Early work
Freud began his study of medicine at the
Classically, the bringing of unconscious thoughts and feelings to consciousness is brought about by encouraging a patient to talk about dreams and engage in free association, in which patients report their thoughts without reservation and make no attempt to concentrate while doing so. Another important element of psychoanalysis is the transference, the process by which patients displace on to their analysts feelings and ideas which derive from previous figures in their lives. Transference was first seen as a regrettable phenomenon that interfered with the recovery of repressed memories and disturbed patients' objectivity, but by 1912 Freud had come to see it as an essential part of the therapeutic process.
The origin of Freud's early work with psychoanalysis can be linked to Josef Breuer. Freud credited Breuer with opening the way to the discovery of the psychoanalytical method by his treatment of the case of Anna O. In November 1880 Breuer was called in to treat a highly intelligent 21-year-old woman (Bertha Pappenheim) for a persistent cough that he diagnosed as hysterical. He found that while nursing her dying father, she had developed a number of transitory symptoms, including visual disorders and paralysis and contractures of limbs, which he also diagnosed as hysterical. Breuer began to see his patient almost every day as the symptoms increased and became more persistent, and observed that she entered states of absence. He found that when, with his encouragement, she told fantasy stories in her evening states ofabsence her condition improved, and most of her symptoms had disappeared by April 1881. However, following the death of her father in that month her condition deteriorated again. Breuer recorded that some of the symptoms eventually remitted spontaneously, and that full recovery was achieved by inducing her to recall events that had precipitated the occurrence of a specific symptom. In the years immediately following Breuer's treatment, Anna O. spent three short periods in sanatoria with the diagnosis "hysteria" with "somatic symptoms," and some authors have challenged Breuer's published account of a cure. Richard Skues rejects this interpretation, which he sees as stemming from both Freudian and anti-psychoanalytical revisionism, that regards both Breuer's narrative of the case as unreliable and his treatment of Anna O. as a failure.
In the early 1890s Freud used a form of treatment based on the one that Breuer had described to him, modified by what he called his "pressure technique" and his newly developed analytic technique of interpretation and reconstruction. According to Freud's later accounts of this period, as a result of his use of this procedure most of his patients in the mid-1890s reported early childhood sexual abuse. He believed these stories, but then came to believe that they were fantasies. He explained these at first as having the function of "fending off" memories of infantile masturbation, but in later years he wrote that they represented Oedipal fantasies.
Another version of events focuses on Freud's proposing that unconscious memories of infantile sexual abuse were at the root of the psychoneuroses in letters to Fliess in October 1895, before he reported that he had actually discovered such abuse among his patients. In the first half of 1896 Freud published three papers stating that he had uncovered, in all of his current patients, deeply repressed memories of sexual abuse in early childhood. In these papers Freud recorded that his patients were not consciously aware of these memories, and must therefore be present as unconscious memories if they were to result in hysterical symptoms or obsessional neurosis. The patients were subjected to considerable pressure to "reproduce" infantile sexual abuse "scenes" that Freud was convinced had been repressed into the unconscious. Patients were generally unconvinced that their experiences of Freud's clinical procedure indicated actual sexual abuse. He reported that even after a supposed "reproduction" of sexual scenes the patients assured him emphatically of their disbelief.
As well as his pressure technique, Freud's clinical procedures involved analytic inference and the symbolic interpretation of symptoms to trace back to memories of infantile sexual abuse. His claim of one hundred percent confirmation of his theory only served to reinforce previously expressed reservations from his colleagues about the validity of findings obtained through his suggestive techniques.
Cocaine
As a medical researcher, Freud was an early user and proponent of cocaine as a stimulant as well as analgesic. He believed that cocaine was a cure for many mental and physical problems, and in his 1884 paper "On Coca" he extolled its virtues. Between 1883 and 1887 he wrote several articles recommending medical applications, including its use as an antidepressant. He narrowly missed out on obtainingscientific priority for discovering its anesthetic properties of which he was aware but had mentioned only in passing. (Karl Koller, a colleague of Freud's in Vienna, received that distinction in 1884 after reporting to a medical society the ways cocaine could be used in delicate eye surgery.) Freud also recommended cocaine as a cure for morphine addiction. He had introduced cocaine to his friend Ernst von Fleischl-Marxow who had become addicted to morphine taken to relieve years of excruciating nerve pain resulting from an infection acquired while performing an autopsy. However, his claim that Fleischl-Marxow was cured of his addiction was premature, though he never acknowledged he had been at fault. Fleischl-Marxow developed an acute case of "cocaine psychosis", and soon returned to using morphine, dying a few years later after more suffering from intolerable pain.
The application as an anesthetic turned out to be one of the few safe uses of cocaine, and as reports of addiction and overdose began to filter in from many places in the world, Freud's medical reputation became somewhat tarnished.
After the "Cocaine Episode" Freud ceased to publicly recommend use of the drug, but continued to take it himself occasionally for depression, migraine and nasal inflammation during the early 1890s, before giving it up in 1896. In this period he came under the influence of his friend and confidant Fliess, who recommended cocaine for the treatment of the so-called nasal reflex neurosis. Fliess, who operated on the noses of several of his own patients, also performed operations on Freud and on one of Freud's patients whom he believed to be suffering from the disorder, Emma Eckstein. However, the surgery proved disastrous.
Some critics[who?] have suggested that much of Freud's early psychoanalytical theory was a by-product of his cocaine use.
The Unconscious
Freud argued for the importance of the unconscious mind in understanding conscious thought and behavior. However, as psychologist Jacques Van Rillaer pointed out, "the unconscious was not discovered by Freud. In 1890, when psychoanalysis was still unheard of, William James, in his monumental treatise on psychology, examined the way Schopenhauer, von Hartmann, Janet, Binet and others had used the term 'unconscious' and 'subconscious'". Moreover, as historian of psychology Mark Altschule observed, "It is difficult—or perhaps impossible—to find a nineteenth-century psychologist or psychiatrist who did not recognize unconscious cerebration as not only real but of the highest importance."
Freud developed his first topology of the psyche in The Interpretation of Dreams (1899) in which he proposed that the unconscious exists and described a method for gaining access to it. The preconscious was described as a layer between conscious and unconscious thought; its contents could be accessed with a little effort. One key factor in the operation of the unconscious is "repression". Freud believed that many people "repress" painful memories deep into their unconscious mind. Although Freud later attempted to find patterns of repression among his patients in order to derive a general model of the mind, he also observed that repression varies among individual patients.
Later, Freud distinguished between three concepts of the unconscious: the descriptive unconscious, the dynamic unconscious, and the system unconscious. The descriptive unconscious referred to all those features of mental life of which people are not subjectively aware. The dynamic unconscious, a more specific construct, referred to mental processes and contents that are defensively removed from consciousness as a result of conflicting attitudes. The system unconscious denoted the idea that when mental processes are repressed, they become organized by principles different from those of the conscious mind, such as condensation and displacement.
Eventually, Freud abandoned the idea of the system unconscious, replacing it with the concept of the id, ego, and super-ego. Throughout his career, however, he retained the descriptive and dynamic conceptions of the unconscious.
Dreams
Freud believed that the function of dreams is to preserve sleep by representing as fulfilled wishes that would otherwise awaken the dreamer.
Psychosexual development
Freud hoped to prove that his model was universally valid and thus turned to ancient mythology and contemporary ethnography for comparative material. Freud named his new theory the Oedipus complex after the famous Greek tragedy Oedipus Rex by Sophocles. "I found in myself a constant love for my mother, and jealousy of my father. I now consider this to be a universal event in childhood," Freud said. Freud sought to anchor this pattern of development in the dynamics of the mind. Each stage is a progression into adult sexual maturity, characterized by a strong ego and the ability to delay gratification (cf. Three Essays on the Theory of Sexuality). He used the Oedipus conflict to point out how much he believed that people desire incest and must repress that desire. The Oedipus conflict was described as a state of psychosexual development and awareness. He also turned to anthropological studies of totemism and argued that totemism reflected a ritualized enactment of a tribal Oedipal conflict. Freud also believed that the Oedipus complex was bisexual, involving an attraction to both parents
Traditional accounts have held that, as a result of frequent reports from his patients, in the mid-1890s Freud posited that psychoneuroses were a consequence of early childhood sexual abuse. More specifically, in three papers published in 1896 he contended that unconscious memories of sexual abuse in infancy are a necessary precondition for the development of adult psychoneuroses. However, examination of Freud's original papers has revealed that his clinical claims were not based on patients' reports but were findings deriving from his analytical clinical methodology, which at that time included coercive procedures. He privately expressed his loss of faith in the theory to his friend Fliess in September 1897, giving several reasons, including that he had not been able to bring a single case to a successful conclusion. In 1906, while still maintaining that his earlier claims to have uncovered early childhood sexual abuse events remained valid, he postulated a new theory of the occurrence of unconscious infantile fantasies. He had incorporated his notions of unconscious fantasies in The Interpretation of Dreams (1900), but did not explicitly relate his seduction theory claims to the Oedipus theory until 1925. Notwithstanding his abandonment of the seduction theory, Freud always recognized that some neurotics had experienced childhood sexual abuse.
Freud also believed that the libido developed in individuals by changing its object, a process codified by the concept of sublimation. He argued that humans are born "polymorphously perverse", meaning that any number of objects could be a source of pleasure. He further argued that, as humans develop, they become fixated on different and specific objects through their stages of development—first in the oral stage (exemplified by an infant's pleasure in nursing), then in the anal stage (exemplified by a toddler's pleasure in evacuating his or her bowels), then in the phallic stage. In the latter stage, Freud contended, male infants become fixated on the mother as a sexual object (known as the Oedipus Complex), a phase brought to an end by threats of castration, resulting in the castration complex, the severest trauma in his young life. (In his later writings Freud postulated an equivalent Oedipus situation for infant girls, the sexual fixation being on the father. Though not advocated by Freud himself, the term 'Electra complex' is sometimes used in this context.)[107] The repressive or dormant latency stage of psychosexual development preceded the sexually mature genital stage of psychosexual development. The child needs to receive the proper amount of satisfaction at any given stage in order to move on easily to the next stage of development; under or over gratification can lead to a fixation at that stage, which could cause a regression back to that stage later in life.
No comments:
Post a Comment