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- COVER STORIES, Page 60IS FREUD FINISHED?
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- By John Elson. Reported by Janice M. Horowitz/New York
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- He is rightly regarded as the father of modern psychiatry
- -- as revolutionary a thinker as Darwin, as daring an explorer
- of the interior world as Columbus was of the exterior. Sigmund
- Freud not only developed the most profound theory to explain
- the workings of the human mind, but he also devised much of the
- terminology -- from Oedipus complex to penis envy -- that has
- become part of the language. The discipline he founded,
- psychoanalysis, became the world's most famous technique for
- helping the troubled come to grips with the demons haunting
- their minds.
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- But with the advent of new drug therapies, Freudian analysis
- has become almost irrelevant to the treatment of severe
- depression and schizophrenia. Granted, even the most
- pharmacology-minded of experts agree that the drugs work best in
- conjunction with some form of therapy. Yet psychiatrist Samuel
- Perry of Cornell University Medical College estimates that less
- than 1% of depression sufferers in the U.S. are being treated
- with traditional psychoanalysis -- that is, a long-term series
- of regular sessions with a psychiatrist. Though this technique
- is still considered suitable for treating neurotics who have
- trouble coping with everyday stress, not even the most fanatic
- Freudians believe psychoanalysis alone can cope with severe
- cases of schizophrenia or severe depression.
-
- Relatively little of Freud's voluminous work is devoted to
- the empirical study of clinical depression. His writings discuss
- only four patients who were known for certain to have suffered
- from major depression, and he published only one paper on the
- subject -- "Mourning and Melancholia" (1917) -- which contrasted
- ordinary grief and acute depression. He wrote somewhat more
- extensively about schizophrenia, which he called "paraphrenia."
- But he was always doubtful that psychoanalysis would be of much
- help in treating it. The schizophrenic's lack of interest in the
- external world, Freud wrote, made him inaccessible to
- transference. That is the key psychological process by which a
- patient redirects unconscious feelings retained from childhood
- toward an analyst. It was Freud's later disciples, rather than
- the master himself, who popularized the use of psychoanalysis
- to treat depression and even schizophrenia.
-
- Feminists complain that Freud's view of women, as mercurial
- creatures with a deficient sense of moral standards, was
- downright misogynistic. Even some orthodox Freudians concede
- that his emphasis on sexuality as the root cause of all
- neuroses was too narrow. Nonetheless, Freud's ideas still have
- impact. Says Arnold Cooper, past president of the American
- Psychoanalytic Association: "You and everybody you know is a
- Freudian, and they probably don't even know it. We have all
- drunk in basic Freudian tenets." Freud was a pioneer in mapping
- the unconscious mind and theorizing how it could be reached and
- interpreted. He was the first to speculate that traumatic
- events of childhood could influence the way adults see the
- world. And he was the first also to postulate that patients in
- psychoanalysis, rather than the doctor, could direct therapy
- and contribute to their own cure.
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- "Freud took two pieces of Vermont folk wisdom and turned
- them into a science," says psychiatry professor Thomas Gutheil
- of Harvard medical school. "The first was, `There's a whole lot
- more to folks than meets the eye.' This became known as the
- theory of the unconscious. The second was, `Keep your mouth
- shut and you might learn something.' He changed the position of
- the doctor from that of an authoritarian giving orders to a
- more receptive role. Freud said, `Let the patient talk and tell
- the story.' "
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- In that sense, all forms of talk therapy can be considered a
- Freudian legacy. Even the sex obsession of today's society can
- be read as evidence that contemporary culture indirectly
- reflects Freud's deepest concerns. Perhaps W.H. Auden got it
- right after all in his poetic tribute to the Viennese master,
- written a few months after Freud's death in 1939:
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- If often he was wrong and at times absurd,
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- To us he is no more a person now
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- But a whole climate of opinion
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- Under whom we conduct our differing lives.
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