What is Psychoanalysis and How Does it Differ from Psychotherapy?
University of Colorado’s Department of Psychiatry member, Jonathan Shedler, has provided a great service by composing a wonderfully accessible explanation of what defines psychoanalysis and how it is and isn’t related to other forms of psychotherapy. I obtained his essay through Dr. Jeffrey Longhofer’s website. The views expressed by Dr. Shedler are his own and do not necessarily represent the views of Abel’s Voice blog, and vice versa. I have reproduced the first few paragraphs of his work, “That Was Then, This is Now: Psychoanalytic Psychotherapy for The Rest of Us,” and the complete work is available at his website Jonathanshedler.com, or by clicking here. Enjoy!
Chapter 1: Roots of Misunderstanding
Psychoanalytic psychotherapy may be the most misunderstood of all therapies. I teach a course in psychoanalytic therapy for clinical psychology doctoral students, many of whom would not be there if it were not required. I begin by asking the students to write down their beliefs about psychoanalytic therapy. Most express highly inaccurate preconceptions. The preconceptions come not from first-hand encounters with psychoanalytic practitioners, but from media depictions, from undergraduate psychology professors who refer to psychoanalytic concepts in their courses but understand little about them, and from textbooks that present caricatures of psychoanalytic theories that were out of date half a century ago.
Some of the more memorable misconceptions are: That psychoanalytic concepts apply only to the privileged and wealthy; that psychoanalytic concepts and treatments lack empirical support (for a review of empirical evidence, see Shedler, 2010); that psychoanalysts “reduce everything” to sex and aggression; that they keep patients in long term treatment merely for financial gain; that psychoanalytic theories are sexist, racist, or classist (insert your preferred politically incorrect adjective); that Sigmund Freud, the originator of psychoanalysis, was a cocaine addict who developed his theories under the influence; that he was a child molester (a graduate of an Ivy League university had somehow gotten this bizarre notion from one of her professors); and that the terms “psychoanalytic” and “Freudian” are synonyms—as if psychoanalytic knowledge has not advanced since the early 1900s.
Most psychoanalytic therapists have no idea how to respond to the question (all too common at cocktail parties), “Are you a ‘Freudian?’” The question has no meaningful answer, and I myself fear that any answer I give will lead to misunderstanding. In a basic sense, all mental health professionals are “Freudian” because so many of Freud’s concepts have simply been assimilated into the broader culture of psychotherapy. Many Freudian ideas now seem so commonplace, commonsense, and taken-for-granted that people do not recognize that they originated with Freud and were radical at the time. For example, most people take it for granted that trauma can cause emotional and physical symptoms, that our care in the early years profoundly shapes our adult lives, that people have complex and often contradictory motives, that sexual abuse of children occurs and can have disastrous consequences, that emotional difficulties can be treated by talking, that we sometimes find fault with others for the very things we do not wish to see in ourselves, that it is exploitive and destructive for therapists to have sexual relations with clients, and so on. These and many more ideas that are commonplace in the culture of psychotherapy are “Freudian.” In this sense, every contemporary psychotherapist is a (gasp) Freudian, like it or not. Even the practice of meeting with clients for regularly scheduled appointments originated with Freud.
In another sense, the question “Are you a Freudian?” is unanswerable because no contemporary psychoanalytic therapist is a “Freudian.” What I mean is that psychoanalytic thinking has evolved radically since Freud’s day—not that you would know this from reading most textbooks. In the past decades, there have been sea changes in theory and practice. The field has grown in diverse directions, far from Freud’s historical writings. In this sense, no one is a Freudian. Psychoanalysis is continually evolving new models and paradigms. The development of psychoanalytic thought did not end with Freud any more than the development of physics ended with Newton, or the development of the behavioral tradition in psychology ended with Watson.
There are multiple schools of thought within psychoanalysis with different and sometimes bitterly divisive views, and the notion that someone could tell you “the” psychoanalytic view of something is quaint and naïve. There may be greater diversity of viewpoints within psychoanalysis than within any other school of psychotherapy, if only because psychoanalysis is the oldest of the therapy traditions. Asking a psychoanalyst for “the” psychoanalytic perspective may be as meaningful as asking a philosophy professor “the” philosophical answer to a question. I imagine the poor professor could only shake her head in bemusement and wonder where to begin. So it is with psychoanalysis. Psychoanalysis is not one theory but a diverse collection of theories, each of which represents an attempt to shed light on one or another facet of human functioning…
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