is a system of psychology originated by the Viennese
physician Sigmund FREUD in the 1890's and then further developed by himself,
his students, and other followers. It consists of three kinds of related
activities: (1) a method for research into the human mind, especially inner
experiences such as thoughts, feelings, emotions, fantasies, and dreams;
(2) a systematic accumulation of a body of knowledge about the mind; and
(3) a method for the treatment of psychological or emotional disorders.

Psychoanalysis began with the discovery that HYSTERIA, an illness with
physical symptoms that occurred in a completely healthy physical body--such
as a numbness or paralysis of a limb or a loss of voice or a blindness--
could be caused by unconscious wishes or forgotten memories. (Hysteria is
now commonly referred to as conversion disorder.) The French neurologist
Jean Martin CHARCOT tried to rid the mind of undesirable thoughts through
hypnotic suggestion, but without lasting success. Josef Breuer, a Viennese
physician, achieved better results by letting Anna O., a young woman
patient, try to empty her mind by just telling him all of her thoughts and
feelings.

Freud refined Breuer's method by conceptualizing theories about it and,
using these theories, telling his patients through interpretations what was
going on inside the unconscious part of their minds, thus making the
unconscious become conscious. Many hysterias were cured this way, and in
1895, Breuer and Freud published their findings and theories in Studies in
Hysteria.

CLASSIC PSYCHOANALYTIC THEORY

Traditional psychoanalytical theory states that all human beings are born
with instinctual drives that are constantly active even though a person is
usually not conscious of thus being driven. Two drives--one for sexual
pleasure, called libido, the other called aggression--motivate and propel
most behavior. In the infant, the libido first manifests itself by making
sucking an activity with pleasurable sensations in the mouth. Later similar
pleasures are experienced in the anus during bowel movements, and finally
these erotically tinged pleasures are experienced when the sexual organ is
manipulated. Thus psychosexual development progresses from the oral through
the anal to the phallic stage. (Phallic, in psychoanalytic theory, refers
to both male and female sexual organs.)

During the height of the phallic phase, about ages three to six, these
libidinous drives focus on the parent of the opposite sex and lend an
erotic cast to the relation between mother and son or between father and
daughter, the so-called Oedipus COMPLEX. However, most societies strongly
disapprove of these sexual interests of children. A TABOO on incest rules
universally. Parents, therefore, influence children to push such
pleasurable sensations and thoughts out of their conscious minds into the
unconscious by a process called repression. In this way the mind comes to
consist of three parts: (1) an executive part, the EGO, mostly conscious
and comprising all the ordinary thoughts and functions needed to direct a
person in his or her daily behavior; (2) the id, mostly unconscious and
containing all the instincts and everything that was repressed into it; and
(3) the superego, the conscious that harbors the values, ideals, and
prohibitions that set the guidelines for the ego and that punishes through
the imposition of guilt feelings.

Strong boundaries between the three parts keep the ego fairly free from
disturbing thoughts and wishes in the id, thereby guaranteeing efficient
functioning and socially acceptable behavior. During sleep the boundaries
weaken; disturbing wishes may slip into the ego from the id, and warnings
may come over from the superego. The results are intrapsychic conflicts,
often manifested in dreams (see DREAMS AND DREAMING), sometimes even in
frightening NIGHTMARES. Freud elucidated this concept in his first major
work, The Interpretation of Dreams (1900; Eng. trans., 1913). Something
very similar to the weakening of boundaries during sleep sometimes happens
during ordinary daytime activities when some impulses from the id manages
to cross the repression barrier to invade the ego and cause faulty actions
such as slips of the tongue. Psychoneurotic symptoms occur if
psychologically hurtful experiences during childhood have left the
repression too weak or have distorted the ego, or if overstimulation has
left the id wishes too strong, or if the delicate balance between ego, id,
and superego has been upset by injury or other events. Any kind of psychic
trauma may lead to the ego becoming an area of intrapsychic conflict
between the intruding id, the threatening superego, and the powerful
influences emanating from the surrounding environment. Furthermore, the
damage done to the basic psychological structures by traumatic experiences
leaves those structures weakened and with defective functioning.

Such conflicts and defects can cause intense ANXIETY and severe DEPRESSION.
In order to keep functioning effectively, the ego attempts to maintain
control by achieving some sort of compromise between the contending forces.
Often such compromises appear in the form of inhibitions or compulsions
that affect behavior. Abnormal behavior and the anxiety, depressions, and
PHOBIAS that go with them are called psychoneurotic symptoms in
psychoanalytic theory. Neurotic character is the phrase used to designate a
consistent pattern of neurotic behavior. When the damage abnormally
distorts self-esteem, the resulting disturbance is called a narcissistic
personality disorder, or a disorder of the self.

TREATMENT

Patients seek psychoanalytic treatment because they suffer from one or more
of a variety of psychological symptoms such as anxiety, depression, sexual
and other inhibitions, obsessive thoughts, compulsive actions, irrational
angers, shyness and timidity, phobias, inability to get along with friends
or spouses or co-workers, low self-esteem, a sense of feeling unfulfilled,
nervous irritability, and blocked creativity. The defects and ...