the 20th century. The theory first emerged with the pioneering efforts of neuroscientists Jean-Martin Charcot and Josef Breuer. Charcot believed that individuals did not suffer from a specific trauma but from the ideas they developed in relation to it, and his research challenged the historical concept of what was believed to be a physical manifestation of a weak hereditary neurological system. He theorized that exposure to an emotional or physical trauma would result in chronic and debilitating conditions, including partial paralysis, hallucinations, and anxiety. Breuer, an Austrian physician and physiologist, is known as the founder of psychoanalysis based on his theory of unconscious processes and his assertion that the neurotic symptoms of hysteria could disappear when underlying causes became part of the conscious mind. The primary features of the theory were later adapted, refined, and popularized by Freud.
Traditional Psychoanalysis
Sigmund Freud diligently studied medicine at the University of Vienna and in 1882 began practicing medicine and researching medical pathology at Vienna General Hospital. His interest in the clinical presentation of aphasia and neuropathy in asylum patients led to collaborative research efforts with Charcot and Breuer. He coauthored “Studies on Hysteria” with Breuer, published in 1895, but then shortly thereafter abandoned hypnosis in favor of his talking cure, which he promoted as an effective psychological treatment for repressed trauma and its related emotions (Swartz, 2014). During the following years in private practice, he incorporated free association and dream analysis as techniques for treating anxiety, amnesia, unexplained paralysis, and psychosomatic complaints, primarily observed in his female patients. By 1896, Freud redefined hysteria in the psychological community and popularized the term psychoanalysis to refer to his new clinical method and the theories on which it was based (Gay, 2006).
HUMAN NATURE: A DEVELOPMENTAL PERSPECTIVE
The psychoanalytic view of human nature is basically deterministic, whereby humans are driven by desires, fantasies, and unconscious factors that can include impulses and memories (Eremie & Ubulom, 2016). These unconscious elements remain unknown because they are threatening or culturally unacceptable and would cause psychological pain if brought into conscious awareness. Aggressive impulses and sexual feelings are present throughout all developmental stages, and are often repressed (Eremie & Ubulom, 2016). People are generally ambivalent about change and develop self-defeating patterns as a result of their interpretation of both the past and the present. Ultimately, people are motivated to repeat experiences that have previously resulted in tension reduction (Wedding & Corsini, 2014).
MAJOR CONSTRUCTS
Id, Ego, and Superego
One of the most well-known constructs of psychoanalytic theory is that of an interactive system comprising the human personality. The instinctual and biological drives of the psyche are referred to as the id; the critical, moralizing function is the superego; and the organized, realistic part that mediates and seeks a balance between the former two is known as the ego. The id, the ego, and the superego are used to describe the structural model of the personality that drives and guides one’s functions and behavior. This concept is also the foundation for many other major constructs in psychoanalysis (Pigman, 2014).
Psychosexual Stages of Development
Additionally, traditional psychoanalysis assumes that personality develops through a series of childhood stages during which the pleasure-seeking energies of the id become focused on certain erogenous areas. Freud posited five psychosexual stages: oral stage, anal stage, phallic stage, latent stage, and genital stage. Psychosexual energy, or libido, is suggested to be the driving force behind behavior. At particular points in the developmental process, a single body part is particularly sensitive to sexual, erotic stimulation (Zepf, 2010). These erogenous zones are the mouth, the anus, and the genital region. A child at a given stage of development has certain needs and demands, and if these psychosexual stages are completed successfully, the result is a healthy functioning personality. However, frustration occurs when these needs are not met, and if these frustrations are not resolved in the associated psychosexual stage, the individual will become fixated and will exhibit dysfunctional symptomatology until this early conflict is resolved.
