Toward the end of the nineteenth century. it was clear to many that there were mental disorders with a psychological basis as well as those with an organic basis. But one major question remained to be answered- How do these psychologically caused mental disorder", actually come about?

Freud and the beginnings of psychoanalysis.
The first systematic attempt to answer this question was made by Sigmund Freud. Freud was a brilliant young Viennese physician who at first specialized in neurology and received an appointment as lecturer on nervous diseases at the University of Vienna. On one occasion, however, he introduced to his audience a neurotic patient suffering from a persistent headache, and mistakenly diagnosed the case as chronic localized meningitis.

As a result of this error in diagnosis, he lost his job al though, as he pointed out in his autobiography, greater authorities than he were in the habit of diagnosing Similar cases as cerebral tumor. Freud went to Paris in 1885 to study under Charcot and later became acquainted. He was impressed by their use of hypnosis on hysterical patients and came away convinced that powerful mental processes may remain hidden from consciousness.

On his return to Vienna, Freud worked in collaboration with an older physician,_Joseph breuer. who had introduced an Interesting innovation in the use of hypnosis on his neurotic patients, chiefly women. He let the patient under hypnosis talk about her problems and about what bothered her- Under these cir- cumstances the patient usually spoke rather freely, displayed considerable emotion, and on awakening from the hypnotic state felt considerably relieved. Because of the emotional release involved, this method was called the "cathartic method." This simple innovation in the use of hypnosis proved to be of great significance, for not only did it help the patient discharge their emotional tensions by discussion of her problems, but it revealed the nature of the difficulties that had brought about her neurotic symptoms. The patient saw no relationship between her problems and her hysterical symptoms, but the therapist could usually see it quite readily.

Thus was made the discovery of the "unconscious"—the realization of the important role played by unconscious processes in the determination of behavior. In 1893, Freud and Breuer published their joint paper 0n the Psychical Mechanism!, of Hysterical Phenomena, which constituted one of the great mile stones of psychodynamics.

Freud soon discovered. moreover, that he could dispense with the hypnotic state entirely. By encouraging the patient to say freely whatever came into her mind without regard to logic or decency- Freud found that she would eventually overcome inner obstacles to remembering and would discuss her Problem
freely. The new method was called free association, and the term psycho analysis was given to the principles involved in analyzing and interpreting what  the patient said.. and in helping her gain insight and achieve a more adequate adjustment.

Freud devoted the remainder of his long and energetic life to the development and elaboration of the psychoanalytic model. His views were formally introduced to American scientists in 1909, when he delivered a now-famous series of lectures at dark University at the invitation of G. Stanley Hall, the eminent American psychologist who was then president of the university. These Introductory Lectures on Psychoanalysis led to a great deal of controversy that helped publicize the concepts of psychoanalysis to both scientists and the general public.

Basic principles of the psychoanalytic model.
The psychoanalytic model is both highly systematized and complex, and we shall not at- tempt to deal with it in detail. Its general principles. however, may be sketched as follows:

1- Id, ego, and superego. Basically the individual's behavior is assumed to result from the interaction of three key subsystems within the personality: the id, ego, and superego.

The id is the source of instinctual drives,which are considered to be of two types (a). constructive drive primarily of sexual nature. which constitute the libido or basic energy of life, and (b) destructive  drives which tend towards  aggression, destruction, and  eventual death. Thus life or constructive, in- stincts are opposed by death, or destructive, instincts. Here it may be noted that Freud used the term sex in a broad sense to  refer to almost anything pleasurable, from eating to creativity. The id is completely selfish, condeemed only with the immediate gratification of instinctual needs without reference to reality or moral considerations. Hence it is said to operate i terms of  pleasure principle.

RELATION OF ID, EGO, AND SUPEREGO
While the id can generate mental images and wish-fulfilling fantasies, referred to as the primary process, it cannot undertake the action needed to meet instinctual demands.

Consequently a second key subsystem develops-the ego which mediates between the demands of the id and the realities of the external world. The basic purpose of the ego is to meet id demands, but in such a way as to ensure the well-being and survival of the individual. This requires the use of reason and other intellectual resources in dealing with the external world, as well as the exercise of control over id demands. Such adaptive measures o f the ego are referred to as the secondary process and the ego is said to operas in terms of the reality principle. Freud viewed id demands especially  sexual and aggressive strivings as inherently in conflict with rules and prohibitions imposed by society.

Since the. id-ego relationship is merely one of expediency, Freud introduced a third key subsystem—the superego-which is the out-growth of learning the taboos and moral values of society. The superego is essentially what we refer to as conscience, and is  concerned with right  and wrong. As the superego
develops, we find an additional inner control system coming into operation to cope with the uninhibited desires of the id. However, the superego also operates through the ego system and strives to compel the ego to inhibit desires that are considered wrong or immoral.

The interplay between these intrapsychic subsystems of id, ego, and superego is of crucial significance in determining behavior.Often inner conflicts arise because each sub- system is striving for somewhat different goals. Neuroses and other mental disorders result when the individual is unable to resolve these conflicts.

2, Anxiety, defense mechanisms, and the unconscious. The concept of anxiety is prominent in the psychoanalytic model. Freud distinguished among three types of anxiety, or psychic -pain. that people can suffer from  reality anxiety, arising from dangers or threats in the external world (b) neurotic anxiety, caused by the id's impulses threatening to break through ego controls, resulting  in behavior that will be punished  someway; and (c) morall anxiety, arising from a real or contemplated action in conflict with the individual's super ego or moral values, and arousing feelings of guilty

Anxiety is a warning of impending danger as well as a painful experience, so it forces the individual to undertake corrective action. Often the ego can cope with the anxiety by rational measures; if these do not suffice, however. the ego resorts to irrational protective measures—such as rationalization or repres sion—which are referred to as ego-defense mechanisms and will he examined in detail later .These defense mechanisms alleviate the painful anxiety, but they do so by distorting reality instead of dealing directly with the problem. This creates an undesirable schism between actual reality and the way the individual sees reality.

Another important concept in the psychoanalytic model is that of the unconscious, Freud thought that the conscious represents a relatively small area of the mind while the unconscious  part like the submerged part of an ice berg, is the much larger portion. In the depths are the unconscious are the hurtful  memories, forbidden desires, and other experiences that have been pushed out of the conscious. Al- though the individual is unaware of such unconscious material, it continues to seek expression and may be reflected in fantasies and dreams when ego controls are temporarily lowered. Until such unconscious material is brought to awareness and integrated into the ego structure—for example, via psychoanalysis-it presumably leads to irrational and mal-adaptive behavior.

3. Psychosexual development. Freud viewed personality development as a succession of stages, each characterized by a dominant mode of achieving libidinal (sexual) pleasure-\5i' The five stages as he outlined them were

a) Oral stage. During the first two years of life the mouth is the principal erogenous zone; the infant's greatest source of gratification is assumed to be sucking.

b) Anal stage. From age 2 to age 3. the membranes of the anal region presumably provide the major source of pleasurable stimulation.

c) Phallic stage. From age 3 to age 5 or 6, self-manipulation of the genitals provides the major source of pleasurable sensation.

d) Latency stage. In the years from 6 to 13,, sexual motivations presumably recede in importance as the child becomes preoccupied with developing skills and other activities.

e) Genital stage. After puberty the deepest feelings of pleasure presumably come from heterosexual relations.

Freud believed that gratification during each stage is important if the individual is not to be fixated at that level. For example, an individual who does not receive adequate oral gratification during infancy ^may^be prone to excessive eating or drinking in adult life.

In general, each stage of development places demands on the individual that must be met. and arouses conflicts that must be resolved. One of the most important conflicts occurs during the phallic stage, when the pleasures of masturbation and accompanying fantasies pave the way for the Oedipus complex- Oedipus, according to Greek mythology, unknowingly killed his father and married his mother. Each young boy. Freud thought, symbolically relives the Oedipus drama. He has incestuous cravings for his; mother and views his father as a hated rival; however, he also dreads the wrath of his dominant male parent and fears especially that his father may harm

The female Oedipus (Electra) complex is more intricate, but it is based essentially on the view that the girl wants lo possess her father and replace her mother. For either sex, resolution of the Oedipal conflict is considered essential if the young adult is to develop satisfactory heterosexual relationships.

Impact on our views of psychopathology. Ac- cording to the psychoanalytic model, people are dominated by instinctual biological drives as well as by unconscious desires and motives.
Although there is a constructive libidinal side in each individual, there are also the darker forces of aggression leading toward destruction and death. And although the ego tends toward rationality, the counter forces of intra- psychic conflict, defense mechanisms, and the unconscious all tend toward a high degree of irrationality and maladaptive behavior. In addition, behavior is further determined through past learning, especially from early experiences. About the best we can hope for is a compromise from which we will realize as much instinctual gratification as possible with miinimal punishment and guilt.

Thus the psychoanalytic model presents a negativistic and deterministic view of human behavior that minimizes rationality and freedom for self-determination. On a group level it interprets violence, war. and related phenomena as the inevitable product of the aggressive and destructive instincts present in human nature.

Many of Freud's ideas have been revised or discarded as a result of subsequent research findings, and the psychoanalytic model is no longer widely used as a principal frame work for organizing and interpreting scientific observations about psychopathology, However two  of Freud's contributions stand out as particularly noteworthy:

1. The development of psychoanalytical techniques-for example. free association and dream analysis .for becoming acquainted with both the conscious and unconscious aspects of the mental life of the individual. the data thus obtained led Freud to emphasize (a) the dynamic role of unconscious motives and ego-defense processes, (b) the importance of early childhood experiences in later personality adjustment and maladjustment (c)the importance of sexual  factors in human  behavior and mental disorders although  as we have said, Freud used the term sex in a much broader sense than it is ordinarily used, the idea caught the popular fancy, and the role of sexual factors in human behavior was finally  brought out into the open as an appropriate topic- for scientific investigation,

2. The demonstration that certain abnormal mental phenomena-such as  repression of traumatic experiences and irrational fears occurred as a result of  attempts lo cope  with difficult problems ,and were  simply exaggeration.

Built-in" psychological coping and damage-repair mechanisms
There appear to be a number of coping and damage-repair mechanisms built into the human system which operate on a psychological level. While learning may influence these reaction patterns, they appear to operate automatically and to be part of the coping resources of human beings. Among the more common and important of these mechanisms, a re the following:

Crying.
"Crying it out" seems to be a common means of alleviating emotional tension and hurt. This reaction-is commonly seen in children who have bean frustrated or hurt, but It is not uncommon among adults. This pattern is particularly apparent as part of the "grief work" one goes through to regain emotional equilibrium after a period of bereavement for the foss of a loved one.

Talking It out
This pattern is so widely used that Its importance is often overlooked.
Yet people who have undergone traumatic experiences seem to have a need to repetitively tell others about the experience as a means of alleviating tension and desensitizing themselves to the point where the experience can be accepted as something in the past and integrated into the self-structure.

Laughing it of. Viewing setbacks and hurts with a sense of humor and trying to joke about them and laugh them off is another common damage-repair mechanism. In essence this pattern appears to both alleviate emotional tension and also help the Individual see the experience In a broader perspective. Historically this reaction has been emphasized in the role of the clown who presumably laughs to cover his Inner sadness: in fact. when this mechanism fails, the individual often bursts into tears.

Seeking support
In times of stress, infants often put their arms around their mothers and cling to  them for protection and support. On an adult level, we see the same pattern In more sophisticated form, as in the increased need of critically ill patients for affection and companionship. But even in less severe stress situations, many people turn to others for emotional support until they can regain their own equilibrium.

Dreaming and nightmares.
Individuals who have undergone highly traumatic experiences—for example, severe earthquakes, fires, airplane crashes, or other civilian catastrophes—often report repetitive dreams or nightmares in which they relive the traumatic experience. As in the case of repetitive talking, this pattern appears to desensitize the individual to the traumatic experience so that he can accept it as something in the past and integrate it into his self-structure without undue disruption.

These built-in reaction patterns may be used in varying degrees and combinations depending on the individual, the social setting, and the nature of the traumatic event which resulted in the psychological hurt or damage.

Repression is an extremely important self- defense mechanism in that it affords protection from sudden, traumatic experiences until time has somewhat desensitized the individual to the shock. Repression may also help the individual to control dangerous and unacceptedable desires-and at the same time alleviate the anxiety associated with such desires. The reality of repression in freeing the individual from anxiety has been demonstrated in an interesting study by Sommerschield and Reyher (1973). They induced posthypnotic conflicts in their subjects and found that various symptoms, including gastric distress, tension, and anxiety, appeared as the hypnotically induced repression weakened and the conflict threatened to enter consciousness.

Repression, in varying degrees, enters into many other defense mechanisms. There is some evidence that it is only when repression fails that stronger, more maladaptive defenses are tried.

4. Rationalisation. Rationalization is justifying maladaptive behavior by faulty logic or ascribing it to noble motives that did not in fact inspire it. Rationalization has two major defensive values: (a) it helps justify_specific behaviors, and b) it aids in softening the dis- appointment connected with unattainable goals

"Typically, rationalization involves thinking up logjcal. socially approved reasons For past. present, or proposed behaviors. With a little effort a person may be able to justify to himself spending money needed for essentials on lavish entertainment, neglecting work for cultural pursuits, or marrying someone whom he does not love- Even callous brutality can be rationalized as necessary or even praise worthy. Adolf Killer saw the extermination of the Jews as his patriotic duty.

Rationalization is also used to soften the disappointment of thwarted desires. "A common example of such rationalization is the "sour grapes" reaction-stemming from Ae- sop's fable of the fox who, unable to reach a cluster of delicious grapes, decided he did not want them after all because they were proba- bly sour. Similarly, students may justify their mediocre college performance On the grounds that they are refusing to gel involved in the "competitive rat race" of model society. One way of reducing the discrepancy embodied in failure to take action toward a desired goal is to decide that the goal is really not anything worth having anyway.

Frequently,. of course, it is difficult to tell where an objective consideration of realities leaves off and rationalisation begins. Behaviors that commonly indicate rationalization are (a) hunting for reasons to justify one's behavior or beliefs; (b) being unable to recognize inconsistencies or contradictory evidence; and (c) becoming upset when one's "reasons" are questioned- Such questioning is a threat to the defenses the individual has managed to construct against self-devaluation.

5. Projection. Projection is a defensive reaction by means of which (a) others are seen as responsible for one's own shortcomings, mistakes, and misdeeds; and (b) others are seen as responsible for one's unacceptable impulses, thoughts, and desires,

Projection is perhaps most commonly evidenced by the first tendency. The student who fails an examination may feel that the teacher was unfair; "the delinquent teen-ager may blame her problems on a rejecting and non understanding parent; and even the small boy being punished for fighting may protest, "it wasn't my fault-he hit me first." Fate and bad luck are particularly overworked objects of projection. Even inanimate objects are not exempt from blame. The three-year-old who fails off a hobby horse may attack it with blows and kicks; the basketball player who slips  return to inspect 'the alleged slippery spot. In extreme cases  individual may become convinced that other persons or forces  are systematically working against him. Such ideas may develop into delusions of persecution involving the supposed plots and conspiracies of "the enemy."

In other projective reactions, the individual attributes his own unacceptable desires and thoughts to others. This tendency appears to be particularly common among those with rig- id moral values and strict conscience development. For example, a man who is sexually attracted to children may Insist that a child is behaving seductively toward him- Consequently, the child becomes the offender, while the man remains conveniently "pure," un- aware of his own unacceptable inclinations.

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