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Psychoanalysis began, as did most clinical disciplines before it, as a deficit model. Freud's original aim was to cure hysterical symptoms by a kind of psychological debridement of emotionally toxic material, a process he quite unselfconsciously compared to lancing a boil (Breuer & Freud, 1895). Subsequently expanding his clinical focus to include the neuroses, Freud came to understand many symptoms and disturbances of behavior more in terms of a kind of psychical orthopedic model, that is, produced by developmental skews and twists in what should ordinarily be a smooth and orderly psychodevelopmental progression from birth to maturity. Only later did the scope of psychoanalysis come to encompass the full range of normal and disordered behavior-dreams and parapraxes, for example, as well as psychopathological symptoms, syndromes, and variations of personality.
Coming from a thorough immersion in clinical neurology, cognitive psychology, and both positivistic and romantic philosophy, Freud, over his lifetime, elaborated the scientific and clinical philosophy we know today as psychoanalysis and its many offshoots in psychodynamic personality theory. But the emphasis on deficit and maldevelopment has largely remained. Recently, there has been a movement in psychology to conceptualize human mental life in terms of strengths and abilities as well as weaknesses and deficiencies. Some of this impetus has emerged from within psychoanalysis itself, and this paper will explore the importance of this orientation for both theory and clinical practice. I have considered the neuropsychological foundations of psychoanalysis and personality theory elsewhere (Miller, 1986, 1988b, , , 1991b, , , , , 1997).