Psychoanalysis: So Bad It’s Good?

By Neuroskeptic | January 16, 2011 11:20 pm

Many of the best things in life are terrible.

We all know about the fun to be found in failure, as exemplified by Judge A Book By Its Cover and of course FailBlog. The whole genre of B-movie appreciation is based on the maxim of: so bad, it’s good.

But could the same thing apply to psychotherapies?

Here’s the argument. Freudian psychoanalysis is a bit silly. Freud had pretensions to scientific respectability, but never really achieved it, and with good reason. You can believe Freud, and if you do, it kind of make sense. But to anyone else, it’s a bit weird. If psychoanalysis were a person, it would be the Pope.

By contrast, cognitive-behavioural therapy is eminently reasonable. It relies on straightforward empirical observations of the patient’s symptoms, and on trying to change people’s beliefs by rational arguments and real-life examples (“behavioural experiments”). CBT practitioners are always keen to do randomized controlled trials to provide hard evidence for their success. CBT is Richard Dawkins.

But what if the very irrationality of psychoanalysis is its strength? Mental illness is irrational. So’s life, right? So maybe you need an irrational kind of therapy to deal with it.

This is almost the argument advanced by Robert Rowland Smith in a short piece In Defence of Psychoanalysis:

…The irony is that in becoming more “scientific”, CBT becomes less therapeutic. Now, Freud himself liked to be thought of as a scientist (he began his career in neurology, working on the spinal ganglia), but it’s the non-scientific features that make psychoanalysis the more, not the less, powerful.

I’m referring to the therapeutic relationship itself. Although like psychoanalysis largely a talking cure, CBT prefers to set aside the emotions in play between doctor and patient. Psychoanalysis does the reverse. To the annoyance no doubt of many a psychoanalytic patient, the very interaction between the two becomes the subject-matter of the therapy.

The respected therapist and writer Irvin Yalom, among others, argues that depression and associated forms of sadness stem from an inability to make good contact with others. Relationships are fundamental to happiness. And so a science that has the courage to include the doctor’s relationship with the patient within the treatment itself, and to work with it, is a science already modelling the solution it prescribes. What psychoanalysis loses in scientific stature, it gains in humanity.

Rowland Smith’s argument is that psychoanalysis offers a genuine therapeutic relationship complete with transference and countertransference, while CBT doesn’t. He also suggests that analysis is able to offer this relationship precisely because it’s unscientific.

Human relationships aren’t built on rational, scientific foundations. They can be based on lots of stuff, but reason and evidence ain’t high on the list. Someone who agrees with you on everything, or helps you to discover things, is a colleague, but not yet a friend unless you also get along with them personally. Working too closely together on some technical problem can indeed prevent friendships forming, because you never have time to get to know each other personally.

Maybe CBT is just too sensible: too good at making therapists and patients into colleagues in the therapeutic process. It provides the therapist with a powerful tool for understanding and treating the patient’s symptoms, at least on a surface level, and involving the patient in that process. But could this very rationality make a truly human relationship impossible?

I’m not convinced. For one thing, there can be no guarantee that psychoanalysis does generate a genuine relationship in any particular case. But you might say that you can never guarantee that, so that’s a general problem with all such therapy.

More seriously, psychoanalysis still tries to be scientific, or at least technical, in that it makes use of a specialist vocabulary and ideas ultimately derived from Sigmund Freud. Few psychoanalysts today agree with Freud on everything, but, by definition, they agree with him on some things. That’s why they’re called “psychoanalysts”.

But if psychoanalysis works because of the therapeutic relationship, despite, or even because, Freud was wrong about most things… why not just chat about the patient’s problems with the minimum of theoretical baggage? Broadly speaking, counselling is just that. Rowland Smith makes an interesting point, but it’s far from clear that it’s an argument for psychoanalysis per se.

A truncated version of this post briefly appeared earlier because I was a wrong-button-clicking klutz this morning. Please ignore that if you saw it.

CATEGORIZED UNDER: freud, media, mental health
  • Kapitano

    If someone had worded Smith's idea slightly differently…

    “Freudian Psychoanalysis is basically a religion. It's got a revered founder, some holy books no one reads, a set of ideas that are either meaningless or easily refuted by observation, and a collection of circular pretend-scientific rationalisations to vaccinate the patient against such refutations.

    Some people are happier when they join a cult. And Freud's cult is less harmful than most, so lets just be happy they're happy.”

    …who would consider it worth the time they spent reading it?

  • Anonymous

    Neuro – I'm a longtime listener, first time caller – thought I should have a go at this comments thing…


    1. Observational Selection.

    What about the possibility of the 'therapeutic relationship' – as described by the author – being damaging or harmful? This begs the question – Are there particular kinds of relationships that can aid this process more so than others?

    2. Resolving the 'removal from the problem' effect.

    I've always been interested in this idea – that there's something about the 'situational detachment' of the other person. That is, the fact that the other person is NOT INVOLVED OR IS IN SOME WAY REMOVED FROM THE PROBLEM can be a good thing; that they bring a 'fresh perspective' (whatever that is), and contributes to the outcome. If this is the case, then surely some kind of boundary between therapist and patient is necessary to aid the recovery process. Furthermore, it also raises questions as to the definition of 'therapeutic relationship' and its strengths and limitations.

    3. Forgotten…

  • mercurialmind

    I think there is some evidence that we react towards individuals based on previous experience. He or she reminds us of a previous relationship.I am not so sure about the rest of psychoanlysis.

    I don't see why CBT and psychoanlysis can't be combined. It seems like they would complement each other.

  • pj

    I wonder why Smith thinks there's no relationship between a CBT therapist and patient? I mean, apart from the extra time involved, I'm not sure that psychoanalysis particularly fosters a relationship. It may focus on transference and counter-transference but that isn't the same thing. I don't think psychoanalytic psychotherapists are particularly encouraged to share anything about themselves with the patient.

  • Anonymous

    I'm a big fan of Yalom's insights into the therapeutic process, and most of his insights and suggestions can be applied to various 'techniques' and theories. He exposes theoretical pluralism and not being a true believe in one rigid theoretical perspective.

    I have found that training in many areas from more manualized CBT, DBT, and all the rest continue to leave me far from impressed with their ability to truly help clients–without also having a good relationships with the person and the willingness to address process oriented here and now issues in addition to the more directive treatment.

    I find that some clients just don't want the more directive treatment types and it can promote more passivity and clients that work with me–usually complain of previous therapists who didn't 'understand' or listen to them much, and led sessions. I believe that occasionally specific modalities appeal more to the therapists and actually help alleviate their anxiety, and help confirm their desire to be a valid helper–by sticking to a more scripted/controlled therapy experience.

    I see the therapeutic relationship, authenticity, spontaneity as the vehicle for psychotherapy, and the different theories as the transmission–allowing for shifting gears and customizing therapy to each client.

    Almost nothing new under the sun applies to most of these EVT anyway, I see it mostly as a money making machine for those that sell the info. Adler, Karen Horney and many other 'older' theorist encompass varied approaches within their so called theoretical orientation. Customized treatment is key, flexibility, and the willingness to tolerate anxiety in sessions without attempting to overly control the counseling–by relying on rigid treatment modalities which often are really geared toward alleviating therapist frustrations–or to make them feel better about themselves–or more scientifically based. We need to attend more to what clients need/want/experience therapy and the growing body of data on the primacy of therapy relationship–and how technique driven treatment in all but perhaps acute phobias etc are lacking for clients–whom we should focus on, not the needs of a professional to feel more secure by removing/reducing spontaneity.

  • Anonymous

    I have been to cognitive behavioral therapists and various forms of counselors all my life with no real success– I ended up eventually slipping back into new patterns that were variations on the things I “fixed” in therapy.

    Currently I am in Lacanian Psychoanalysis and have been for two years. It's not burdened with “theoretical baggage.” Conversely it is the only therapy I've ever experienced that gets past the “conversation between colleagues” dynamic that you speak of with CBT. Through transference and free-association, there's something going on that is beyond anything I've ever experienced. I'm a devoted convert, in other words.

    If you read a book that teaches you how to paint, no matter how good the book, it's nothing compared to studying with a great painter. All the therapy I've ever had before this was akin to reading a book. The clinical distance kept the conversation at one level, and kept the boundaries and the definitions of the relationship very sanitized. As a result I never truly understood my subjectivity. I could give you all sorts of anecdotal evidence but I will leave it at that.

  • Lee Charles Kelley,

    If Freud is the pope (and CBT is Richard Dawkins) then I guess that would make Carl Jung a combination of the Dalai Lama and Carlos Casteneda?

    I'm a dog trainer. I'm not in therapy, nor am I a therapist. But I consider myself a post-Freudian dog trainer because my model for solving behavioral problems in dogs is based on Freud's view that what we call happiness is “the sudden release of emotions that have been dammed up to a high degree.”

    Yes, dogs can have repressed emotions. And yes, they have an ego and an id (the ego is the owner, the id is the dog's drives and instincts, which are often quashed during a puppy's developmental phases). In fact it was either here or at Neurocritic's blog, that I first heard about some of the latest research in neurobiology, which validates Freud's views that the psyche is divided into the id and the ego, and how they correlate with the limbic system and the pre-frontal cortex.

    I have no quarrel with cognitive therapy, but with its counterpart in the dog world, operant conditioning.

    Here's the problem, as I see it. The Skinnerian model of positive reinforcement (which is just a clinical outgrowth of the pleasure principle), is more “scientific,” in that it has empirical data supporting it. And yet it's far less effective at solving behavioral problems than the neo-Freudian, post-Lacanian model I use, which is designed to find out what kinds of repressed emotional energy are causing the behavioral problem, and giving that energy through play.

    I think that's because Skinner's model is only 2nd or 3rd approximation when done in a laboratory setting, where all the variables can supposedly be accounted for, but it's only a 1st approximation when used on dogs living in the real world, not a maze or Skinner box.

    Anyway, that's how I see it.


  • Lee Charles Kelley,

    sorry, that should have read “giving that energy a positive outlet through play.”

  • Zarathustra

    A few random thoughts and opinions from me, in no particular order.

    – We have some psychoanalytic psychotherapists in my CAMHS clinic. They tend to base their theoretical framework on John Bowlby and attachment theory rather than Freud and kill Daddy/fuck Mummy. This seems like a good thing to me, since attachment theory is basically what happened when psychoanalysis had a sudden attack of Sensible.

    2. I've done some CBT training, and our trainer very strongly emphasised the importance of developing a therapeutic relationship, and that you should do lots of person-centred counselling and socratic questioning as the basis for your CBT work.

    3. Despite point 2 above, I do see lots and lots of very rubbish caricatures of CBT being provided. Unqualified support workers sitting down with a deeply-troubled teenager and going through an “anger management” worksheet with them – that sort of thing. It's an attractive option because (a) it's cheap and (b) people get to have a nice warm fuzzy feeling that “we've provided CBT”. So everybody benefits – except of course, the troubled teenager, who benefits from it to the tune of the square root of fuck all.

    4. Arguably, one could say that Freud is one of those figures in the history of ideas alongside Aristotle or Hippocrates – almost all of their theories were wrong, but they laid the framework from which other, better theories emerged. Freud may be dead to psychiatry now, but John Bowlby and Carl Rogers both came out of the psychoanalytic tradition, and their ideas most certainly are not.

  • Zarathustra

    John Bowlby = Penny from Inspector Gadget. Quietly but effectively resolving the mystery while the supposed genius blunders around acting like a pillock.

  • mount analogue

    Let's get down to brass tacks

    Some problems require an objective and rational perspective to cast a little light on the problem. Others require a feeling of real connection, communication and sympathy. I'm sure everyone has had the feeling of annoyance that arises when they go looking for one and get the other.

    I think this post brings an interesting problem to light. Is CBT hobbled in the relational/sympathetic department precisely because it is rational and objective.?

    Of course, as has been pointed out above, there are plenty of CBT practitioners out there who do relate to clients, just as I'm sure there are plenty of psychodynamic practitioners who are .formulaic

    A skillful lifelong therapist like Irving Yalom might base some of his techniques on mumbo-jumbo, but still be a thousand times more effective than a twenty-something overly cerebral CBT practiotioner with no social skills. Practitioner personality, experience, skill and patient/doctor compatibiltiy are all confounds in a complex system beyond our ability to accurately measure, model or predict. This is why there is so much mumbo jumbo around – and why it is so hard to get rid of it. We simply don't know what is important.

    Amidst these unknowns, the efficacy of the individual practitioner is primary – not the orthodoxy of one type or another that people like to cling to.

    Our theories are just like working hypotheses – we use them to gain understanding of one type or another, and discard them when they cease to be useful. In fifty years, CBT will be as laughable as Freud is now…. but in the meantime we make use of it as a tool with which to do the job as best we can.

  • Anonymous

    Excellent points by mount analogue there I think.

    I agree with the psychoanalytic insistence on the importance of relationship patterns, but I do not think its own idiosyncratic and value-laden theories do a good job at it, especially when confined to two people talking in a room somewhere, which is already an idiosyncratic relationship from both sides. Not to mention that the client has to brainwash themselves into various arcane and often prejudiced terms and concepts, or else they're resisting.

    The typical CBT process does pay insufficient detail to underlying nuances and this often undermines the whole effort, and also requires the client to brainwash themselves into it.

    One thing CBT does have going for it that often isn't mentioned enough in my opinion, is that it can involve leaving the therapy room and accompanying client within their daily life, helping to see the REAL PSYCHOLOGICAL AND RELATIONSHIP AND PRACTICAL patterns in that person's own SOCIETY. OK CBT does it within a particular framework about negative assumptions and cycles of biased perception and whatever, and the therapist with their socioeconomic background is still imposing their own values on it of course and if they're too far removed then there still won't be a good enough understanding. But at least the therapist and client can work together on the reality for the client, not just an abstracted version of it.

    Of course, there are various support workers and people who do go out more regularly to meet clients on their terms, and sometimes they are equipped with bits and pieces of counselling skills or certain CBT techniques, but since that kind of work is in some ways more difficult and devalued, it really isn't given the emphasis it should be in my opinion.

  • veri

    '..the best things in life are terrible.'

    Wow, that's a lovely Mastercards moment :)

  • Neuroskeptic

    Wow, some great comments here.

    Anonymous: “One thing CBT does have going for it that often isn't mentioned enough in my opinion, is that it can involve leaving the therapy room and accompanying client within their daily life…”

    I agree, this is one of the most attractive things about CBT. I know a therapist who gets great results with people with panic disorder and agorophobia / claustrophobia, which involves going with them on buses, into stores, and the clever use of a “locked” utility cupboard.

    I think that kind of thing is where CBT shines. A “deeper” therapist might say, OK you've stopped their panic attacks, but you haven't addressed why they developed them in the first place.

    However the CBT therapist would reply, who cares? They can go out shopping now.

    But that's panic. With other symptoms, a “deeper” approach might be required.

  • Anonymous

    I agree that many things need a deeper and broader analysis based on a more understanding relationship. I think sometimes the “it's fixed the symptom that's enough” approach can have some truth to it but is often used to justify limited funding of services – often ultimately leaving limited improvement and limited lives.

    But deeper and broader and more understandign doesn't necessarily mean 'confined to a room'. In fact that's kind of bizarre. It means therapists – who come from certain backgrounds – have to hype up how much they can be all things to all people and can verbally extract from their minds the relevant details about someone's personality and feelings and life without ever seeing any of them in any context other than their own little room. Yes that's valuable and many people probably don't want anything else.

    But some people need something a lot deeper and broader than that, both to provide better raw material for analysis and as a way to be helped to actually tackle things in reality. Especially those with the most extensive psychological/social difficulties, who of course are often just labelled and neglected, especially if they don't have the same ability or inclination to abstractly express themselves in rooms.

    Couch or chair or standing or doing or living?

  • Maia Szalavitz

    The research is pretty clear that the *major* determinant of therapeutic success is therapist empathy and ability to connect, not therapeutic technique.

    That said, CBT has the advantage of providing specific cognitive techniques to fight depression, anxiety, etc. on top of this without the dangers that can come from reinforcing rumination on the past.

  • Anonymous

    Therapist empathy and ability to connect can be a result of sharing with a client a certain background or personality or social perspective or whatever, and can't necessarily be attributed to magical properties of the therapist. An emergent property of both within a certain social context.

    One of the problems with that is that it can flounder when confronted by people with more complex or 'abnormal' states of mind (relative to the therapist/society), especially without accurate models of the relevant cognitive and behavioural (and emotional and social) processes.

    Apparently psychs have sometimes used their own feeling of a lack of empathy as a diagnostic marker for 'schizophrenia', and Freud apparently wrote to a friend in 1928 that he gave up on 'psychotics' and that they irritated him and seemed alien to him and to everything human. Most psych theorising about such conditions reads like a character assassination actually, all about failure, lack, absence, inability, immaturity. And I'm not thereby defending the other extreme of the current medical-pharmaceutical model that tries to counter that line by instead attributing everything to brain illness , also thus denying the humanity of the people concerned.

  • mount analogue

    Wow, lots of interesting comments here…. and everyone is being really careful to allow a bit of breathing space to contrary opinions.

    Every time I come here I realise that I still have a lot to learn. Thanks everyone.

  • Anonymous

    Yeah well you could make a similar argument about the state of affairs in psychopharmacolgy. Anti-psychotics treat depression and anxiety; antidepressants treat anxiety and mania, OCD, and chronic pain, and on and on and on. More and more, the curative factors in psychiatric “illness” appear to be non-specific. And it doesn't matter whether you are talking to someone or popping pills.

  • Roger Bigod


    Why did you ask that question?

  • Anonymous

    There is no breathing space for people being crushed by society and the so-called mental health system. People care more about practitioners and theories than them or their opinions.

  • Chris

    This argument conflates two different ways in which CBT might be “scientific.” One is that the therapy itself consists in evaluating the patient's beliefs rationally. Another sense in which CBT is “Scientific” is that it has been tested and shown to be effective. Psychoanalysis is not scientific in either sense. Most importantly, it is not scientific in the latter sense. That is to say It has not been shown, by science, to be effective. That's the bottom line. It's not as effective as CBT. We don't need to guess about this and we don't have to engage in speculative a priori arguments. We can just look at the data and see that CBT is far more effective than psychoanalysis.

  • Anonymous

    Thanks for these interesting thoughts. I also suggest you take a look at the article linked below on the efficacy of psychodynamic therapy, which argues that the empirical evidence of the effectiveness of psychoanalysis and other psychodynamic approaches to therapy is actually quite hight.

  • UnmotheredChild

    I am a therapist in training [psychodynamic] and am also in therapy with a jungian analyst. It is my believe and experience that mental illness [which is a very very broad term], the one caused through 'relationship' can only be healed through the relationship. Meaning, if somoene's blueprint of the world and its people [which was formed as a baby via the relationship with the maternal caregiver] is negative then it is my believe that its only the working through and understanding of such errors in another relationship which is containing, consistant and therapeutic in other ways, that will be able to help heal the psyche on a long term basis.

    RE: Freud. It is important to remember the times he lived in to understand where he was coming from. Of course, reading about his ideas in 2011, we can look at it as 'weird' and out dated. But at the time he was the pioneer of something awesome and also very risky. Not too long beofre that, people got burned alive if the had for example lucid dreams.
    Feel free to follow my blog and hear more about my own thoughts :)

  • The Drink Shrink

    So much criticism of psychoanalysis is actually criticism about Freud. It's like evaluating neuroscience as a field based entirely on your thoughts about Charcot and his work. Having said that, most debates on this topic get trolled out of proportion, so it's nice to see some great comments on this post. As a jobbing psychiatrist in the NHS I'll give my two pence worth.

    1. Zarathustra makes a good point about seeing Freud as a base for so many greater men and women to build upon. The work of Klein, Mahler, Bowlby, Winnicott, Kernberg, Kohut, Miller, Bateman, etc. are equally if not more relevant nowadays than Freud. And yes, even Aaron Beck, father of CBT, came from a psychodynamic background.

    2. In response to mercurialmind's post, when Aaron Beck and Jeffrey Young looked at groups where CBT isn't as effective such as personality disorders and tried to modify their approach, they started to come back to using techniques closer to psychoanalytic therapy. This led to the development of Schema Focused Therapy, which oversimply put is kinda like a hybrid of the two.

    3. Most people believe that CBT is 'here and now' and psychoanalysis is about 'your childhood'. This is such a widely and fundamentally held erroneous belief. In real life (good) practice, nothing could be further from the truth, the opposite does happen more than you may think.

    4. In the UK, the IAPT agenda has changed the game significantly. The huge push to set up, get people trained and in post to provide CBT quick sharp has not been a good thing IMHO. Quick training does not necessarily give you the skills of building a therapeutic relationship.

  • Mike

    1. Simply because something is not scientific does not mean it is not rational. To say so is to use a very liberal definition of “scientific” and/or a very stringent definition of “rational.”

    2. It has yet to be shown that the efficacy of CBT is related in any way to its structure or content; to the contrary, several studies have indicated that the presence of a therapeutic relationship and a shared goal are the sole determinants of a positive outcome.

    3. Psychoanalytic/psychodynamic psychotherapy can be adequately described by two principles: (a) we have thoughts, feelings, and behaviors that are “unconscious,” i.e. we do not explicitly narrate them in our minds, and (b) dysfunctional relationship patterns occur repeatedly and are likely to repeat in a relationship with a therapist. CBT, with its automatic thoughts, behavioral chains, core beliefs, and schemata, is conceptually reducible to (a) above, but (typically) lacks an explicit acknowledgement of (b).

  • Anonymous

    1 & 2:

    Very misleadingly worded. Many studies have demonstrated specific roles of specific cognitive and behavioural patterns in maintaining psychological problems including relationship dynamics, and shown how they relate to outcomes.

    They just don't happen to be talked about in the way that neo-Freudians like to talk about them via their cultish axioms which they can't escape from no matter how elegantly verbose and tortuously pseudo-logical they become.

    Meanwhile neo-Freudians somehow pretend that their proposed structure of the mind is proven and that the content of their ramblings is proven to be effective, claiming without any evidence that it is behind true therapeutic magic. Playing on the public reputation of Freud (who, like Jesus, is credited as saviour on those things that people agree with, and for those things now seen as outdated or wrong well he was a character of his era). I've seen psychoanalytically trained people come out with the most horrendous prejudiced arrogant crap justified in that way, or by reference to one of his acolytes or revisionists.

    You only have to read the wikipedia article on the unconscious mind to see that he was far from being the first to conceptualise it or talk about it, which is what many people erroneously think.

    Incidentally Beck as I understand is generally credited as father of his particular version of cognitive therapy, not CBT per se. And he was rejected by the psychoanalyts because he wanted to conduct scientific studies, and I remember reading his breakthrough understanding was when he realised he needed to listen to what his patient was trying to tell him about her belief system, instead of trying to impose his psychoanalytic training on to everything.

    This is not a defense of the over-hyped practice of the limited paradigm of CBT.

  • Anonymous

    2&3 that should say in relation to first para

  • Anonymous

    & I have to add something regarding the mentions of people who supposedly built on Freud's foundation and worked within a psychoanalytic framework. Bowlby I'm somewhat familar with his work and checking out Wikipedia appears to confirm my suspicions re. above claim, such as he learned from deprived children themselves, and:

    He co-produced a documentary illustrating the impact of loss and suffering experienced by young children separated from their primary caretakers while in hospital. “In 1952 when he and Robertson presented their film…psychoanalysts did not accept that a child would mourn or experience grief on separation but instead saw the child's distress as caused by elements of unconscious fantasies”

    And he was influenced by Klein in his training but “Klein stressed the role of the child's fantasies about his mother, but Bowlby emphasized the actual history of the relationship. Bowlby's views—that children were responding to real life events and not unconscious fantasies—were rejected by psychoanalysts, and Bowlby was effectively ostracized by the psychoanalytic community.”

    “on the basis of ethological evidence he was able to reject the dominant Cupboard Love theory of attachment prevailing in psychoanalysis and learning theory of the 1940s and 1950s”

    “Bowlby rejected psychoanalyst explanations for attachment, and in return, psychoanalysts rejected his theory”

    In other words, Freudian frameworks are cultish enough to be lucrative but vague enough to adapt and retrospectively embrace those whose almost opposite ideas become popular within the same ideological territory.

    It's also misleading to cite people who built on Freud but treat Freud as year zero. Something not in the Wikipedia article on unconscious mind:

    “The discovery of the unconscious is commonly attributed to Sigmund Freud — but, as Ellenberger (Ellenberger, 1970) has shown, the idea of unconscious mental activity can be traced back at least to Leibniz's notion of unconscious petites perceptions, and Helmholtz's argument that conscious perception is mediated by unconscious inferences. At the end of the 18th century, Kant discussed “the ideas which we have without being conscious of them”, and in 1890, fully two years before Freud's Studies on Hysteria, William James elaborated a concept of “subconscious” or “co-conscious” mental states, based largely on the work of Freud's French rival , Pierre Janet.”

    Even directly in terms of specific theories, his concept of transference was based on colleague Josef Breuer's clinical work with a patient – and actually the wisdom of the patient herself contributed key elements:

    “Breuer observed that her symptoms were reduced or disappeared after she described them to him. Anna O. humorously called this procedure chimney sweeping. She also coined the more serious appellation for this form of therapy, 'her talking cure', which is widely regarded as the basis of Freudian psychoanalysis.”

  • Sam

    I still see psychoanalysis as a waste of time and money. “Insight” to a problem doesn't lead to a solution, especially when the psychoanalytic therapy mode brings a therapist-dependent relationship into play, making the analysand feel less compelled to take independent action and more compelled to come back to the therapist like cocaine. Psychoanalysis is like religion because it is so rigid and dares not look outside its own walls. I've been in psychoanalysis for years now and I've tried many times to get my therapist to help me with some concrete problems. Improvement in life isn't from learning about what happened when your father sold your teddy bear on the flea market. It's about taking risks to solve problems you face today and taking risks to suppress unhealthy behaviors.

  • Tom

    This comment by annonymous
    >”Breuer observed that her symptoms were reduced or disappeared after she described them to him. Anna O. humorously called this procedure chimney sweeping.

    is what my therapy still does.

    She tells me what I already know for years. How is that expected to cause any change?

    Was this effective in Anna O because she was an hysteric?

    Anyway, her life did not end well. She was hospitalized right?



No brain. No gain.

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Neuroskeptic is a British neuroscientist who takes a skeptical look at his own field, and beyond. His blog offers a look at the latest developments in neuroscience, psychiatry and psychology through a critical lens.


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