Lesson 6 "Psychoanalysis"

Psychoanalysis is a set of theories and therapeutic techniques^[1] related to the study of the unconscious mind,^[2] which together form a method of treatment for mental-health disorders. The discipline was established in the early 1890s by Austrian neurologist Sigmund Freud and stemmed partly from the clinical work of Josef Breuer and others.

Freud first used the term psychoanalysis (in French) in 1896. Die Traumdeutung (The Interpretation of Dreams), which Freud saw as his "most significant work", appeared in November 1899.^[3] Psychoanalysis was later developed in different directions, mostly by students of Freud such as Alfred Adler and Carl Gustav Jung,^[a] and by neo-Freudians such as Erich Fromm, Karen Horney and Harry Stack Sullivan.^[4] Freud retained the term psychoanalysis for his own school of thought.^[5] The basic tenets of psychoanalysis include:                                                                                                                                    

1. a person's development is determined by often forgotten events in early childhood, rather than by inherited traits alone;
2. human behaviour and cognition are largely determined by instinctual drives that are rooted in the unconscious;
3. attempts to bring those drives into awareness triggers resistance in the form of defense mechanisms, particularly repression;
4. conflicts between conscious and unconscious material can result in mental disturbances such as neurosis, neurotic traits, anxiety and depression;
5. unconscious material can be found in dreams and unintentional acts, including mannerisms and slips of the tongue;
6. liberation from the effects of the unconscious is achieved by bringing this material into the conscious mind through therapeutic intervention;
7. the "centerpiece of the psychoanalytic process" is the transference, whereby patients relive their infantile conflicts by projectingonto the analyst feelings of love, dependence and anger.^[6]

            During psychoanalytic sessions, which typically last 50 minutes and ideally take place 4–5 times a week,^[7] the patient (the "analysand") may lie on a couch, with the analyst often sitting just behind and out of sight. The patient expresses his or her thoughts, including free associations, fantasies and dreams, from which the analyst infers the unconscious conflicts causing the patient's symptoms and character problems. Through the analysis of these conflicts, which includes interpreting the transference and countertransference^[8] (the analyst's feelings for the patient), the analyst confronts the patient's pathological defenses to help the patient gain insight.

Psychoanalysis is a controversial discipline and its validity as a science is contested. Nonetheless, it remains a strong influence within psychiatry, more so in some quarters than others.^[b][c] The proportion of practitioners of Freudian psychoanalysis has declined as evidence-based medicine has increased the use of cognitive behavioral therapy.^[11] Psychoanalytic concepts are also widely used outside the therapeutic arena, in areas such as psychoanalytic literary criticism, as well as in the analysis of film, fairy tales and other cultural phenomena.