ESSAY ON SOME OF THE PROBLEMS IN DETERMINING WHETHER THE EFFECTS OF
PSYCHOANALYSIS ARE REAL.
Psychoanalytic therapy has been taking a considerable barrage of abuse
since it's birth nearly a century ago. The legs of the
`Psychoanalysist's Couch'( for that is what is mainly used in therapy
sessions) is riddled with holes drilled into it by many schools of
Scientific and Psychological thought. But `the couch' is still around ,
the holes forever patched and repaired by contemporary the analysists
(Malen 1979, Sandler 1970 i.e theories and hypothesise are continually
changing) and their are still `patients' on the waiting list. If there
are problems with the Psychoanalysis concept they cannot be that severe
or surely `the couch' would have been `chopped up for firewood' long
ago'. This essay will offer up critics and criticisms to the
Psychoanalytical doctrine in regards to the theoretical hypothesise
identified by Freud, developed by the Psychoanalytic school and the
critical aspects of therapeutic technique and evidence. `The couch'
will have opportunity to respond to any attacks made: but it is the
identification of the problems associated with Psychoanalysis and
primarily it's position in the modern scientific world, that the body
of this essay will concentrate upon.
A brief moment had betterbe taken to characterise Psychoanalysis,
painting with broad brushstrokes the foundation of theory and
therapeutic aims. This definition concentrates on `sessions on the
couch' (one to oneinteractions between analyst and patient) and there
is not the paper to define all the theories or applications (a large
tree would be needed) such as childhood disorders, Schizophrenic theory
and treatment etc. " As a therapy ,Psychoanalysis is based on the
observation that individuals are often unaware of the factors that
determine their emotions and behaviour... Analysis is an intimate
partnership, in the course of which the patient becomes aware of the
underlying sources of his/her difficulties not simply intellectually
,but emotionally- by re-experiencing them with the analysts ...
Eventually the patients life - his/her behaviour, relationships,
sense of self ; changes in a deep and abiding way" (American
Psychoanalytical Society - Home Page, WWW 1995). This definition is
not to be used as a `blue-print' for the problems in the
Psychoanalytical concept, that will endeavoured to be explained,
but more as an overview to the many of us who are unsure of `what
Psychoanalysis actually entails'.
The problems adhered toPsychoanalytic therapy can be separated into
criticisms of themethods used in `the therapy situation', arguments
against Freudian theories and hypotheses (concentration on the failings
of the `repression hypothesis') and a critic of `the couch' as a whole
concept, on a scientific (empirical refutability) and philosophical
level. There is considerable overlap in problems identified by this
essay and others, but this is the structure of the that will be
undertaken.
Firstly, scientific questioning of the subject of Introspection as a
means of collecting data in the Psychoanalysis situation should be
given. Introspection (the inspection of ones own subjective experience
and thought) cannot be awarded the status of `scientifically approved
method of observation'. There is no way to confirm individual
experience or to check `whether your introspective reading was
accurate'(Harnad 1995 Bookmarks- WWW).
This has to be major flaw in the theory of Psychoanalysis if the
analyst is unable to confirm whether any of his/her interpretations
are accurate or if the analysand ( i.e. patient) has not just
invented them.
Memories form an intregal part, if not `the basis', for
introspection and the use of memories as a reliable source of
information has to be questioned. Memories are `un-trustworthy ...
(and) are constructions, not mere registrations (of the truth)' (M.
Eddeson 1984 Hypothesis and Evidence In Psychoanalysis). Memories
are prone to retrieval problems (where time is a factor -William
James 1890 & Brown 1958), content loss, in-accuracy to the truth and
even the `implantation of completely false memories' ( Loftus 1993
Reality of Repressed Memories - Ian case study ). Response by `the
couch' state that they are more concerned in `what happened' rather
than in the fine detail of `what actually happened' (M. Eddeson
1984). A clearer picture of the problems with memory use in therapy
is discussed by E. Kriss - Psychoanalytic Study Of The Child 1956.
Remaining with the subject matter (the patient) as a possible source of
problems. There has to be some remark as to the wishes and desires,
both conscious and un-conscious, of the patient. The effectiveness of
any introspection and memory analysis has to be mainly attributed to
the compliance and knowledge of the person on the couch. Jacob's (1984)
states that `the goals of therapy are limited by what client
consciously wants to achieve and communicate' and that the
pre-conceptions of the patient to what they know/expect from a session
may have a substantial effect of a therapy . It can be identified that
the analysand may limit the effects of Psychoanalysis simply by doing
what is asked `re-experiencing thoughts and feelings' and trying to
consciously achieve a `insight' into what is found.
Turning from who is `on the couch' to the Analyst, a careful scrutiny
has to be made as to the relationship that is achieved and moulded by
the analysts in the therapy situation. Results from the Psychoanalytic
method can become corrupted by suggestion and that `analysts induces
their patients by suggestion to furnish the responses needed to
validate their Psychoanalytic theory...' (Wilhelm Fleis 1954). A
patient can be lulled into following in-correct paths in their
introspection and arrive at conclusions that are un-representative of
the real reasons for their neurotic disorders. Suggestion can be
explicit ("tell me about that"), or implicit (analysts remains "silent"
may be indicating something to the patient). The analysts then makes
interpretations of introspective findings into associations (this will
be looked at in depth in a moment). This has two underlying currents :
that the analysts interpretations (and associations) are determined by
his/her prior knowledge and philosophies and that the patient may
observe these and perceive them as possible avenues, or explanations,
for his/her problems. `The couch' would argue that ` clinicians can be
trained not to elicit suggestion' (Glymour 1974) and that personal
interpretations are removed and therapy is directed through proven (?)
Psychoanalytic theories.
Suggestive corruption was identified by Graunbum (1985) in
`Philosophical Critique Of Foundations Of Psychoanalysis' and
illustrated in the use of `Free Association' method used in
therapy(`client says what ever comes into their mind no matter how
silly/irrelevant -R.D. Gross 1987). Free Association seems to fail due
to the analyst `unwittingly, he conveys non-verbal or para-verbal
cues...the psychoanalysists own selection biases may determine which
associations he uses and weaves together' (Graunbum 1985) ie may direct
patient introspection along in-correct fields of symptom explanation.
It would seem that Freud's `covering for his couch' (Free Association)
is not a valid method of achieving evidence in Psychoanalysis.
Other methods used in the therapy situations that can be seen as a
little 'scientifically suspect' on grounds of validity and reliability
are the Thematic Apperception Test (T.A.T), the Rosarch Ink Blot
Test, Word Association and various other `Activity Methods' (i.e.
drawing and structured play). The above, all fall prey to
Psychoanalytical suggestion, and their suspected claim of being
scientifically valid is even identified by `the couch' who consider
them as; `techniques' used in therapy not as `tests' to quantify
theories. They do yield some valid results( Ink Blot test on brain
damaged patients - R.L Gregory 1990): but in general will not bow to
Psychometric Standardisation and remain too ideographic in concept,
as methods of data collection.
Moving away from the problems within the area of testing attention will
now be turned to the problems and criticisms of the theories and
hypotheses that were constructed by Freud and developed by the
Psychoanalytic school. It would be time consuming to describe and
criticise all the theories that make up the `Psychoanalytic Dynasty'
Instead concentration will be made upon the fundamental theories and
offer an evaluation, on a scientific level, of the Freudian
`couch'/concept as a whole. The foundation, and `pillar', to much of
the Freudian thought is the idea of Repression. Freud & Breur (1893)
discovered that `in the course of treatment (hypnosis in this instance
in 1893) the victims had repressed the memory of the trauma that had
closely preceded it's onset and was somehow thematically connected to
it'. This led to them formulating their first major hypothesis and that
`the impairments observed after treatment were caused by the cathartic
lifting of the repression's' (Freud & Breur 1895). They proceeded to
reject the alternate hypothesis put forward at the time: that `the
expectation of the patient and wish of relief from symptoms were the
real cause for removal of the neuroses' and not the `patients insight'
into their repression's (`Placebo Effect' Graunbum 1981).
Unfortunately the rival hypothesis began to take foot as evidence of
symptom re-emission were discovered, and that supposedly `cured'
patients seemed not to be. Freud was in danger of having `the legs
of the couch sawn off' before it was even finished. He then
prescribed that the un-covering of `even earlier childhood
repression's with sexual content' (Freud 1905)would indicate the
cause of neuroses . But even the new `Childhood Sexual Hypothesis of
1917' fared no better in regards to analysand's wishes of symptom
removal and other evidence found in the therapeutic situation. It
was concluded that there seemed to be a lack of evidence to validate
the claim that the lifting of repression's cause symptoms to be
removed, even the `existence of repression as a concept' as a whole
is discussed by E. Kline (1981).
What is `A Successfully Analysed'person? and how can it be identified
that they are indeed cured ofwhat ever it is that they wished to be
removed or induced. Freud answered this by classifying success that the
`treatment can yield or mediate for the patient correct insight into
the un-conscious causes of his/her neuroses' and that a `patients
correct insight into the conflictual cases of his condition and into
theun-conscious dynamics of his/her character... are necessary for the
durable cure of his neuroses' (characterised as Necessary Condition
Thesis by Graunbum 1983). Graunbum then dissected the Freudian success
concept and constructed a `Tally Argument' (Graunbum 1983) for which
the premise's of success could be attributed. The fundamental premise
was that (1) the analysand achieves `Veridical Insight' (M. Edelson
1978) which in turn can only be achieved by the tallying of the
analysts interpretations to the objective truth. (3) That any data
collected from patients does not come from self-forfilling predictions
or by therapist contamination. (4) That only the Psychoanalytic
treatment can produce genuine cures of neuroses not other methods or
theories. The Necessary Condition Thesis is Freud's key witness in the
Psychoanalytic defence, and the Tally Argument the `jury' which is to
pass sentence against `The Case Of Whether Psychoanalysis Is A
Successful Therapy'. Under the first premise (1) Freud's case begins to
fall apart immediately, and ,that the patient might perceive that
he/she has achieved Veridical Insight :but it may not be in the area of
the cause of the relevant neurosis evidence by `Spontaneous Neurotic
Symptom Re-Emission' and then even if it is `Tallied' with the
objective truth it does not always correlate. In his later years Freud
weakened his Necessary Condition Thesis by stating that `a satisfactory
Psychoanalysis will not even prevent he re-occurrence of the problem
for which he/she is treated' (Graunbum 1983). Premise (2) has been
discussed in other sections in the light of therapeutic corruption by
analysts suggestion and analysand's conscious/un-conscious wishes.
Premise (3) is somewhat unfounded as contemporary thought advocates
that greater self knowledge, increases in social support and halting
the events that may lead to the creation neuroses before they happen,
are better ways dealing with neuroticism as a whole rather, than time
spent `on the couch'.The `increase in support' idea is identified as a
factor in dealing with neurotics by Jerome Frank (1973) `both analysts
and their rivals (disciplines) heal neurotics by being supportive, not
by un-covering their repression's.
Finally discussion of the problems of Psychoanalysis on a Philosophical
level will be discussed. It will now be seen if `the couch' can weather
`Scientifically Empirical Testing' storm. Due to it's methodology
`there are no facts in Psychoanalysis, for the analysis does not
observe he interprets (Riciour 1970). Graunbun 1982 Philosophical
Critique Of Psychoanalysis looks in depth at the Freudian concept and
it's status in the `scientific world' with specific reference to Popper
(1980) theory that Psychoanalysis "is simply non-testable,
irrefutable". This is then characterised in the article through the
creation of Graunbun's `Cannons Of Eliminative Inductivism' (like the
tally argument already mentioned) which Freud appears to fail on. It
could be concluded that `the couch' (Psychoanalysis )is a useless
method of obtaining results of a persons thoughts and feelings and that
`the couch should be burned'.
But Psychoanalysis has yielded some valid results and valuable insight
into the world of the un-conscious. Many analyst's themselves argue
that Psychoanalysis is `essentially founded on clinical evidence (Jones
1970) and `the only method so far available made possible the
scientific observation of motivational forces of mans mental
life'(Bruner 1982). Though the debate as to the reliability of the
Psychoanalytic concept as a whole will continue to rage, it also will
continue to produce valuable insight into the area of human behaviour
and motivation.
REFERENCES:
-Precise of The Foundations of Psychoanalysis: A Philosophical
Critique (Adolf Grunbaum)Behaviour and Brain Sciences 1986 -S. Harnad
- The Foundations of Psychoanalysis -A. Grunbaum (1984)
Part 1 The Clinical Method Of Psychoanalytical Investigation
- Hypothesis & Evidence in Psychoanalysis - M. Edelson (1928)
Part 1 The Challenge
- Introduction To Psychology - R.D Gross (1987) Chapter 23
Psychoanalytic Thoery
- The American Psychoanalytic Home Page (WWW)
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