Psychoanalysis as a Theory

All psychoanalytic theories are based on the idea that people are motivated
by thoughts and feelings outside their awareness, that the past influences
the present, and that each individual is unique. Because so much change
and growth has occurred since Freud’s era, psychoanalysis is no longer a single
theory but encompasses many different theories. All psychoanalytic theories
are theories of motivation (what makes people do what they do), theories
of development (how people get to be the way they are), and theories of
change (how psychoanalytic treatment works). Psychoanalytic theories are
usually also theories of personality development (who people are) and personality
disturbance.
Most theories emphasize the complexity of each person’s symptoms
and behavior and take into account many different influences. For example,
the psychoanalytic theory called ego psychology describes development
as a complex interaction of biology (inborn factors) and experience over
time. Early childhood experiences are especially important because they
influence the way a person’s ability to cope with the world (ego functioning)
develops. Each person adapts to the environment in a unique way that
gradually becomes more consistent by the time the person grows to adulthood.
Psychoanalytic theories are comprehensive theories of mental functioning
and disorder. For this reason, they originally formed the basis for the diagnosis
and classification of mental disorders in the United States. The
American Psychiatric Association published its Diagnostic and Statistical Manual
of Mental Disorders (DSM) in 1952 and the second edition (DSM-II) in
1968. Many changes and developments took place in psychoanalytic theory
during the second half of the twentieth century. The greatest changes took
place in theories about psychotic illness, female psychology, homosexuality,
and the nature of the patient/analyst relationship. By the turn of the twentyfirst
century, it was unusual to find, in real life, the silent analysts who were
still sometimes depicted in films and cartoons.
Because of their complexity, psychoanalytic theories are more difficult to
study and test than other theories. For example, Freud believed that dreams
have meaning and are based on the fulfillment of unconscious wishes.
Neuroscientists dismissed this theory for many years because it could not be
demonstrated. Behavioral psychologists, who based their theories on observable
behavior, did not consider thoughts and feelings outside a person’s
awareness to be important. Because of the emphasis on experimental testing
and the increasing public expectation for quick cures during the last
quarter of the twentieth century, psychoanalytic theories became less popular.
The DSM-III, the third edition of the diagnostic manual for mental disorders
which came out in 1980, was based on categories of symptoms and behaviors,
without any reference to underlying theory. The categories of
mental disturbance in DSM-III (and in later editions) were described in a
way that would be easy to test in controlled experiments. People, and particularly
insurance companies, became more interested in medicines and
short-term treatments for symptoms and were less willing to pay for treatments
like psychoanalysis that address the whole person.
Toward the end of the twentieth century and the beginning of the twentyfirst,
cognitive scientists (scientists who study the way people think) and
neuroscientists (scientists who study the way the brain works) began to make
discoveries that proved psychoanalytic theory to be correct in some important
areas. For example, cognitive scientists proved that much of mental
functioning goes on outside a person’s awareness. Mark Solms, a neuroscientist,
proved that dreams are formed in the part of the brain that deals
with motivation and emotional meaning. Psychoanalysts began a dialogue
with neuroscientists and cognitive scientists. Although some psychoanalysts
thought psychoanalysis could not be studied experimentally in the same way
as shorter-term therapies, others began to publicize studies demonstrating
the effectiveness of psychoanalysis and psychoanalytic psychotherapy. Others
began to develop further ways to study psychoanalytic theory and treatment. 645