Remember when you first heard about Freud’s theory of the mind? Id and it’s struggles to break through to the conscious? For many of us in the mental health field, it was what first sucked us in. Hooked from the days of Psych 101…. Time and hard work brought about a lot of other theories and therapies. But what happened to Freud’s psychoanalysis? And why isn’t old-school psychoanalytic therapy widely practiced today?
Many now view some assertions of psychoanlysis as far fetched (e.g., penis envy held by biological females). Some tenets actually hold up in modern clinical, developmental, and social psychology research, whereas others do not. For example, research shows that thoughts do not go away and even “rebound” when humans attempt to suppress them (“The White Bear” effect). Note that, despite popular belief, research finds such rebound effects do not occur for emotions and that catharsis does not work.
Unfounded assertions is not the main the reason that psychoanalysis is not as widespread. Actually, psychoanalysis is still alive and well in some corners. In particular, New York City is a bastion for Freud’s psychoanalysis in its old-school form. It’s even a large part of New York urban culture. Coffee shops there are abuzz with “my analyst told me I should…”.
Interestingly, Freud’s theories are also very influential in Western literature and screen writing. So many of our favorite movies and TV shows portray characters struggling with repressed memories or difficult decisions they don’t want to face. These often characterize some progressing struggle for the character and eventual emotional release once they “uncover” and reconcile with that struggle in their “conscious mind”. It makes compelling fiction! Good Will Hunting is a prime example.
But if psychoanalytic therapy was so dominant and widely practiced 100 years ago, what happened? First, mental health as a discipline comes out of both philosophical and scientific traditions. In the beginning, the field started as much more philosophical. Freud proposed and explained his theories through writing and rhetoric, leading many today to regard them as philosophical in nature. Some single-case studies supported these assertions.
As therapists know from working with clients, thoughts or assumptions humans make about the world can be inaccurate. Conclusions or assumptions about the nature of humans can as such be inaccurate, even when they are well formulated or “make sense”. So we needed a tool to test those assumptions more objectively. In stepped science…. By the 1930s, the rise of Pavlov (you know his dogs), Watson (Little Albert), and Skinner’s radical behaviorism created a greater push to bring the scientific method into the fold. This eventually influenced our understanding of mental health, in particular.
Second, psychoanalysis concepts are difficult to observe or measure, so testing psychoanalytic concepts in study designs is not possible. That is, there is no way to objectively observe unconscious struggles or changes between the id or superego as an individual progresses through therapy. Any benefits of psychoanalysis cannot be objectively observed without therapist bias (and we’re all biased). This also makes it impossible to subject psychoanalytic ideas to falsification. Finding ideas to not be false is a key requirement for scientific testing.
Additionally and importantly, other briefer approaches began to arise around the 1960s. For example, approaches like CBT, behavioral activation, and exposure therapies for anxiety or for PTSD help individuals experience relief in months-time. Engaging clients in periods of psychoanalysis lasting years or decades for therapy to show benefit therefore fell out of favor.
The impact of psychoanalysis on the mental health field will always be present, however. It pretty much invented mental health therapy! And psychoanalysis has roots in its more modern and more evidence-based offspring, psychodynamic therapy (more detail and training info to come). You might say its part of the mental health field’s unconscious.
