Psychology Psychoanalysis Critical thinking.

Each reaction paper must address principally—though not exclusively—a critical analysis of the designated reading and/or media resource in accordance with the following titled subsections: (a) Background addressing a brief summary of the principal theoretical constructs and empirical research bases; (b) Evaluative Critique inclusive of your pro and con assessment of the aforementioned constructs and research bases; and (c) Real-World Applications addressing viable ways in which the designated focus under consideration may relate to pragmatic concerns such as, e.g., therapy, instruction, parenting, and/or workplace behavior.

The stylistic/ formatting specifications for each reaction paper are as follows: (a) two word-processed pages (approximately 500-600 words in toto); (b) the heading on the very first page should include only one horizontal line displaying the student’s name, module number/topic, and date; (c) double-spaced; (d) maximum of one-inch margins—top, bottom, right, and left; (e) 12-point Times New Roman font; and (f) American Psychological Association (APA) stylistic format preferred, but any standard format is acceptable.

Regarding the two word-processed pages, the Background subsection should span the entire first page and should label explicitly by name and address five issues/themes/topics you consider to be critical in the module(s); the Evaluative Critique subsection should encompass only the top-half of the second page and should address explicitly by name two pro and two con positions in the module; and the Real-World Applications subsection should address only the bottom-half of the second page and should address explicitly by name three pragmatic concerns in the module such as, e.g., therapy, instruction, parenting, and/or workplace behavior.

Chapter 4 Psychoanalysis

Psychoanalysis
Background of Psychoanalysis
The Freudian Setting
Concept of the Unconscious
Structure of Personality
Development of Personality
The Psychosexual Stages
Fixations in Everyday Living
Crises Through the Life Cycle
Expressions of the Unconscious
Symbolism in Behavior
Dreams and Mistakes
Defense Mechanisms
Adjustments and Lifestyles
Psychoanalysis as a Therapy
Use of Free Association
Resistance and Transference
Commentary and Critique
Psychoanalysis stresses unconscious mental life. Memories, dreams, and other long-forgotten remnants of earlier conflicts and frustrations presumably lie in this realm of the mind. Outside normal awareness, but not entirely out of one’s life, these latent conflicts do not disappear. The anxiety they arouse can reappear in daily life in subtle, disguised ways known as unconscious motivation, the core concept in psychoanalysis and the focus of psychoanalytic therapy.

When Breuer discontinued Bertha’s therapy, which was not psychoanalytic, he left suddenly, without warning—today a serious breach of therapeutic ethics. After so many intensive sessions together, a contemporary psychotherapist would give notice several months before departure, enabling the patient to prepare for this important event and assisting the patient in gaining contact with another therapist, if that seemed appropriate. Instead, when Breuer left the case, he left Bertha facing still another crisis: how to cope with his abrupt, inexplicable departure.

Much in the fashion of a discarded lover, Bertha had been jilted. According to legend, she responded with an imagined pregnancy and other unconfirmed reactions to their final separation (Jones, 1953). This story, steeped in romance, illustrates unconscious motivation in principle, probably not in fact. The fantasy pregnancy appears fictional—but not the painful parting (Ellenberger, 1970; Hirschmüller, 1989).

The disruption in that parting would not surprise anyone knowledgeable about intensive psychotherapy today. If the therapeutic process goes well, a bond develops, and its unplanned cessation can become traumatic, especially for the patient. Bertha was troubled by her father’s death, hostility toward her mother, resentment of her brother, and lack of any close relationship with any other family member or friend, and her contact with Breuer had become the one reliable, supportive human relationship in her life. A strong emotional reaction to this sudden break in intensive therapy would not be surprising at all. In fact, it would be expected—as would various efforts, conscious and unconscious, to ensure its continuation.

The case of Anna O., terminated so abruptly, stands at the beginning of the real-life story of Bertha Pappenheim. And Bertha’s fate proved worse than Breuer expected. Their extraordinary therapy seemed to work for a while after each session. But it brought no lasting improvement.

Beginning with the background of psychoanalysis, this chapter then focuses on the structure and development of personality. Afterward, it considers the sequence of events creating unconscious motivation and, later, the way unconscious motivation is approached in psychoanalytic therapy. Finally, it concludes with a commentary and critique of the psychoanalytic perspective.

Background of Psychoanalysis
The fanciful pregnancy tale dramatizes the patient-therapist relationship, especially as it develops in the system of psychology called psychoanalysis. The term psychoanalysis has two meanings, one referring to a theory of personality, the other to a method of therapy, both emphasizing unconscious conflicts in mental life that are typically shaped by childhood experiences (Freud, 1925b).

Psychoanalysis developed during Bertha’s most turbulent years, the last decades of the 19th century, in the Viennese flat of Sigmund Freud (1856–1939). Specifically, it emerged from two places in that apartment at 19 Berggasse: the couch on which his patients reclined in his consulting room and the desk where he wrote in longhand in his study.

The couch stood against the wall in that elaborately decorated room. A pillow lay at its head, some folded blankets at its foot. Using the pillow, a patient could assume almost a sitting position; the blankets offered protection against chilly temperatures. Each patient was instructed to relax and say whatever came to mind, no matter how foolish or embarrassing it might seem.

Sitting most of the day in a green stuffed chair at the head of that couch, out of the patient’s line of sight, Freud listened to disturbed people describing their lives. That process was psychoanalysis as a therapy.

Later in the evening, usually after nine o’clock, he retreated to his study at the back of his flat and tried to make sense out of these jumbled monologues. There he sat, in seclusion, for three or four hours. Smoking cigars at the rate of 20 per day, scratching out his manuscripts with pen and ink, he brought forth the ideas for his theory of personality, also called psychoanalysis.

The Freudian Setting
In a sense, psychoanalysis arose as Freud’s lofty intellectual protest against his culture and times. The celebrated Viennese society of his day had a dark side. The long reign of Emperor Franz Josef had yielded to favoritism and corruption in city politics, and multiculturalism, responsible for Vienna’s cosmopolitan character, had generated political unrest. In fact, cafe society owed some of its popularity to shortages of housing and fuel, which forced people out of their cold, crowded homes and into public places. The city’s renowned culture makers—Mahler in music, Kraus in letters, Klimt in painting, and, eventually, Freud in psychoanalysis—were vilified or suppressed. Turn-of-the-century Vienna hardly merited its long reputation as the City of Dreams.

Freud also resisted Viennese culture on more personal grounds. Anti-Semitism ran rampant in the Vienna of his day. He did not practice any religion, but as a Jew he became acutely aware of the indignities suffered by his father. In one instance, unforgettable for little Sigmund, a stranger intentionally knocked his father’s new hat into a mud puddle, declaring that people of Freud’s ethnic background deserved such treatment.

Graduating from medical school with high promise, Freud had no interest in the practice of medicine. He sought instead a career in laboratory research, which was initially delayed by youthful misadventures. While serving in the military, authorities arrested him for being absent without leave. Absent again later, this time from his laboratory, he lost credit for successful research he had conducted in neurology. Still later he became implicated in a difficult matter involving cocaine and a friend’s untimely demise.

But the major deterrent to his research career occurred because Freud, a minority person, experienced discrimination not only in his social life but also in his professional aspirations. Successful in school, Freud nevertheless found himself and other Jews excluded from opportunities at the university. With this barrier, his lack of funds, and a growing interest in marriage, he turned to clinical work to earn a living, though he professed no desire for “playing the doctor game” (1926). Finally, years later, he gained an academic affiliation, working twice the usual period before receiving that recognition.

In the meantime, without access to academic circles, he encountered a research opportunity within his practice as a physician. In this private setting, consulting with people about their personal problems, he developed all sorts of ideas about human behavior. He found himself free to engage in unrestrained flights of speculation on the human condition, calling this decade of the 1890s his years of “Splendid Isolation,” for he worked essentially without colleagues. In short, Freud’s early poverty, ethnic background, and career frustrations prompted in him an ever-growing resentment against his city and culture. As a result, he completely avoided the political arena. The only favorable characteristic of the Viennese government, he once wryly remarked, was the inefficiency with which it operated. Instead, late at night, in the quiet of his study, he devoted himself to making “explosives”—broadsides directed at the whole way of life he experienced. Slowly, he alone developed psychoanalysis, which can be considered a grand intellectual protest against his time.

Psychoanalysis came not from laboratory studies or other traditional research but instead from a clinical practice, notably case studies. And far more than any other perspective in the 20th century, psychoanalysis arose through the work of one person—“The Professor,” as colleagues called him.

As an astute observer of the human condition, Freud’s ideas eventually permeated much of the 20th-century outlook on human behavior in Western society, especially with regard to unconscious mental processes and the importance of childhood for the development of adult personality. His work initiated voluminous research in both these areas, which is still vigorously pursued today.

Before Freud, the German philosopher Arthur Schopenhauer ruminated on unconscious mental life. He described human beings as perpetrators and victims of forces they do not comprehend, seeking goals they do not fully understand. But Freud declared that he developed his idea of the unconscious prior to discovering Schopenhauer’s work. Yet it is clear that Darwin’s work on evolution stimulated Freud’s thinking about early experiences and the adult personality. If prehistoric environments influenced current behavior in the manner suggested by natural selection, earlier events in an individual’s lifetime also might become powerful influences in one’s adult behavior.

Freud’s wide-ranging thought created resistance even within his limited circle of early supporters. Later followers were often still more rebellious. Loosely called neo-Freudians, they individually reformulated selective aspects of psychoanalysis, generally developing a less biological, more social orientation.

Through the reports of his patients and his own reflections, Freud had decided that even the mind of a child contains hidden sexual and aggressive impulses. This startling announcement in Victorian society brought forth criticism and condemnation in both scientific and public circles. His thinking continues to be controversial, and even his character has been doubted. But prolonged debate arises only over the life and work of people of note (Gleaves & Hernandez, 1999).

Freud’s dramatic case studies earned him the Goethe Prize for excellence in literature, the only international award he received in his lifetime. In fact, many observers today view his system of thought as belonging more to literature than to science. As a storyteller, he showed this inclination even in the pseudonyms he chose for his male patients, reflecting their symptoms: Wolf Man, Gingerbread Boy, Rat Man, and so forth. His more restrained pseudonyms for women reflected the gentler social roles assigned to them in Austria and elsewhere at that time: Emmy, Dora, Elizabeth von R., and others.

Practicing psychoanalysts today collect their data in much the same way as Freud did, through case studies, but often without the couch. The analyst listens and observes, gathering information about the patient. But psychoanalytic scientists today also collect data in formal laboratory experiments, studying groups of people in more restricted, controlled ways (Cramer, 2000; Westen, 1998). In both research methods, the exploration of unconscious mental processes becomes a central goal.

Concept of the Unconscious
The concept of the unconscious is the core of psychoanalysis. A generic term, the unconscious, or unconscious mental processes, refers to the thoughts and feelings of an individual not open to examination by that person. In fact, Freud described two categories of unconscious processes. In one, unconscious cognition, mental processes operate outside a person’s awareness, but they do not pose any threat to that person. No conflict is involved. They arouse no deep-seated anxiety. The individual therefore makes no effort, intentional or otherwise, to exclude them from consciousness. When hitting a 95 miles-per-hour baseball, for example, the time required to respond precludes thinking in any detail about exactly what to do. Information processing takes place automatically. In a like manner, unconscious cognition does not become a significant issue in psychoanalysis.

The other category of unconscious mental processes does play a vital role in psychoanalysis, however, and here the mental activities do pose a threat. In unconscious motivation, certain mental processes instigate anxiety about earlier circumstances, prompting the person to exclude from normal awareness these thoughts and also the relevant feelings and behaviors they may arouse. Psychoanalysts sometimes speak of unconscious emotion when emphasizing the feelings; they speak of unconscious motivation with reference to the behaviors and reasons for them. Both types of reactions become unconscious, excluded from awareness because the individual perceives them as threatening.

Unconscious motivation begins with conflict, which occurs in everyone’s life. Here conflict takes on a broad meaning, indicating a problem of almost any sort producing trauma, indecision, frustration, confusion, abuse—or any other manifestation of anxiety. Bertha undoubtedly experienced anxiety over the conflict with her rivalrous brother, with her overprotective mother, perhaps even with her romanticized father, and definitely with the restrictive gender roles in her society.

To defend against this anxiety, the individual develops various mechanisms, some described later as defense mechanisms. But the chief mechanism, on which all others are based, is repression. In repression, a person unintentionally excludes the anxiety-provoking memories, thoughts, and impulses from normal awareness, preventing them from entering consciousness. This concept has become widely debated today partly because of the various ways in which Freud labeled and described this process, partly because of the difficulty in producing this unconscious but motivated condition in laboratory studies (Erdelyi, 2000). But repression takes a primary place in traditional psychoanalytic theory. In a word, the solution for managing these anxiety-provoking thoughts is forgetting. The person forgets the event; it seemingly never occurred. It is kept from awareness by the barrier of repression. Or a whole series of related events are kept outside normal awareness.

However, the anxiety does not disappear. The so-called forgotten problem remains in the background of the individual’s mental life, hidden but at the same time seeking expression. Thus, the conflict is only partly or tentatively solved by repression; still deep in the recesses of the individual’s mind, it festers and smolders. In short, the individual commonly develops a fixation, meaning that the person becomes preoccupied with the unresolved problems, behaving in persistent, puzzling, and generally ineffective ways. A fixated person, intensely concerned with some past event that prompted anxiety, exhibits this tension again and again when confronted with similar events in present-day life. But the individual deals with the problem only indirectly.

These unconscious, anxiety-arousing thoughts and memories may simply appear as an inexplicable nervousness in the individual. Or they may be expressed in an indirect fashion, through an inordinate preoccupation with an almost infinite number of issues: family, food, fantasy, freedom, and friendship, just to name a few. Even in adult life, the person remains fixed on the earlier, unresolved issue, commonly dating back to childhood. Human beings, according to psychoanalysis, spend their lives in an endless struggle, shielding themselves and society from their unconscious fixations. Laid down early in life, they can influence later behavior in unconscious ways.

To portray unconscious motivation in everyday living, Freud used as a metaphor a historical monument, constructed as a memorial to some specific, earlier emotional event. The Great Fire of 1666 destroyed much of London. That fire is over, but the city erected a monument to the catastrophe. Hundreds of feet high, it stands where the fire started. An underground railway station has taken its name, Monument Station, and visitors to London can climb its stairs for a panoramic view of the city.

Suppose a modern Londoner sheds copious tears daily when passing that monument, each time overcome with remorse over the loss of lives and property of his ancestral family hundreds of years ago. Others would view this man with some concern, for he remains fixated on a disaster that occurred long ago. He would be far better served by going about his current business or thinking with pleasure about how London has survived that dreadful event. But many disturbed people behave like this sobbing, impractical man, except they have little idea about what is troubling them. Still dealing with disruptive, unknown events from long ago, they cannot live in a satisfied, productive manner. They neglect what is real and current in their lives. According to psychoanalysis, this fixation with past trauma is the most fundamental characteristic of a disturbed personality (Freud, 1909).

Incidentally, one of Freud’s early followers, Carl Gustav Jung, also emphasized our past, but he focused on our distant past, including the experiences of much earlier ancestors. As a neo-Freudian, he conceived of a deeper unconscious, well beyond our personal or individual unconscious. For Jung, the collective unconscious contains memories and thoughts common to all people everywhere, described as archetypes, meaning mental imprints or patterns to which we are universally predisposed. He found evidence for archetypes and other dimensions of the collective unconscious in human symbols, myths, fairy tales, religions, and other seemingly universal cultural expressions (Rosen, 2000). Critics call for more empirical, controlled support for this theory, but since Freud, the idea of unconscious thought has been pursued vigorously in many directions.

Traditional psychoanalysis approaches personality from the viewpoint of unconscious residues of earlier events in the lifetime of the individual. Prior to Freud, with his emphasis on childhood experience, people commonly explained a disturbed personality in terms of the devil, chance factors, one’s constitution, or divine intervention. In particular, the 19th-century outlook explained bad behavior as the result of “bad blood,” described by Charles Dickens, George Eliot, and other prominent writers. This preoccupation with blood as the responsible agent did not cease until the 20th century, and Sigmund Freud’s concept of the personal unconscious played a very large role in this new line of thought.

Structure of Personality
In psychoanalysis, personality emerges from the interactions of three forces or building blocks, all hypothesized internal structures, within the individual. The first, the id, is inborn, part of our biological inheritance; it is the source of all our energies, mental and physical, erotic and aggressive. The id serves as the “motor” of behavior, providing Bertha, for example, with the vitality needed for riding horseback, telling stories, and engaging in her private theater. Following the pleasure principle, the id seeks immediate satisfaction of all biological drives, sometimes automatically through sneezing, sweating, and blinking. The satisfaction of other drives—hunger, thirst, safety, and sexuality—requires effort and planning. The individual must find solutions or receive assistance.

From the energy of the id and through the baby’s contact with the environment, the second dimension, the ego, emerges. The ultimate task of the ego, which is the center of the self or “I,” is to preserve the individual; it does so as the executive director or problem solver of the personality. In contrast to the id, the ego follows the reality principle, regulating the individual’s behavior according to circumstances in the environment. It seeks appropriate ways to satisfy hunger, thirst, safety, and other demands of the id. A strong ego redirects expressions of the id that would be inappropriate in a particular time or place. In the early years, before the ego is adequately developed, an adult must play the ego’s role for a child or adolescent, satisfying many of the demands of the id and redirecting others.

From a psychoanalytic perspective, young Bertha lacked the ego strength for coping with her family environment in Vienna. Unable to pursue her personal goals in realistic fashion, she resorted to the fantasy of her private theater. Sad, angry, and confused, she then stayed in bed all day, remained silent, and refused to take nourishment, displaying negative behaviors like those of a small child. She also made suicidal gestures. Her weak ego barely succeeded in the task of self-preservation. Eventually, Bellevue Hospital supplanted Bertha’s ego, providing the support and structure she was unable to obtain for herself within her family.

The third force, the superego, begins to develop somewhat later and is significantly influenced by the acquisition of language. As a set of values and standards for behavior in a particular society, the superego is acquired through contact with parents, teachers, and other elders. It serves as a moral guide for the individual, developing along two paths. As the child internalizes parental and other social prohibitions, these prohibitions become the conscience, that part of the superego placing restraints on “bad” behavior. As the child internalizes parental and other social goals, they become the ego ideal, that part of the superego that stresses achievement and other “good” behavior. Both parts of the superego develop through imitation of adults, as well as through direct instruction (Freud, 1925b).

Even as a young adult, Bertha refrained from all sexual expression and all direct confrontation with her overprotective parents. In psychoanalytic terms, this delayed development reflected an overly strong, almost punishing superego. Sex and aggression were “bad” behaviors, and the ego found an escape. Bertha retreated into the fantasy world of her private theater—and then became ill.

As the problem-solving dimension of personality, the ego faces a difficult task. Beset on one side by the urges of the id, on the other by the restrictions and goals of the superego, it must seek effective solutions in a particular environment. An extremely broad concept, the environment includes all external factors that have the potential to influence an individual, running the gamut from physical to social, subtle to obvious, family members to strangers, and so forth.

With the support of the Bellevue hospital, Bertha gained some ego strength. She began telling tales again, still dealing with personal problems, but this time with more refinement. Then she began writing some tales. They gave her a way of expressing herself, an opportunity she seized and then lost with Breuer. At first she wrote stories just for herself; later she shared them with cousins; and eventually she authored a small book.

As suggested in these activities, the ego is the problem-solving element in the personality—the responsible agent or self. A resourceful ego directs the individual into successful ways of dealing with problems—writing stories, doing volunteer work, and so forth (Figure 4.1). Bertha published these tales anonymously with her own money. Little Stories for Children described lonely people and abandoned babies, hardly the expected themes for young minds (Pappenheim, n.d.). Lonely and depressed, angry at family members, Bertha perhaps wrote these stories as a way of dealing with her own fate. In psychoanalytic terms, her writing was an attempt by the ego to find a solution to her loveless life.

Figure 4.1 Psychoanalytic Approach to Personality. As the executive dimension of the personality, the ego must deal with the requirements of the id, the restrictions of the superego, and the reality of environmental constraints. Not circled as a component of personality, the environment is vital in the development of the ego. In traditional psychoanalysis, a strong ego is a highly desirable attribute, the prime factor in resolving conflict in human life

Bertha stayed two months with her Karlsruhe cousins, gaining confidence through her fairy tales and new friendships. Then she spent a short time with relatives in Frankfurt. Afterward, she returned to Vienna. Still experiencing symptoms, she wanted to resume therapy with Josef Breuer. But he refused (Rosenbaum, 1984b).

One of Bertha’s Viennese neighbors struggled with these same symptoms—in a different way. He studied them in other people, although he experienced some himself as well. For his ideas, he was scorned by many and then lionized, first in Europe, later in the United States, and finally throughout much of the world. He occupied a flat not far from the center of Old Vienna. These quarters served as the home and offices for Sigmund Freud.

He began his practice with the traditional therapies of his day, all without success, at least by his standards. Gradually, he abandoned these medicines, direct advice, and even hypnosis. Instead, he learned to listen to his patients’ innermost thoughts and feelings. These halting, commonly disturbing descriptions revealed the inner workings of the human mind; they became Freud’s key to personality and its development.

Scrutinizing himself, his family, and friends, as well as his patients, Freud decided that much of human personality is formed early in life, chiefly during the first five years. The id remains constant, but the ego and superego undergo fundamental, enduring developments in the early years. One of Freud’s major contributions to Western thought lay in pointing to childhood as a foundation of adult personality.

Development of Personality
Much of the child’s development proceeds through predictable, biologically driven changes, called maturational stages. They occur throughout human life: physical, mental, social, and emotional. A common genetic background underlies most of the rapid developments in infancy, childhood, and adolescence, as well as the slower changes at later ages. From this standpoint, human life becomes a sequence of unfolding stages. But they are modified for each individual by unique hereditary and environmental factors.

The most obvious stages appear in physical developments. In locomotion, the child learns to sit, then crawl, later stand, still later walk, and finally run. In grasping, the child at first can only wave its arms wildly; later it gains control of its arms and hands; still later, it can oppose its thumb to other fingers; and eventually it can use just the thumb and index finger to grasp a cookie crumb or button its clothes.

The Psychosexual Stages
Freud speculated about a similarly predictable sequence in sexual development, defining sexuality broadly to include activities related to ingestion and excretion, as well as reproduction. He also considered the mental and social dimensions to be more important than the physical component.

In physical terms, these developments begin with the alimentary canal, first at the front end, in the lips and mouth. Then they move to the anus and later shift to the genitals. All these developments are the result of biological maturation in what we now call the erogenous zones. These phases of sexual growth, with their mental, social, and physical changes, are known as psychosexual stages, and they can have important consequences for the child’s emerging personality, depending on the management of tasks that accompany each stage.

The roots of personality lie with these tasks because the erogenous zones provide our greatest sources of pleasure, and yet sexuality is something the child cannot understand or control. Moreover, sexuality involves social prohibitions, thereby creating anxiety in the child. Thus, the child’s experiences can leave their marks, especially if performance of the task goes awry. Then the child becomes “stuck” or fixated on that problem (Freud, 1907).

According to psychoanalysis, all normal children pass through these stages. They do so at somewhat different ages, but the sequence is invariant.

The tasks in the first three stages are feeding, toilet training, and adjustment to family life. In each case, the task may generate conflict, depending on the child’s readiness to manage it and the caretakers’ modes of assistance. The outcomes have implications for the child’s feelings of trust and well-being, competence and independence, and capacity for interpersonal relationships.

In the oral stage, the infant first derives pleasure through stimulation of the mouth when obtaining food, which in turn produces the energy needed for survival. For this task, the highly sensitive lips and tongue are well suited. The infant enjoys this stimulation, emitting the sucking reflex even in the absence of food. If the infant’s nutritional and emotional needs are adequately met during this first stage, the child develops the potential for a confident, trusting outlook on life. If not, feelings of apprehension and dissatisfaction may arise instead. And if repressed, these feelings may become major components of the adult personality.

In the second and third years, with gains in muscular control, the child is confronted with a new and more difficult task: toilet training. Contrary to the feeding task in the oral stage, which is compatible with the demands of the id, the child in the anal stage must oppose id impulses, resisting the pleasure associated with elimination. The child must withstand the tension until reaching a proper time and place for excretion. The child who manages this task successfully gains a sense of competence and pleasure in the world. Successful toilet training is most important in developing and strengthening the ego. If instead, the training is too strict, the child’s resentment again may become enduring, appearing in adulthood as a rebellious, impulsive personal style or as an excessive concern with correctness. Needless to say, the caretaker’s supervision of this task and the child’s biological readiness play major roles in bringing about favorable or unfavorable outcomes.

These stages may interact and overlap with one another and with the next stage, which begins around age three—with another shift in erotic pleasure. And here we come to another point of resistance in one of Freud’s followers. Freud called this next phase the phallic stage, for the child becomes more sharply aware of gender differences and relationships among adults, including the parents’ particular roles. Adopting the ways of one or both parents, the child also takes greater notice of the genitals, obtaining pleasure from self-stimulation. The child may engage in related fantasy activities, including a desire for intimate relations, notably with the parent of the opposite sex. According to psychoanalysis, the child’s relationships with the parents and siblings at this stage, however stable or turbulent, set the pattern for personal relationships in later life.

But Freud’s expression excludes one gender, and Karen Horney raised this issue. As a neo-Freudian speaking of feminine psychology, she disagreed with several of Freud’s basic concepts, declaring that females must be understood on their own terms, not simply as different from males. Acknowledging Freud’s genius and his work in a male-dominated society, she argued that men’s exclusion from pregnancy, childbirth, and breast feeding prompted them unconsciously to depreciate women. For these thoughts, she became recognized as the first female psychoanalyst and a pioneer in female psychology (Paris, 2000). Late in his career, Freud turned to female sexuality, but he expressed less confidence about his understanding owing in some substantial measure to the times and culture in which he lived.

Freud had another label for this third stage, when children become more sharply aware of gender differences. He called this condition the Oedipus complex, referring to an ancient Greek tragedy in which King Oedipus unwittingly killed his father and married his mother, a potential curse, Freud claimed, laid on every male child. The son directs his first desire for sexual intimacy toward his mother and, accordingly, his first hostile wish toward his father, who has become his rival. The boy wants his mother all to himself; he views his father as a nuisance, feeling resentful about his father’s relations with his mother and expressing satisfaction when his father is absent. But at other times the boy feels affection for his father, who protects him and satisfies many of his needs. The result is ambivalence; the child experiences conflict.

Encouraged by Jung much later, Freud incorporated into his thinking a Greek drama about women. In this tale, Electra fell in love with her father and participated in the murder of her mother. Freud regarded the daughter’s desire for intimacy with her father and rivalry with her mother as another universal theme, which Jung described as the Electra complex, and here the daughter experiences conflict. Thus, both boys and girls participate in a family triangle, seeking a special intimacy with the parent of the opposite sex and adopting a cautiously adversarial stance toward the same-sexed parent. And when brothers and sisters arrive, this rivalry is enlarged to include them. With several siblings, all contesting for places in the family, these interpersonal struggles, conscious and unconscious, can exert considerable influence on the development of personality. These struggles, Freud declared, become inevitable whenever human beings must live together.

In this context of problems in living together, still another of Freud’s rebellious followers became prominent. In his individual psychology, Alfred Adler stated that each person, in his or her own individual way, strives for mastery in the environment. This striving becomes the chief force in life because shortly after birth we all experience feelings of inferiority, owing to our physical limitations with respect to our caretakers, all of whom are stronger, bigger, quicker, and wiser. Our great deficit in life begins with our enormous dependence on others. Our enduring difficulty lies with this early experience of not being a fully capable adult (Adler, 1927).

Freud’s emphasis on childhood stimulated these thoughts, but Adler, well before his time, developed them into topics of considerable modern interest, such as parenting, family relationships, and living successfully in a community. Among them, sibling rivalry and the influence of birth order are now widely recognized and investigated (Stewart, 2000). Today in popular psychology, interest in self-help books on marital relationships, parenting, and sibling rivalry is exceeded only by the unremitting interest in self-help books on human sexuality.

Unlike other creatures, Freud continued, human beings begin their sex lives twice; the first time, like all other animals, occurs early in life, when the child is only three to six years of age. This effort is a feeble one. Then, after a quiescent period of several years, in a stage called latency, the sex life begins again, this time evolving toward sexual maturity. The patterns in this second instance, beginning at puberty, have already been laid down by the preceding childhood sexuality. Intense emotional processes accompany these years of adolescence, reflecting the prior Oedipus/Electra outcomes, and they function partly outside normal awareness.

Freud described this love-and-aggression triangle as “the romance of the family” (Freud, 1905). It had more relevance in his Vienna than in societies that offer more opportunities for diverse, open lifestyles (Malinowski, 1927, 1929).

There are traditional resolutions of the Oedipus and Electra complexes. Through identification, the child adopts the characteristics of someone else, typically the same-sexed parent, rather than maintaining an adversarial relationship with that person. The parent thus becomes a model, not a rival. Identification is the chief but not the only means by which the ego deals with the Oedipus/Electra conflict. In any case, this conflict subsides during a latency of four or five years and then arises again in adolescence. When this second phase goes well, teenagers gradually detach themselves from their parents, ceasing to be children and becoming adult members of society. In adult life, the earlier struggle may be transformed into affectionate and competitive expressions, as well as other derivative forms.

These conclusions about the outcomes in adult life need further empirical support. And times and cultures have changed since Freud’s day. But the idea that roots of adult personality lie in the management of childhood conflict has exerted a powerful influence on research in developmental psychology and also in clinical practice.

Fixations in Everyday Living
Life is full of hazards, however. No one makes the journey without some bumps and bruises, mental and physical. Passing through these early stages without any significant disruption requires careful, intelligent caretakers and extraordinarily good luck. Typically the child’s needs at some point are unmet or disrupted through negligence or misfortune. Then, as noted already, the outcome may be a fixation, in which the gratification of a certain need has been blocked, and the individual becomes controlled or possessed by that issue, overly but unconsciously focused on resolving it. Freud speculated extensively about fixation and its outcomes in adulthood (Freud, 1905, 1909).

According to traditional psychoanalysis, a child in the oral stage is especially susceptible to conflict related to the need for nourishment—when food is not available, not satisfying, not presented in an emotionally satisfying manner, and so forth. As a result, the child may become fixated on these issues later, remaining overly concerned with food, constantly seeking love and support, worried about nutrition, demanding special treatment, and the like. This insecurity, Freud speculated, may remain for the rest of the child’s life.

Similarly, if toilet training goes poorly because of the child’s lack of readiness, the parents’ unreasonable expectations, or any related tension, the child may become fixated at this stage, again becoming unconsciously preoccupied with the problem. Attempting to make amends at later ages, the child may become excessively neat, clean, obedient, and prompt, reflecting an overdeveloped superego. Or, adopting the opposite stance, the child may become messy, tardy, disobedient, and inconsiderate of others. In either case, the frustration over the earlier failure remains. Fixation is a sign of arrested ego development; the person cannot “let go” of the earlier difficulty. Later, even as an adult, the person struggles unsuccessfully to achieve a solution or to retaliate.

And when the great adolescent task goes badly, owing to disturbed groundwork in the Oedipus/Electra stage, issues of sexuality and personal relationships appear. Restrictions, punishment, and guilt have left their mark, and again, the development of the ego is arrested. The normal capacity for love is blocked or diverted. The individual may remain for the rest of life overly combative, submissive, or otherwise unable to deal with authority, intimate relations, and so forth. On this basis, Freud argued, the Oedipal/Electra stage is the seat of adult personality disorders (Freud, 1917).

The Pappenheims’ management of these childhood conflicts and Bertha’s response to them remain unknown. But psychoanalysts would speculate that things went poorly. The prevailing sexual code, Bertha’s later behavior, and comments by relatives suggest life was not easy for the little girl. In addition to severe restrictions of the superego and the early deaths of two older sisters, an unresolved Electra complex perhaps contributed too.

Even in her teens, Bertha displayed some unusual difficulties in everyday living. For example, Breuer described her sexuality as “astonishingly undeveloped,” and she enjoyed few satisfying relationships with peers, male or female. In a psychoanalytic sense, these problems were remnants of unresolved Oedipus/Electra issues. And some of her tales can be viewed in this way.

In the last of her Little Stories for Children, a water sprite lived alone by a pond. As punishment for some misdeed, she was prevented from ever leaving her little sanctuary. A great stone head with a forbidding look kept a watchful eye on her. But one night she became uncontrollably drawn out of the pond by dance music. Reaching the dance floor, she met a tall, bearded, blue-eyed man. She became his partner, wrapped in his embrace, dancing to music more and more intoxicating, until it faded. Then the little sprite looked into his eyes. Instantly, a tremor seized the man’s body, and he turned away. He knew he had danced with a little sprite; she knew the dance was over and the romance too.

The little sprite crept back to the pond and found it frozen. So she lay down beside the pond waiting for the ice to melt. It snowed and snowed, covering her body. The stone head laughed at her plight. Finally, spring arrived and melted the mantle of snow. Then the stone head, gazing sternly on the scene below, observed a tiny plant. Its solitary white flower sprouted from the place where the sprite had lain beside the pond (Pappenheim, n.d.).

Bertha perhaps composed this melancholy tale from her own life. She too had been prevented from leaving her home. A malicious stone head guarded the water sprite’s virtue, just as a death’s head, perhaps resembling her over-protective father, threatened Bertha during her hallucinations. And she too heard dance music, which brought thoughts of romance. In coloring and countenance, the water sprite’s dance partner resembled Josef Breuer who, in turn, resembled Bertha’s father (Hirschmüller, 1989). And that romantic figure disappeared instantly from the sprite’s life, just as Breuer had done with Bertha in earlier days.

Written some years after her father’s death and her therapy with Breuer, this tale suggests that Bertha still remained disturbed over those earlier events. From a psychoanalytic perspective, that reaction might be expected.

But numerous factors can contribute to any psychological disorder, and early conflict can produce many disparate outcomes. These psychoanalytic stages today are viewed as speculative. More conservatively, it is safe to say that life at times is difficult for everyone, especially in childhood, and that for most of us, some childhood problems persist in adult life. Psychoanalysis is significantly responsible for this view. The importance of childhood for later adjustment and personality is widely accepted today.

By the outset of the 20th century, Freud’s work had stimulated considerable support and vociferous objections. Several of his hypotheses and theories have been impossible to investigate scientifically because the underlying concepts are too vague. Others have yielded mixed results, not a surprising outcome, for the value of theory lies primarily in the research it generates. But recent studies in cognitive, social, developmental, and clinical psychology have offered empirical support for the unconscious, which stands as the cornerstone of psychoanalysis (Cramer, 2000; Westen, 1998, 1999).

Crises Through the Life Cycle
Neo-Freudians have modified and extended psychoanalytic theory through the full course of human development. One of them, Erik Erikson, identified eight stages in the life cycle from birth through old age but, like Freud, without impressive empirical support. These stages include a series of tasks or changes in social functioning, called psychosocial crises, each involving relationships with other people (Erikson, 1963).

Four crises occur in childhood. In the first, trust versus mistrust, the infant develops confidence and optimism, or a negative, distrustful outlook, depending on the caretaker’s management of the infant’s need for nourishment and support. In the child’s second year, the caretaker’s task is to allow the ambulatory child as much freedom as possible without endangering itself, creating the crisis of autonomy versus doubt. From ages three to six the child is ready to attempt simple tasks, producing the crisis of initiative versus guilt, depending again on the caretaker’s response to the child’s inept efforts. In the final childhood crisis, industry versus inferiority, the caretaker guides the child to appropriate tasks, thereby enhancing a sense of achievement, or presents tasks too demanding for the youngster’s level of maturity, producing feelings of inadequacy in that child.

With puberty, the teenager’s social goals and circumstances change markedly. In this crisis of identity versus role diffusion, the adolescent begins an intensive effort to develop a sense of self as an individual, seeking his or her own pathway in life. Erikson called this challenge of moving away from the family the identity crisis, a time of personal upheaval and uncertainty.

Bertha Pappenheim experienced much emotional turmoil in late adolescence. One might speculate that her parents and culture forced her toward an identity that she could not accept—that of a dependent housewife.

The tensions aroused by moving away from one’s family create in young adulthood the crisis of intimacy versus isolation. If this crisis is successfully managed, through a close relationship with someone else, the person feels supported rather than alone and alienated. The crisis of generativity versus stagnation occurs in middle adulthood, raising the challenge of progressing beyond intimacy and one’s own welfare to a broader concern for humanity. In the final crisis, called integrity versus despair, the individual looks back on his or her life and finds meaning and satisfaction or disappointment and despair. Integrity here refers to emotional integration, and the issue is not what has happened but rather how a person feels about those earlier events.

Like many theories, Erikson’s work has been criticized as lacking precision and empirical support, especially in the later crises. But in emphasizing the full life cycle, social development, and an identity crisis, this theory offers useful points of departure for the study of adjustment and maladjustment. At the core of this view, founded on Freud’s work, stands the notion of fixation. Unresolved childhood social crises can become core aspects of the personality later in life.

Expressions of the Unconscious
This concept of the unconscious can incite disagreement. As something apart from normal awareness, something not available through ordinary introspection, its presence or absence cannot be proven directly. Instead, evidence can be collected for or against the presence of unconscious mental processes, and in each instance, a case must be built. Seeking degrees of certainty, psychoanalysis often makes such a case (Schwartz, 2003). And support has been gained from investigations outside the traditional psychoanalytic context, revealing empirical evidence for unconscious thought in cognition, motivation, and emotion (Westen, 1998).

Symbolism in Behavior
Unconscious motivation occurs when someone behaves in certain ways, but neither these actions nor the reasons behind them are open to direct, conscious scrutiny, though they may convey traces of their origins (Freud, 1915, 1917). And here a brief review is in order.

Psychoanalysis is sometimes called the study of personality from the viewpoint of conflict, referring to the incompatible urges and tendencies that pervade human life. Our biological requirements and interests are commonly at odds with the restraints imposed by civilization. The struggle for survival continues in all cultures. At a more personal level, we experience ambivalence toward those people most important in our lives—those who have loved and protected us during our earliest, most vulnerable years. At one time or another, our interactions with them became frustrating and painful—for example, when we were punished for something we did not understand, when we were denied requests that seemed perfectly reasonable, or when we were ignored when we needed assistance. Emotional closeness in a family inevitably produces a great variety of feelings within each member, including tenderness, rivalry, fear, respect, and other incompatible feelings.

The individual is most vulnerable to conflict during the early years. Too weak to fight, too small to threaten, too ignorant to scheme, too clumsy to flee, too speechless to explain—the child is at others’ mercy. Despite the most watchful caretakers, childhood traumas are almost inevitable. For little Bertha, the early deaths of her siblings certainly had this potential, as did her later quarrels with Wilhelm, restrictions in sexual expression, and the cultural discrimination against females.

Conflict, then, sets the stage for something to follow—the ego’s effort to cope with conflict and the anxiety it generates. What happens when the ego cannot manage this task directly? In psychoanalysis, the answer is clear. The ego solves the problem indirectly.

In repression, a controversial concept, anxiety-provoking thoughts are excluded from consciousness through unintentional forgetting. In psychoanalysis, repression is the primary defense mechanism of the ego. Fearing reprisal for forbidden impulses, a person may repress the whole experience, thereby diminishing the overt anxiety. But repression is only a partial solution. The conflict is not truly resolved; the anxiety does not disappear completely.

In dealing with this persistent, puzzling anxiety, the individual develops a fixation, becoming overly and unconsciously concerned with the unknown problem. The person becomes “possessed” by it. Coping with it in the back of the mind, the person’s effectiveness in daily life is thereby reduced (Freud, 1915).

This fixation occurs because repression is not a static state, like a lid screwed onto the top of a jar. It is instead a bubbling cauldron in which highly emotional conflicts seek expression, kept from daily awareness at the cost of considerable psychic energy. When these conflicts threaten to break the ego’s barrier of repression, the fixation appears in indirect and unexpected ways called symbolic behavior. In other words, symbolic behavior is any disguised expression of some fixation; it is the behavioral manifestation of a partly repressed thought or feeling. Thus, fixation is a process, referring to the covert, internal state of tension. Symbolic behavior is an outcome, referring to any presumably disguised expression of that internal state appearing in dreams, mistakes, adjustment reactions, and other forms.

Unlike typical symbols, such as a wedding ring or a person’s signature, symbolic behavior becomes a representation and a misrepresentation, a compromise between the underlying impulse and its complete denial. Especially in the context of maladjustment, a symbolic behavior is sometimes called a symptom, meaning any overt condition that suggests an underlying disorder.

Symbolic behavior can appear, Freud emphasized, in people in any condition—ill or healthy. Moreover, different symbolic behaviors can represent the same or different fixations in a particular individual. For the observer of human nature, Freud concluded, symbolic behavior can convey all sorts of information—at times more than the observer wants to know (Freud, 1901). But these behavioral expressions are most likely to occur when a person is sick, tired, under emotional strain, or in an otherwise weakened condition.

Still sick and experiencing emotional strain, two years after completing Little Stories for Children Bertha published another book, this one for adults. Again, writing these tales could be considered symbolic behavior, revealing something about her personal issues, conscious or unconscious. But this time she became more open about herself, perhaps showing further signs of growth. She used a pseudonym with obvious elements of her own name, P. Berthold, and told a collection of stories through a collection of junk, calling the book In the Junk Shop (Pappenheim, 1890).

All the characters in these stories remain lonesome souls. In a junk shop, they are not suited for everyday life. And they betray one another, or some chance factor disrupts their bond, perhaps symbolizing what happened to Bertha.

According to psychoanalysis, Bertha’s depression, paralyses, headaches, anesthesia, and other symptoms were partial expressions of buried conflicts—childhood concerns about love, sex, rejection, anger, and relations with parents and siblings, all thrust into an unconscious realm at the price of these debilitating symptoms. Psychoanalysts regard such symptoms as possible symbolic behavior—clues to underlying emotional disturbance (Muroff, 1984). Freud, in particular, pointed to the symbolism in dreams, odd mistakes, defense mechanisms, and adjustment reactions, as well as one’s overall lifestyle (Figure 4.2).

Figure 4.2 Forms of Symbolic Behavior. When the ego cannot manage a conflict directly, it may seek an indirect solution through repression, resulting in a fixation. Signs of the unconscious fixation may appear later in various symbolic forms, ranging from dreams and everyday mistakes to an unusual lifestyle

Dreams and Mistakes
In the study of symbolism, Freud developed an elaborate theory of dreams, the intermittent visual and auditory images occurring in a semi-narrative sequence during sleep. He postulated that the ego, less vigilant in sleep, allows repressed conflicts to escape from the unconscious and appear symbolically in the dream story (Freud, 1900). This dream story, however incoherent, is the manifest content of the dream, the obvious sequence of events depicted by the visual, auditory, and other dream images. Freud’s interest lay instead in the latent content of dreams, the underlying, unconscious meaning, which is partly symbolized and partly hidden by the manifest content. The latent content becomes available only through careful inquiry into the dreamer’s recent and earlier experiences and into the dreamer’s spontaneous reactions to specific elements of the manifest content. In other words, any dream interpretation requires carefully obtained background information about the dreamer.

One night Bertha dreamed that she had tamed two jackals and kept them each on a leash. Reeking with an offensive odor, these animals turned into a pair of men she recognized as her neighbors in Vienna. She controlled them by pulling on their leashes, which concluded the manifest content of the dream. Some observers might view these actions as symbolically sexual, aggressive, or both on the part of the dreamer, perhaps elements of the latent content. But according to psychoanalysis, no dream interpretation can be of any use whatsoever without a detailed knowledge of Bertha’s life at the time and without her unrestrained thoughts about the dream, called free associations. Freud remained emphatic on this point, which is constantly overlooked by enthusiastic but unenlightened followers.

Especially in dream interpretation, Freud made extensive use of universal symbols. Transcending culture, a universal symbol conveys the same meaning or the same set of meanings for all people everywhere, regardless of background. These symbols presumably have existed down through the ages. In contrast, an individual or private symbol carries a specific meaning for a particular person, which is not necessarily shared by others. According to Freud, most symbols, especially those that are universal, pertain to relatively few topics: the human body, family members, birth and death, nakedness, and sexuality (Freud, 1916).

Freud’s approach was highly speculative and included dozens of universal symbols for male and female genitalia (Freud, 1916). But simply enumerating these symbols does no justice to Freud’s thought. Even discussing his ideas in one or two paragraphs produces an inadequate account, almost a caricature. His range of interests and emphasis on human beings as symbolizing creatures have been of major importance in literature, art, drama, and other humanities. But by today’s standards, this thinking lacks the empirical support considered essential in science.

Freud spoke of The Interpretation of Dreams as his most important work. The text of this book shows a logical, step-by-step organization befitting a scientific report. The illustrations, often of Freud’s own dreams, reflect a series of disparate but personally important themes in his life. Thus, at the first level the book takes readers ever upward to increasingly sophisticated dream analysis. At the second and lower level, the illustrations transport the reader ever downward into increasingly deeper reaches of Freud’s unconscious mind (Schorske, 1979). Owing to its magnitude and dual content, this work best illustrates Freud’s thought and stands as the masterpiece of his writings, though the theory still lacks convincing support.

The unconscious appears in dreams, Freud speculated, because the ego becomes less vigilant during sleep. But symbolic expressions of the unconscious also appear regularly throughout waking life, he declared. In daily behavior, we sometimes do or say things incorrectly or clumsily because unconscious conflicts break the barrier of repressions, revealing our inner concerns and unacceptable wishes. In fact, the popularity of psychoanalysis in public life centers around the attention it devotes to dreaming and to these lapses in appropriate behavior.

Sometimes a mistake in everyday life is popularly called a Freudian slip because Freud regarded many such errors, but not all, as symbolic behavior—further expressions of the unconscious. They include temporary forgetting, errors of the tongue or pen, accidental self-injury, and various bungled actions. Bertha injured herself by nursing her father in a needlessly strenuous fashion, though her wealthy family could readily afford full-time help.

Why did Bertha place such unreasonable demands on herself? Did this “accidental” self-injury serve some unconscious purpose in her life? Was her overly stressful nightly nursing driven by unconscious conflicts? In traditional psychoanalysis, her totally unnecessary sacrifice perhaps became her way of seeking assistance for her own personal problems.

With the widespread interest in The Psychopathology of Everyday Life, his book about errors in everyday life, Freud became jubilant. He called it a triumph for psychoanalysis; the gulf between normal and abnormal mental life had been narrowed (Freud, 1901).

Defense Mechanisms
Another sign of the unconscious appears in a defense mechanism, a way of thinking or behaving that enables a person to avoid awareness of anxiety-arousing thoughts. Formally, these reactions are called the ego’s mechanisms of defense because the ego defends against unwanted thoughts by deceiving itself. This idea, that people unconsciously avoid what they do not want to know, became so popular that the public and psychologists themselves lengthened Freud’s list of defense mechanisms, often incorrectly. Anna Freud, his daughter and noted psychoanalyst, deserves much credit for clarifying and elaborating the defense mechanisms. In contrast, coping mechanisms are employed consciously to deal with stress. They include thinking about the situation in a more positive way, focusing attention elsewhere, and relieving stress through relaxation techniques and physical exercise.

In defense mechanisms, the individual defends without awareness of the real problem, as in the following: rationalization, by concocting plausible but false explanations; reaction formation, by taking a stance opposite one’s deeper feelings; displacement, by directing an emotional reaction onto something or someone other than its appropriate target; and sublimation, by engaging in socially acceptable behavior as an indirect expression of socially unacceptable impulses. There is no intent to be deceitful in any of these mechanisms. The individual’s conflict remains unconscious. Repression, the basic defense mechanism, underlies all others.

Bertha’s passionate declaration of love for her father may be viewed on this basis. It perhaps had origins in displacement, whereby she directed onto him the love she wanted to express toward a male peer. It may have involved reaction formation, whereby she disguised even from herself the hostility she felt toward her father because of his overprotectiveness, which prevented her from establishing close relationships with peers. These statements are consistent with psychoanalytic theory, but without more precise information, they remain mere conjecture.

In one study of defense mechanisms, two groups of 10 children each were examined four times over a two-year period. Beginning at age six years and six months, each child individually told stories in response to a traditional projective test. Altogether, 134 stories were recorded, coded, and randomized to make identification of the author and date impossible. Then they were scored for use of three defense mechanisms: denial, refusing to acknowledge disturbing events; projection, attributing one’s undesirable traits to others; and identification, accepting as one’s own the goals and ideas of another person.

It was predicted that denial, the simplest mechanism, would decrease as the children gained increased cognitive development; that it would be replaced by projection, which assigns the blame to others; and that identification would show a gradual increase, presumably reaching a peak later, in adolescence, when the individual encounters the identity crisis. All three predictions were confirmed, providing further evidence that children do not suddenly adopt and discard defense mechanisms. Instead, they experience shifts among them almost automatically, reflecting the usual patterns of cognitive development (Cramer, 1997).

Adjustments and Lifestyles
From a psychoanalytic standpoint, the unconscious sometimes emerges dramatically in an adjustment reaction—a disturbed condition that may include diverse symptoms, ranging from personal discomfort to socially disruptive behavior. Bertha’s phobia about black snakes, her puzzling cough, inexplicable deafness and blindness, and paralyses with no medical bases revealed adjustment reactions described today in the Diagnostic and Statistical Manual of Ment

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