As a candidate at the Chicago Institute for Psychoanalysis and an assistant professor at the Illinois School of Professional Psychology, I am often approached by members of the public or my students with the question, “Why would anyone want to do psychoanalysis?” There are many misunderstandings of psychoanalysis in the community. Therefore, I have written a document in response to the top 10 myths regarding psychoanalysis and hope TAP readers find it useful.
False. Freud's shortest case, that of Katharina (Freud 1893), was concluded in one day. His longest case lasted several years. There is room for individual variation here. Never was it truer that “your mileage may vary.”
False, though it may be both. Psychoanalysis is the father of psychodynamic psychotherapy. Growing numbers of studies are providing robust empirical data support that psychodynamic methods, including psychoanalysis, are effective forms of therapy. Do not let insurance companies push back without protest. See the works of Jonathan Shedler, Barbara Milrod, David Orlinski, Arnold Goldberg, Nathan Schlessinger and Fred Robbins among others.
False. One of the few things about which Freud never changed his mind was the essentially bisexual nature of the human being. Given the technical definition of “perversion” as a developmental, pre-genital form of sexuality, it was not (and is not) a devaluing term, unless you have devaluation in your heart. Get over it—we are all perverts now.
False. CBT was developed by two psychoanalysts, Albert Ellis and Aaron Beck, working separately and at different times. CBT is effective due to those aspects of empathic listening and optimal responsiveness that are the essence of psychoanalysis. If you read Beck carefully, the sessions are intended to be training in CBT. That is, the work with the trainer is to teach the patient how to do CBT so that he or she can go back into their lives and apply the therapeutic distinctions, reporting back periodically on the results. Survivors of hard-core CBT often endorse the assessment: Absent a warm empathic listener, psychotherapy is often indistinguishable from dental work—or CBT.
False. Freud's first 18 patients experienced sexual boundary violations, euphemistically called “seductions” in Victorian times, amongst the definitive causes of their neuroses. The decisive engagement with trauma as a source of neurosis occurred during and after World War I, which presented new horrors to civilians and soldiers. An ambitious project was envisioned whereby clinics and hospitals would be set up using psychoanalytic methods for treating war neuroses. The collapse of governments and the post WWI political and economic chaos thwarted this vision. However, Freud went on to publish Beyond the Pleasure Principle in which the mastery of trauma through the repetition compulsion was on the critical path to dealing with aggression and overcoming neurotic suffering. Given that our community is dealing with the return of soldiers from two wars, psychoanalytic methods are more important than they have ever been.
False. A short history of psychoanalysis since Freud: Melanie Klein and Anna Freud ventured to learn about psychosocial sexual development by talking with children rather than theorizing. A diverse group of psychoanalysts, including Robert Fairbairn, Donald W. Winnicott and Harry Guntrip, decided to formulate human interactions in terms of relationships. Heinz Kohut proposed innovations in strengthening the ego through transformations of narcissism in treating the self and breakthroughs in forms of transference.
It depends. One thing is definite. The most expensive approach is doing nothing about personal, emotional suffering. It can cost a person a lifetime of satisfaction and fulfillment, do almost incalculable harm to entire families, and damage whole communities through violence, substance abuse and diverse antisocial behavior. As Freud wrote in his Recommendations for Physicians Beginning Psychoanalysis, “Nothing in life is so expensive as illness and stupidity.”
False. In 1993 Peter Kramer published a book entitled Listening to Prozac. This book knocked the knees out from under all forms of talk therapy, without exception, and, as the jewel in the crown, psychoanalysis perhaps had more at stake and further to fall than most.
Lou Agosta, Ph.D., candidate and psychotherapist in private practice in Chicago, teaches History of Psychology at Argosy University. He is author of Empathy in the Context of Philosophy (Palgrave 2010) and A Rumor of Empathy (Routledge, forthcoming). See
Kramers promises were abroad in the land, even if the ultimate outcome was disappointing. In 2008 Stephen Stahl (one of America's premier psychopharmacologists) wrote “…antipsychotics have been on the market for over a decade, and only now is it becoming clear that some of these agents are associated with significant cardiometabolic risk…and with pharmacological actions that may mediate this cardiometabolic risk… At first, weight gain and obesity were clearly linked to atypical antipsychotics, but more recently, increased risk for dyslipidemia, diabetes, accelerated cardiovascular disease, and premature death have been linked to certain drugs in this class as well.” Premature death indeed.
Guffaw. Think: Lost in Translation. The level of understanding is Analyze This and In Treatment Admittedly, each one compelling in its own way. See the post for a response
False. Even if the patient agrees with the analyst's interpretation, that is not confirmation of its accuracy. It could be conforming and agreeing with authority. It is only if additional relevant personal material is expressed that aligns with the interpretation that it is considered to be a confirmation (“yes”). Oftentimes a “no” means that the interpretation is incomplete or something significant is missing.
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