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The sexual revolution

Bosch Hieronymus
Triptych of Garden of Earthly Delights (central panel)
c. 1500
Art historian Wilhelm Fraenger speculates that Bosch was a sympathiser
or member of the free-love sect known as the Brethren of the Free Spirit.



In Focus:

The sexual revolution



Sexual revolution

From Wikipedia, the free encyclopedia

Industrial Revolution
Free love

see also:

Body art
Erotica in Art
Fine Art Photography
Nude in Art of the 20th century
Pin-Up Art
"Rubenesque" proportions
Superstar Stormy Daniels


Freudian school

see also: FREUD  SIGMUND

Doctor Sigmund Freud of Vienna believed human behavior was motivated by unconscious drives, primarily by the libido or "Sexual Energy". Freud proposed to study how these unconscious drives were repressed and found expression through other cultural outlets. He called his therapy Psychoanalysis.

While Freud's ideas were ignored and embarrassing to Viennese society, his work provoked a serious challenge to Victorian prudishness by providing the groundwork for the ideas of sex drive and infant sexuality. Freud's theory of psychosexual development proposed a model for the development of sexual orientations and desires; children emerged from the Oedipus complex, a sexual desire towards their mother.

According to Freud's theory, in the earliest stage in a child's psychosexual development, the oral stage, the mother's breast became the formative source of all later erotic sensation. This new philosophy was the new intellectual and cultural underpinning ideology of the new age of sexual frankness. Nonetheless, much of his research is widely discredited by professionals in the field.

Anarchist Freud scholars Otto Gross and Wilhelm Reich (who famously coined the phrase "Sexual Revolution") developed a sociology of sex in the 1910s to 1930's.



Sigmund Freud

Psychoanalysis is a body of ideas developed by Austrian physician Sigmund Freud and continued by others. It is primarily devoted to the study of human psychological functioning and behavior, although it also can be applied to societies.

Psychoanalysis has three applications:

1.a method of investigation of the mind;
2.a systematized set of theories about human behaviour;
3.a method of treatment of psychological or emotional illness.

Under the broad umbrella of psychoanalysis there are at least twenty-two different theoretical orientations regarding the underlying theory of understanding of human mentation and human development. The various approaches in treatment called "psychoanalytic" vary as much as the different theories do. In addition, the term refers to a method of studying child development.

Freudian psychoanalysis refers to a specific type of treatment in which the "analysand" (analytic patient) verbalizes thoughts, including free associations, fantasies, and dreams, from which the analyst formulates the unconscious conflicts causing the patient's symptoms and character problems, and interprets them for the patient to create insight for resolution of the problems.

The specifics of the analyst's interventions typically include confronting and clarifying the patient's pathological defenses, wishes and guilt. Through the analysis of conflicts, including those contributing to resistance and those involving transference onto the analyst of distorted reactions, psychoanalytic treatment can clarify how patients unconsciously are their own worst enemies: how unconscious, symbolic reactions that have been stimulated by experience are causing symptoms.


The idea of Psychoanalysis was developed in Vienna in the 1890s by Sigmund Freud, a neurologist interested in finding an effective treatment for patients with neurotic or hysterical symptoms. Freud had become aware of the existence of mental processes that were not conscious as a result of his neurological consulting job at the Children's Hospital, where he noticed that many aphasic children had no organic cause for their symptoms. He wrote a monograph about this subject. In the late 1880s, Freud obtained a grant to study with Jean-Martin Charcot, the famed neurologist and syphilologist, at the Salpêtrière in Paris. Charcot had become interested in patients who had symptoms that mimicked general paresis, the psychotic illness that occurs due to tertiary syphilis. Charcot had found that many patients experienced paralyses, pains, coughs, and a variety of other symptoms with no demonstrable physical cause. Prior to Charcot's work, women with these symptoms were thought to have a wandering uterus (hysteria means "uterus" in Greek), but Freud learned that men could have psychosomatic symptoms as well. He also became aware of an experimental treatment for hysteria utilized by his mentor and colleague, Dr. Josef Breuer. The treatment was a combination of hypnotism and catharsis which utilized abreaction (ventilation of emotion). This treatment was used to treat the hysterical symptoms of Dr. Breuer's now famous patient, Anna O.

Freud's first theory to explain hysterical symptoms was the so-called "seduction theory." Since his patients under treatment with this new method "remembered" incidents of having been sexually seduced in childhood, Freud believed that they had actually been abused only to later repress those memories. This led to his publication with Dr. Breuer in 1893 of case reports of the treatment of hysteria. This first theory became untenable as an explanation of all incidents of hysteria. As a result of his work with his patients, Freud learned that the majority complained of sexual problems, especially coitus interruptus as birth control. He suspected their problems stemmed from cultural restrictions on sexual expression and that their sexual wishes and fantasies had been repressed. Between this discovery of the unexpressed sexual desires and the relief of the symptoms by abreaction, Freud began to theorize that the unconscious mind had determining effects on hysterical symptoms.

His first comprehensive attempt at an explanatory theory was the then unpublished Project for a Scientific Psychology in 1895. In this work Freud attempted to develop a neurophysiologic theory based on transfer of energy by the neurons in the brain in order to explain unconscious mechanisms. He abandoned the project when he came to realize that there was a complicated psychological process involved over and above neuronal activity. By 1900, Freud had discovered that dreams had symbolic significance, and generally were specific to the dreamer. Freud formulated his second psychological theory – that of there being an unconscious "primary process" consisting of symbolic and condensed thoughts, and a "secondary process" of logical, conscious thoughts. This theory was published in his 1900 opus magnum, The Interpretation of Dreams. Chapter VII was a re-working of the earlier "Project" and Freud outlined his "Topographic Theory." In this theory, which was mostly later supplanted by the Structural Theory, unacceptable sexual wishes were repressed into the "System Unconscious," unconscious due to society's condemnation of premarital sexual activity, and this repression created anxiety. Freud also discovered what most of us take for granted today: that dreams were symbolic and specific to the dreamer. Often, dreams give clues to unconscious conflicts, and for this reason, Freud referred to dreams as the "royal road to the Unconscious."

This "topographic theory" is still popular in much of Europe, although it has been superseded in much of North America. In 1905, Freud published Three Essays on the Theory of Sexuality in which he laid out his discovery of so-called psychosexual phases: oral (ages 0-2), anal (2-4), phallic-oedipal (today called 1st genital) (3-6), latency (6-puberty), and mature genital (puberty-onward). His early formulation included the idea that because of societal restrictions, sexual wishes were repressed into an unconscious state, and that the energy of these unconscious wishes could be turned into anxiety or physical symptoms. Therefore the early treatment techniques, including hypnotism and abreaction, were designed to make the unconscious conscious in order to relieve the pressure and the apparently resulting symptoms.

In On Narcissism (1915) Freud turned his attention to the subject of narcissism. Still utilizing an energic system, Freud conceptualized the question of energy directed at the self versus energy directed at others, called cathexis. By 1917, In "Mourning and Melancholia," he suggested that certain depressions were caused by turning guilt-ridden anger on the self. In 1919 in "A Child is Being Beaten" he began to address the problems of self-destructive behavior (moral masochism) and frank sexual masochism. Based on his experience with depressed and self-destructive patients, and pondering the carnage of WW I, Freud became dissatisfied with considering only oral and sexual motivations for behavior. By 1920, Freud addressed the power of identification (with the leader and with other members) in groups as a motivation for behavior (Group Psychology and Analysis of the Ego). In that same year (1920) Freud suggested his "dual drive" theory of sexuality and aggression in Beyond the Pleasure Principle, to try to begin to explain human destructiveness.

In 1923, he presented his new "structural theory" of an id, ego, and superego in a book entitled, The Ego and the Id. Therein, he revised the whole theory of mental functioning, now considering that repression was only one of many defense mechanisms, and that it occurred to reduce anxiety. Note the 180 degree shift - earlier he had thought that repression caused anxiety. Moreover, in 1926, in Inhibitions, Symptoms and Anxiety, Freud laid out how intrapsychic conflict among drive and superego (wishes and guilt) caused anxiety, and how that anxiety could lead to an inhibition of mental functions, such as intellect and speech. Inhibitions, Symptoms and Anxiety was written in response to Otto Rank, who, in 1924, published Das Trauma der Geburt (translated into English in 1929 as The Trauma of Birth), exploring how art, myth, religion, philosophy and therapy were illuminated by separation anxiety in the “phase before the development of the Oedipus complex” (p. 216). But there was no such phase in Freud’s theories. The Oedipus complex, Freud explained tirelessly, was the nucleus of the neurosis and the foundational source of all art, myth, religion, philosophy, therapy – indeed of all human culture and civilization. It was the first time that anyone in the inner circle had dared to suggest that the Oedipus complex might not be the only factor contributing to intrapsychic development

By 1936, the "Principle of Multiple Function" was clarified by Robert Waelder. He widened the formulation that psychological symptoms were caused by and relieved conflict simultaneously. Moreover, symptoms (such as phobias and compulsions) each represented elements of some drive wish (sexual and/or aggressive), superego (guilt), anxiety, reality, and defenses. Also in 1936, Anna Freud, Sigmund's famous daughter, published her seminal book, The Ego and the Mechanisms of Defense, outlining numerous ways the mind could shut upsetting things out of consciousness.

Following the death of Freud, a new group of psychoanalysts began to explore the function of the ego. Led by Hartmann, Kris, Rappaport and Lowenstein, the group made new discoveries in understanding the synthetic function of the ego as a mediator in psychic functioning. Hartmann in particular distinguished between autonomous ego functions (such as memory and intellect which could be secondarily affected by conflict) and synthetic functions which were a result of compromise formation. These "Ego Psychologists" of the '50s paved a way to focus analytic work by attending to the defenses (mediated by the ego) before exploring the deeper roots to the unconscious conflicts. In addition there was burgeoning interest in child psychoanalysis. Although criticized since its inception, psychoanalysis has been used as a research tool into childhood development, and has developed into a flexible, effective treatment for certain mental disturbances. In the 1960s, Freud's early thoughts on the childhood development of female sexuality were challenged; this challenge led to the development of a variety of understandings of female sexual development, many of which modified the timing and normality of several of Freud's theories (which had been gleaned from the treatment of women with mental disturbances). Several researchers, followed Karen Horney's studies of societal pressures that influence the development of women. Most contemporary North American psychoanalysts employ theories that, while based on those of Sigmund Freud, include many modifications of theory and practice developed since his death in 1939.

In the 2000s there are approximately 35 training institutes for psychoanalysis in the United States accredited by the American Psychoanalytic Association  which is a component organization of the International Psychoanalytical Association, and there are over 3,000 graduated psychoanalysts practicing in the United States. The International Psychoanalytical Association accredits psychoanalytic training centers throughout the rest of the world, including countries such as Serbia, France, Germany, Austria, Italy, Switzerland, and many others, as well as about six institutes directly in the U.S. Freud published a paper entitled The History of the Psychoanalytic Movement in 1914, German original being first published in the Jahrbuch der Psychoanalyse.

The predominant psychoanalytic theories can be grouped into several theoretical "schools." Although these theoretical "schools" differ, most of them continue to stress the strong influence of unconscious elements affecting people's mental lives. There has also been considerable work done on consolidating elements of conflicting theory (cf. the work of Theodore Dorpat, B. Killingmo, and S. Akhtar). As in all fields of healthcare, there are some persistent conflicts regarding specific causes of some syndromes, and disputes regarding the best treatment techniques. In the 2000s, psychoanalytic ideas are embedded in Western culture, especially in fields such as childcare, education, literary criticism, cultural studies, and mental health, particularly psychotherapy. Though there is a mainstream of evolved analytic ideas, there are groups who follow the precepts of one or more of the later theoreticians. Psychoanalytic ideas also play roles in some types of literary analysis such as Archetypal literary criticism.

Topographic theory
Topographic theory was first described by Freud in "The Interpretation of Dreams" (1900) The theory posits that the mental apparatus can be divided in to the systems Conscious, Pre-conscious and Unconscious. These systems are not anatomical structures of the brain but, rather, mental processes. Although Freud retained this theory throughout his life he largely replaced it with the Structural theory. The Topographic theory remains as one of the metapsychological points of view for describing how the mind functions in classical psychoanalytic theory.

Structural theory
Structural theory divides the psyche into the id, the ego, and the super-ego. The id is present at birth as the repository of basic instincts, which Freud called "Triebe" ("drives"): unorganised and unconscious, it operates merely on the 'pleasure principle', without realism or foresight. The ego develops slowly and gradually, being concerned with mediating between the urgings of the id and the realities of the external world; it thus operates on the 'reality principle'. The super-ego is held to be the part of the ego in which self-obsevation, self-criticism and other reflective and judgemental faculties develop. The ego and the super-ego are both partly conscious and partly unconscious.

Ego psychology
Ego psychology was initially suggested by Freud in Inhibitions, Symptoms and Anxiety (1926). The theory was refined by Hartmann, Loewenstein, and Kris in a series of papers and books from 1939 through the late 1960s. Leo Bellak was a later contributor. This series of constructs, paralleling some of the later developments of cognitive theory, includes the notions of autonomous ego functions: mental functions not dependent, at least in origin, on intrapsychic conflict. Such functions include: sensory perception, motor control, symbolic thought, logical thought, speech, abstraction, integration (synthesis), orientation, concentration, judgment about danger, reality testing, adaptive ability, executive decision-making, hygiene, and self-preservation. Freud noted that inhibition is one method that the mind may utilize to interfere with any of these functions in order to avoid painful emotions. Hartmann (1950s) pointed out that there may be delays or deficits in such functions.

Frosch (1964) described differences in those people who demonstrated damage to their relationship to reality, but who seemed able to test it. Deficits in the capacity to organize thought are sometimes referred to as blocking or loose associations (Bleuler), and are characteristic of the schizophrenias. Deficits in abstraction ability and self-preservation also suggest psychosis in adults. Deficits in orientation and sensorium are often indicative of a medical illness affecting the brain (and therefore, autonomous ego functions). Deficits in certain ego functions are routinely found in severely sexually or physically abused children, where powerful effects generated throughout childhood seem to have eroded some functional development.

Ego strengths, later described by Kernberg (1975), include the capacities to control oral, sexual, and destructive impulses; to tolerate painful affects without falling apart; and to prevent the eruption into consciousness of bizarre symbolic fantasy. Synthetic functions, in contrast to autonomous functions, arise from the development of the ego and serve the purpose of managing conflictual processes. Defenses are an example of synthetic functions and serve the purpose of protecting the conscious mind from awareness of forbidden impulses and thoughts. One purpose of ego psychology has been to emphasize that there are mental functions that can be considered to be basic, and not the derivatives of wishes, affects, or defenses. However, it is important to note that autonomous ego functions can be secondarily affected because of unconscious conflict. For example, a patient may have an hysterical amnesia (memory being an autonomous function) because of intrapsychic conflict (wishing not to remember because it is too painful).

Taken together, the above theories present a group of Metapsychological Assumptions. Therefore, the inclusive group of the different classical theories provides a cross-sectional view of human mentation. There are six "points of view", five of which were described by Freud and a sixth added by Hartmann. Unconscious processes can therefore be evaluated from each of these six points of view. The "points of view are" are: 1. Topographic 2. Dynamic (the theory of conflict) 3. Economic (the theory of energy flow) 4. Structural 5. Genetic (propositions concerning origin and development of psychological functions) and 6. Adaptational (psychological phenomena as it relates to the external world).

Conflict Theory
Conflict theory is an update and revision of structural theory that does away with some of the more arcane features of structural theory (such as where repressed thoughts are stored). Conflict theory looks at how emotional symptoms and character traits are complex solutions to mental conflict.  This revision of Freud's structural theory (Freud, 1923, 1926) dispenses with the concepts of a fixed id, ego and superego, and instead posits unconscious and conscious conflict among wishes (dependent, controlling, sexual, and aggressive), guilt and shame, emotions (especially anxiety and depressive affect), and defensive operations that shut off from consciousness some aspect of the others. Moreover, healthy functioning (adaptive) is also determined, to a great extent, by resolutions of conflict.

A major goal of modern conflict theorist analysts is to attempt to change the balance of conflict through making aspects of the less adaptive solutions (also called compromise formations) conscious so that they can be rethought, and more adaptive solutions found. Current theoreticians following Brenner's many suggestions (see especially Brenner's 1982 book, "The Mind in Conflict") include Sandor Abend, MD (Abend, Porder, & Willick, (1983), Borderline Patients: Clinical Perspectives), Jacob Arlow (Arlow and Brenner (1964), Psychoanalytic Concepts and the Structural Theory), and Jerome Blackman (2003), 101 Defenses: How the Mind Shields Itself).

Object relations theory
Object relations theory attempts to explain vicissitudes of human relationships through a study of how internal representations of self and of others are structured. The clinical problems that suggest object relations problems (usually developmental delays throughout life) include disturbances in an individual's capacity to feel warmth, empathy, trust, sense of security, identity stability, consistent emotional closeness, and stability in relationships with chosen other human beings. (It is not suggested that one should trust everyone, for example). Concepts regarding internal representations (also sometimes termed, "introjects," "self and object representations," or "internalizations of self and other") although often attributed to Melanie Klein, were actually first mentioned by Sigmund Freud in his early concepts of drive theory (1905, Three Essays on the Theory of Sexuality). Freud's 1917 paper "Mourning and Melancholia", for example, hypothesized that unresolved grief was caused by the survivor's internalized image of the deceased becoming fused with that of the survivor, and then the survivor shifting unacceptable anger toward the deceased onto the now complex self image.

Vamik Volkan, in "Linking Objects and Linking Phenomena," expanded on Freud's thoughts on this, describing the syndromes of "Established pathological mourning" vs. "reactive depression" based on similar dynamics. Melanie Klein's hypotheses regarding internalizations during the first year of life, leading to paranoid and depressive positions, were later challenged by Rene Spitz (e.g., The First Year of Life, 1965), who divided the first year of life into a coenesthetic phase of the first six months, and then a diacritic phase for the second six months. Margaret Mahler (Mahler, Fine, and Bergman (1975), "The Psychological Birth of the Human Infant") and her group, first in New York, then in Philadelphia, described distinct phases and subphases of child development leading to "separation-individuation" during the first three years of life, stressing the importance of constancy of parental figures, in the face of the child's destructive aggression, to the child's internalizations, stability of affect management, and ability to develop healthy autonomy.

Later developers of the theory of self and object constancy as it affects adult psychiatric problems such as psychosis and borderline states have been John Frosch, Otto Kernberg, and Salman Akhtar. Peter Blos described (1960, in a book called On Adolescence) how similar separation-individuation struggles occur during adolescence, of course with a different outcome from the first three years of life: the teen usually, eventually, leaves the parents' house (this varies with the culture). During adolescence, Erik Erikson (1950–1960s) described the "identity crisis," that involves identity-diffusion anxiety. In order for an adult to be able to experience "Warm-ETHICS" (warmth, empathy, trust, holding environment (Winnicott), identity, closeness, and stability) in relationships (see Blackman (2003), 101 Defenses: How the Mind Shields Itself), the teenager must resolve the problems with identity and redevelop self and object constancy.

Self psychology
Self psychology emphasizes the development of a stable and integrated sense of self through empathic contacts with other humans, primary significant others conceived of as "selfobjects." Selfobjects meet the developing self's needs for mirroring, idealization, and twinship, and thereby strengthen the developing self. The process of treatment proceeds through "transmuting internalizations" in which the patient gradually internalizes the selfobject functions provided by the therapist. Self psychology was proposed originally by Heinz Kohut, and has been further developed by Arnold Goldberg, Frank Lachmann, Paul and Anna Ornstein, Marian Tolpin, and others.

Jacques Lacan/Lacanian psychoanalysis
Lacanian psychoanalysis integrates psychoanalysis with semiotics and Hegelian philosophy, and is practiced throughout the world. It is especially popular in France and Latin America. Lacanian psychoanalysis is a departure from the traditional British and American psychoanalysis, which is predominantly Ego psychology. Lacan frequently used the phrase "retourner à Freud" in his seminars and writings meaning "back to Freud" as he claimed that his theories were an extension of Freud's own, contrary to those of Anna Freud, the Ego Psychology, object relations and "self" theories. Lacan's first major contributions concern the "mirror stage", the Real, the Imaginary and the Symbolic, and the claim the "unconscious is structured as a language".

Interpersonal psychoanalysis
Interpersonal psychoanalysis accents the nuances of interpersonal interactions, particularly how individuals protect themselves from anxiety by establishing collusive interactions with others, and the relevance of actual experiences with other persons developmentally (e.g. family and peers) as well as in the present. This is contrasted with the primacy of intrapsychic forces, as in classical psychoanalysis. Interpersonal theory was first introduced by Harry Stack Sullivan, MD, and developed further by Frieda Fromm-Reichmann, Clara Thompson, Erich Fromm, and others who contributed to the founding of the William Alanson White Institute and Interpersonal Psychoanalysis in general.

Culturalist psychoanalysts
Some psychoanalysts have been labeled culturalist, because of the prominence they gave on culture for the genesis of behavior. Among others, Erich Fromm, Karen Horney, Harry Stack Sullivan, have been called culturalist psychoanalysts. They were famously in conflict with orthodox psychoanalysts.

Relational psychoanalysis
Relational psychoanalysis combines interpersonal psychoanalysis with object-relations theory and with Inter-subjective theory as critical for mental health, was introduced by Stephen Mitchell. Relational psychoanalysis emphasizes how the individual's personality is shaped by both real and imagined relationships with others, and how these relationship patterns are re-enacted in the interactions between analyst and patient. Fonagy and Target, in London, have propounded their view of the necessity of helping certain detached, isolated patients, develop the capacity for "mentalization" associated with thinking about relationships and themselves.

Interpersonal-Relational psychoanalysis
The term interpersonal-relational psychoanalysis is often used as a professional identification. Psychoanalysts under this broader umbrella debate about what precisely are the differences between the two schools, without any current clear consensus.

Intersubjective psychoanalysis
The term "intersubjectivity" was introduced in psychoanalysis by George E. Atwood and Robert Stolorow (1984). Intersubjective approaches emphasize how both personality development and the therapeutic process are influenced by the interrelationship between the patient's subjective perspective and that of others. The authors of the interpersonal-relational and intersubjective approaches: Otto Rank, Heinz Kohut, Stephen A. Mitchell, Jessica Benjamin, Bernard Brandchaft, J. Fosshage, Donna M.Orange, Arnold Modell, Thomas Ogden, Owen Renik, Harold Searles, Colwyn Trewarthen, Edgar A. Levenson, Jay R. Greenberg, Edward R. Ritvo, Beatrice Beebe, Frank M. Lachmann, Herbert Rosenfeld and Daniel Stern.

Modern psychoanalysis
"Modern psychoanalysis" is a term coined by Hyman Spotnitz and his colleagues to describe a body of theoretical and clinical work undertaken from the 1950s onwards, with the aim of extending Freud's theories so as to make them applicable to the full spectrum of emotional disorders. Interventions based on this approach are primarily intended to provide an emotional-maturational communication to the patient, rather than to promote intellectual insight.


Psychopathology (mental disturbances)

Adult patients
The various psychoses involve deficits in the autonomous ego functions (see above) of integration (organization) of thought, in abstraction ability, in relationship to reality and in reality testing. In depressions with psychotic features, the self-preservation function may also be damaged (sometimes by overwhelming depressive affect). Because of the integrative deficits (often causing what general psychiatrists call "loose associations," "blocking," "flight of ideas," "verbigeration," and "thought withdrawal"), the development of self and object representations is also impaired. Clinically, therefore, psychotic individuals manifest limitations in warmth, empathy, trust, identity, closeness and/or stability in relationships (due to problems with self-object fusion anxiety) as well.

In patients whose autonomous ego functions are more intact, but who still show problems with object relations, the diagnosis often falls into the category known as "borderline." Borderline patients also show deficits, often in controlling impulses, affects, or fantasies – but their ability to test reality remains more or less intact. Adults who do not experience guilt and shame, and who indulge in criminal behavior, are usually diagnosed as psychopaths, or, using DSM-IV-TR, antisocial personality disorder.

Panic, phobias, conversions, obsessions, compulsions and depressions (analysts call these "neurotic symptoms") are not usually caused by deficits in functions. Instead, they are caused by intrapsychic conflicts. The conflicts are generally among sexual and hostile-aggressive wishes, guilt and shame, and reality factors. The conflicts may be conscious or unconscious, but create anxiety, depressive affect, and anger. Finally, the various elements are managed by defensive operations – essentially shut-off brain mechanisms that make people unaware of that element of conflict. "Repression" is the term given to the mechanism that shuts thoughts out of consciousness. "Isolation of affect" is the term used for the mechanism that shuts sensations out of consciousness. Neurotic symptoms may occur with or without deficits in ego functions, object relations, and ego strengths. Therefore, it is not uncommon to encounter obsessive-compulsive schizophrenics, panic patients who also suffer with borderline personality disorder, etc.

Childhood origins
Freudian theories point out that adult problems can be traced to unresolved conflicts from certain phases of childhood and adolescence. Freud, based on the data gathered from his patients early in his career, suspected that neurotic disturbances occurred when children were sexually abused in childhood (the so-called seduction theory). Later, Freud came to realize that, although child abuse occurs, that not all neurotic symptoms were associated with this. He realized that neurotic people often had unconscious conflicts that involved incestuous fantasies deriving from different stages of development. He found the stage from about three to six years of age (preschool years, today called the "first genital stage") to be filled with fantasies of having romantic relationships with both parents. Although arguments were generated in early 20th-century Vienna about whether adult seduction of children was the basis of neurotic illness, there is virtually no argument about this problem in the 21st century.

Many psychoanalysts who work with children have studied the actual effects of child abuse, which include ego and object relations deficits and severe neurotic conflicts. Much research has been done on these types of trauma in childhood, and the adult sequelae of those. On the other hand, many adults with symptom neuroses and character pathology have no history of childhood sexual or physical abuse. In studying the childhood factors that start neurotic symptom development, Freud found a constellation of factors that, for literary reasons, he termed the Oedipus complex (based on the play by Sophocles, Oedipus Rex, where the protagonist unwittingly kills his father Laius and marries his mother Jocasta). The shorthand term, "oedipal," (later explicated by Joseph Sandler in "On the Concept Superego" (1960) and modified by Charles Brenner in "The Mind in Conflict" (1982)) refers to the powerful attachments that children make to their parents in the preschool years. These attachments involve fantasies of sexual relationships with either (or both) parent, and, therefore, competitive fantasies toward either (or both) parents. Humberto Nagera (1975) has been particularly helpful in clarifying many of the complexities of the child through these years.

The terms "positive" and "negative" oedipal conflicts have been attached to the heterosexual and homosexual aspects, respectively. Both seem to occur in development of most children. Eventually, the developing child's concessions to reality (that they will neither marry one parent nor eliminate the other) lead to identifications with parental values. These identifications generally create a new set of mental operations regarding values and guilt, subsumed under the term "superego." Besides superego development, children "resolve" their preschool oedipal conflicts through channeling wishes into something their parents approve of ("sublimation") and the development, during the school-age years ("latency") of age-appropriate obsessive-compulsive defensive maneuvers (rules, repetitive games).

Using the various analytic theories to assess mental problems, several particular constellations of problems are particularly suited for analytic techniques (see below) whereas other problems respond better to medicines and different interpersonal interventions. To be treated with psychoanalysis, whatever the presenting problem, the person requesting help must demonstrate a desire to start an analysis. The person wishing to start an analysis must have some capacity for speech and communication. As well, they need to be able to have trust and empathy within the psychoanalytic session. Potential patients must undergo a preliminary stage of treatment to assess their amenability to psychoanalysis, at that time, and also to enable the analyst to form a working psychological model which the analyst will use to direct the treatment. Psychoanalysts mainly work with neurosis and hysteria in particular however adapted forms of psychoanalysis are used in working with schizophrenia and other forms of psychosis. Finally, if a prospective patient is severely suicidal a longer preliminary stage may be employed, sometimes with sessions which have a twenty minute break in the middle. There are modifications of techniques due to the radically individualistic nature of each persons analysis.

The most common problems treatable with psychoanalysis include: phobias, conversions, compulsions, obsessions, anxiety attacks, depressions, sexual dysfunctions, a wide variety of relationship problems (such as dating and marital strife), and a wide variety of character problems (for example, painful shyness, meanness, obnoxiousness, workaholism, hyperseductiveness, hyperemotionality, hyperfastidiousness). The fact that many of such patients also demonstrate deficits above makes diagnosis and treatment selection difficult.

Analytical organizations such as the International Psychoanalytic Association, The American Psychoanalytic Association, and the European Federation for Psychoanalytic Psychotherapy, have established procedures and models for the indication and practice of psychoanalytical therapy for trainees in analysis. The match between the analyst and the patient can be viewed as another contributing factor for the indication and contraindication for psychoanalytic treatment. The analyst decides whether the patient is suitable for psychoanalysis. This decision made by the analyst, besides made on the usual indications and pathology, is also based to a certain degree by the "fit" between analyst and patient. A person's suitability for analysis at any particular time is based around their desire to know something about where their illness has come from. Someone who is not suitable for analysis expresses no desire to know more about the root causes of their illness. An evaluation may include one or more other analysts' independent opinions and will include discussion of the patient's financial situation and insurances.

The basic method of psychoanalysis is interpretation of the patient's unconscious conflicts that are interfering with current-day functioning – conflicts that are causing painful symptoms such as phobias, anxiety, depression, and compulsions. Strachey (1936) stressed that figuring out ways the patient distorted perceptions about the analyst led to understanding what may have been forgotten (also see Freud's paper "Repeating, Remembering, and Working Through"). In particular, unconscious hostile feelings toward the analyst could be found in symbolic, negative reactions to what Robert Langs later called the "frame" of the therapy – the setup that included times of the sessions, payment of fees, and necessity of talking. In patients who made mistakes, forgot, or showed other peculiarities regarding time, fees, and talking, the analyst can usually find various unconscious "resistances" to the flow of thoughts (sometimes called free association).

Freud's patients would lie on this couch during psychoanalysisWhen the patient reclines on a couch with the analyst out of view, the patient tends to remember more, experience more resistance and transference, and be able to reorganize thoughts after the development of insight – through the interpretive work of the analyst. Although fantasy life can be understood through the examination of dreams, masturbation fantasies (cf. Marcus, I. and Francis, J. (1975), Masturbation from Infancy to Senescence) are also important. The analyst is interested in how the patient reacts to and avoids such fantasies (cf. Paul Gray (1994), The Ego and the Analysis of Defense). Various memories of early life are generally distorted – Freud called them "screen memories" – and in any case, very early experiences (before age two) – can not be remembered (See the child studies of Eleanor Galenson on "evocative memory").

Variations in technique
There is what is known among psychoanalysts as "classical technique," although Freud throughout his writings deviated from this considerably, depending on the problems of any given patient. Classical technique was summarized by Allan Compton, MD, as comprising instructions (telling the patient to try to say what's on their mind, including interferences); exploration (asking questions); and clarification (rephrasing and summarizing what the patient has been describing). As well, the analyst can also use confrontation to bringing an aspect of functioning, usually a defense, to the patient's attention. The analyst then uses a variety of interpretation methods, such as dynamic interpretation (explaining how being too nice guards against guilt, e.g. - defense vs. affect); genetic interpretation (explaining how a past event is influencing the present); resistance interpretation (showing the patient how they are avoiding their problems); transference interpretation (showing the patient ways old conflicts arise in current relationships, including that with the analyst); or dream interpretation (obtaining the patient's thoughts about their dreams and connecting this with their current problems). Analysts can also use reconstruction to estimate what may have happened in the past that created some current issue.

These techniques are primarily based on conflict theory. As object relations theory evolved, grass supplemented by the work of Bowlby, Ainsorth, and Beebe, techniques with patients who had more severe problems with basic trust (Erikson, 1950) and a history of maternal deprivation (see the works of Augusta Alpert) led to new techniques with adults. These have sometimes been called interpersonal, intersubjective (cf. Stolorow), relational, or corrective object relations techniques. These techniques include expressing an empathic attunement to the patient or warmth; exposing a bit of the analyst's personal life or attitudes to the patient; allowing the patient autonomy in the form of disagreement with the analyst (cf. I.H. Paul, Letters to Simon.); and explaining the motivations of others which the patient misperceives. Ego psychological concepts of deficit in functioning led to refinements in supportive therapy. These techniques are particularly applicable to psychotic and near-psychotic (cf., Eric Marcus, "Psychosis and Near-psychosis") patients. These supportive therapy techniques include discussions of reality; encouragement to stay alive (including hospitalization); psychotropic medicines to relieve overwhelming depressive affect or overwhelming fantasies (hallucinations and delusions); and advice about the meanings of things (to counter abstraction failures).

The notion of the "silent analyst" has been criticized. Actually, the analyst listens using Arlow's approach as set out in "The Genesis of Interpretation"), using active intervention to interpret resistances, defenses creating pathology, and fantasies. Silence and non-responsiveness was a technique promulgated by Carl Rogers, in his development of so-called "Client Centered Therapy" – and is not a technique of psychoanalysis (also see the studies and opinion papers of Owen Renik, MD). "Analytic Neutrality" is a concept that does not mean the analyst is silent. It refers to the analyst's position of not taking sides in the internal struggles of the patient. For example, if a patient feels guilty, the analyst might explore what the patient has been doing or thinking that causes the guilt, but not reassure the patient not to feel guilty. The analyst might also explore the identifications with parents and others that led to the guilt.

Interpersonal-Relational psychoanalysts emphasize the notion that it is impossible to be neutral. Sullivan introduced the term "participant-observer" to indicate the analyst inevitably interacts with the analysand, and suggested the detailed inquiry as an alternative to interpretation. The detailed inquiry involves noting where the analysand is leaving out important elements of an account and noting when the story is obfuscated, and asking careful questions to open up the dialogue.

Group therapy and play therapy
Although single-client sessions remain the norm, psychoanalytic theory has been used to develop other types of psychological treatment. Psychoanalytic group therapy was pioneered by Trigant Burrow, Joseph Pratt, Paul F. Schilder, Samuel R. Slavson, Harry Stack Sullivan, and Wolfe. Child-centered counseling for parents was instituted early in analytic history by Freud, and was later further developed by Irwin Marcus, Edith Schulhofer, and Gilbert Kliman. Psychoanalytically based couples therapy has been promulgated and explicated by Fred Sander, MD. Techniques and tools developed in the 2000s have made psychoanalysis available to patients who were not treatable by earlier techniques. This meant that the analytic situation was modified so that it would be more suitable and more likely to be helpful for these patients. M.N. Eagle (2007) believes that psychoanalysis cannot be a self-contained discipline but instead must be open to influence from and integration with findings and theory from other disciplines.

Psychoanalytic constructs have been adapted for use with children with treatments such as play therapy, art therapy, and storytelling. Throughout her career, from the 1920s through the 1970s, Anna Freud adapted psychoanalysis for children through play. This is still used today for children, especially those who are preadolescent (see Leon Hoffman, New York Psychoanalytic Institute Center for Children). Using toys and games, children are able to demonstrate, symbolically, their fears, fantasies, and defenses; although not identical, this technique, in children, is analogous to the aim of free association in adults. Psychoanalytic play therapy allows the child and analyst to understand children's conflicts, particularly defenses such as disobedience and withdrawal, that have been guarding against various unpleasant feelings and hostile wishes. In art therapy, the counselor may have a child draw a portrait and then tell a story about the portrait. The counselor watches for recurring themes—regardless of whether it is with art or toys.

Cultural variations
Psychoanalysis can be adapted to different cultures, as long as the therapist or counseling understands the client's culture. For example, Tori and Blimes found that defense mechanisms were valid in a normative sample of 2,624 Thais. The use of certain defense mechanisms was related to cultural values. For example Thais value calmness and collectiveness (because of Buddhist beliefs), so they were low on regressive emotionality. Psychoanalysis also applies because Freud used techniques that allowed him to get the subjective perceptions of his patients. He takes an objective approach by not facing his clients during his talk therapy sessions. He met with his patients wherever they were, such as when he used free association — where clients would say whatever came to mind without self-censorship. His treatments had little to no structure for most cultures, especially Asian cultures. Therefore, it is more likely that Freudian constructs will be used in structured therapy (Thompson, et al., 2004). In addition, Corey postulates that it will be necessary for a therapist to help clients develop a cultural identity as well as an ego identity.

Cost and length of treatment
The cost to the patient of psychoanalytic treatment ranges widely from place to place and between practitioners. Low-fee analysis is often available in a psychoanalytic training clinic and graduate schools. Otherwise, the fee set by each analyst varies with the analyst's training and experience. Since, in most locations in the United States, unlike in Ontario and Germany, classical analysis (which usually requires sessions three to five times per week) is not covered by health insurance, many analysts may negotiate their fees with patients whom they feel they can help, but who have financial difficulties. The modifications of analysis, which include dynamic therapy, brief therapies, and certain types of group therapy (cf. Slavson, S. R., A Textbook in Analytic Group Therapy), are carried out on a less frequent basis - usually once, twice, or three times a week - and usually the patient sits facing the therapist.

Many studies have also been done on briefer "dynamic" treatments; these are more expedient to measure, and shed light on the therapeutic process to some extent. Brief Relational Therapy (BRT), Brief Psychodynamic Therapy (BPT), and Time-Limited Dynamic Therapy (TLDP) limit treatment to 20-30 sessions. On average, classical analysis may last 5.7 years, but for phobias and depressions uncomplicated by ego deficits or object relations deficits, analysis may run for a shorter period of time. Longer analyses are indicated for those with more serious disturbances in object relations, more symptoms, and more ingrained character pathology (such as obnoxiousness, severe passivity, or heinous procrastination).

Training and research
Psychoanalytic training in the United States, in most locations, involves personal analytic treatment for the trainee, conducted confidentially, with no report to the Education Committee of the Analytic Training Institute; approximately 600 hours of class instruction, with a standard curriculum, over a four-year period. Classes are often a few hours per week, or for a full day or two every other weekend during the academic year; this varies with the institute; and supervision once per week, with a senior analyst, on each analytic treatment case the trainee has. The minimum number of cases varies between institutes, often two to four cases. Male and female cases are required. Supervision must go on for at least a few years on one or more cases. Supervision is done in the supervisor's office, where the trainee presents material from the analytic work that week, examines the unconscious conflicts with the supervisor, and learns, discusses, and is advised about technique.

Many psychoanalytic Training Centers in the United States have been accredited by special committees of the American Psychoanalytic Association or the International Psychoanalytical Association. Because of theoretical differences, other independent institutes arose, usually founded by psychologists, who until 1987 were not permitted access to psychoanalytic training institutes of the American Psychoanalytic Association. Currently there are between seventy-five and one hundred independent institutes in the United States. As well, other institutes are affiliated to other organizations such as the American Academy of Psychoanalysis and Dynamic Psychiatry, and the National Association for the Advancement of Psychoanalysis. At most psychoanalytic institutes in the United States, qualifications for entry include a terminal degree in a mental health field, such as Ph.D., Psy.D., M.S.W., or M.D. A few institutes restrict applicants to those already holding an M.D. or Ph.D., and most institutes in Southern California confer a Ph.D. or Psy.D. in psychoanalysis upon graduation, which involves completion of the necessary requirements for the state boards that confer that doctoral degree.

Some psychoanalytic training has been set up as a post-doctoral fellowship in university settings, such as at Duke University, Yale University, New York University, Adelphi University, and Columbia University. Other psychoanalytic institutes may not be directly associated with universities, but the faculty at those institutes usually hold contemporaneous faculty positions with psychology Ph.D. programs and/or with Medical School psychiatry residency programs.

The International Psychoanalytical Association (IPA) is the world's primary accrediting and regulatory body for psychoanalysis. Their mission is to assure the continued vigour and development of psychoanalysis for the benefit of psychoanalytic patients. It works in partnership with its 70 constituent organizations in 33 countries to support 11,500 members. In the US, there are 77 psychoanalytical organizations, institutes associations in the United States, which are spread across the states of America. The American Psychoanalytic Association (APSaA) has 38 affiliated societies, which have ten or more active members who practice in a given geographical area. The aims of the APSaA and other psychoanalytical organizations are: provide ongoing educational opportunities for its members, stimulate the development and research of psychoanalysis, provide training and organize conferences. There are eight affiliated study groups in the USA (two of them are in Latin America). A study group is the first level of integration of a psychoanalytical body within the International Psychoanalytic Association (IPA), followed by a provisional society and finally a member society.

The Division of Psychoanalysis (39) of the American Psychological Association (APA) was established in the early 1980s by several psychologists, principal among them were Ruben Fine, Ph.D., Robert C. Lane.Ph.D., Max Rosenbaum, Ph.D. Nathan Stockhamer, Ph.D, Helen Block Lewis,Ph.D. and George Goldman, Ph.D. Until the establishment of the Division of Psychoanalysis, psychologists who had trained in independent institutes had no national organization. The Division of Psychoanalysis now has approximately 4,000 members and approximately thirty local chapters in the United States. The Division of Psychoanalysis holds two annual meetings/conferences and offers continuing education in theory, research and clinical technique, as do their affiliated local chapters. The European Psychoanalytical Federation (EPF) is the scientific organization that consolidates all European psychoanalytic societies. This organization is affiliated with the IPA. In 2002 there were approximately 3900 individual members in twenty-two countries, speaking eighteen different languages. There are also twenty-five psychoanalytic societies.

History of training
Psychoanalysis was limited to those "in the know" from the early 1920s (when A.A. Brill began the New York Psychoanalytic Institute) through the end of World War II, although the idea that repression of sexual urges could make you mentally ill (Freud's first, discarded theory) proved popular with college students in the 1920s – who used the theory to argue with their conservative parents. During those early years, Andrew Carnegie was perhaps one of the most famous patients who benefited; he later made his gratitude public by endowing a psychoanalytic fund in Pittsburgh.

Psychoanalysis became popular post-war, as many celebrities found it useful – such as Steve Allen, Jayne Meadows, and Art Buchwald. Psychoanalytic treatment became somewhat less popular during the 1980s and early 1990s. Circa 1986, when insurance companies decimated health insurance coverage for all mental illnesses people for whom psychoanalytic treatment was indicated were increasingly unable to afford it. Gradually, as psychiatry departments became more dependent on grants from pharmaceutical companies, chairs of Psychiatry Departments in the nation's medical schools tended to come from backgrounds involving pharmacological research – not from backgrounds involving analytic training. Interestingly, psychoanalytic institutes have experienced an increase in the number of applicants in recent years, but, not surprisingly, about 70-80% of incoming students are non-MDs.


Psychoanalysis in Britain
The London Psychoanalytical Society was founded by Ernest Jones on 30th October 1913. With the expansion of psychoanalysis in the United Kingdom the Society was renamed the [British Psychoanalytical Society] in 1919. Soon after, the Institute of Psychoanalysis was established to administer the Society’s activities. These include: the training of psychoanalysts, the development of the theory and practice of psychoanalysis, the provision of treatment through The London Clinic of Psychoanalysis, the publication of books in the The New Library of Psychoanalysis and Psychoanalytic Ideas. The Institute of Psychoanalysis also publishes The International Journal of Psychoanalysis, maintains a library, furthers research, and holds public lectures. The Society has a Code of Ethics and an Ethical Committee. The Society, the Institute and the Clinic are all located at Byron House.

The Society is a component of the International Psychoanalytical Association, a body with members on all five continents that safeguards professional and ethical practice. The Society is a member of the British Psychoanalytic Council (BPC); the BPC publishes a register of British psychoanalysts and psychoanalytical psychotherapists. All members of the British Psychoanalytical Society are required to undertake continuing professional development.

Through its work – and the work of its individual members – the British Psychoanalytical Society has made an unrivalled contribution the understanding and treatment of mental illness. Members of the Society have included Michael Balint, Wilfred Bion, John Bowlby, Anna Freud, Melanie Klein, Joseph Sandler, and Donald Winnicott.

The [Institute of Psychoanalysis] is the foremost publisher of psychoanalytic literature. The 24-volume Standard Edition of the Complete Psychological Works of Sigmund Freud was conceived, translated, and produced under the direction of the British Psychoanalytical Society. The Society, in conjunction with Random House, will soon publish a new, revised and expanded Standard Edition. With [The New Library of Psychoanalysis] the Institute continues to publish the books of leading theorists and practitioners. [The International Journal of Psychoanalysis] is published by the Institute of Psychoanalysis. Now in its 84th year, it has one of the largest circulation of any psychoanalytic journal.

Over a hundred years of case reports and studies in the journal Modern Psychoanalysis, the Psychoanalytic Quarterly, the International Journal of Psychoanalysis and the Journal of the American Psychoanalytic Association have analyzed efficacy of analysis in cases of neurosis and character or personality problems. Psychoanalysis modified by object relations techniques has been shown to be effective in many cases of ingrained problems of intimacy and relationship (cf. the many books of Otto Kernberg). As a therapeutic treatment, psychoanalytic techniques may be useful in a one-session consultation. Psychoanalytic treatment, in other situations, may run from about a year to many years, depending on the severity and complexity of the pathology.

Psychoanalytic theory has, from its inception, been the subject of criticism and controversy. Freud remarked on this early in his career, when other physicians in Vienna ostracized him for his findings that hysterical conversion symptoms were not limited to women. Challenges to analytic theory began with Otto Rank and Adler (turn of the 20th century), continued with behaviorists (e.g. Wolpe) into the 1940s and '50s, and have persisted. Criticisms come from those who object to the notion that there are mechanisms, thoughts or feelings in the mind that could be unconscious. Criticisms also have been leveled against the discovery of "infantile sexuality" (the recognition that children between ages two and six imagine things about procreation). Criticisms of theory have led to variations in analytic theories, such as the work of Fairbairn, Balint, and Bowlby. In the past 30 years or so, the criticisms have centered on the issue of empirical verification, in spite of many empirical, prospective research studies that have been empirically validated (e.g., See the studies of Barbara Milrod, at Cornell University Medical School, et al.).

Psychoanalysis has been used as a research tool into childhood development (cf. the journal The Psychoanalytic Study of the Child), and has developed into a flexible, effective treatment for certain mental disturbances. In the 1960s, Freud's early (1905) thoughts on the childhood development of female sexuality were challenged; this challenge led to major research in the 1970s and 80s, and then to a reformulation of female sexual development that corrected some of Freud's concepts.

A 2005 review of randomized controlled trials found that "psychoanalytic therapy is (1) more effective than no treatment or treatment as usual, and (2) more effective than shorter forms of psychodynamic therapy". Empirical research on the efficacy of psychoanalysis and psychoanalytic psychotherapy has also become prominent among psychoanalytic researchers.

Research on psychodynamic treatment of some populations shows mixed results. Research by analysts such as Bertram Karon and colleagues at Michigan State University had suggested that when trained properly, psychodynamic therapists can be effective with schizophrenic patients. More recent research casts doubt on these claims. The Schizophrenia Patient Outcomes Research Team (PORT) report argues in its Recommendation 22 against the use of psychodynamic therapy in cases of schizophrenia, noting that more trials are necessary to verify its effectiveness. However, the PORT recommendation is based on the opinions of clinicians rather than on empirical data, and empirical data exist that contradict this recommendation (link to abstract).

A review of current medical literature in The Cochrane Library, (the updated abstract of which is available online) reached the conclusion that no data exist that demonstrate that psychodynamic psychotherapy is effective in treating schizophrenia. Dr. Hyman Spotnitz and the practitioners of his theory known as Modern Psychoanalysis, a specific sub-specialty, still report (2007) much success in using their enhanced version of psychoanalytic technique in the treatment of schizophrenia. Further data also suggest that psychoanalysis is not effective (and possibly even detrimental) in the treatment of sex offenders. Experiences of psychoanalysts and psychoanalytic psychotherapists and research into infant and child development have led to new insights. Theories have been further developed and the results of empirical research are now more integrated in the psychoanalytic theory.

There are different forms of psychoanalysis and psychotherapies in which psychoanalytic thinking is practiced. Besides classical psychoanalysis there is for example psychoanalytic psychotherapy. Other examples of well known therapies which also use insights of psychoanalysis are Mentalization-Based Treatment (MBT), and Transference-Focused Psychotherapy (TFP). There is also a continuing influence of psychoanalytic thinking in different settings in the mental health care. To give an example: in the psychotherapeutic training in the Netherlands, psychoanalytic and system therapeutic theories, drafts, and techniques are combined and integrated. Other psychoanalytic schools include the Kleinian, Lacanian, and Winnicottian schools.



This article may contain too much repetition or redundant language. Please help improve it to fix this issue. (December 2007)
This article's Criticism or Controversy section(s) may mean the article does not present a neutral point of view of the subject. It may be better to integrate the material in those sections into the article as a whole.

Exchanges between critics and defenders of psychoanalysis have often been so heated that they have come to be characterized as the Freud Wars. Popper argued that psychoanalysis is a pseudoscience because its claims are not testable and cannot be refuted; that is, they are not falsifiable. For example, if a client's reaction was not consistent with the psychosexual theory then an alternate explanation would be given (e.g. defense mechanisms, reaction formation). Karl Kraus, an Austrian satirist, was the subject of a book written by noted libertarian author Thomas Szasz. The book Anti-Freud: Karl Kraus's Criticism of Psychoanalysis and Psychiatry, originally published under the name Karl Kraus and the Soul Doctors, portrayed Kraus as a harsh critic of Sigmund Freud and of psychoanalysis in general. Other commentators, such as Edward Timms, author of Karl Kraus - Apocalyptic Satirist, have argued that Kraus respected Freud, though with reservations about the application of some of his theories, and that his views were far less black-and-white than Szasz suggests.

Grünbaum argues that psychoanalytic based theories are falsifiable, but that the causal claims of psychoanalysis are unsupported by the available clinical evidence. Other schools of psychology have produced alternative methods for psychotherapy, including behavior therapy, cognitive therapy, Gestalt therapy and person-centered psychotherapy. Hans Eysenck determined that improvement was no greater than spontaneous remission. Between two-thirds and three-fourths of “neurotics” would recover naturally; this was no different from therapy clients. Prioleau, Murdock, Brody reviewed several therapy-outcome studies and determined that psychotherapy is not different from placebo controls.

Michel Foucault and Gilles Deleuze, as a sociological analysis without meaning to criticize, claimed that the institution of psychoanalysis has become a center of power and that its confessional techniques resemble the Christian tradition. Strong criticism of certain forms of psychoanalysis is offered by psychoanalytical theorists. Jacques Lacan criticized the emphasis of some American and British psychoanalytical traditions on what he has viewed as the suggestion of imaginary "causes" for symptoms, and recommended the return to Freud. Together with Gilles Deleuze, Felix Guattari criticised the Oedipal structure. Luce Irigaray criticised psychoanalysis, employing Jacques Derrida's concept of phallogocentrism to describe the exclusion of the woman from Freudian and Lacanian psychoanalytical theories.

Due to the wide variety of psychoanalytic theories, varying schools of psychoanalysis often internally criticize each other. One consequence is that some critics offer criticism of specific ideas present only in one or more theories, rather than in all of psychoanalysis while not rejecting other premises of psychoanalysis. Defenders of psychoanalysis argue that many critics (such as feminist critics of Freud) have attempted to offer criticisms of psychoanalysis that were in fact only criticisms of specific ideas present only in one or more theories, rather than in all of psychoanalysis. As the psychoanalytic researcher Drew Westen puts it, "Critics have typically focused on a version of psychoanalytic theory—circa 1920 at best—that few contemporary analysts find compelling. In so doing, however, they have set the terms of the public debate and have led many analysts, I believe mistakenly, down an indefensible path of trying to defend a 75 to 100-year-old version of a theory and therapy that has changed substantially since Freud laid its foundations at the turn of the century." A further consideration with respect to cost is that in circumstances when lower cost treatment is provided to the patient as the analyst is funded by the government, then psychoanalytic treatment occurs at the expense other forms of more effective treatment.

Freud's psychoanalysis was criticized by his wife, Martha. René Laforgue reported Martha Freud saying, "I must admit that if I did not realize how seriously my husband takes his treatments, I should think that psychoanalysis is a form of pornography." To Martha there was something vulgar about psychoanalysis, and she dissociated herself from it. According to Marie Bonaparte, Martha was upset with her husband's work and his treatment of sexuality.

Charges of fascism
Deleuze and Guattari, in their 1972 work Anti-Œdipus, take the cases of Gérard Mendel, Bela Grunberger and Janine Chasseguet-Smirgel, prominent members of the most respected associations (IPa), to show how traditionally psychoanalysis enthusiastically embraces a police state:

“ As to those who refuse to be oedipalized in one form or another, at one end or the other in the treatment, the psychoanalyst is there to call the asylum or the police for help. The police on our side!—never did psychoanalysis better display its taste for supporting the movement of social repression, and for participating in it with enthusiasm. [...] notice of the dominant tone in the most respected associations: consider Dr. Mendel and the Drs Stéphane, the state of fury that is theirs, and their literally police-like appeal at the thought that someone might try to escape the Oedipal dragnet. Oedipus is one of those things that becomes all the more dangerous the less people believe in it; then the cops are there to replace the high priests. ”

Dr. Bela Grunberger and Dr. Janine Chasseguet-Smirgel were two psychoanalysts from the Paris section of the International Psychoanalytical Association (IPa). In November 1968, disguising themselves under the pseudonym André Stéphane, they published L’univers Contestationnaire, in which they assumed that the left-wing rioters of May 68 were totalitarian stalinists, and psychoanalyzed them saying that they were affected by a sordid infantilism caught up in an Oedipal revolt against the Father.

Noteably Lacan, mentioned this book with great disdain. While Grunberger and Chasseguet-Smirgel were still disguised under the pseudonym, Lacan remarked that for sure none of the authors belonged to his school, as none would abase themselves to such low drivel. The IPa analysts responded accusing the Lacan school of "intellectual terrorism". Gérard Mendel, had instead pubblished La révolte contre le père (1968) and Pour décoloniser l’enfant (1971).

Scientific criticism
Early critics of psychoanalysis believed that its theories were based too little on quantitative and experimental research, and too much on the clinical case study method. Some even accused Freud of fabrication, most famously in the case of Anna O. (Borch-Jacobsen 1996). An increasing amount of empirical research from academic psychologists and psychiatrists has begun to address this criticism. A survey of scientific research suggested that while personality traits corresponding to Freud's oral, anal, Oedipal, and genital phases can be observed, they do not necessarily manifest as stages in the development of children. These studies also have not confirmed that such traits in adults result from childhood experiences (Fisher & Greenberg, 1977, p. 399). However, these stages should not be viewed as crucial to modern psychoanalysis. What is crucial to modern psychoanalytic theory and practice is the power of the unconscious and the transference phenomenon.

The idea of "unconscious" is contested because human behavior can be observed while human psychology has to be guessed at. However, the unconscious is now a popular topic of study in the fields of experimental and social psychology (e.g., implicit attitude measures, fMRI, and PET scans, and other indirect tests). One would be hard pressed to find scientists who still think of the mind as a "black box". Currently, the field of psychology embraces the study of things outside one's awareness. Even strict behaviorists acknowledge that a vast amount of classical conditioning is at least subconscious and that this has profound effects on our emotional life. The idea of unconscious, and the transference phenomenon, have been widely researched and, it is claimed, validated in the fields of cognitive psychology and social psychology (Westen & Gabbard 2002), though such claims are also contested. Recent developments in neuroscience have resulted in one side arguing that it has provided a biological basis for unconscious emotional processing in line with psychoanalytic theory i.e., neuropsychoanalysis (Westen & Gabbard 2002), while the other side argues that such findings make psychoanalytic theory obsolete and irrelevant.

E. Fuller Torrey, writing in Witchdoctors and Psychiatrists (1986), stated that psychoanalytic theories have no more scientific basis than the theories of traditional native healers, "witchdoctors" or modern "cult" alternatives such as est. Some scientists regard psychoanalysis as a pseudoscience (Cioffi, 1998). Among philosophers, Karl Popper argued that Freud's theory of the unconscious was not falsifiable and therefore not scientific. Popper did not object to the idea that some mental processes could be unconscious but to investigations of the mind that were not falsifiable. In other words, if it were possible to connect every conceivable experimental outcome with Freud's theory of the unconscious mind, then no experiment could refute the theory.

Some proponents of psychoanalysis suggest that its concepts and theories are more akin to those found in the humanities than those proper to the physical and biological/medical sciences, though Freud himself tried to base his clinical formulations on a hypothetical neurophysiology of energy transformations. For example, the philosopher Paul Ricoeur argued that psychoanalysis can be considered a type of textual interpretation or hermeneutics. Like cultural critics and literary scholars, Ricoeur contended, psychoanalysts spend their time interpreting the nuances of language — the language of their patients. Ricoeur claimed that psychoanalysis emphasizes the polyvocal or many-voiced qualities of language, focusing on utterances that mean more than one thing. Ricoeur classified psychoanalysis as a hermeneutics of suspicion. By this he meant that psychoanalysis searches for deception in language, and thereby destabilizes our usual reliance on clear, obvious meanings. Despite criticism regarding the validity of psychoanalytic therapeutic technique, numerous outcome studies have shown that its efficacy is equal to that of other mainstream therapy modalities such as cognitive-behavioral therapy, while a french 2004 report from INSERM says instead, that psychoanalysis therapy is far less effective than other psychotherapies(among which Cognitive behavioral therapy).

Theoretical criticism
Some theoretical criticism of psychoanalysis is based on the argument that it is over simplistic and reductive, because it reduces everything to the idea that we are all driven by our sexuality and does not take into consideration other factors. For example: class, political ideology, ecosystem or even spirituality. People like the Marxist-Freudian Wilhelm Reich redress this, as does Carl Gustav Jung by factoring in economic and political factors (such as relationship to the means of production in the case of Reich), culture and ideas like the paranormal in the case of Jung respectively. However, there is no clean break between the theories of Freud and Jung. For example, Jung's theories on alchemy as externalised individuation were rooted in Freud's ideas on projection but factored in culture and spiritual teachings. Psychoanalysts have often complained about the significant lack of theoretical agreement among analysts of different schools. Many authors have attempted to integrate the various theories, with limited success. However, with the publication of the Psychodynamic Diagnostic Manual much of this lack of cohesion has been resolved.

Jacques Derrida incorporated aspects of psychoanalytic theory into deconstruction in order to question what he called the 'metaphysics of presence'. Freud's insistence, in the first chapter of The Ego and the Id, that philosophers will recoil from his theory of the unconscious is clearly a forbear to Derrida's understanding of metaphysical 'self-presence'. Derrida also turns some of these ideas against Freud, to reveal tensions and contradictions in his work. These tensions are the conditions upon which Freud's work can operate. For example, although Freud defines religion and metaphysics as displacements of the identification with the father in the resolution of the Oedipal complex, Derrida insists in The Postcard: From Socrates to Freud and Beyond that the prominence of the father in Freud's own analysis is itself indebted to the prominence given to the father in Western metaphysics and theology since Plato. Thus Derrida thinks that even though Freud remains within a theologico-metaphysical tradition[citation needed] of 'phallologocentrism', Freud nonetheless criticizes that tradition.

The purpose of Derrida's analysis is not to refute Freud, which would only reaffirm traditional metaphysics[why?], but to reveal an undecidability at the heart of his project. This deconstruction of Freud casts doubt upon the possibility of delimiting psychoanalysis as a rigorous science. Yet it celebrates the side of Freud which emphasises the open-ended and improvisatory nature of psychoanalysis, and its methodical and ethical demand that the testimony of the analysand should be given prominence in the practice of analysis. Psychoanalysis, or at least the dominant version of it, has been denounced as patriarchal or phallocentric by some proponents of feminist theory. Other feminist scholars have argued that Freud opened up society to female sexuality.

Some post-colonialists argue that psychoanalysis imposes a white, European model of human development on those without European heritage, hence they will argue Freud's theories are a form or instrument of intellectual imperialism.


Psychosexual development

Freud Sofa aufgenommen im Freud-Museum London

The concept of psychosexual development, as envisioned by Sigmund Freud at the end of the nineteenth and the beginning of the twentieth century, is a central element in his sexual drive theory, which posits that, from birth, humans have instinctual sexual appetites (libido) which unfold in a series of stages. Each stage is characterized by the erogenous zone that is the source of the libidinal drive during that stage. These stages are, in order: oral, anal, phallic, latency, and genital. Freud believed that if, during any stage, the child experienced anxiety in relation to that drive, that themes related to this stage would persist into adulthood as neurosis.


Freud observed that, at somewhat predictable points during early development, children's behavior often orients around certain body parts (the mouth during breast-feeding, the anus during Toilet-training, and later the genitals). Believing, due to his previous work with hysterical patients, that adult neurosis often has root in childhood sexuality, Freud proposed that these behaviors were childhood expressions of sexual fantasy and desire. He suggested that humans are born "polymorphously perverse", meaning that infants can derive sexual pleasure from any part of the body, and that it is only through socialization that libidinal drives are focused into adult heterosexuality.

Due to the fairly predictable time-line that the childhood behaviors in question follow, Freud developed a model for what he considered to be the "normal" sexual development of the child, which he called "libido development". According to this theory, each child passes through five psychosexual stages. During each stage, the libido has a different erogenous zone as the source of its drives. The libido refers to various kinds of sensual pleasures and gratifications.

However, in the pursuit of satisfying these sexual urges, the child may experience failure or reprimands from its parents or society and may thus come to associate anxiety with this erogenous zone. In order to avoid this anxiety, the child becomes preoccupied with themes related to this zone, a phenomenon Freud termed fixation. Freud believed the fixation persists into adulthood and underlies the personality structure and psychopathology, including neurosis, hysteria and personality disorders. Freud called this psychosexual infantilism.

Freud's model of psychosexual development

Stage Age Range Erogenous zone(s) Consequences of Fixation
Oral 0-1 years Mouth Orally aggressive: Signs include chewing gum or ends of pens.
Orally Passive: Signs include smoking/eating/kissing/fellatio/cunnilingus
Fixation at this stage may result in passivity, gullibility, immaturity and manipulative personality
Anal 2-3 years Bowel and bladder elimination Anal retentive: Obsession with organization or excessive neatness
Anal expulsive: Reckless, careless, defiant, disorganized, Coprophiliac
Phallic 4-6 years Genitals Oedipus complex (in boys only according to Freud)

Electra complex (in girls only, later developed by Carl Jung)

Latency 7-10 years (until puberty) Dormant sexual feelings (People do not tend to fixate at this stage, but if they do, they tend to be extremely sexually unfulfilled.)
Genital 11+ years (Puberty and beyond) Sexual interests mature Frigidity, impotence, unsatisfactory relationships

Oral phase
The first stage of psychosexual development is the oral stage, which lasts from the beginning of one’s life up to 1 year. During this stage, the focus of gratification is on the mouth and pleasure is the result of nursing, but also of exploration of the surroundings (as infants tend to put new objects in their mouths). In this stage the Id is dominant since neither the ego nor the super ego is yet fully formed. Thus the baby does not have a sense of self and all actions are based on the pleasure principle.

The ego, however, is under formation during this first stage. There are two factors that contribute to the formation of the ego. Firstly, body image is developed, which implies that the infant recognizes that the body is distinct from the outer world. For instance, one will start understanding that one feels pain only when force is applied on one’s own body. By the identification of the body boundaries, one starts developing the sense of ego. A second factor to which ego formation is attributed is experiences involving delay of gratification and leads to the understanding that specific behaviors can satisfy some needs. The infant gradually realises that gratification is not immediate and that it has to produce certain behaviors to initiate actions that lead to gratification. An example of such behavior is crying, which seems to be purposeless during the first 2 months of the baby’s life, but later seems to be used productively and is connected to certain needs. (Leach 1997)

The key experience in this stage is weaning, during which the child loses much of the intimate contact with the mother and leads to the first feeling of loss ever experienced by the baby. Weaning also adds to the baby’s awareness of self, since it learns that not everything is under its control, but also that gratification is not always immediate.

In this stage, the gratification of needs will lead to the formation of independence (since the baby forms a clear idea about the limits of the self and has formed its ego), and trust (since the baby learned that specific behaviors will lead to gratification). On the other hand, a fixation can lead to passivity, gullibility, immaturity and unrealistic optimism, and also to the formation of a generally manipulative personality due to improper formation of the ego. This can be the result of either too much or too little gratification. In the case of too much gratification, the child does not learn that not everything is under its control and that gratification is not always immediate (which are the results of weaning), forming an immature personality. On the other hand, the child’s needs may be insufficiently met, and thus the child becomes passive since it has learned that whether it produces behavior or not, no gratification will come. In some societies it is common for a child to be nursed by its mother for several years, whereas in others the stage is much shorter. Sucking and eating, however, compose the earliest memories for infants in every society. This stage holds special importance because some tribal societies commonly found in the Southwest Pacific and Africa, consider the stomach to be the seat of emotions.

Anal phase
In the anal stage of the psychosexual development the focus of drive energy (erogenous zone) moves from the upper digestive tract to the lower end and the anus. This stage lasts from about the 15th month to the third year of age. In this stage, the formation of ego continues.

According to the theory, the major experience during this stage is toilet training. This occurs around the age of two (there may be fluctuations among different societies as to the age in which toilet training occurs), and results to conflict between the id, which asks for immediate gratification of its drives that involves elimination and activities related to it (such as handling fæces) and the demands of their parents. The resolution of this conflict can be gradual and non-traumatic, or intense and stormy, depending on the methods the parents will use to handle the situation. The ideal resolution will come if the child tries to adjust and the parents are moderate, so that the child will learn the importance of cleanliness and order gradually, which will lead to a self-controlled adult. If the parents put too much emphasis on toilet training while the child decides to accommodate, this may lead to the development of compulsive personality, extensively concerned about order and neatness. On the other hand, if the child decides to heed the demands of the id and the parents give in, the child may develop a messy and self-indulgent personality. If the parents react, the child will have to comply, but it will develop a weakened sense of self, since the parents were the ones who controlled the situation, not the ego.


Phallic phase
The phallic stage extends from about three to five years of age, and the erogenous zone associated with it as the area of the genitals. Even though the gratification is focused on the genitals, this is not in the form of adult sexuality, since the children are physically immature. However, stimulation of genitals is welcomed as pleasurable and boys, like adult males, may have erections during their sleep. Children become increasingly aware of their body and are curious about the bodies of other children, but also their parents. Freud observed that children of this age can very often be observed taking off their clothes and playing “doctor” with each other, or asking their mothers whether she has a penis. These observations persuaded Freud that the gratification is focused on and around the genitals during this period.

The major conflict of this stage is called Oedipal conflict, the name deriving from Oedipus, who killed his father and unintentionally slept with his mother. Freud used the term Oedipal for both sexes, but other analysts proposed the female variant to be referred to as "Electra complex". In the beginning, for both sexes the primary care giver (at least in most societies) and main source of gratification is the mother. As the child develops, however, it starts forming a sexual identity and the dynamics for boys and girls alter. For both sexes, the parents become the focus of drive energy.

For the boy, the mother becomes more desired, while the father is the focus of jealousy and rivalry, since he is the one who sleeps with the mother, but still he is one of the main caregivers. The id wants to unite with the mother and kill the father (like Oedipus did), but the ego, based on the reality principle, knows that the father is stronger. The child also feels affectionate towards the father, one of the caregivers, and his feelings are ambivalent. The fear that the father will object to the boy’s feelings is expressed by the id as fear that the father will castrate him. The castration fear is not rational, and occurs in a subconscious irrational level.

Freud argued that young girls followed more or less the same psychosexual development as boys. Whereas the boy would develop a castration anxiety , the girl would go on to develop penis envy, envy felt by females toward the males because the males possess a penis. The envy is rooted in the fact that without a penis, the female cannot sexually possess the mother as driven to by the Id. As a result of this realization, she is driven to desire sexual union with the father. After this stage, the woman has an extra stage in her development when the clitoris should wholly or in part hand over its sensitivity and its importance to the vagina. The young girl must also at some point give up her first object-choice, the mother, in order to take the father as her new proper object-choice. Her eventual move into heterosexual femininity, which culminates in giving birth, grows out of her earlier infantile desires, with her own child taking place of the penis in accordance with an ancient symbolic equivalence. Generally, Freud considered the Oedipal conflict experienced by girls more intense than that experienced by boys, potentially resulting in a more submissive and less confident personality.

In both cases the conflict between the id drives and the ego is resolved through two basic defence mechanisms of the ego. One of them is repression, which involves the blocking of memories, impulses and ideas from the conscious mind, but does not lead to resolution of the conflict. The second is identification, which involves incorporation of characteristics of the same-sex parent into the child’s own ego. The boy by adopting this mechanism seeks for the reduction of castration fears, since his similarity with the father is thought to protect the boy from him. The identification of girls with the mother is easier, since the girl realizes that neither she, nor her mother have a penis. Freud's theory regarding the psychosexual dynamic present in female children in this point of their psychosexual development is termed, though not by Freud himself, the Electra complex. Freud's theory of feminine sexuality, particularly penis envy, has been sharply criticized in both gender theory and feminist theory.

If the conflict is not resolved, a fixation in this stage may lead to adult women striving for superiority over men, if she had overwhelming feelings of devastation due to lack of penis, being seductive and flirtatious, or very submissive and with low self-esteem. On the other hand, men can exhibit excessive ambition and vanity. Overall, the Oedipal conflict is very important for the super-ego development, since by identifying with one of the parents, morality becomes internalized, and compliance with rules is not any more the result of punishment fear. A poor identification with the opposite sex parent may lead to recklessness or even immorality.

Latency phase
The latency stage is typified by a solidifying of the habits that the child developed in the earlier stages. Whether the Oedipal conflict is successfully resolved or not, the drives of the id are not accessible to the ego during this stage of development, since they have been repressed during the phallic stage. Hence the drives are seen as dormant and hidden (latent), and the gratification the child receives is not as immediate as it was during the three previous stages. Now pleasure is mostly related to secondary process thinking. Drive energy is redirected to new activities, mainly related to schooling, hobbies and friends. Problems however might occur during this stage, and this is attributed to inadequate repression of the Oedipal conflict, or to the inability of the ego to redirect the drive energy to activities accepted by the social environment.

Genital phases
The fifth and last stage of psychosexual development, the genital stage, lasts from puberty, about the twelfth year of age, and onwards. It actually continues until development stops,[citation needed] which is ideally in the eighteenth year of age,[citation needed] when adulthood starts. This stage represents the major portion of life, and the basic task for the individual is the detachment from the parents. It is also the time when the individual tries to come in terms with unresolved residues of the early childhood. In this stage the focus is again on the genitals, like in the phallic stage, but this time the energy is expressed with adult sexuality. Another crucial difference between these two stages is that, while in the phallic gratification is linked with satisfaction of the primary drives, the ego in the genital stage is well-developed, and so uses secondary process thinking, which allows symbolic gratification. The symbolic gratification may include the formation of love relationships and families, or acceptance of responsibilities associated with adulthood.

Criticism of Freud's theory of psychosexual development

Scientific critique
A common scientific criticism regarding Freudian theory of human psychosexual development is that Freud was personally overly fixated on human sexuality himself, which may have served to subjectively bias his work in favor of defining human development solely upon normative human sexual development. It is possible that said fixation regarding human sexuality could have negatively influenced Freud in manners that may have led to him ignoring other significant variables that contribute to human's psychosexual development, such as hormonal and pheromonal activity. The stage that has caused the most controversy is the phallic stage. Freud supported his assertions on the Oedipal Complex with a series of clinical observations. In 1909, he published a case study of a boy called “little Hans”, who had a phobia of horses. Freud connected Hans’ fear for horses to his fear for his father. Hans's fear and anxiety were thought to be the result of various factors, including the birth of his sister, the desire of his id to replace his father as his mother's companion and conflicts over masturbation. Hans admitted his want to have children with his mother, which was considered an adequate proof for patient’s sexual attraction for the opposite-sex parent. Little Hans, however, was unable to connect the fear for the horses with his father, and, as Freud admitted, “Hans had to be told many things that he could not say himself” and that “he had to be presented with thoughts which he had so far shown no signs of possessing”, so that one may suggest that Freud manipulated the patients’s mind.

Scientifically minded researchers have criticized Freud's statement, in his 1914 paper, "On Narcissism," that "It is impossible to suppose that a unity comparable to the ego can exist in the individual from the very start". Ample evidence documents a functioning ego in infants, even in neonates, contrary to Freud's speculation. The neonate shows surprising ability to track moving targets, to differentiate a familiar from an unfamiliar stimulus, and to react meaningfully with the care giver. Further, children show signs of superego behaviour earlier than Freud's suggestion that it does not arise until after the Oedipal Complex has been resolved.

Cultural considerations have largely influenced the assumptions within the psychodynamic perspective. Freud stated that the Oedipal Complex is universal and essential for development. Bronislaw Malinowski, an anthropologist who studied the behaviour of villagers in the Trobriand Islands, challenged common western views such as Freud's Oedipus complex and their claim to universality. In the Trobriand society the boys are disciplined by their mothers’ brothers instead of their biological fathers (avunclular society). As he recounts in his work, Sex and Repression in Savage Society (1927), Malinowski found that boys had dreams in which the target of fears was not their father, but their uncle. Based on this observation, Malinowski argued that power, not sexual jealousy, is the base for the oedipal tension. As a result, Segall et al. hypothesised that Freud’s theory was based on a misinterpretation of a confounding variable.

A survey of scientific research showed that while personality traits corresponding to Freud's oral, anal, Oedipal, and genital phases can be observed, they cannot be observed as stages in the development of children, nor can it be confirmed that such traits in adults result from childhood experiences (Fisher & Greenberg, 1977, p. 399).

Feminist critique
Despite their popularity among psychoanalytical psychologists, Freud's psychosexual theories are commonly criticized as being sexist. Freud's theories were often informed by his own introspection and self-analysis, and thus were infused with an inherently male perspective, resulting in a great deal of criticism from feminists as well as from gender theory practitioners. He had difficulty incorporating female desire into his theories and attempted to provide a theoretical explanation for feminine psychosexual development only rather late in his career. Freud personally confessed a lack of understanding of female sexuality and did not hold out hope that psychology would ever explain the phenomenon.

For example, Freud stated that young females develop "penis envy" toward the males during their psychosexual development. In response, Karen Horney, a German Freudian psychoanalyst, argued that young females develop "power envy" instead of "penis envy" toward the male. She also suggested the concept of "womb envy" in males, which is defined as jealousy of ability to bear children. However, more modern formulations consider this as an envy of the perceived right of women to be nurturing.



Libido in its common usage means sexual desire; however, more technical definitions, such as those found in the work of Carl Jung, are more general, referring to libido as the free creative—or psychic—energy an individual has to put toward personal development or individuation.

History of the concept
Sigmund Freud popularized the term and defined libido as the instinct energy or force, contained in what Freud called the id, the largely unconscious structure of the psyche. Freud pointed out that these libidinal drives can conflict with the conventions of civilized behavior, represented in the psyche by the superego. It is this need to conform to society and control the libido that leads to tension and disturbance in the individual, prompting the use of ego defenses to dissipate the psychic energy of these unmet and mostly unconscious needs into other forms. Excessive use of ego defenses results in neurosis. A primary goal of psychoanalysis is to bring the drives of the id into consciousness, allowing them to be met directly and thus reducing the patient's reliance on ego defenses.

According to Swiss psychiatrist Carl Gustav Jung, the libido is identified as psychic energy. Duality (opposition) that creates the energy (or libido) of the psyche, which Jung asserts expresses itself only through symbols: "It is the energy that manifests itself in the life process and is perceived subjectively as striving and desire." (Ellenberger, 697)

Defined more narrowly, libido also refers to an individual's urge to engage in sexual activity. In this sense, the antonym of libido is destrudo.[citation needed]

Libido impairment
Sexual desire can be impaired or reduced. It also may be weak or not be present at all, such as in occurrences of asexuality. Factors of reduced libido can be both psychological and physical. Absence of libido may or may not correlate with infertility or impotence.

Psychological factors
Reduction in libido can occur from psychological causes such as loss of privacy and/or intimacy, stress, distraction or depression. It may also derive from the presence of environmental stressors such as prolonged exposure to elevated sound levels or bright light. Other causes include:

stress or fatigue
childhood sexual abuse, assault, trauma, or neglect
body image issues
sexual performance anxiety

Physical factors
Physical factors that can affect libido include: endocrine issues such as hypothyroidism, levels of available testosterone in the bloodstream of both women and men, the effect of certain prescription medications (for example proscar (a.k.a. finasteride) or minoxidil), various lifestyle factors and the attractiveness and biological fitness of one's partner. Inborn lack of sexual desire, often observed in asexual people, can also be considered a physical factor.

Being very underweight, severely obese, or malnourished can cause a low libido due to disruptions in normal hormonal levels. There is also evidence to support that specific foods have an effect on libido.

Reduced libido is also often iatrogenic and can be caused by many medications, such as hormonal contraception, SSRIs and other antidepressants, antipsychotics, opioids and beta blockers. In some cases iatrogenic impotence or other sexual dysfunction can be permanent, as in PSSD.

Testosterone is one of the hormones controlling libido in human beings. Emerging research is showing that hormonal contraception methods like "the pill" (which rely on estrogen and progesterone together) are causing low libido in females by elevating levels of Sex hormone binding globulin (SHBG). SHBG binds to sex hormones, including testosterone, rendering them unavailable. Research is showing that even after ending a hormonal contraceptive method, SHBG levels remain elevated and no reliable data exists to predict when this phenomenon will diminish. Some[who?] question whether "the pill" and other hormonal methods (Depo-Provera, Norplant, etc) have permanently altered gene expression by epigenetic mechanisms.

Left untreated, with low testosterone levels will experience loss of libido which in turn can often cause relationship stress, and loss of bone and muscle mass throughout their lives.

Conversely, increased androgen steroids (e.g. testosterone) generally have a positive correlation with libido in both sexes.

Menstrual cycle
Women's libido is correlated to their menstrual cycle. Many women experience heightened sexual desire in the several days immediately before ovulation.

Other causes of low libido include not getting enough sleep, unresolved conflicts within the relationship, and suboptimal amounts of testosterone in the body


Kinsey & Masters and Johnson

In the late 1940s and early 1950s, Alfred C. Kinsey published two surveys of modern sexual behaviour. In 1948, Alfred C. Kinsey and his co-workers, responding to a request by female students at Indiana University for more information on human sexual behaviour, published the book Sexual behaviour in the Human Male. They followed this five years later with Sexual behaviour in the Human Female. These books began a revolution in social awareness of, and public attention given to, human sexuality.

It is said that at the time, public morality severely restricted open discussion of sexuality as a human characteristic, and specific sexual practices, especially sexual behaviours that did not lead to procreation. Kinsey's books contained studies about controversial topics such as the frequency of homosexuality, and the sexuality of minors ages two weeks to thirteen years. Scientists working for Kinsey reported data which led to the conclusion that people are capable of sexual stimulation from birth.

These books laid the groundwork for Masters and Johnson's life work. A study called Human Sexual Response in 1966 revealed the nature and scope of the sex practices of young Americans.


Lady Chatterley's Lover, Tropic of Cancer, and Fanny Hill

In the United States in the years 1959 through 1966, bans on three books with explicit erotic content were challenged and overturned.

Prior to this time, a patchwork of regulations (as well as local customs and vigilante actions) governed what could and could not be published. For example the United States Customs Service "banned" JAMES JOYCE's Ulysses by refusing its importation into the USA. The Roman Catholic Church's Index Librorum Prohibitorum carried great weight among Catholics and amounted to an effective and instant boycott of any book appearing on it. Boston's Watch and Ward Society, a largely Protestant creation inspired by Anthony Comstock, made "banned in Boston" a national by-word.

In 1959, Grove Press published an unexpurgated version of Lady Chatterley's Lover by D. H. Lawrence. The U.S. Post Office confiscated copies sent through the mail.

Lawyer Charles Rembar sued the New York city postmaster, and won in New York and then on federal appeal. In 1965, Tom Lehrer was to celebrate the erotic appeal of the novel in his cheerfully satirical song "Smut" with the couplet "Who needs a hobby like tennis or philately?/I've got a hobby: rereading Lady Chatterley."

HENRY MILLER 's 1934 novel, Tropic of Cancer, had explicit sexual passages and could not be published in the United States; an edition was printed by the Obelisk Press in Paris and copies were smuggled into the United States. (As of 2003[update], used book dealers asked $7500 and up for copies of this edition.)

Henry Miller in Brooklyn

see also: HENRY MILLER

In 1961, Grove Press issued a copy of the work, and lawsuits were brought against dozens of individual booksellers in many states for selling it. The issue was ultimately settled by the U.S. Supreme Court's 1973 decision in Miller v. California. In this decision, the court defined obscenity by what is now called the Miller test.

In 1965, Putnam published   JOHN CLELAND's 1750 novel "Fanny Hill, Memoirs of a Woman of Pleasure". This was the turning point, because Charles Rembar appealed a restraining order against it all the way to the U.S. Supreme Court and won. In Memoirs v. Massachusetts, 383 U.S. 413, the court ruled that sex was "a great and mysterious motive force in human life", and that its expression in literature was protected by the First Amendment.
Only books primarily appealing to "prurient interest" could be banned. In a famous phrase, the court said that obscenity is "utterly without redeeming social importance" — meaning that, conversely, any work with redeeming social importance was not obscene, even if it contained isolated passages that could "deprave and corrupt" some readers.

This decision was especially significant, because, of the three books mentioned, Fanny Hill has by far the largest measure of content that seems to appeal to prurient interest, and the smallest measures of literary merit and "redeeming social importance". Whereas an expurgated version of Lady Chatterley's Lover had actually once been published, no expurgated version of Fanny Hill has ever been (and it is difficult even to imagine what such a work could possibly consist of). By permitting the publication of Fanny Hill, the Supreme Court set the bar for any ban so high that Rembar himself called the 1966 decision "the end of obscenity."

see also:  JOHN CLELAND
"Fanny Hill, Memoirs of a Woman of Pleasure" (text)

Illustrations by Avril Paul



Mead's Coming of Age in Samoa

The publication of renowned anthropologist and student of Franz Boas, Margaret Mead's Coming of Age in Samoa brought the sexual revolution to the public scene, as her thoughts concerning sexual freedom pervaded academia. Published in 1928, Mead's ethnography focused on the psychosexual development of adolescent children on the island of Samoa.

She recorded that their adolescence was not in fact a time of "storm and stress" as Erikson's stages of development suggest, but that the sexual freedom experienced by the adolescents actually permitted them an easy transition from childhood to adulthood.

Her findings were later challenged by anthropologist Derek Freeman who later investigated her claims of promiscuity and conducted his own ethnography of Samoan society. Mead called for a change in suppression of sexuality in America and her work directly resulted in the advancement of the sexual revolution in the 1930s.

Nonfiction sex manuals

The court decisions that legalised the publication of Fanny Hill had an even more important effect: freed from fears of legal action, nonfiction works about sex and sexuality started to appear.

In 1962, Helen Gurley Brown published Sex and the Single Girl: The Unmarried Woman's Guide to Men, Careers, the Apartment, Diet, Fashion, Money and Men. The title itself would have been unthinkable a decade earlier. (In 1965 she went on to transform Cosmopolitan magazine into a life manual for young career women.

In 1969, Joan Garrity, identifying herself only as "J.", published The Way to Become the Sensuous Woman, replete with everything from exercises for improving the dexterity of the tongue, to how to have anal sex.

The same year saw the appearance of Dr. David Reuben's book Everything You Always Wanted to Know About Sex (But Were Afraid to Ask). Despite the dignity of Reuben's medical credentials, this book was light-hearted in tone. For many readers, it delivered quite literally on its promise. Despite the book's one-sided and prejudiced statements about gay men, one middle-aged matron from a small town in Wisconsin was heard to say "Until I read this book, I never actually knew precisely what it was that homosexuals did".

In 1970, the Boston Women's Health Collective published Women and their Bodies (which became far better known a year later under its subsequent title, Our Bodies, Ourselves). Not an erotic treatise or sex manual, the book nevertheless included frank descriptions of sexuality, and contained illustrations that could have caused legal problems just a few years earlier.

Alex Comfort's The Joy of Sex: A Gourmet Guide to Love Making. appeared in 1972. In later editions though, Comfort's libertinism was tamed as a response to AIDS.

In 1975 Will McBride's Zeig Mal!, Show Me!, written with psychologist Helga Fleichhauer-Hardt for children and their parents, appeared in bookstores on both sides of the Atlantic. Appreciated by many parents for its frank depiction of pre-adolescents discovering and exploring their sexuality, it scandalised others and eventually it was pulled from circulation in the United States and some other countries. It was followed up in 1989 by Zeig Mal Mehr! ("Show Me More!").

These books had a number of things in common. They were factual and, in fact, educational. They were available to a mainstream readership. They were stacked high on the tables of discount bookstores, they were book club selections, and their authors were guests on late-night talk shows. People were seen reading them in public.

In a respectable middle-class home, Playboy magazine and Fanny Hill might be present but would usually be kept out of sight. But at least some of these books might well be on the coffee table. Most important, all of these books acknowledged and celebrated the conscious cultivation of erotic pleasure.

The contribution of such books to the sexual revolution cannot be overstated. Earlier books such as What Every Girl Should Know (Margaret Sanger, 1920) and A Marriage Manual (Hannah and Abraham Stone, 1939) had broken the utter silence in which many people, women in particular, had grown up.

By the 1950s, in the United States, it had finally become rare for women to go into their wedding nights literally not knowing what to expect. But the open discussion of sex as pleasure, and descriptions of sexual practices and techniques, was truly revolutionary. There were practices which, perhaps, some had heard of. But many adults did not know for sure whether they were realities, or fantasies found only in pornographic books.

Were they "normal", or were they examples of psychopathology? (When we use words such as fellatio we are still using the terminology of Krafft-Ebing's Psychopathia Sexualis). Did married ladies do these things, or only prostitutes? The Kinsey report revealed that these practices were, at the very least, surprisingly frequent. These other books asserted, in the words of a 1980 book by Dr. Irene Kassorla, that Nice Girls Do -- And Now You Can Too.

Medicine and sex
The development of antibiotics in the 1940s made most of the severe venereal diseases of the time curable, namely gonorrhea and syphilis. In the early 1960s, The Pill became available; at first for married women only, but demand and changes in attitudes later led to it becoming available to unmarried women as well.

With the threat of disease and pregnancy now reduced, much of the post-WW2 baby boom generation fearlessly experimented with sex without considering marriage.

As birth control become more available, men and women gained unprecedented control of their reproductive capabilities. The 1916 invention of thin, disposable latex condoms for men led to widespread affordable condoms by the 1930s; the demise of the Comstock laws in 1936 set the stage for promotion of available effective contraceptives such as the diaphragm and cervical cap; the 1960s introduction of the IUD and oral contraceptives for women gave a sense of freedom from barrier contraception. Opposition of Churches (e.g. Humanae Vitae) led parallel movement of secularization and exile from religion.

In the UK the new generation growing up after the Second World War had grown tired of the rationing and austerity of the 1940s and 1950s and the Victorian values of their elders, so the 1960s were a time of rebellion against the fashions and social mores of the previous generation.

An early inkling of changing attitudes came in 1960, when the government of the day tried unsuccessfully to prosecute Penguin Books for obscenity, for publishing the D. H. Lawrence novel Lady Chatterley's Lover, which had been banned since the 1920s for its racy (for the time) content. The prosecution counsel Mervyn Griffith-Jones famously stood in front of the jury and asked, in his closing statement: "Is it a book you would wish your wife or servants to read?".

When the case collapsed, the novel went on to become a best seller, selling 2 million copies. The Pill became available free of charge on the National Health Service in the 1960s, at first restricted to married women, but early in the 1970s its availability was extended to all women.




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