Sigmund Freud

Sigmund Freud
Sigmund Freud by Max Halberstadt, 1921
Born	Sigismund Schlomo Freud (1856-05-06)6 May 1856 Freiberg in Mähren, Moravia, Austrian Empire (today Příbor, Czech Republic)
Died	23 September 1939(1939-09-23) (aged 83) London, England
Nationality	Austrian
Fields	Neurology Psychotherapy Psychoanalysis
Institutions	University of Vienna
Alma mater	University of Vienna (MD, 1881)
Known for	Psychoanalysis
Influences	Aristotle, Börne, Brentano, Breuer, Charcot, Darwin, Dostoyevsky, Fliess, Goethe, Haeckel, Hartmann, Jackson, Jacobsen, Kant, Mayer, Nietzsche, Plato, Schopenhauer, Shakespeare, Sophocles
Influenced	Adorno, Althusser, Bass, Bloom, Breton, Brown, Chodorow, Dalí, Deleuze, Derrida, Firestone, Anna Freud, Fromm, Gallop, Gilligan, Grosz, Guattari, Habermas, Horney, Irigaray, Janov, Jones, Jung, Kandel, Khanna, Klein, Kovel, Kristeva, Lacan, Lyotard, Marcuse, Merleau-Ponty, Mitchell, Molyneux, Paglia, Perls, Rank, Reich, Ricœur, Rieff, Sartre, Solms, Stekel, Sullivan, Trilling
Notable awards	Goethe Prize (1930) Foreign Member of the Royal Society (London)
Spouse	Martha Bernays (m. 1886-1939, his death)
Signature

Sigmund Freud (German pronunciation: [ˈziːkmʊnt ˈfʁɔʏt]; born Sigismund Schlomo Freud; 6 May 1856 – 23 September 1939) was an Austrian neurologist who became known as the founding father of psychoanalysis.

Freud qualified as a Doctor of Medicine at the University of Vienna in 1881, and then carried out research into cerebral palsy, aphasia and microscopic neuroanatomy at the Vienna General Hospital. He was appointed a University lecturer in neuropathology in 1885 and became a Professor in 1902.

In creating psychoanalysis, a clinical method for treating psychopathology through dialogue between a patient and a psychoanalyst, Freud developed therapeutic techniques such as the use of free association (in which patients report their thoughts without reservation and in whichever order they spontaneously occur) and discovered transference (the process in which patients displace on to their analysts feelings derived from the sexual experiences and fantasies of their childhood), establishing its central role in the analytic process. Freud’s analysis of his own and his patients dreams as wish-fulfilments provided him with models for the clinical analysis of symptom formation and the mechanisms of repression as well as for further elaboration of his theory of the unconscious as an agency disruptive of conscious states of mind. Freud postulated the existence of libido, an energy with which mental process and structures are invested and which generates erotic attachments, and a death drive, the source of repetition, hate, aggression and guilt. In his later work Freud drew on psychoanalytic theory to develop a wide-ranging interpretation and critique of religion and culture.

Psychoanalysis remains influential within psychiatry and across the humanities. As such it continues to generate extensive debate, notably over its scientific status and as to whether it advances or is detrimental to the feminist cause. Regardless of the scientific content of his theories, Freud's work has suffused intellectual thought and popular culture to the extent that in 1939 W. H. Auden wrote, in a poem dedicated to him: "to us he is no more a person / now but a whole climate of opinion / under whom we conduct our different lives".

Background

Early life and education

Freud was born the first of eight children to Jewish Galician parents in the Moravian town of Příbor (German: Freiberg in Mähren), Austrian Empire, now part of the Czech Republic. His father, Jacob Freud (1815–1896), was a wool merchant, 41 years old when Freud was born, who had been married twice before and already had two children. Jacob's family were Hassidic Jews, and though Jacob himself had moved away from the tradition, he came to be known for his Torah study. He and Freud's mother, Amalia (née Nathansohn), 20 years her husband's junior, were married by Rabbi Isaac Noah Mannheimer on 29 July 1855. They were struggling financially and living in a rented room, in a blacksmith's house at Schlossergasse 117 when their son Sigmund was born. He was born with a caul, which his mother saw as a positive omen for the boy's future.

Jacob and Amalia apparently favored Sigmund over his siblings, and despite their poverty, supported his education. As a result of the Panic of 1857, his father lost his business, and the Freud family moved to Leipzig, before settling in Vienna. In 1865, the nine-year-old Freud entered the Leopoldstädter Kommunal-Realgymnasium, a prominent high school. He proved an outstanding pupil and graduated from the Matura in 1873 with honours. He loved literature and was proficient in German, French, Italian, Spanish, English, Hebrew, Latin and Greek. Freud read William Shakespeare in English throughout his life, and it has been suggested that his understanding of human psychology was derived from Shakespeare's plays.

Freud entered the University of Vienna at age 17. He had planned to study law, but joined the medical faculty at the University, where his studies included philosophy under Franz Brentano, physiology under Ernst Brücke, and zoology under Darwinist Professor Karl Claus. In 1876 Freud spent four weeks at Claus's zoological research station in Trieste, dissecting hundreds of eels in an inconclusive search for their male reproductive organs. He graduated with an MD in 1881.

Early career and marriage

The following year, 1882, he began his medical career in Theodor Meynert's psychiatric clinic at the Vienna General Hospital. He resigned his hospital post and entered private practice in 1886, specializing in "nervous disorders". The same year he married Martha Bernays, the granddaughter of Isaac Bernays, a Chief Rabbi in Hamburg. The couple had six children: Mathilde, born 1887; Jean-Martin, born 1889; Oliver, born 1891; Ernst, born 1892; Sophie, born 1893; and Anna, born 1895.

Carl Jung started the rumor that a romantic relationship may have developed between Freud and his sister-in-law, Minna Bernays, who had moved in to the Freud household at Berggasse 19 in 1896 after the death of her fiancé. The publication in 2006 of a Swiss hotel log, dated 13 August 1898, showing Freud had stayed there with a woman not his wife, has been regarded by some Freud scholars as showing that there was a factual basis to these rumors. Peter Gay, previously skeptical of the suggestion that Freud had an affair with Bernays, revised his view of the matter and concluded that an affair between them was possible. Based on historical investigations and contextual analysis of relevant Freud writings, Peter J. Swales suggested that Bernays became pregnant and had an abortion during their affair.

Freud began smoking tobacco at age 24; initially a cigarette smoker, he became a cigar smoker. He believed that smoking enhanced his capacity to work and that he could exercise self-control in moderating it. Despite health warnings from colleague Wilhelm Fliess, he remained a smoker, eventually suffering a buccal cancer. Freud suggested to Fliess in 1897 that addictions, including that to tobacco, were substitutes for masturbation, "the one great habit".

Freud had greatly admired his philosophy tutor Brentano, who was known for his theories of perception and introspection, as well as Theodor Lipps, who was one of the main contemporary theorists of the concepts of the unconscious and empathy. Brentano discussed the possible existence of the unconscious mind in his 1874 book Psychology from an Empirical Standpoint. Although Brentano denied the existence of the unconscious, his discussion of it probably helped introduce Freud to the concept. Freud owned and made use of Charles Darwin's major evolutionary writings, and was also influenced by Eduard von Hartmann's The Philosophy of the Unconscious.

He read Friedrich Nietzsche as a student, and analogies between his work and that of Nietzsche were pointed out almost as soon as he developed a following. In 1900, the year of Nietzsche's death, Freud bought his collected works; he told his friend, Fliess, that he hoped to find in Nietzsche's works "the words for much that remains mute in me." Later he said he had not yet opened them. Freud came to treat Nietzsche's writings "as texts to be resisted far more than to be studied". His interest in philosophy declined after he had decided on a career in neurology and psychiatry.

Freud’s Jewish origins and his allegiance to his secular Jewish identity were of significant influence in the formation of his intellectual and moral outlook, especially with respect to his intellectual non-conformism, as he was the first to point out in his Autobiographical Study. They would also have a substantial effect on the content of psychoanalytic ideas “particularly in respect of the rationalist values to which it committed itself”.

Development of psychoanalysis

In October 1885, Freud went to Paris on a fellowship to study with Jean-Martin Charcot, a renowned neurologist who was conducting scientific research into hypnosis. He was later to recall the experience of this stay as catalytic in turning him toward the practice of medical psychopathology and away from a less financially promising career in neurology research. Charcot specialized in the study of hysteria and susceptibility to hypnosis, which he frequently demonstrated with patients on stage in front of an audience.

Once he had set up in private practice in 1886, Freud began using hypnosis in his clinical work. He adopted the approach of his friend and collaborator, Josef Breuer, in a use of hypnosis which was different from the French methods he had studied in that it did not use suggestion. The treatment of one particular patient of Breuer's proved to be transformative for Freud's clinical practice. Described as Anna O she was invited to talk about her symptoms while under hypnosis (she would coin the phrase " talking cure" for her treatment). In the course of talking in this way these symptoms became reduced in severity as she retrieved memories of early traumatic incidents in her life. This led Freud to eventually establish in the course of his clinical practice that a more consistent and effective pattern of symptom relief could be achieved, without recourse to hypnosis, by encouraging patients to talk freely about whatever ideas or memories occurred to them. In addition to this procedure, which he called "free association", Freud found that patient's dreams could be fruitfully analysed to reveal the complex structuring of unconscious material and to demonstrate the psychic action of repression which underlay symptom formation. By 1896 Freud had abandoned hypnosis and was using the term "psychoanalysis" to refer to his new clinical method and the theories on which it was based.

On the basis of his early clinical work Freud postulated that unconscious memories of sexual molestation in early childhood were a necessary precondition for the psychoneuroses (hysteria and obsessional neurosis), a formulation now known as Freud's seduction theory. By 1897, however, Freud had abandoned this theory, now arguing that the repressed sexual thoughts and fantasies of early childhood were the key causative factors in neuroses, whether or not derived from real events in the child's history. This would lead to the emergence of Freud's new theory of infantile sexuality, and eventually to the Oedipus complex.

Freud's development of these new theories took place during a period in which he experienced several medical problems, including depression and heart irregularities, which became particularly acute after the death of his father in 1896. Suspecting them to be psychosomatic in origin and disturbed by a superstitious belief that he would die at the age of 51, Freud began exploring his own dreams and childhood memories. During this self-analysis, he became aware of the hostility he felt towards his father and also became convinced that he had developed sexual feelings towards his mother in infancy ("between two and two and a half years"), citing a memory of seeing her naked on a train journey. Richard Webster argues that Freud's account of his self-analysis shows that he "had remembered only a long train journey, from whose duration he deduced that he might have seen his mother undressing", and that Freud's memory was an artificial reconstruction.

After the publication of The Interpretation of Dreams in November 1899, interest in his theories began to grow, and a circle of supporters developed. However, Freud often clashed with those supporters who criticized his theories, the most famous of whom was Carl Jung. Part of the disagreement between them was due to Jung's interest in and commitment to spirituality and occultism, which Freud saw as unscientific.

Karen Horney, a pupil of Karl Abraham and Freud's most outspoken critic, opposed Freud's theory of femininity, leading him to defend it against her. The disagreement was over how to interpret penis envy, rather than whether it existed. Horney understood Freud's conception of the castration complex as a theory about the biological nature of women, one in which women were biologically castrated men, and rejected it as scientifically unsatisfying. Horney's opposition, along with that of Melanie Klein, produced the first psychoanalytic debate on femininity. British neurologist, Ernest Jones, although usually an "ultra-orthodox" Freudian, sided with Horney and Klein.

Jacques Lacan attempted to attract Freud's attention by sending him his thesis. Freud replied to Lacan by sending him a postcard in January 1933; it read, "Thank you for sending your thesis."

Early followers

Freud spent most of his life in Vienna. From 1891 until 1938 he and his family lived in an apartment at Berggasse 19 near the Innere Stadt or historical quarter of Vienna. As a docent of the University of Vienna, Freud, since the mid-1880s, had been delivering lectures on his theories to small audiences every Saturday evening at the lecture hall of the university's psychiatric clinic. He gave lectures in the University every year from 1886 to 1919. His work generated a considerable degree of interest from a small group of Viennese physicians. From the autumn of 1902 and shortly after his promotion to the honorific title of außerordentlicher Professor, a small group of followers formed around him, meeting at his apartment every Wednesday afternoon, to discuss issues relating to psychology and neuropathology. This group was called the Wednesday Psychological Society (Psychologischen Mittwoch-Gesellschaft) and it marked the beginnings of the worldwide psychoanalytic movement.

This discussion group was founded around Freud at the suggestion of the physician Wilhelm Stekel. Stekel had studied medicine at the University of Vienna under Richard von Krafft-Ebing. His conversion to psychoanalysis is variously attributed to his successful treatment by Freud for a sexual problem or as a result of his reading The Interpretation of Dreams, to which he subsequently gave a positive review in the Viennese daily newspaper Neues Wiener Tagblatt. The other three original members whom Freud invited to attend, Alfred Adler, Max Kahane, and Rudolf Reitler, were also physicians and all five were Jewish by birth. Both Kahane and Reitler were childhood friends of Freud. Kahane had attended the same secondary school and both he and Reitler went to university with Freud. They had kept abreast of Freud's developing ideas through their attendance at his Saturday evening lectures. In 1901, Kahane, who first introduced Stekel to Freud's work, had opened an out-patient psychotherapy institute of which he was the director in Bauernmarkt, in Vienna. In the same year, his medical textbook, Outline of Internal Medicine for Students and Practicing Physicians was published. In it, he provided an outline of Freud's psychoanalytic method. Kahane broke with Freud and left the Wednesday Psychological Society in 1907 for unknown reasons and in 1923 he committed suicide. Reitler was the director of an establishment providing thermal cures in Dorotheergasse which had been founded in 1901. He died prematurely in 1917. Adler, regarded as the most formidable intellect among the early Freud circle, was a socialist who in 1898 had written a health manual for the tailoring trade. He was particularly interested in the potential social impact of psychiatry.

Max Graf, a Viennese musicologist and father of " Little Hans", who had first encountered Freud in 1900 and joined the Wednesday group soon after its initial inception, described the ritual and atmosphere of the early meetings of the society:

The gatherings followed a definite ritual. First one of the members would present a paper. Then, black coffee and cakes were served; cigar and cigarettes were on the table and were consumed in great quantities. After a social quarter of an hour, the discussion would begin. The last and decisive word was always spoken by Freud himself. There was the atmosphere of the foundation of a religion in that room. Freud himself was its new prophet who made the heretofore prevailing methods of psychological investigation appear superficial.

By 1906 the group had grown to sixteen members, including Otto Rank, who was employed as the group's paid secretary. Also in that year Freud began correspondence with Jung who was then an assistant to Eugen Bleuler at the Burghölzli Mental Hospital in Zurich. In March 1907 Jung and Ludwig Binswanger, also a Swiss psychiatrist, travelled to Vienna to visit Freud and attend the discussion group. Thereafter they established a small psychoanalytic group in Zurich. In 1908, reflecting its growing institutional status, the Wednesday group was renamed the Vienna Psychoanalytic Society. In 1911 the first women members were admitted to the Society. Tatiana Rosenthal and Sabina Spielrein were both Russian psychiatrists and graduates of the Zurich University medical school. Prior to the completion of her studies, Spielrein had been a patient of Jung at the Burghölzli and the clinical and personal details of their relationship became the subject of an extensive correspondence between Freud and Jung. Both women would go on to make important contributions to the work of Russian Psychoanalytic Society which was founded in 1910.

Freud's early followers met together formally for the first time at the Hotel Bristol, Salzburg on 27 April 1908. This meeting, which was retrospectively deemed to be the first International Psychoanalytic Congress, was convened at the suggestion of Ernest Jones, then a London based neurologist who had discovered Freud's writings and begun applying psychoanalytic methods in his clinical work. Jones had met Jung at a conference the previous year and they met up again in Zurich to organize the Congress. There were, as Jones records, "forty-two present, half of whom were or became practicing analysts". As well as Jones and the Viennese and Zurich contingents accompanying Freud and Jung, also present and notable for their subsequent importance in the psychoanalytic movement were Abraham and Max Eitingon from Berlin, Sándor Ferenczi from Budapest and the New York based Abraham Brill.

Important decisions were taken at the Congress with a view to advancing the impact of Freud's work. A journal, the Jahrbuch fur psychoanlytische und psychopathologishe Forschungen, was launched in 1909 under the editorship of Jung. This was followed in 1910 by the monthly Zentralblatt fur Psychoanalyse edited by Adler and Stekel, in 1911 by Imago, a journal devoted to the application of psychoanalysis to the field of cultural and literary studies edited by Rank and in 1913 by the Internationale Zeitschrift fur Psychoanalyse, also edited by Rank.

Plans for an International Association of psychoanalysts were put in place and these were implemented at the Nuremberg Congress of 1910 where Jung was elected, with Freud's support, as its first president.

Freud turned to Brill and Jones to further his ambition to spread the psychoanalytic cause in the English-speaking world. Both were invited to Vienna following the Salzburg Congress and a division of labour was agreed with Brill given the translation rights for Freud's works, and Jones, who was to take up a post at Toronto University later in the year, tasked with establishing a platform for Freudian ideas in North American academic and medical life. Jones's advocacy prepared the way for Freud's visit to the United States, accompanied by Jung and Ferenczi, in September 1909 at the invitation of Stanley Hall, president of Clark University, Worcester, Massachusetts, where he gave five lectures on psychoanalysis. (When the ocean liner George Washington arrived in New York, Freud is rumored to have remarked to Jung, "They don't realize that we are bringing them the plague.") The event, at which Freud was awarded an Honorary Doctorate, marked the first public recognition of Freud's work and attracted widespread media interest. Freud's audience included the distinguished neurologist and psychiatrist James Jackson Putnam, Professor of Diseases of the Nervous System at Harvard, who invited Freud to his country retreat where they held extensive discussions over a period of four days. Putnam's subsequent public endorsement of Freud’s work represented a significant breakthrough for the psychoanalytic cause in the United States. When Putnam and Jones organised the founding of the American Psychoanalytic Association in May 1911 they were elected president and secretary respectively.

Brill founded the New York Psychoanalytic Society the same year. His translations of Freud's work began to appear from 1909.

Some of Freud's followers subsequently withdrew from the International Psychoanalytic Association (IPA) and founded their own schools.

From 1909, Adler's views on topics such as neurosis began to differ markedly from those held by Freud. As Adler's position appeared increasingly incompatible with Freudianism a series of confrontations between their respective viewpoints took place at the meetings of the Viennese Psychoanalytic Society in January and February 1911. In February 1911 Adler, the then president of the society, resigned his position. At this time Stekel also resigned his position as vice-president of the society. Adler finally left the Freudian group altogether in June 1911 to found his own organization with nine other members who had also resigned from the group. This new formation was initially called Society for Free Psychoanalysis but it was soon renamed the Society for Individual Psychology. In the period after World War I, Adler became increasingly associated with a psychological position he devised called individual psychology.

In 1912 Jung published Wandlungen und Symbole der Libido (published in English in 1916 as Psychology of the Unconscious) and it became clear that his views were taking a direction quite different from those of Freud. To distinguish his system from psychoanalysis, Jung called it analytical psychology.

Anticipating the final breakdown of the relationship between Freud and Jung, Ernest Jones initiated the formation of a committee of loyalists charged with safeguarding the theoretical coherence and institutional legacy of the psychoanalytic movement. Formed in the Autumn of 1912, the committee comprised Freud, Jones, Abraham, Ferenczi, Rank and Hans Sachs. Max Eitingon joined the committee in 1919. Each member pledged themselves not to make any public departure from the fundamental tenets of psychoanalytic theory before they had discussed their views with the others. After this development Jung recognised that his position was untenable and resigned as editor of the Jarhbuch and then as president of the IPA in April 1914; the Zürich Society withdrew from the IPA the following July.

Later the same year Freud published a paper entitled " The History of the Psychoanalytic Movement", the German original being first published in the Jahrbuch, giving his view on the birth and evolution of the psychoanalytic movement and the withdrawal of Adler and Jung from it.

The committee continued to function until 1927 by which time institutional developments within the IPA, such as the establishment of the International Training Commission, served to allay some of Freud's anxieties about the transmission of psychoanalytic theory and practice.

The final defection from Freud's inner circle occurred following the publication in 1924 of Rank's The Trauma of Birth which other members of the committee read as, in effect, abandoning the Oedipus Complex as the central tenet of psychoanalytic theory. Abraham and Jones became increasingly forceful critics of Rank and though he and Freud were reluctant to end their close and long-standing relationship the break finally came in 1926 when Rank resigned from his official posts in the IPA and left Vienna for Paris. His place on the committee was taken by Anna Freud. Rank eventually settled in the United States where his revisions of Freudian theory were to influence a new generation of therapists uncomfortable with the orthodoxies of the IPA.

Early psychoanalytic movement

After the founding of the IPA in 1910, an international network of psychoanalytical societies, training institutes and clinics became well established and a regular schedule of biannual Congresses commenced after the end of World War I to coordinate their activities. Freud attended his last Congress in Berlin in 1922.

Abraham and Eitingon founded the Berlin Psychoanalytic Society in 1910 and then the Berlin Psychoanalytic Institute and the Poliklinik in 1920. The Poliklinik's innovations of free treatment, and child analysis and the Berlin Institute's standardisation of psychoanalytic training had a major influence on the wider psychoanalytic movement. In 1927 Ernst Simmel founded the Schloss Tegel Sanatorium on the outskirts of Berlin, the first such establishment to provide psychoanalytic treatment in an institutional framework. Freud organised a fund to help finance its activities and his architect son, Ernst, was commissioned to refurbish the building. It was forced to close in 1931 for economic reasons.

The 1910 Moscow Psychoanalytic Society became the Russian Psychoanalytic Society and Institute in 1922. Freud's Russian followers were the first to benefit from translations of his work, the 1904 Russian translation of The Interpretaion of Dreams appearing nine years before Brill's English edition. The Russian Institute was unique in receiving state support for its activities, including publication of translations of Freud's works.

After helping found the American Psychoanalytic Association in 1911, Ernest Jones returned to Britain from Canada in 1913 and founded the London Psychoanalytic Society the same year. In 1919, he dissolved this organisation and, with its core membership purged of Jungian adherents, founded the British Psychoanalytical Society, serving as its president until 1944. The Institute of Psychoanalysis was established 1924 and the London Clinic of Psychonanlysis established in 1926, both under Jones's directorship.

The Vienna Ambulatorium (Clinic) was established in 1922 and the Vienna Psychoanalytic Institute was founded in 1924 under the directorship of Helene Deutsch. Ferenczi founded the Budapest Psychoanalytic Institute in 1913 and a clinic in 1929.

Psychoanalytic societies and institutes were established in France (1926), Italy (1932), Holland (1933) and in Jerusalem (1933) by Eitingon, who had fled Berlin after Adolf Hitler came to power. The New York Psychoanalytic Institute was founded in 1931.

Patients

Freud used pseudonyms in his case histories. Some patients known by pseudonyms were Cäcilie M. (Anna von Lieben); Dora (Ida Bauer, 1882–1945); Frau Emmy von N. (Fanny Moser); Fräulein Elisabeth von R. (Ilona Weiss); Fräulein Katharina (Aurelia Kronich); Fräulein Lucy R.; Little Hans ( Herbert Graf, 1903–1973); Rat Man (Ernst Lanzer, 1878–1914); Enos Fingy (Joshua Wild, 1878–1920); and Wolf Man (Sergei Pankejeff, 1887–1979). Other famous patients included H.D. (1886–1961); Emma Eckstein (1865–1924); Gustav Mahler (1860–1911), with whom Freud had only a single, extended consultation; and Princess Marie Bonaparte.

Several writers have criticized both Freud's clinical efforts and his accounts of them. Frederick Crews writes that "...even applying his own indulgent criteria, with no allowance for placebo factors and no systematic followup to check for relapses, Freud was unable to document a single unambiguously efficacious treatment". Mikkel Borch-Jacobsen writes that historians of psychoanalysis have shown "that things did not happen in the way Freud and his authorised biographers told us"; he cites Han Israëls's view that "Freud...was so confident in his first theories that he publicly boasted of therapeutic successes that he had not yet obtained." Freud, in that interpretation, was forced to provide explanations for his abandonment of those theories that concealed his real reason, which was that the therapeutic benefits he expected did not materialise; he knew that his patients were not cured, but "did not hesitate to build grand theories on these non-existent foundations."

Struggle with cancer

In February 1923, Freud detected a leukoplakia, a benign growth associated with heavy smoking, on his mouth. Freud initially kept this secret, but in April 1923 he informed Ernest Jones, telling him that the growth had been removed. Freud consulted the dermatologist Maximilian Steiner, who advised him to quit smoking but lied about the growth's seriousness, minimizing its importance. Freud later saw Felix Deutsch, who saw that the growth was cancerous; he identified it to Freud using the euphemism "a bad leukoplakia" instead of the technical diagnosis epithelioma. Deutsch advised Freud to stop smoking and have the growth excised. Freud was treated by Marcus Hajek, a rhinologist whose competence he had previously questioned. Hajek performed an unnecessary cosmetic surgery in his clinic's outpatient department. Freud bled during and after the operation, and may narrowly have escaped death. Freud subsequently saw Deutsch again. Deutsch saw that further surgery would be required, but refrained from telling Freud that he had cancer because he was worried that Freud might wish to commit suicide.

Escape from Nazism

In 1930, Freud was awarded the Goethe Prize in recognition of his contributions to psychology and to German literary culture. In January 1933, the Nazis took control of Germany, and Freud's books were prominent among those they burned and destroyed. Freud quipped: "What progress we are making. In the Middle Ages they would have burned me. Now, they are content with burning my books."

Freud continued to maintain his optimistic underestimation of the growing Nazi threat and remained determined to stay in Vienna, even following the Anschluss of 13 March 1938 in which Nazi Germany annexed Austria, and the outbursts of violent anti-Semitism that ensued.

Ernest Jones, the then president of the International Psychoanalytic Association (IPA), flew into Vienna from London via Prague on 15 March determined to get Freud to change his mind and seek exile in Britain. This prospect and the shock of the detention and interrogation of Anna Freud by the Gestapo finally convinced Freud it was time to leave Vienna. Jones left for London the following week with a list provided by Freud of the party of émigrés for whom immigration permits would be required. Back in London, Jones used his personal acquaintance with the Home Secretary, Sir Samuel Hoare to expedite the granting of permits. There were seventeen in all and work permits were provided where relevant. Jones also used his influence in scientific circles, persuading the president of the Royal Society, Sir William Bragg, to write to the Foreign Secretary Lord Halifax, requesting to good effect that diplomatic pressure be applied in Berlin and Vienna on Freud's behalf. Freud also had support from American diplomats, notably his ex-patient and American ambassador to France, William Bullitt.

The departure from Vienna began in stages throughout April and May 1938. Freud's grandson Ernst Halberstadt and Freud's son Martin's wife and children left for Paris in April. Freud's sister-in-law, Minna Bernays, left for London on 5 May, Martin Freud the following week and Freud's daughter Mathilde and her husband, Robert Hollitscher, on 24 May.

By the end of the month, arrangements for Freud's own departure for London had become stalled, mired in a legally tortuous and financially extortionate process of negotiation with the Nazi authorities. However, the Nazi appointed Kommissar put in charge of his assets and those of the IPA proved to be sympathetic to Freud's plight. Anton Sauerwald had studied chemistry at Vienna University under Professor Josef Herzig, an old friend of Freud's, and evidently retained, notwithstanding his Nazi Party allegiance, a respect for Freud's professional standing. Expected to disclose details of all Freud's bank accounts to his superiors and to follow their instructions to destroy the historic library of books housed in the offices of the IPA, in the event Sauerwald did neither, removing evidence of Freud's foreign bank accounts to his own safe-keeping and arranging the storage of the IPA library in the Austrian National Library where they remained until the end of the war.

Though Sauerwald's intervention lessened the financial burden of the "flight" tax on Freud's declared assets, other substantial charges were levied in relation to the debts of the IPA and the valuable collection of antiquities Freud possessed. Unable to access his own accounts, Freud turned to Princess Marie Bonaparte, the most eminent and wealthy of his French followers, who had travelled to Vienna to offer her support and it was she who made the necessary funds available. This allowed Sauerwald to sign the necessary exit visas for Freud, his wife Martha and daughter Anna. They left Vienna on the Orient Express on 4 June, accompanied by their household staff and a doctor, arriving in Paris the following day where they stayed as guests of Princess Bonaparte before travelling overnight to London arriving at Victoria Station on 6 June.

Many famous names were soon to call on Freud to pay their respects, notably Salvador Dalí, Stefan Zweig, Leonard and Virginia Woolf, and H.G. Wells. Representatives of the Royal Society called with the Society's Charter for Freud to sign himself into membership. Princess Bonaparte arrived towards the end of June to discuss the fate of Freud's four elderly sisters left behind in Vienna. Her subsequent attempts to get them exit visas failed and they were all to die in Nazi concentration camps. In the Spring of 1939 Anton Sauerwald arrived to see Freud, ostensibly to discuss matters relating to the assets of the IPA. He was able to do Freud one last favour. He returned to Vienna to drive Freud's Viennese cancer specialist, Hans Pichler, to London to operate on the worsening condition of Freud's cancerous jaw.

Sauerwald was tried and imprisoned in 1945 by an Austrian court for his activities as a Nazi Party official. Responding to a plea from his wife, Anna Freud wrote to confirm that Sauerwald "used his office as our appointed commissar in such a manner as to protect my father". Her intervention helped secure his release from jail in 1947.

In the Freuds' new home at 20 Maresfield Garden, Hampstead, North London, Freud's Vienna consulting room was recreated in faithful detail. He continued to see patients there until the terminal stages of his illness. He also worked on his last books, Moses and Monotheism, published in German in 1938 and in English the following year and the uncompleted Outline of Psychoanalysis which was published posthumously.

Death

By mid-September 1939, Freud's cancer of the oral cavity was causing him increasingly severe pain and had been declared to be inoperable. After reading Honouré de Balzac's La Peau de chagrin in a single sitting, Freud turned to his doctor, friend and fellow refugee, Max Schur, reminding him that they had previously discussed the terminal stages of his illness: "Schur, you remember our 'contract' not to leave me in the lurch when the time had come. Now it is nothing but torture and makes no sense." When Schur replied that he had not forgotten, Freud said, "I thank you," and then "Talk it over with Anna, and if she thinks it's right, then make an end of it." Anna Freud wanted to postpone her father’s death, but Schur convinced her it was pointless to keep him alive, and on 21 and 22 September administered doses of morphine that resulted in Freud's death on 23 September 1939.

Three days after his death, Freud's body was cremated at the Golders Green Crematorium in North London. Ernest Jones gave the funeral oration to a gathering of friends, psychoanalysts and Austrian refugees, including the author Stefan Zweig. Freud's ashes were later placed in the crematorium's columbarium. They rest in an ancient Greek urn that Freud had received as a gift from Princess Bonaparte and which he had kept in his study in Vienna for many years. After his wife Martha died in 1951, her ashes were also placed in the urn.

Ideas

Early work

Freud began his study of medicine at the University of Vienna in 1873. He took almost nine years to complete his studies, due to his interest in neurophysiological research, specifically investigation of the sexual anatomy of eels and the physiology of the fish nervous system, and because of his interest in studying philosophy with Franz Brentano. He entered private practice in neurology for financial reasons, receiving his M.D. degree in 1881 at the age of 25. Amongst his principal concerns in the 1880s was the anatomy of the brain, specifically the medulla oblongata; he intervened in the important debates about aphasia with his monograph of 1891, Zur Auffassung der Aphasien, in which he coined the term agnosia, and counselled against a too locationist view of the explanation of neurological deficits; like his contemporary Eugen Bleuler, he emphasized brain function rather than brain structure. He was also an early researcher in the field of cerebral palsy, which was then known as "cerebral paralysis". He published several medical papers on the topic, and showed that the disease existed long before other researchers of the period began to notice and study it. He also suggested that William Little, the man who first identified cerebral palsy, was wrong about lack of oxygen during birth being a cause. Instead, he suggested that complications in birth were only a symptom. Freud hoped that his research would provide a solid scientific basis for his therapeutic technique. The goal of Freudian therapy, or psychoanalysis, was to bring repressed thoughts and feelings into consciousness in order to free the patient from suffering repetitive distorted emotions.

Classically, the bringing of unconscious thoughts and feelings to consciousness is brought about by encouraging a patient to talk about dreams and engage in free association, in which patients report their thoughts without reservation and make no attempt to concentrate while doing so. Another important element of psychoanalysis is transference, the process by which patients displace on to their analysts feelings and ideas which derive from previous figures in their lives. Transference was first seen as a regrettable phenomenon that interfered with the recovery of repressed memories and disturbed patients' objectivity, but by 1912 Freud had come to see it as an essential part of the therapeutic process.

The origin of Freud's early work with psychoanalysis can be linked to Josef Breuer. Freud credited Breuer with opening the way to the discovery of the psychoanalytical method by his treatment of the case of Anna O. In November 1880, Breuer was called in to treat a highly intelligent 21-year-old woman (Bertha Pappenheim) for a persistent cough that he diagnosed as hysterical. He found that while nursing her dying father, she had developed a number of transitory symptoms, including visual disorders and paralysis and contractures of limbs, which he also diagnosed as hysterical. Breuer began to see his patient almost every day as the symptoms increased and became more persistent, and observed that she entered states of absence. He found that when, with his encouragement, she told fantasy stories in her evening states of absence her condition improved, and most of her symptoms had disappeared by April 1881. However, following the death of her father in that month her condition deteriorated again. Breuer recorded that some of the symptoms eventually remitted spontaneously, and that full recovery was achieved by inducing her to recall events that had precipitated the occurrence of a specific symptom. In the years immediately following Breuer's treatment, Anna O. spent three short periods in sanatoria with the diagnosis "hysteria" with "somatic symptoms", and some authors have challenged Breuer's published account of a cure. Richard Skues rejects this interpretation, which he sees as stemming from both Freudian and anti-psychoanalytical revisionism, that regards both Breuer's narrative of the case as unreliable and his treatment of Anna O. as a failure.

In the early 1890s Freud used a form of treatment based on the one that Breuer had described to him, modified by what he called his "pressure technique" and his newly developed analytic technique of interpretation and reconstruction. According to Freud's later accounts of this period, as a result of his use of this procedure most of his patients in the mid-1890s reported early childhood sexual abuse. He believed these stories, but then came to believe that they were fantasies. He explained these at first as having the function of "fending off" memories of infantile masturbation, but in later years he wrote that they represented Oedipal fantasies.

Another version of events focuses on Freud's proposing that unconscious memories of infantile sexual abuse were at the root of the psychoneuroses in letters to Fliess in October 1895, before he reported that he had actually discovered such abuse among his patients. In the first half of 1896 Freud published three papers stating that he had uncovered, in all of his current patients, deeply repressed memories of sexual abuse in early childhood. In these papers Freud recorded that his patients were not consciously aware of these memories, and must therefore be present as unconscious memories if they were to result in hysterical symptoms or obsessional neurosis. The patients were subjected to considerable pressure to "reproduce" infantile sexual abuse "scenes" that Freud was convinced had been repressed into the unconscious. Patients were generally unconvinced that their experiences of Freud's clinical procedure indicated actual sexual abuse. He reported that even after a supposed "reproduction" of sexual scenes the patients assured him emphatically of their disbelief.

As well as his pressure technique, Freud's clinical procedures involved analytic inference and the symbolic interpretation of symptoms to trace back to memories of infantile sexual abuse. His claim of one hundred percent confirmation of his theory only served to reinforce previously expressed reservations from his colleagues about the validity of findings obtained through his suggestive techniques.

Cocaine

As a medical researcher, Freud was an early user and proponent of cocaine as a stimulant as well as analgesic. He believed that cocaine was a cure for many mental and physical problems, and in his 1884 paper "On Coca" he extolled its virtues. Between 1883 and 1887 he wrote several articles recommending medical applications, including its use as an antidepressant. He narrowly missed out on obtaining scientific priority for discovering its anesthetic properties of which he was aware but had mentioned only in passing. ( Karl Koller, a colleague of Freud's in Vienna, received that distinction in 1884 after reporting to a medical society the ways cocaine could be used in delicate eye surgery.) Freud also recommended cocaine as a cure for morphine addiction. He had introduced cocaine to his friend Ernst von Fleischl-Marxow who had become addicted to morphine taken to relieve years of excruciating nerve pain resulting from an infection acquired while performing an autopsy. However, his claim that Fleischl-Marxow was cured of his addiction was premature, though he never acknowledged he had been at fault. Fleischl-Marxow developed an acute case of "cocaine psychosis", and soon returned to using morphine, dying a few years later after more suffering from intolerable pain.

The application as an anesthetic turned out to be one of the few safe uses of cocaine, and as reports of addiction and overdose began to filter in from many places in the world, Freud's medical reputation became somewhat tarnished.

After the "Cocaine Episode" Freud ceased to publicly recommend use of the drug, but continued to take it himself occasionally for depression, migraine and nasal inflammation during the early 1890s, before giving it up in 1896. In this period he came under the influence of his friend and confidant Fliess, who recommended cocaine for the treatment of the so-called nasal reflex neurosis. Fliess, who operated on the noses of several of his own patients, also performed operations on Freud and on one of Freud's patients whom he believed to be suffering from the disorder, Emma Eckstein. However, the surgery proved disastrous. It has been suggested that much of Freud's early psychoanalytical theory was a by-product of his cocaine use.

The unconscious

The concept of the unconscious was central to Freud's account of the mind. Freud believed that while poets and thinkers had long known of the existence of the unconscious, he had ensured that it received scientific recognition in the field of psychology. However, the concept made an informal appearance in Freud's writings. It was first introduced in connection with the phenomenon of repression, to explain what happens to ideas that are repressed; Freud stated explicitly that the concept of the unconscious was based on the theory of repression. He postulated a cycle in which ideas are repressed, but remain in the mind, removed from consciousness yet operative, then reappear in consciousness under certain circumstances. The postulate was based upon the investigation of cases of traumatic hysteria, which revealed cases where the behavior of patients could not be explained without reference to ideas or thoughts of which they had no awareness. This fact, combined with the observation that such behaviour could be artificially induced by hypnosis, in which ideas were inserted into people's minds, suggested that ideas were operative in the original cases, even though their subjects knew nothing of them. Freud, like Breuer, found the hypothesis that hysterical manifestations were generated by ideas to be not only warranted, but given in observation. Disagreement between them arose, however, when they attempted to give causal explanations of their data: Breuer favored a hypothesis of hypnoid states, while Freud postulated the mechanism of defense. Richard Wollheim comments that given the close correspondence between hysteria and the results of hypnosis, Breuer's hypothesis appears more plausible, and that it is only when repression is taken into account that Freud's hypothesis becomes preferable.

Freud originally allowed that repression might be a conscious process, but by the time he wrote his second paper on the "Neuro-Psychoses of Defence" (1896), he apparently believed that repression, which he referred to as "the psychical mechanism of (unconscious) defense", occurred on an unconscious level. Freud further developed his theories about the unconscious in The Interpretation of Dreams (1899) and in Jokes and their Relation to the Unconscious (1905), where he dealt with condensation and displacement as inherent characteristics of unconscious mental activity. Freud presented his first systematic statement of his hypotheses about unconscious mental processes in 1912, in response to an invitation from the London Society of Psychical Research to contribute to its Proceedings. Freud in 1915 expanded that statement into a more ambitious metapsychological paper entitled "The Unconscious." In both these papers, when Freud tried to distinguish between his conception of the unconscious and those that predated psychoanalysis, he found it in his postulation of ideas that are simultaneously latent and operative.

Dreams

Freud believed that the function of dreams is to preserve sleep by representing as fulfilled wishes that would otherwise awaken the dreamer. Freud also believed that there is a specific psychological technique through which dreams can be interpreted, and that, if the technique is successfully accomplished, each dreams is revealed as a physical structure, which has a significant meaning and functioning in the mental activities of the awakened life.

Id, ego and super-ego

In his later work, Freud proposed that the human psyche could be divided into three parts: Id, ego and super-ego. Freud discussed this model in the 1920 essay Beyond the Pleasure Principle, and fully elaborated upon it in The Ego and the Id (1923), in which he developed it as an alternative to his previous topographic schema (i.e., conscious, unconscious and preconscious). The id is the completely unconscious, impulsive, childlike portion of the psyche that operates on the "pleasure principle" and is the source of basic impulses and drives; it seeks immediate pleasure and gratification.

Freud acknowledged that his use of the term Id (das Es, "the It") derives from the writings of Georg Groddeck. The super-ego is the moral component of the psyche, which takes into account no special circumstances in which the morally right thing may not be right for a given situation. The rational ego attempts to exact a balance between the impractical hedonism of the id and the equally impractical moralism of the super-ego; it is the part of the psyche that is usually reflected most directly in a person's actions. When overburdened or threatened by its tasks, it may employ defense mechanisms including denial repression, undoing, rationalization, repression, and displacement. This concept is usually represented by the "Iceberg Model". This model represents the roles the Id, Ego, and Super Ego play in relation to conscious and unconscious thought.

Freud compared the relationship between the ego and the id to that between a charioteer and his horses: the horses provide the energy and drive, while the charioteer provides direction.

Life and death drives

Freud believed that people are driven by two conflicting central desires: the life drive (libido or Eros) (survival, propagation, hunger, thirst, and sex) and the death drive. The death drive was also termed "Thanatos", although Freud did not use that term; "Thanatos" was introduced in this context by Paul Federn. Freud hypothesized that libido is a form of mental energy with which processes, structures and object-representations are invested.

In Beyond the Pleasure Principle, Freud inferred the existence of the death instinct. Its premise was a regulatory principle that has been described as "the principle of psychic inertia", "the Nirvana principle", and "the conservatism of instinct". Its background was Freud's earlier Project for a Scientific Psychology, where he had defined the principle governing the mental apparatus as its tendency to divest itself of quantity or to reduce tension to zero. Freud had been obliged to abandon that definition, since it proved adequate only to the most rudimentary kinds of mental functioning, and replaced the idea that the apparatus tends toward a level of zero tension with the idea that it tends toward a minimum level of tension.

Freud in effect readopted the original definition in Beyond the Pleasure Principle, this time applying it to a different principle. He asserted that on certain occasions the mind acts as though it could eliminate tension entirely, or in effect to reduce itself to a state of extinction; his key evidence for this was the existence of the compulsion to repeat. Examples of such repetition included the dream life of traumatic neurotics and children's play. In the phenomenon of repetition, Freud saw a psychic trend to work over earlier impressions, to master them and derive pleasure from them, a trend was prior to the pleasure principle but not opposed to it. In addition to that trend, however, there was also a principle at work that was opposed to, and thus "beyond" the pleasure principle. If repetition is a necessary element in the binding of energy or adaptation, when carried to inordinate lengths it becomes a means of abandoning adaptations and reinstating earlier or less evolved psychic positions. By combining this idea with the hypothesis that all repetition is a form of discharge, Freud reached the conclusion that the compulsion to repeat is an effort to restore a state that is both historically primitive and marked by the total draining of energy: death.

Religion

Freud regarded the monotheistic God as an illusion based upon the infantile emotional need for a powerful, supernatural pater familias. He maintained that religion – once necessary to restrain man's violent nature in the early stages of civilization – in modern times, can be set aside in favour of reason and science. "Obsessive Actions and Religious Practices" (1907) notes the likeness between faith (religious belief) and neurotic obsession. Totem and Taboo (1913) proposes that society and religion begin with the patricide and eating of the powerful paternal figure, who then becomes a revered collective memory. In Civilization and its Discontents (1930), he quotes his friend Romain Rolland, who described religion as an "oceanic sensation", but says he never experienced this feeling. Moses and Monotheism (1937) proposes that Moses was the tribal pater familias, killed by the Jews, who psychologically coped with the patricide with a reaction formation conducive to their establishing monotheist Judaism; analogously, he described the Roman Catholic rite of Holy Communion as cultural evidence of the killing and devouring of the sacred father.

Moreover, he perceived religion, with its suppression of violence, as mediator of the societal and personal, the public and the private, conflicts between Eros and Thanatos, the forces of life and death. Later works indicate Freud's pessimism about the future of civilization, which he noted in the 1931 edition of Civilization and its Discontents.

Legacy

Psychotherapy

Though not the first methodology in the practice of individual verbal psychotherapy, Freud's psychoanalytic system came to dominate the field from early in the twentieth century, forming the basis for many later variants. While these systems have adopted different theories and techniques, all have followed Freud by attempting to effect behavioural change through having patients talk about their difficulties. Psychoanalysis itself has, according to psychoanalyst Joel Kovel, declined as a distinct therapeutic practice, despite its pervasive influence on psychotherapy.

The neo-Freudians, a group understood by Kovel to include Adler, Rank, Horney, Harry Stack Sullivan and Erich Fromm, rejected Freud's theory of instinctual drive, emphasized interpersonal relations and self-assertiveness, and made modifications to therapeutic practice that reflected these theoretical shifts. Adler originated the approach, although his influence was indirect due to his inability to systematically formulate his ideas. In Kovel's view, neo-Freudian practice shares the same assumption as most current therapeutic approaches in the United States: "If what is wrong with people follows directly from bad experience, then therapy can be in its basics nothing but good experience as a corrective." Neo-Freudian analysis therefore places more emphasis on the patient's relationship with the analyst and less on exploration of the unconscious.

Jung believed that the collective unconscious, which reflects the cosmic order and the history of the human species, is the most important part of the mind. It contains archetypes, which are manifested in symbols that appear in dreams, disturbed states of mind, and various products of culture. Jungians are less interested in infantile development and psychological conflict between wishes and the forces that frustrate them than in integration between different parts of the person. The object of Jungian therapy was to mend such splits. Jung focused in particular on problems of middle and later life. His objective was to allow people to experience the split-off aspects of themselves, such as the anima (a man's suppressed female self), the animus (a woman's suppressed male self), or the shadow (an inferior self-image), and thereby attain wisdom.

Lacan approached psychoanalysis through linguistics and literature. Lacan believed that Freud's essential work had been done prior to 1905, and concerned the interpretation of dreams, neurotic symptoms, and slips, which had been based on a revolutionary way of understanding language and its relation to experience and subjectivity. Lacan believed that ego psychology and object relations theory were based upon misreadings of Freud's work; for Lacan, the determinative dimension of human experience is neither the self (as in ego psychology) nor relations with others (as in object relations theory), but language. Lacan saw desire as more important than need, and considered it necessarily ungratifiable.

Wilhelm Reich developed ideas that Freud had developed at the beginning of his psychoanalytic investigation, but then superseded but never finally discarded; these were the concept of the Actualneurosis, and a theory of anxiety based upon the idea of dammed-up libido. In Freud's original view, what really happened to a person (the "actual") determined the resulting neurotic disposition. Freud applied that idea both to infants and to adults; in the former case, seductions were sought as the causes of later neuroses, and in the latter incomplete sexual release. Unlike Freud, Reich retained the idea that actual experience, especially sexual experience, was of key significance. By the 1920s, Reich had "taken Freud's original ideas about sexual release to the point of specifying the orgasm as the criteria of healthy function." Reich was also "developing his ideas about character into a form that would later take shape, first as "muscular armour", and eventually as a transducer of universal biological energy, the "orgone"."

Fritz Perls, who helped to develop Gestalt therapy, was influenced by Reich, Jung and Freud. The key idea of gestalt therapy is that Freud overlooked the structure of awareness, which, properly understood, is "an active process that moves toward the construction of organized meaningful wholes...between an organism and its environment." These wholes, called gestalts, are "patterns involving all the layers of organismic function — thought, feeling, and activity." Neurosis is seen as splitting in the formation of gestalts, and anxiety as the organism sensing "the struggle towards its creative unification." Gestalt therapy attempts to cure patients through placing them in contact with "immediate organismic needs." Perls rejected the verbal approach of classical psychoanalysis; talking in gestalt therapy serves the purpose of self-expression rather than gaining self-knowledge. Gestalt therapy usually takes place in groups, and in concentrated "workshops" rather than being spread out over a long period of time; it has been extended into new forms of communal living.

Arthur Janov's primal therapy, which has been an influential post-Freudian psychotherapy, resembles psychoanalytic therapy in its emphasis on early childhood experience, but nevertheless has profound differences with it. While Janov's theory is akin to Freud's early idea of Actualneurosis, he does not have a dynamic psychology but a nature psychology like that of Reich or Perls, in which need is primary while wish is derivative and dispensable when need is met. Despite its surface similarity to Freud's ideas, Janov's theory lacks a strictly psychological account of the unconscious and belief in infantile sexuality. While for Freud there was a hierarchy of danger situations, for Janov the key event in the child's life is awareness that the parents do not love it. Janov writes that primal therapy has in some ways returned to Freud's early ideas and techniques.

Crews considers Freud the key influence upon "champions of survivorship" such as Ellen Bass and Laura Davis, co-authors of The Courage to Heal, although in his view they are indebted not to classic psychoanalysis but to "the pre-psychoanalytic Freud, the one who supposedly took pity on his hysterical patients, found that they were all harboring memories of early abuse...and cured them by unknotting their repression." Crews sees Freud as having anticipated the recovered memory movement's "puritanical alarmism" by emphasizing "mechanical cause-and-effect relations between symptomatology and the premature stimulation of one body zone or another", and with pioneering its "technique of thematically matching a patient's symptom with a sexually symmetrical 'memory.'" Crews believes that Freud's confidence in accurate recall of early memories anticipates the theories of recovered memory therapists such as Lenore Terr, which in his view have led to people being wrongfully imprisoned or involved in litigation.

Ethan Watters and Richard Ofshe write that the psychodynamic conception of the mind may be at the end of its usefulness, which could affect "thousands upon thousands and therapists and their patients." They believe that due to "the massive investment the field of psychotherapy has made in the psychodynamic approach, the dying convulsions of the paradigm will not be pretty", even though uninformed or unsophisticated people may continue to accept the psychodynamic paradigm despite its lack of validity.

Science

Research projects designed to empirically test Freud's theories have led to a vast literature on the topic. Seymour Fisher and Roger P. Greenberg concluded in 1977, on the basis of their analysis of research literature, that Freud's concepts of oral and anal personality constellations, his account of the role of Oedipal factors in certain aspects of male personality functioning, his formulations about the relatively greater concern about loss of love in women's as compared to men's personality economy, and his views about the instigating effects of homosexual anxieties on the formation of paranoid delusions were supported by empirical evidence. They also found limited and equivocal support for Freud's theories about the development of homosexuality. However, they found that several of Freud's other theories, including his portrayal of dreams as primarily containers of secret, unconscious wishes, as well as some of his views about the psychodynamics of women, were either not supported or contradicted by research. Reviewing the issues again in 1996, they concluded that much experimental data relevant to Freud's work exists, and supports some of his major ideas and theories. Fisher and Greenberg's similar conclusions in their more extensive earlier volume on experimental studies have, however, been strongly criticised for alleged methodological deficiencies by Paul Kline, who writes that they "accept results at their face value with almost no consideration of methodological adequacy", and by Edward Erwin.

Other viewponts include Eysenck's contention that Freud set back the study of psychology and psychiatry "by something like fifty years or more", and that of Malcolm Macmillan, who concluded that "Freud's method is not capable of yielding objective data about mental processes". Morris Eagle states that it has been "demonstrated quite conclusively that because of the epistemologically contaminated status of clinical data derived from the clinical situation, such data have questionable probative value in the testing of psychoanalytic hypotheses". Webster considers psychoanalysis perhaps the most complex and successful pseudoscience in history. J. Allan Hobson believes that Freud, by rhetorically discrediting 19th century investigators of dreams such as Alfred Maury and the Marquis de Hervey de Saint-Denis at a time when study of the physiology of the brain was only beginning, interrupted the development of scientific dream theory for half a century. Karl Popper, who argued that all proper scientific theories must be potentially falsifiable, claimed that Freud's psychoanalytic theories were presented in unfalsifiable form, meaning that no experiment could ever disprove them. Adolf Grünbaum has maintained, in opposition to Popper, that many of Freud's theories are empirically testable. Whilst in agreement with Grünbaum regarding Popper, Donald Levy rejects Grünbaum's argument that therapeutic success is the empirical basis on which Freud’s theories stand or fall in that it rests on a “false dichotomy between intra- and extraclinical evidence”. In his wider consideration of and response to philosophical critics of Freud’s scientific credibility Levy argues for the importance of clinical case material and the concepts related to it, notably resistance and transference, in establishing the evidentiary status of Freud's work.

In a study of psychoanalysis in the United States, Nathan Hale reported on the "decline of psychoanalysis in psychiatry" during the years 1965-1985. The continuation of this trend was noted by Alan Stone: "As academic psychology becomes more 'scientific' and psychiatry more biological, psychoanalysis is being brushed aside." Paul Stepansky, while noting that psychoanalysis remains influential in the humanities, records the "vanishingly small number of psychiatric residents who choose to pursue psychoanalytic training" and the "nonanalytic backgrounds of psychiatric chairpersons at major universities" among the evidence he cites for his conclusion that "Such historical trends attest to the marginalisation of psychoanalysis within American psychiatry."

Researchers in the emerging field of neuro-psychoanalysis, founded by neuroscientist and psychoanalyst Mark Solms, have argued for Freud's theories, pointing out brain structures relating to Freudian concepts such as libido, drives, the unconscious, and repression. However, Solms's case frequently depends on the notion of neuro-scientific findings being "broadly consistent" with Freudian theories, rather than strict validations of those theories. More generally, the dream researcher G. William Domhoff has disputed claims of specifically Freudian dream theory being validated. There has also been criticism of the very concept of neuro-psychoanalysis by psychoanalysts. Neuroscientist and Nobel laureate Eric Kandel argues that "psychoanalysis still represents the most coherent and intellectually satisfying view of the mind."

Psychoanalytic theory

Psychoanalysis has been interpreted as both radical and conservative. By the 1940s, it had come to be seen as conservative by the European and American intellectual community. Critics outside the psychoanalytic movement, whether on the political left or right, saw Freud as a conservative. Fromm had argued that several aspects of psychoanalytic theory served the interests of political reaction in his The Fear of Freedom (1942), an assessment confirmed by sympathetic writers on the right. Philip Rieff's Freud: The Mind of the Moralist (1959) portrayed Freud as a man who urged men to make the best of an inevitably unhappy fate, and admirable for that reason. Three books published in the 1950s challenged the then prevailing interpretation of Freud as a conservative: Herbert Marcuse's Eros and Civilization (1955), Lionel Trilling's Freud and the Crisis of Our Culture, and Norman O. Brown's Life Against Death (1959). Eros and Civilization helped make the idea that Freud and Marx were addressing similar questions from different perspectives credible to the left. Marcuse criticized neo-Freudian revisionism for discarding seemingly pessimistic theories such as the death instinct, arguing that they could be turned in a utopian direction. Freud's theories also influenced the Frankfurt school and critical theory as a whole.

Reich saw Freud's importance for psychiatry as parallel to that of Marx for economics. Fromm identifies Freud, together with Marx and Einstein, as the "architects of the modern age", but rejects the idea that Marx and Freud were equally significant, arguing that Marx was both far more historically important than Freud and a finer thinker. Fromm nevertheless credits Freud with permanently changing the way human nature is understood, writing that Freud's accomplishments should not be dismissed simply because they were less than those of Marx. Paul Robinson sees Freud as a revolutionary whose contributions to twentieth century thought are comparable in importance to Marx's contributions to nineteenth century thought. Gilles Deleuze and Félix Guattari write in Anti-Oedipus that psychoanalysis resembles the Russian Revolution in that it became corrupted almost from the beginning. They believe this began with Freud's development of the theory of the Oedipus complex, which they see as idealist.

Jean-Paul Sartre critiques Freud's theory of the unconscious in Being and Nothingness, claiming that consciousness is essentially self-conscious. Sartre also attempts to adapt some of Freud's ideas to his own account of human life, and thereby develop an "existential psychoanalysis" in which causal categories are replaced by teleological categories. Maurice Merleau-Ponty considers Freud to be one of the anticipators of phenomenology, while Theodor W. Adorno considers Edmund Husserl, the founder of phenomenology, to be Freud's philosophical opposite, writing that Husserl's polemic against psychologism could have been directed against psychoanalysis. Paul Ricœur sees Freud as a master of the "school of suspicion", alongside Marx and Nietzsche. Ricœur and Jürgen Habermas have helped create "a distinctly hermeneutic version of Freud", one which "claimed him as the most significant progenitor of the shift from an objectifying, empiricist understanding of the human realm to one stressing subjectivity and interpretation." Louis Althusser drew on Freud's concept of overdetermination for his reinterpretation of Marx's Capital. Jean-François Lyotard developed a theory of the unconscious that reverses Freud's account of the dream-work: for Lyotard, the unconscious is a force whose intensity is manifest via disfiguration rather than condensation. Jacques Derrida finds Freud to be both a late figure in the history of western metaphysics and, with Nietzsche and Heidegger, an important precursor of his own brand of radicalism.

Gellner sees Freud as parallel to Plato, writing that they hold nearly the same theory of dreams and have similar theories of the tripartite structure of the human soul or personality. Gellner concludes that Freud's theories are an inversion of Plato's. Whereas Plato saw a hierarchy inherent in the nature of reality, and relied upon it to validate norms, Freud was a naturalist who could not follow such an approach. Both men's theories drew a parallel between the structure of the human mind and that of society, but while Plato wanted to strengthen the super-ego, which corresponded to the aristocracy, Freud wanted to strengthen the ego, which corresponded to the middle class. Michel Foucault writes that Plato and Freud meant different things when they claimed that dreams fulfill desires, since the meaning of a statement depends on its relation to other propositions.

Paul Vitz compares Freudian psychoanalysis to Thomism, noting St. Thomas's belief in the existence of an "unconscious consciousness" and his "frequent use of the word and concept 'libido' - sometimes in a more specific sense than Freud, but always in a manner in agreement with the Freudian use." Vitz suggests that Freud may have been unaware that his theory of the unconscious was reminiscent of Aquinas. Bernard Williams writes that there has been hope that some psychoanalytical theories may "support some ethical conception as a necessary part of human happiness", but that in some cases the theories appear to support such hopes because they themselves involve ethical thought. In his view, while such theories may be better as channels of individual help because of their ethical basis, it disqualifies them from providing a basis for ethics.

Literary criticism

Literary critic Harold Bloom has been influenced by Freud. Camille Paglia has also been influenced by Freud, whom she calls "Nietzsche's heir" and one of the greatest sexual psychologists in literature, but has rejected the scientific status of his work in her Sexual Personae, writing, "Freud has no rivals among his successors because they think he wrote science, when he in fact he wrote art."

Feminism

The decline in Freud's reputation has been attributed partly to the revival of feminism. Simone de Beauvoir criticizes psychoanalysis from an existentialist standpoint in The Second Sex, arguing that Freud saw an "original superiority" in the male that is in reality socially induced. Betty Friedan criticizes Freud and what she considered his Victorian view of women in The Feminine Mystique. Freud's concept of penis envy was attacked by Kate Millett, whose Sexual Politics accused him of confusion and oversights. Naomi Weisstein writes that Freud and his followers erroneously thought that his "years of intensive clinical experience" added up to scientific rigor. Freud is also criticized by Shulamith Firestone and Eva Figes. In The Dialectic of Sex, Firestone argues that Freud was a "poet" who produced metaphors rather than literal truths; in her view, Freud, like feminists, recognized that sexuality was the crucial problem of modern life, but ignored the social context and failed to question society itself. Firestone interprets Freudian "metaphors" in terms of the literal facts of power within the family. Figes tries in Patriarchal Attitudes to place Freud within a "history of ideas". Juliet Mitchell defends Freud against his feminist critics in Psychoanalysis and Feminism, accusing them of misreading him and misunderstanding the implications of psychoanalytic theory for feminism. Mitchell helped introduce English-speaking feminists to Lacan. Mitchell is criticized by Jane Gallop in The Daughter's Seduction. Gallop compliments Mitchell for her criticism of "the distortions inflicted by feminists upon Freud's text and his discoveries", but finds her treatment of Lacanian theory lacking.

Some French feminists, among them Julia Kristeva and Luce Irigaray, have been influenced by Freud as interpreted by Lacan. Irigaray has produced a theoretical challenge to Freud and Lacan, using their theories against them to put forward a "psychoanalytic explanation for theoretical bias". Irigaray claims that "the cultural unconscious only recognizes the male sex", and "details the effects of this unconscious belief on accounts of the psychology of women". Feminist scholars such as Ranjana Khanna and Elizabeth Grosz have used Freud's work to try to create an understanding of sexual difference that accounts for the materiality of the body without reifying the biological and the neurological. They suggest that psychoanalysis can be put to work in ways which challenge anti-biologism and its reinforcement of binary oppositions such as human/animal, nature/the social, empirical reality/interpretation and man/woman.

Carol Gilligan writes that "The penchant of developmental theorists to project a masculine image, and one that appears frightening to women, goes back at least to Freud." She sees Freud's criticism of women's sense of justice reappearing in the work of Jean Piaget and Lawrence Kohlberg. Gilligan notes that Nancy Chodorow, in contrast to Freud, attributes sexual difference not to anatomy but to the fact that "the early social environment differs for and is experienced differently by male and female children." Chodorow, writing against the masculine bias of psychoanalysis, "replaces Freud's negative and derivative description of female psychology with a positive and direct account of her own."

Works