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Working initially in close collaboration with Joseph Breuer, Freud elaborated the theory that the mind is a complex energy-system, the structural in estigation of which is proper pro ince of psychology. !e articulated and refined the concepts of the unconscious, of infantile sexuality, of repression, and proposed a tripartite account of the mind"s structure, all as part of a radically new conceptual and therapeutic frame of reference for the understanding of human psychological de elopment and the treatment of abnormal mental conditions. #otwithstanding the multiple manifestations of psychoanalysis as it exists today, it can in almost all fundamental respects be traced directly back to Freud"s original work. Further, Freud"s inno ati e treatment of human actions, dreams, and indeed of cultural artifacts as in ariably possessing implicit symbolic significance has pro en to be extraordinarily fecund, and has had massi e implications for a wide ariety of fields, including anthropology, semiotics, and artistic creati ity and appreciation in addition to psychology. !owe er, Freud"s most important and fre$uently re-iterated claim, that with psychoanalysis he had in ented a new science of the mind, remains the sub%ect of much critical debate and contro ersy.
1. Life
Freud was born in Frieberg, &ora ia in '()*, but when he was four years old his family mo ed to +ienna, where Freud was to li e and work until the last year of his life. ,n '-./ the #a0is annexed 1ustria, and Freud, who was Jewish, was allowed to lea e for 2ngland. For these reasons, it was abo e all with the city of +ienna that Freud"s name was destined to be deeply associated for posterity, founding as he did what was to become known as the 3first +iennese school" of psychoanalysis, from which, it is fair to say, psychoanalysis as a mo ement and all subse$uent de elopments in this field flowed. 4he scope of Freud"s interests, and of his professional training, was ery broad 5 he always considered himself first and foremost a scientist, endea oring to extend the compass of human knowledge, and to this end 6rather than to the practice of medicine7 he enrolled at the medical school at the 8ni ersity of +ienna in '(/.. !e concentrated initially on biology, doing research in physiology for six years under the great 9erman scientist 2rnst Br:cke, who was director of the ;hysiology <aboratory at the 8ni ersity, thereafter specialising in neurology. !e recei ed his medical degree in '((', and ha ing become engaged to be married in '((=, he rather reluctantly took up more secure and financially rewarding work as a doctor at +ienna 9eneral !ospital. Shortly after his marriage in '((* 5 which was extremely happy, and ga e Freud six children, the youngest of whom, 1nna, was herself to become a distinguished psychoanalyst 5 Freud set up a pri ate practice in the treatment of psychological disorders, which ga e him much of the clinical
material on which he based his theories and his pioneering techni$ues. ,n '(()-(* Freud spent the greater part of a year in ;aris, where he was deeply impressed by the work of the French neurologist Jean >harcot, who was at that time using hypnotism to treat hysteria and other abnormal mental conditions. When he returned to +ienna, Freud experimented with hypnosis, but found that its beneficial effects did not last. 1t this point he decided to adopt instead a method suggested by the work of an older +iennese colleague and friend, Josef Breuer, who had disco ered that when he encouraged a hysterical patient to talk uninhibitedly about the earliest occurrences of the symptoms, the latter sometimes gradually abated. Working with Breuer, Freud formulated and de eloped the idea that many neuroses 6phobias, hysterical paralyses and pains, some forms of paranoia, etc.7 had their origins in deeply traumatic experiences which had occurred in the past life of the patient but which were now forgotten, hidden from consciousness? the treatment was to enable the patient to recall the experience to consciousness, to confront it in a deep way both intellectually and emotionally, and in thus discharging it, to remo e the underlying psychological causes of the neurotic symptoms. 4his techni$ue, and the theory from which it is deri ed, was gi en its classical expression in Studies in Hysteria, %ointly published by Freud and Breuer in '(-).
Shortly thereafter, howe er, Breuer, found that he could not agree with what he regarded as the excessi e emphasis which Freud placed upon the sexual origins and content of neuroses, and the two parted company, with Freud continuing to work alone to de elop and refine the theory and practice of psychoanalysis. ,n '-@@, after a protracted period of selfanalysis, he published The Interpretation of Dreams, which is generally regarded as his greatest work, and this was followed in '-@' by The Psychopathology of Everyday Life, and in '-@) by Three Essays on the Theory of Sexuality . Freud"s psychoanalytic theory was initially not well recei ed 5 when its existence was acknowledged at all it was usually by people who were, as Breuer had foreseen, scandali0ed by the emphasis placed on sexuality by Freud 5 and it was not until '-@(, when the first ,nternational ;sychoanalytical >ongress was held at Sal0burg, that Freud"s importance began to be generally recogni0ed. 4his was greatly facilitated in '-@-, when he was in ited to gi e a course of lectures in the 8nited States, which were to form the basis of his '-'* book Five Lectures on Psycho- nalysis. From this point on Freud"s reputation and fame grew enormously, and he continued to write prolifically until his death, producing in all more than twenty olumes of theoretical works and clinical studies. !e was also not ad erse to critically re ising his iews, or to making fundamental alterations to his most basic principles when he considered that the scientific e idence demanded it 5 this was most clearly e idenced by his ad ancement of a completely new tripartite 6id, ego, and super-ego7 model of the mind in his '-=. work The Ego and the Id. !e was initially
greatly heartened by attracting followers of the intellectual calibre of 1dler and Jung, and was correspondingly disappointed personally when they both went on to found ri al schools of psychoanalysis 5 thus gi ing rise to the first two of many schisms in the mo ement 5 but he knew that such disagreement o er basic principles had been part of the early de elopment of e ery new science. 1fter a life of remarkable igour and creati e producti ity, he died of cancer while exiled in 2ngland in '-.-.
shame and hate 6such a mixed attitude he termed 3ambi alence"7. ;articularly re ealing was his disco ery that he had often fantasised as a youth that his half-brother ;hilip 6who was of an age with his mother7 was really his father, and certain other signs con inced him of the deep underlying meaning of this fantasy 5 that he had wished his real father dead, because he was his ri al for his mother"s affections. 4his was to become the personal 6though by no means exclusi e7 basis for his theory of the Aedipus complex. Secondly, and at a more general le el, account must be taken of the contemporary scientific climate in which Freud li ed and worked. ,n most respects, the towering scientific figure of nineteenth century science was >harles Barwin, who had published his re olutionary !rigin of Species when Freud was four years old. 4he e olutionary doctrine radically altered the pre ailing conception of man 5 whereas before man had been seen as a being different in nature to the members of the animal kingdom by irtue of his possession of an immortal soul, he was now seen as being part of the natural order, different from non-human animals only in degree of structural complexity. 4his made it possible and plausible, for the first time, to treat man as an ob%ect of scientific in estigation, and to concei e of the ast and aried range of human beha ior, and the moti ational causes from which it springs, as being amenable in principle to scientific explanation. &uch of the creati e work done in a whole ariety of di erse scientific fields o er the next century was to be inspired by, and deri e sustenance from, this new world-
iew, which Freud, with his enormous esteem for science, accepted implicitly. 1n e en more important influence on Freud, howe er, came from the field of physics. 4he second )@ years of the nineteenth century saw monumental ad ances in contemporary physics, which were largely initiated by the formulation of the principle of the conser ation of energy by !elmhol0. 4his principle states, in effect, that the total amount of energy in any gi en physical system is always constant, that energy $uanta can be changed but not annihilated, and conse$uently that when energy is mo ed from one part of the system it must reappear in another part. 4he progressi e application of this principle led to the monumental disco eries in the fields of thermodynamics, electromagneticism, and nuclear physics which, with their associated technologies, ha e so comprehensi ely transformed the contemporary world. 1s we ha e seen, when he first came to the 8ni ersity of +ienna Freud worked under the direction of 2rnst Br:cke, who in '(/C published a book setting out the iew that all li ing organisms, including the human one, are essentially energy-systems to which, no less than to inanimate ob%ects, the principle of the conser ation of energy applies. Freud, who had great admiration and respect for Br:cke, $uickly adopted this new 3dynamic physiology" with enthusiasm. From there it was but a short conceptual step 5 but one which Freud was the first to take, and on which his claim to fame is largely grounded 5 to the iew that there is such a thing as 3psychic energy", that the human
personality is also an energy-system, and that it is the function of psychology to in estigate the modifications, transmissions, and con ersions of 3psychic energy" within the personality which shape and determine it. 4his latter conception is the ery cornerstone of Freud"s psychoanalytic theory.
at all. 4his suggests the iew that freedom of the will is, if not completely an illusion, certainly more tightly circumscribed than is commonly belie ed, for it follows from this that whene er we make a choice we are go erned by hidden mental processes of which we are unaware and o er which we ha e no control. 4he postulate that there are such things as unconscious mental states at all is a direct function of Freud"s determinism, his reasoning here being simply that the principle of causality re"uires that such mental states should exist, for it is e ident that there is fre$uently nothing in the conscious mind which can be said to cause neurotic or other beha ior. 1n 3unconscious" mental process or e ent, for Freud, is not one which merely happens to be out of consciousness at a gi en time, but is rather one which cannot, except through protracted psychoanalysis, be brought to the forefront of consciousness. 4he postulation of such unconscious mental states entails, of course, that the mind is not, and cannot be, identified with consciousness or that which can be an ob%ect of consciousness 5 to employ a muchused analogy, it is rather structurally akin to an iceberg, the bulk of it lying below the surface, exerting a dynamic and determining influence upon the part which is amenable to direct inspection, the conscious mind. Beeply associated with this iew of the mind is Freud"s account of the instincts or dri es. 4he instincts, for Freud, are the principal moti ating forces in the mental realm, and as
such they 3energise" the mind in all of its functions. 4here are, he held, an indefinitely large number of such instincts, but these can be reduced to a small number of basic ones, which he grouped into two broad generic categories, Eros 6the life instinct7, which co ers all the self-preser ing and erotic instincts, and Thanatos 6the death instinct7, which co ers all the instincts towards aggression, self-destruction, and cruelty. 4hus it is a mistake to interpret Freud as asserting that all human actions spring from moti ations which are sexual in their origin, since those which deri e from 4hanatos are not sexually moti ated 5 indeed, 4hanatos is the irrational urge to destroy the source of all sexual energy in the annihilation of the self. !a ing said that, it is undeniably true that Freud ga e sexual dri es an importance and centrality in human life, human actions, and human beha ior which was new 6and to many, shocking7, arguing as he does both that the sexual dri es exist and can be discerned in children from birth 6the theory of infantile sexuality7, and that sexual energy 6li#ido7 is the single most important moti ating force in adult life. !owe er, e en here a crucial $ualification has to be added DFreud effecti ely redefined the term 3sexuality" here to make it co er any form of pleasure which is or can be deri ed from the body. 4hus his theory of the instincts or dri es is essentially that the human being is energi0ed or dri en from birth by the desire to ac$uire and enhance bodily pleasure.
4. Infantile Sexuality
Freud"s theory of infantile sexuality must be seen as an integral part of a broader de elopmental theory of human personality. 4his had its origins in, and was a generalisation of, Breuer"s earlier disco ery that traumatic childhood e ents could ha e de astating negati e effects upon the adult indi idual, and took the form of the general thesis that early childhood sexual experiences were the crucial factors in the determination of the adult personality. From his account of the instincts or dri es it followed that from the moment of birth the infant is dri en in his actions by the desire for bodilyEsexual pleasure, where this is seen by Freud in almost mechanical terms as the desire to release mental energy. ,nitially, infants gain such release, and deri e such pleasure, through the act of sucking, and Freud accordingly terms this the 3oral" stage of de elopment. 4his is followed by a stage in which the locus of pleasure or energy release is the anus, particularly in the act of defecation, and this is accordingly termed the 3anal" stage. 4hen the young child de elops an interest in its sexual organs as a site of pleasure 6the 3phallic" stage7, and de elops a deep sexual attraction for the parent of the opposite sex, and a hatred of the parent of the same sex 6the 3Aedipus complex"7. 4his, howe er, gi es rise to 6socially deri ed7 feelings of guilt in the child, who recogni0es that it can ne er supplant the stronger parent. ,n the case of a male, it also puts the child at risk, which he percei es 5 if he persists in pursuing the sexual attraction for his mother, he may be harmed by the father? specifically, he comes to fear that he may be castrated. 4his is termed 3 castration anxiety$. Both the attraction for the mother and the hatred are usually repressed,
and the child usually resol es the conflict of the Aedipus complex by coming to identify with the parent of the same sex. 4his happens at the age of fi e, whereupon the child enters a 3latency" period, in which sexual moti ations become much less pronounced. 4his lasts until puberty, when mature genital de elopment begins, and the pleasure dri e refocuses around the genital area. 4his, Freud belie ed, is the se$uence or progression implicit in normal human de elopment, and it is to be obser ed that at the infant le el the instinctual attempts to satisfy the pleasure dri e are fre$uently checked by parental control and social coercion. 4he de elopmental process, then, is for the child essentially a mo ement through a series of conflicts, the successful resolution of which is crucial to adult mental health. &any mental illnesses, particularly hysteria, Freud held, can be traced back to unresol ed conflicts experienced at this stage, or to e ents which otherwise disrupt the normal pattern of infantile de elopment. For example, homosexuality is seen by some Freudians as resulting from a failure to resol e the conflicts of the Aedipus complex, particularly a failure to identify with the parent of the same sex? the obsessi e concern with washing and personal hygiene which characterises the beha iour of some neurotics is seen as resulting from unresol ed conflictsErepressions occurring at the anal stage.
ha e taken it extremely literally himself7, but it is important to note that what is being offered here is indeed a theoretical model, rather than a description of an obser able ob%ect, which functions as a frame of reference to explain the link between early childhood experience and the mature adult 6normal or dysfunctional7 personality. Freud also followed ;lato in his account of the nature of mental health or psychological well-being, which he saw as the establishment of a harmonious relationship between the three elements which constitute the mind. ,f the external world offers no scope for the satisfaction of the id$s pleasure dri es, or, more commonly, if the satisfaction of some or all of these dri es would indeed transgress the moral sanctions laid down by the super-ego, then an inner conflict occurs in the mind between its constituent parts or elements 5 failure to resol e this can lead to later neurosis. 1 key concept introduced here by Freud is that the mind possesses a number of 3defense mechanisms" to attempt to pre ent conflicts from becoming too acute, such as repression 6pushing conflicts back into the unconscious7, su#limation 6channeling the sexual dri es into the achie ement socially acceptable goals, in art, science, poetry, etc.7, fixation 6the failure to progress beyond one of the de elopmental stages7, and regression 6a return to the beha ior characteristic of one of the stages7. Af these, repression is the most important, and Freud"s account of this is as followsF when a person experiences an instinctual impulse to beha e in a manner which the super-
ego deems to be reprehensible 6e.g. a strong erotic impulse on the part of the child towards the parent of the opposite sex7, then it is possible for the mind push it away, to repress it into the unconscious. Gepression is thus one of the central defense mechanisms by which the ego seeks to a oid internal conflict and pain, and to reconcile reality with the demands of both id and super-ego. 1s such it is completely normal and an integral part of the de elopmental process through which e ery child must pass on the way to adulthood. !owe er, the repressed instinctual dri e, as an energy-form, is not and cannot be destroyed when it is repressed 5 it continues to exist intact in the unconscious, from where it exerts a determining force upon the conscious mind, and can gi e rise to the dysfunctional beha ior characteristic of neuroses. 4his is one reason why dreams and slips of the tongue possess such a strong symbolic significance for Freud, and why their analysis became such a key part of his treatment 5 they represent instances in which the igilance of the super-ego is relaxed, and when the repressed dri es are accordingly able to present themsel es to the conscious mind in a transmuted form. 4he difference between 3normal" repression and the kind of repression which results in neurotic illness is one of degree, not of kind 5 the compulsi e beha ior of the neurotic is itself a beha ioral manifestation of an instinctual dri e repressed in childhood. Such beha ioural symptoms are highly irrational 6and may e en be percei ed as such by the neurotic7, but are completely beyond the control of the sub%ect, because they are dri en by the now unconscious repressed impulse. Freud positioned the key repressions, for both the normal indi idual
and the neurotic, in the first fi e years of childhood, and, of course, held them to be essentially sexual in nature 5 as we ha e seen, repressions which disrupt the process of infantile sexual de elopment in particular, he held, lead to a strong tendency to later neurosis in adult life. 4he task of psychoanalysis as a therapy is to find the repressions which are causing the neurotic symptoms by del ing into the unconscious mind of the sub%ect, and by bringing them to the forefront of consciousness, to allow the ego to confront them directly and thus to discharge them.
#. $sychoanalysis as a Therapy
Freud"s account of the sexual genesis and nature of neuroses led him naturally to de elop a clinical treatment for treating such disorders. 4his has become so influential today that when people speak of 3psychoanalysis" they fre$uently refer exclusi ely to the clinical treatment? howe er, the term properly designates both the clinical treatment and the theory which underlies it. 4he aim of the method may be stated simply in general terms 5 to re-establish a harmonious relationship between the three elements which constitute the mind by exca ating and resol ing unconscious repressed conflicts. 4he actual method of treatment pioneered by Freud grew out of Breuer"s earlier disco ery, mentioned abo e, that when a hysterical patient was encouraged to talk freely about the earliest occurrences of her symptoms and fantasies, the symptoms began to abate, and were eliminated entirely she
was induced to remember the initial trauma which occasioned them. 4urning away from his early attempts to explore the unconscious through hypnosis, Freud further de eloped this 3talking cure", acting on the assumption that the repressed conflicts were buried in the deepest recesses of the unconscious mind. 1ccordingly, he got his patients to relax in a position in which they were depri ed of strong sensory stimulation, e en of keen awareness of the presence of the analyst 6hence the famous use of the couch, with the analyst irtually silent and out of sight7, and then encouraged them to speak freely and uninhibitedly, preferably without forethought, in the belief that he could thereby discern the unconscious forces lying behind what was said. 4his is the method of free-association, the rationale for which is similar to that in ol ed in the analysis of dreamsDin both cases the super-ego is to some degree disarmed, its efficiency as a screening mechanism is moderated, and material is allowed to filter through to the conscious ego which would otherwise be completely repressed. 4he process is necessarily a difficult and protracted one, and it is therefore one of the primary tasks of the analyst to help the patient to recogni0e, and to o ercome, his own natural resistances, which may exhibit themsel es as hostility towards the analyst. !owe er, Freud always took the occurrence of resistance as a sign that he was on the right track in his assessment of the underlying unconscious causes of the patient"s condition. 4he patient"s dreams are of particular interest, for reasons which we ha e already partly seen. 4aking it that the super-ego functioned less effecti ely in sleep, as in free association, Freud made a
distinction between the manifest content of a dream 6what the dream appeared to be about on the surface7 and its latent content 6the unconscious, repressed desires or wishes which are its real ob%ect7. 4he correct interpretation of the patient"s dreams, slips of tongue, free-associations, and responses to carefully selected $uestions leads the analyst to a point where he can locate the unconscious repressions producing the neurotic symptoms, in ariably in terms of the patient"s passage through the sexual de elopmental process, the manner in which the conflicts implicit in this process were handled, and the libidinal content of his family relationships. 4o effect a cure, he must facilitate the patient himself to become conscious of unresol ed conflicts buried in the deep recesses of the unconscious mind, and to confront and engage with them directly. ,n this sense, then, the ob%ect of psychoanalytic treatment may be said to be a form of self-understanding 5 once this is ac$uired, it is largely up to the patient, in consultation with the analyst, to determine how he shall handle this newlyac$uired understanding of the unconscious forces which moti ate him. Ane possibility, mentioned abo e, is the channeling of the sexual energy into the achie ement of social, artistic or scientific goals 5 this is sublimation, which Freud saw as the moti ating force behind most great cultural achie ements. 1nother would be the conscious, rational control of the formerly repressed dri es 5 this is suppression. Het another would be the decision that it is the super-ego, and the social constraints which inform it, which are at fault, in
which case the patient may decide in the end to satisfy the instinctual dri es. But in all cases the cure is effected essentially by a kind of catharsis or purgation 5 a release of the pent-up psychic energy, the constriction of which was the basic cause of the neurotic illness. %ritical &'aluation of (reud ,t should be e ident from the foregoing why psychoanalysis in general, and Freud in particular, ha e exerted such a strong influence upon the popular imagination in the Western World o er the past -@ years or so, and why both the theory and practice of psychoanalysis should remain the ob%ect of a great deal of contro ersy. ,n fact, the contro ersy which exists in relation to Freud is more heated and multi-faceted than that relating to irtually any other recent thinker 6a possible exception being Barwin7, with criticisms ranging from the contention that Freud"s theory was generated by logical confusions arising out of his alleged long-standing addiction to cocaine 6>f. 4hornton, 2.&. Freud and %ocaine& The Freudian Fallacy7 to the iew that he made an important, but grim, empirical disco ery, which he knowingly suppressed in fa our of the theory of the unconscious, knowing that the latter would be more acceptable socially 6>f. &asson, J. The ssault on Truth7. ,t should be emphasised here that Freud"s genius is not 6generally7 in doubt, but the precise nature of his achie ement is still the source of much debate. 4he supporters and
followers of Freud 6and Jung and 1dler7 are noted for the 0eal and enthusiasm with which they espouse the doctrines of the master, to the point where many of the detractors of the mo ement see it as a kind of secular religion, re$uiring as it does an initiation process in which the aspiring psychoanalyst must himself first be analysed. ,n this way, it is often alleged, the un$uestioning acceptance of a set of ideological principles becomes a necessary precondition for acceptance into the mo ement 5 as with most religious groupings. ,n reply, the exponents and supporters of psychoanalysis fre$uently analy0e the moti ations of their critics in terms of the ery theory which those critics re%ect. 1nd so the debate goes on. !ere we will confine oursel es toF 6a7 the e aluation of Freud"s claim that his theory is a scientific one, 6b7 the $uestion of the theory"s coherence, 6c7 the dispute concerning what, if anything, Freud really disco ered, and 6d7 the $uestion of the efficacy of psychoanalysis as a treatment for neurotic illnesses.
it, it has the appearance of being, not %ust a scientific theory, but an enormously strongscientific theory, with the capacity to accommodate, and explain, e ery possible form of human beha iour. !owe er, it is precisely this latter which, for many commentators, undermines its claim to scientific status. An the $uestion of what makes a theory a genuinely scientific one, Iarl ;opper"s criterion of demarcation, as it is called, has now gained ery general acceptanceF namely, that e ery genuine scientific theory must be testable, and therefore falsifia#le, at least in principle 5 in other words, if a theory is incompatible with possi#le obser ations it is scientific? con ersely, a theory which is compatible with all possible obser ations is unscientific 6>f. ;opper, I. The Logic of Scientific Discovery 7. 4hus the principle of the conser ation of energy, which influenced Freud so greatly, is a scientific one, because it is falsifiable 5 the disco ery of a physical system in which the total amount of energy was not constant would conclusi ely show it to be false. 1nd it is argued that nothing of the kind is possible with respect to Freud"s theory 5 if, in relation to it, the $uestion is askedF 3What does this theory imply which, if false, would show the whole theory to be falseJ", the answer is 3nothing", the theory is compatible with every possi#le state of affairs 5 it cannot be falsified by anything, since it purports to explain e erything. !ence it is concluded that the theory is not scientific, and while this does not, as some critics claim, rob it of all alue, it certainly diminishes its intellectual status, as that was and is pro%ected by its strongest ad ocates, including Freud himself.
does not demonstrati ely assertF 3 This is the unconscious cause, and that is its beha ioural effect"? he assertsF 3 This is the beha iour, therefore its unconscious cause must exist"7. 1nd this does raise serious doubts as to whether Freud"s theory offers us genuine causal explanations at all.
c. (reud+s ,isco'ery1t a less theoretical, but no less critical le el, it has been alleged that Freud did make a genuine disco ery, which he was initially prepared to re eal to the world, but the response which he encountered was so ferociously hostile that he masked his findings, and offered his theory of the unconscious in its place 6>f. &asson, J. The ssault on Truth7. What he disco ered, it has been suggested, was the extreme pre alence of child sexual abuse, particularly of young girls 6the vast ma%ority of hysterics are women7, e en in respectable nineteenth century +ienna. !e did in fact offer an early 3seduction theory" of neuroses, which met with fierce animosity, and which he $uickly withdrew, and replaced with theory of the unconscious. 1s one contemporary Freudian commentator explains it, Freud"s change of mind on this issue came about as followsF
Luestions concerning the traumas suffered by his patients seemed to re eal Mto FreudN that +iennese girls were extraordinarily often seduced in ery early childhood by older male relati es? doubt about the actual occurrence of these seductions was soon replaced
by certainty that it was descriptions about childhood fantasy that were being offered. 6&ac,ntyre7.
,n this way, it is suggested, the theory of the Aedipus complex was generated. 4his statement begs a number of $uestions, not least, what does the expression 3extraordinarily often" mean in this contextJ By what standard is this being %udgedJ 4he answer can only beF by the standard of what we generally belie e 5 or would like to belie e 5 to be the case. But the contention of some of Freud"s critics here is that his patients were not recalling childhood fantasies, but traumatic e ents in their childhood which were all too real, and that he had stumbled upon, and knowingly suppressed, the fact that the le el of child sexual abuse in society is much higher than is generally belie ed or acknowledged. ,f this contention is true 5 and it must at least be contemplated seriously 5 then this is undoubtedly the most serious criticism that Freud and his followers ha e to face. Further, this particular point has taken on an added, and e en more contro ersial significance in recent years with the willingness of some contemporary Freudians to com#ine the theory of repression 'ith an acceptance of the wide-spread social pre alence of child sexual abuse. 4he result has been that, in the 8nited States and Britain in particular, many thousands of people ha e emerged from analysis with 3reco ered memories" of alleged childhood sexual abuse by
their parents, memories which, it is suggested, were hitherto repressed. An this basis, parents ha e been accused and repudiated, and whole families di ided or destroyed. 8nsurprisingly, this in turn has gi en rise to a systematic backlash, in which organi0ations of accused parents, seeing themsel es as the true ictims of what they term 3False &emory Syndrome", ha e denounced all such memory-claims as falsidical, the direct product of a belief in what they see as the myth of repression. 6>f. ;endergast, &. (ictims of )emory7. ,n this way, the concept of repression, which Freud himself termed 3the foundation stone upon which the structure of psychoanalysis rests", has come in for more widespread critical scrutiny than e er before. !ere, the fact that, unlike some of his contemporary followers, Freud did not himself e er countenance the extension of the concept of repression to co er actual child sexual abuse, and the fact that we are not necessarily forced to choose between the iews that all 3reco ered memories" are either eridical or falsidical, are, perhaps understandably, fre$uently lost sight of in the extreme heat generated by this debate.
from being an isomorphic one. 64he theory upon which the use of leeches to bleed patients in eighteenth century medicine was based was $uite spurious, but patients did sometimes actually benefit from the treatmentO7. 1nd of course e en a true theory might be badly applied, leading to negati e conse$uences. Ane of the problems here is that it is difficult to specify what counts as a cure for a neurotic illness, as distinct, say, from a mere alle iation of the symptoms. ,n general, howe er, the efficiency of a gi en method of treatment is usually clinically measured by means of a 3control group" 5 the proportion of patients suffering from a gi en disorder who are cured by treatment K is measured by comparison with those cured by other treatments, or by no treatment at all. Such clinical tests as ha e been conducted indicate that the proportion of patients who ha e benefited from psychoanalytic treatment does not di erge significantly from the proportion who reco er spontaneously or as a result of other forms of inter ention in the control groups used. So the $uestion of the therapeutic effecti eness of psychoanalysis remains an open and contro ersial one.