Psychoanalytic Theorist: Gustav Fechner

After looking at the different psychoanalytic theorists, which one do you think has information most relevant to what you plan to do in your chosen profession? How would this information be helpful as you go about your normal work day? Use at least two key concepts as you discuss your answer.

TEXTBOOK: Hergenhahn's An Introduction to the History of Psychology

Tracy Henley.

CHAPTER 16

Psychoanalysis

When psychology became a science, it became first a science of conscious experi- ence and later a science of behavior. Representatives of psychology’s early schools— for example,Wundt,Titchener, and James—were aware of unconscious processes but focused on conscious experience. How then could a psychology that emphasized the unconscious mind emerge? The answer is that it did not come from academic or experimental psychology. Rather, it came from clinical practice.Those who developed the psychology of the unconscious were not concerned with experimental design or the philosophy of science; they were concerned with understanding the causes of mental illness.

By emphasizing the importance of unconscious processes as causes of mental illness, these early pioneers of psychoanalysis set themselves apart not only from the psychologists of the time but also from the medical profession of the day: a medical profession that had been strongly influenced by mechanistic-positivistic philosophy, according to which physical events caused all illness. If they used the term mental illness at all, it was as a descriptive term because they believed that all illnesses have physical origins.

The stressing of psychological causes of mental illness separated this small group of physicians from both their own profession and academic psychology.Theirs was not an easy struggle, but they persisted; in the end, they convinced the medical profession, academic psychology, and the public that unconscious processes must be taken into consideration in understanding why people act as they do. Sigmund Freud was the leader of this group of rebels, but before we examine his work, we consider some of the antecedents of his work.

Antecedents to the Development of Psychoanalysis

As we saw in the last chapter, both hypnotic phenomena and Charcot’s proposed explanation of hysteria strongly influenced the development of Freud’s theory, but there were other influences as well. In fact, a case can be made that all compo- nents of what was to become psychoanalysis existed before Freud began to formulate that doctrine. Some of those components were very much a part of the German culture in which Freud grew up, and others he learned as a medical student trained in the Helmholtzian tradition.

Leibniz (1646–1716), with his monadology, showed that depending on the number of monads involved, levels of awareness could range from clear perception (apperception) to experiences of which we are unaware (petites perceptions). Goethe (1749– 1832) was one of Freud’s favorite authors, and the major thrust of psychoanalysis was certainly com- patible with Goethe’s description of human exis- tence as consisting of a constant struggle between conflicting emotions and tendencies. Hegel (1770– 1831) also saw the resolution of conflicting forces (via the dialectic process) as a near-ubiquitous explanation for human nature and achievement. Resonating with this Zeitgeist, Freud frequently focused on conflicts to explain his own ideas. Herbart (1776–1841) suggested that there is a thresh- old above which an idea is conscious and below which an idea is unconscious. He also postulated a conflict model of the mind because only ideas com- patible with each other could occur in consciousness. If two incompatible ideas occur in consciousness, one of them is forced below the threshold into the unconscious. Herbart used the term repression to denote the inhibiting force that keeps an incompat- ible idea in the unconscious.As far as the notion of the unconscious is concerned, Boring said,“Leibniz foreshadowed the entire doctrine of the unconscious, but Herbart actually began it” (1950, p. 257).

Schopenhauer (1788–1860) believed that humans are governed more by irrational desires than by reason. Because the instincts determine behavior, humans continually vacillate between being in a state of need and being satisfied. Schopenhauer anticipated Freud’s concept of sub- limation when he said that we could attain some relief or escape from the irrational forces within us by immersing ourselves in music, poetry, or art. One could also attempt to counteract these irratio- nal forces, especially the sex drive, by living a life of asceticism. Schopenhauer also spoke of repressing undesirable thoughts into the unconscious and of the resistance one encounters when attempting to recognize repressed ideas. Although Freud cred- ited Schopenhauer as being the first to discover the processes of sublimation, repression, and resistance, Freud also claimed that he had discovered the same processes independently.

Friedrich Nietzsche (1844–1900)—and later, Freud—saw humans as engaged in a perpetual bat- tle between their irrational (Dionysian) and rational (Apollonian) tendencies. According to Nietzsche, it is up to each person to create a unique blend of these tendencies within his or her own personal- ity, even if doing so violates conventional morality. Indeed, concepts closely akin to the id and super- ego can be found in Nietzsche, suggesting that his influence upon Freud may have been greater than is commonly acknowledged (Greer, 2002; Kaufmann, 1974).

Like Herbart, Fechner (1801–1887) employed the concept of threshold in his work. More import- ant to Freud, however, was that Fechner likened the mind to an iceberg, consciousness being the smallest part (about 1/10), or the tip, and the unconscious mind making up the rest. Besides borrowing the iceberg analogy of the mind from Fechner, Freud also followed Fechner in attempting to apply the recently discovered principle of the conservation of energy to living organisms. Freud said, “I was always open to the ideas of G.T. Fechner and have followed that thinker upon many important points” (E. Jones, 1953, p. 374).

By showing the continuity between humans and other animals, Darwin (1809–1882) strengthened Freud’s contention that humans, like nonhuman ani- mals, are motivated by instincts rather than by reason.

According to Freud, it is our powerful animal instincts, such as our urges for sexual activity and willingness to be aggressive, that are the driving forces of personality, and it is these instincts that must be at least partially inhibited for civilization to exist.

Representing the positivistic approach to med- icine and psychology, Helmholtz (1821–1894) tol- erated no metaphysical speculation while studying living organisms, including humans. His approach, which permeated most of medicine and physiology at the time, initially had a profound effect on Freud. However, Freud eventually abandoned Helmholtz’s materialism and switched from a medical (biologi- cal) to a psychological model in his effort to explain human behavior. Also important for Freud was Helmholtz’s concept of the conservation of energy. Helmholtz demonstrated that an organism is an energy system that could be explained entirely on the basis of physical principles. Helmholtz demon- strated that the energy that comes out of an organ- ism depends on the energy that goes into it; no life force is left over.Taking Helmholtz’s idea of the conservation of energy and applying it to the mind, Freud assumed that only so much psychic energy is available at any given time and that it could be distributed in various ways. How this finite amount of energy is distributed in the mind accounts for all human behavior and thought.

Brentano (1838–1917) was one of Freud’s teach- ers at the University ofVienna when Freud was in his early twenties. Brentano taught that motivational factors are extremely important in determining the flow of thought and that there are major differences between objective reality and subjective reality. This distinction was to play a vital role in Freud’s theory. Under the influence of Brentano, Freud almost decided to give up medicine and pursue philoso- phy; but Ernst Brucke (1819–1892), the positivis- tic physiologist, influenced Freud even more than Brentano, and Freud stayed in medicine.

Karl Eduard von Hartmann (1842–1906) wrote a book titled Philosophy of the Unconscious (1869), which went through 11 editions in his lifetime. During the time that Freud was studying medi- cine and later when he was developing his theory,

the idea of the unconscious was quite common in Europe, and no doubt every reasonably educated person was familiar with the concept. Hartmann was strongly influenced by both Schopenhauer’s philoso- phy and Jewish mysticism. For him, there were three types of unconsciousness: processes that govern all natural phenomena in the universe; the physiological unconscious, which directs the bodily processes; and the psychological unconscious, which is the source of all behavior. Although Hartmann’s position was primarily mystical, it had some elements in common with Freud’s theory, especially the notion of the psy- chological unconscious (Capps, 1970).

Clearly then, the notions of an active, dynamic mind with a powerful unconscious component were very much part of Freud’s philosophical heritage.As we will see, other aspects of Freud’s theory—such as infantile sexuality, the emphasis on the psychological causes of mental illness, psychosexual stages of devel- opment, and even dream analysis—were also not orig- inal with Freud. Freud’s genius was synthesizing—and then promoting—all these elements as a comprehen- sive theory of personality:“Much of what is credited to Freud was diffuse current lore, and his role was to crystallize these ideas and give them an original shape” (Ellenberger, 1970, p. 548).

Sigmund Freud

Sigmund Freud (1856–1939) was born in Freiberg, Moravia (now Pribor, Czech Republic). His father, Jakob, was a wool merchant who had 10 children. Both his grandfather and his great-grandfather were rabbis. Freud considered himself a Jew all his life but had a negative attitude toward all organized religion. Jakob’s first wife (Sally Kanner), whom he married when he was 17 years old, bore him two children (Emanuel and Philipp); his second wife apparently bore him none; and his third wife Amalie Nathan- sohn bore him eight children, of whom Sigmund was the first.

When Sigmund was born, his father was 40 years old and already a grandfather, and his mother was a youthful 20. Among the paradoxes that young Freud had to grapple with were the facts that he had halfbrothers as old as his mother and a nephew.

older than he was. Sigmund was the oldest child in the immediate family, however, and clearly Amalie’s favorite. Freud and his mother had a close, strong, and positive relationship, and he always felt that being the indisputable favorite child of his young mother had much to do with his success. Because his mother believed that he was special, he came to believe it too; therefore, much of what he accom- plished later was due, he thought, to a type of self-fulfilling prophecy. Freud’s father lived 81 years, and his mother lived until the age of 95.

When Jakob’s business failed, the Freuds moved first to Leipzig and then, when Sigmund was age 4, to Vienna. From early on, Sigmund showed great intellectual ability; to aid his studies, he was given an oil lamp and a room of his own—the only one in the large household to have those things. His mother would often serve him his meals in his room, and she ordered a piano be taken away from one of his sisters because the music bothered him. Sigmund began reading Shakespeare when he was eight years old, and he deeply admired that author’s power of expression and understanding of human nature all his life. Freud also had an amazing gift for languages. He knew Latin, Greek, Hebrew, French, Spanish, Italian, and English, and later in life he became an acknowledged master of German prose (indeed, a nominee for the Nobel Prize in Litera- ture and winner of the Goethe Prize). He entered school a year earlier than normal and was always at the head of his class; at age 17, he graduated summa cum laude.

Until his final year of high school, Freud was attracted to a career in law or politics, or even in the military; but hearing a lecture on Goethe’s essay on nature and reading Darwin’s theory of evolu- tion aroused his interest in science, and he decided to enroll in the medical school at the University of Vienna in the fall of 1873. He also made this decision partly because, in anti-Semitic Vienna, medicine and law were among the only academic professions open to Jews.Although Freud enrolled in medical school in 1873, it took him eight years to complete the program; because he had such wide interests, he was often diverted from his med- ical studies. For example, Brentano caused him to become interested in philosophy, and Freud even translated one of John Stuart Mill’s books into German.

According to Freud’s own account, the per- son who influenced him most during his medi- cal studies was Ernst Brucke, who had, along with Helmholtz and Du Bois-Reymond, founded the materialistic-positivistic movement in physiology (see Chapter 8). In Brucke’s laboratory, Freud stud- ied the reproductive system of male eels and wrote a number of influential articles on anatomy and neu- rology. Freud obtained his medical degree in 1881 and continued to work in Brucke’s laboratory. Even though doing physiological research was Freud’s main interest, he realized that jobs in that area were scarce, low-paying, and generally not available to Jews. Freud’s financial concerns became acute in 1882, when he became engaged to Martha Bernays. Circumstances and advice from Brucke caused Freud to change his career plans and seek a career in medical practice.To help prepare himself, Freud went to theVienna General Hospital to study with Theodor Meynert (1833–1893), one of the best- known brain anatomists at the time, and Freud soon became a recognized expert at diagnosing various types of brain damage. Freud considered Meynert the most brilliant person he had ever known.

Many important events happened in Freud’s life about this time. In addition to making the decision to practice medicine, Freud was making a name for himself as a neuroanatomist; he had just befriended Joseph Breuer (who, as we will see, introduced Freud to many of the phenomena that would occupy Freud’s attention for the next 50 years), and he obtained the opportunity to study with Charcot in Paris.All these events were to have a significant influence on the development of Freud’s career.

The Cocaine Episode

In the spring of 1884, Freud became interested in the study of cocaine after learning that it had been used successfully in the military to increase the energy and endurance of soldiers. Freud almost decided not to pursue his interest when he learned from the pharmaceutical company, Merck, that the price of 1 gram of cocaine was $1.27 instead of 13 cents as he had believed (E. Jones, 1953). Freud per- sisted, however, and after taking the drug himself, he found that it relieved his feelings of depression and cured his indigestion, helped him work, and appeared to have no negative side effects. Besides taking cocaine regularly himself, Freud gave it to his sisters, friends, colleagues, and patients and sent some to his fiancée Martha Bernays “to make her strong and give her cheeks a red color” (E. Jones, 1953, p. 81).The apparent improvement caused by cocaine in Freud’s patients made him feel, for the first time, that he was a real physician. He became an enthusiastic advocate of cocaine and published six articles in the next two years describing its benefits.

Carl Koller (1857–1944), one of Freud’s younger colleagues, learned from Freud that cocaine could also be used as an anesthetic. Koller was interested in ophthalmology and pursued Freud’s observation as it related to eye operations.Within a few months, Koller delivered a paper describing how eye oper- ations previously impossible could now, using cocaine as an anesthetic, be done with ease. The paper caused a sensation and brought Koller world- wide fame almost overnight. Freud deeply regretted

having just missed gaining this professional recogni- tion himself.

With the exception of the anesthetizing effects of cocaine, most all of Freud’s other beliefs about the substance eventually proved to be problematic. In 1884 he administered cocaine to his colleague and friend Ernst von Fleischl-Marxow (1846–1891), who was addicted to morphine. Freud’s intention was to switch Fleischl-Marxow, who was a promi- nent physicist and physiologist, from morphine to cocaine, believing the latter was harmless. Instead, he died a cocaine addict. Soon reports of cocaine addiction began coming in from throughout the world, and the drug came under heavy attack from the medical community.Although cocaine still has limited medical use today, it certainly didn’t prove to be a viable career path.

Freud’s Addiction to Nicotine. Although Freud avoided addiction to cocaine, he was addicted to nicotine most of his adult life, smoking an average of 20 cigars a day. At the age of 38, it was discov- ered that he had heart arrhythmia; his physician advised him to stop smoking, but he continued to do so. Being a physician himself, Freud was well aware of the health risks associated with smok- ing, and he tried several times to quit but without success. In 1923, when Freud was 67 years old, he developed cancer of the palate and jaw.A series of 33 operations eventually necessitated his wearing of an awkward prosthetic device (which he called “the monster”) to replace the surgically removed sections of his jaw. He was in almost constant pain during the last 16 years of his life, yet he continued to smoke his cigars.

Early Influences on the Development of Psychoanalysis

Josef Breuer and the Case of Anna O.

Shortly before Freud obtained his medical degree, he developed a friendship with Josef Breuer (1842– 1925), another one of Brucke’s former students and the Brentano family’s physician. Breuer was 14 years older than Freud and had a considerable reputa- tion as a physician and researcher. Breuer had made an important discovery concerning the reflexes involved in breathing, and he was one of the first to show how the semicircular canals influenced bal- ance. Breuer loaned Freud money, and after Freud married in April 1886, the Breuer and Freud fami- lies socialized frequently.

It is what Freud learned from Breuer concerning the treatment of a woman, anonymously referred to as Anna O., that essentially launched psycho- analysis. Because Breuer started treating Anna O. in 1880, while Freud was still a medical student, Freud (1910/1949) gave Breuer the credit for creating psychoanalysis:

Granted that it is a merit to have created psychoanalysis, it is not my merit. I was a student, busy with the passing of my last examinations, when another physician of Vienna, Dr. [ Josef ] Breuer, made the first application of this method to the case of an hysterical girl (1880-82). (p. 1) Anna O. was a bright, attractive, 21-year-old woman who had a variety of symptoms associated with hysteria.At one time or another, she had expe- rienced paralysis of the arms or legs, disturbances of sight and speech, memory loss, and general men- tal disorientation. Breuer hypnotized the young woman and then asked her to recall the circum- stances under which she first experienced a partic- ular symptom. For example, one symptom was the perpetual squinting of her eyes.Through hypnosis, Breuer discovered that she had been required to keep a vigil by the bedside of her dying father.The woman’s deep concern for her father had brought tears to her eyes so that when the weak man asked her what time it was she had to squint to see the hands of the clock.

Breuer discovered that each time he traced a symptom to its origin, which was usually some traumatic experience, the symptom disappeared either temporarily or permanently. One by one, Anna O.’s symptoms were relieved in this way. It was as if certain emotionally laden ideas could not be expressed directly but instead manifested them- selves in physical symptoms.When such patho- genic ideas were given conscious expression, their energy dissipated, and the symptoms they initiated disappeared. Because relief followed the emotional release, Breuer called the treatment the cathartic method. Aristotle originally used the term cathar- sis (from the Greek katharsis, which means “to purify”) to describe the emotional release and the feeling of purification that an audience experi- enced as they viewed a drama. Anna O. called the method the “talking cure.” Breuer’s treatment of Anna O. started in December 1880 and continued until June 1882. During that time, Breuer typically saw her several hours each day. Soon after treat- ment started, Anna O. began responding to Breuer as if he were her father, a process later called trans- ference. All emotions Anna had once expressed toward her father, both positive and negative, she now expressed toward Breuer. Breuer also began developing emotional feelings toward Anna, a pro- cess later called countertransference. Because of the excessive amount of time involved and because his emotional involvement in the case began to negatively impact his marriage and his other pro- fessional obligations, Breuer decided to terminate his treatment of Anna O.

The story of Anna O. usually ends with the reve- lation that Anna’s real name was Bertha Pappenheim (1859–1936) and that Breuer’s treatment must have been effective because the woman went on to become a prominent social worker in Germany. Ellenberger (1972), however, discovered that Anna O. was institutionalized after Breuer terminated her treatment. Little is known about her life between the time of her release from the sanatorium and her emergence as a social worker in the late 1880s. However, Pappenheim did eventually go on to become a leader in the European feminist move- ment; a playwright; an author of children’s stories; a founder of several schools and clubs for the poor, the illegitimate, or wayward young women; and an effective spokesperson against white slavery. Her feminism is evident in the following statement she made in 1922:“If there is any justice in the next life women will make the laws there and men will bear the children” (E. Jones, 1953, p. 224). It is interest- ing to note that throughout her professional life she maintained a negative attitude toward psychoanaly- sis and would not allow any of the girls in her care to be psychoanalyzed (Edinger, 1968, p. 15).

Breuer and Freud published Studies on Hysteria (1895/1955), in which the case of Anna O. was the first presented, in 1895, and that date is usually taken as the date of the official founding of the school of psychoanalysis.

Freud’s Visit with Charcot

As we saw in the last chapter, Freud studied with the illustrious Jean-Martin Charcot from October 1885 to February 1886. Until this visit, although Freud was aware of Breuer’s work with Anna O., he remained a materialistic-positivistic physiologist; he sought to explain all disorders, including hyste- ria, only in terms of neurophysiology. As did most physicians at the time, Freud viewed psychological explanations of illness as nonscientific. As we have seen, Charcot assumed hysteria to be a real dis- ease that could be triggered by dissociated ideas.

Taking hysteria seriously and proposing a partially psychological explanation of the disease set Charcot apart from most of his colleagues. It is also significant for the subsequent development of psychoanalysis that Freud claimed to have overheard Charcot say about hysteria,“But in this kind of case it is always something genital—always, always, always” (Boring, 1950, p. 709). Furthermore, Charcot insisted that hysteria occurred in males as well as females.This contention caused a stir because from the time of the Romans it had been assumed that hysteria was caused by a disturbance of the uterus.

Freud returned to Vienna and, on October 15, 1886, presented a paper entitled “On Male Hyste- ria” to the Viennese Society of Physicians, in which he presented and endorsed Charcot’s views on hys- teria.The presentation was poorly received because, according to Freud, it was too radical. Sulloway (1979), however, indicates that the paper was poorly received not because it was shocking but because such views on hysteria, including the fact that hys- teria was not a disorder confined to women, were already widely known within the medical commu- nity. According to Sulloway, Freud’s account of the reaction to his paper on hysteria was perpetuated by his followers to enhance the image of Freud as a bold innovator fighting against the medical establishment.

In April 1886, Freud established a private prac- tice as a neurologist in Vienna, and in Septem- ber 1886, he finally married Martha Bernays after a four-year engagement. The Freuds eventually had six children—three boys and three girls.The youngest, Anna (1895–1982), went on to become a world-renowned child psychoanalyst and assumed leadership of the Freudian movement after her father’s death. Freud soon learned that he could not make an adequate living treating only neurologi- cal disorders, and he made the fateful decision to treat hysterics, becoming one of the few Viennese physicians to do so. At first, he tried the traditional methods of treating neurological disorders—includ- ing baths, massage, electrotherapy, and rest cures— but found them ineffective. It was at this point that everything that he had learned from Breuer about the cathartic method and from Charcot about hyp- nosis became relevant.