Psychoanalysis, a theory of the origins and structure of human personality, and a method of treating some types of mental illness. Sigmund Freud (1856–1939), an Austrian physician, developed the principles on which psychoanalysis and related types of treatment are based.
Levels of Awareness. According to Freudian theory, the human mind functions on three levels:
- Conscious mental material is that of which the person is aware, whether events currently existing, or memories.
- Preconscious material is that of which the person is not aware at the moment, but which may be easily recalled.
- Unconscious material is that which cannot be brought to conscious awareness easily and voluntarily. It consists of two general kinds of material: (1) basic, or innate, drives (urges) that work to preserve the life of the individual and of the species; and (2) memories, wishes, and other mental processes that once were conscious, but that have been repressed (excluded from consciousness) because they are painful to the conscious mind.
Freud recognized the basic unity of the personality. However, he conceived of it as consisting of three interrelated parts, or systems:
- Id. the primitive, or childlike, part of the personality that operates at the unconscious level. The id is the source of two opposing drives: (1) erotic, or constructive, impulses, and (2) aggressive, or destructive, impulses. Together, these drives, when balanced by the other parts of the personality, preserve the life of the individual and the continuation of the species.
- Ego, that part of personality that is in contact with current reality. The ego makes up most of the conscious level of awareness. It helps control the id, and often refuses to acknowledge the existence of impulses arising from the id.
- Superego, the personality system that acts as a censor of the impulses of id and ego. It operates on both the conscious and the unconscious levels of awareness. The conscious activities of the superego are commonly called the conscience.
The id is the source of energy for the ego. A newborn baby is motivated by impulses from the id to seek satisfaction of such biological needs as food, warmth, and rest. The baby learns effective ways of feeling and behaving as the ego develops and the baby's urges are tested against the reality of the environment. As the growing child learns from parents, or substitute parents, what they consider to be right and wrong, the superego develops. Later, other social forces strengthen the superego.
The ego works to control the energy derived from the id, to satisfy the demands of the superego, and to maintain a balance that helps the total personality to function. If the ego is unable to handle these various conflicts—most of them at the unconscious level—mental disturbances result.
Psychoanalysis, and other types of treatment based on psychoanalytic techniques, are classified as psychotherapy (treatment by psychological rather than physical means). Those who practice psychoanalysis are called psychoanalysts. In the United States, psychoanalysts are physicians who specialize in psychiatry (the medical field concerned with mental illness). However, only a few psychiatrists are psychoanalysts. Clinical psychologists may apply psychoanalytic principles in practicing various kinds of psychotherapy.
Psychoanalysis has been most successful in the treatment of mental disturbances characterized by chronic anxiety or emotional conflict; these disturbances are sometimes called neuroses. Psychoanalysis has been less successful in the treatment of disturbances in which the patient loses contact with reality; these disturbances are called psychoses.
is a procedure requiring that the patient and analyst meet for hour-long sessions several times a week for many months. During these hours the analyst helps the patient bring into consciousness the repressed conflicts that have caused the illness. If the treatment is successful, the patient learns methods of dealing with these conflicts.
The technique of free association is an important part of psychoanalysis. The patient is encouraged to talk about whatever comes to mind, without regard to the apparent relevance or propriety of the material. Patients develop resistances in their efforts to talk freely, and it is the analyst's task to help them overcome such resistances. Resistances are usually associated with feelings of guilt in regard to fantasies about hostility, dependency, or sexuality.
The phenomenon known as transference is essential to psychoanalysis. Patients transfer to their psychoanalysts the feelings they had in infancy and childhood toward their parents and others who were important to their early emotional development. By analyzing the transferred feelings, the psychoanalyst gains an understanding of the patient's conflicts, and can guide the patient in arriving at insight.
Free association often leads patients to report their dreams. Dreams are usually censored by the superego, and repressed wishes often appear in symbolic form. For example, a man who fears his own feelings of hostility toward another person may dream that a wild beast has broken into his house. Through free association, and with guidance by the psychoanalyst, the patient may come to realize that the beast represents the patient's own hostile urges. The superego had forced the dreamer to disguise the hostility, and to turn it upon himself.
Psychoanalysts and clinical psychologists may use modified forms of psychoanalytic techniques. Most of these modifications are aimed at shortening the time required to help the patient. Psychiatrists will also make modifications when they feel that certain patients do not need, or will be harmed by, the bringing of deep-seated conflicts to consciousness. Such patients may best be helped by guidance in managing their current problems, without going too deeply into the origins of their mental conflicts.
