Counselling - Coaching - StressManagement

How is it possible to know about the unconscious when it is something that we are unaware of anyway? What sort of evidence can we accept supporting the psychodynamic approach when psychoanalysis itself fails to withstand the critical scientific methods? I can see several flaws in Freud's theories and in psychodynamics generally which leads me to question whether or not psychoanalysis provides the client with a 'cure'. Many people, especially women and feminists, are concerned about Freud's emphasis on sexuality and his implied views that women were inferior but since his death in 1939 psychodynamic theorists have begun to address these criticisms, including his own daughter, Anna, as cited in Webster (1995).

There were shortfalls in Freud's experimental method, the objectivity, replication, formulation of unambiguous predictions and impirical evidence. Freud believed that the work he did was scientific and presented it accordingly but Freud's theories on their own fail to be supported by empirical evidence. Freud failed to keep detailed observations of events and how frequently they occurred. Scientists were concerned about the degree of objectivity as it was difficult to establish exactly what was being measured, counted or observed. In this scientific method a prediction is made about what might happen under certain conditions and if this hypothesis proves correct the theory is given credence until another one replaces it or is introduced refuting it. If the prediction is disproved or shown to be incorrect then the theory is modified or dropped. The psychodynamic theory does not fit this scientific method which is in contradiction with the scientific model with which I am used to working in obtaining a psychology degree.

Many attempts have been made to test Freud's theories and ideas yet despite there being some empirical evidence in support of his theories some researchers proffer simple explanations which appear equally valid. Other explanations from other cultures or psychological theories often account for Freud's findings which are unable to withstand criticism from a traditional scientific approach but it is the complexity of human behaviour that ties-in with Freud's ideas. The psychodynamic theory predicts that different causes promote different effects but no single effect can be predicted specifically. Sometimes the resultant effect for one person is the opposite for another yet the cause could be the same. Take, for example, Freud's theory of psychosexual stages which suggest that fixations at specific stages in development result in certain behaviour. According to Freud, anal fixation can lead to retentiveness and expulsiveness shown behaviourally as avarice and generosity respectively, as cited in Gross (1992). Here each displays the opposite trait.

Some psychologists believe that Freud's psychodynamic theories cannot be scientifically tested and have no validity therefore should be rejected. If I were to accept the scientific model which I am currently working with this would mean me rejecting psychoanalysis! I can understand how it is difficult to measure the results of the psychodynamic approach and to validate its success in the therapeutic process. I have to consider how ethical this is and take into account the confidentiality of the client which makes recording and publication of any findings even more difficult. Most records kept during therapy relate to that persons individual life. It would be hard to convey words spoken to others while maintaining the exact meanings which may be lost in translation.

Another problem is that of replication. Because of the dynamics between counsellor and client it is difficult to achieve the same results over separate occasions. Their relationship, by definition, prohibits the effective intrusion of an independent observer whose very presence would alter the whole course of the therapeutic process.

A further criticism of Freud's theory is his narrow sample which is possibly the most challenged part of psychoanalysis. More recent psychoanalysts argue that Freud's clients were mainly middle-class neurotics from Vienna who were not representative of the population locally or globally. Recent studies by Freud's daughter, Anna, and Melanie Klein, have used much larger samples and a wider range of subjects, especially children, although these too have been criticised due to the feminist attitude of both therapists. Freud's only acknowledged case study of a child was that of Little Hans. The ethical and cultural changes that have developed since the late nineteenth century make it difficult to compare individuals in today's therapeutic setting, however, the emotions of envy, jealousy and rivalry still exist especially where sexuality is involved. These behaviour traits can be observed in most social groups and are often noticed in animals other than human beings.

Although the psychodynamic approach is criticised because of its lack of scientific validity it does seem to work. The 'talking cure' has never been proven to be effective in the scientific sense of the word yet clients are made to feel better by this technique. It is difficult to define a cure when the range of mental illness is so vast. Eysenck (1952) published a paper in which he criticised Freud's approach arguing that, "spontaneous remission accounts for some clients recovery from neurotic problems." Hayes (1994:303) About thirty per cent of his sample recovered spontaneously, i.e. without treatment, which matched the thirty per cent success of psychoanalysis in a similar sample. Eysenck reviewed his study in 1985 and reinforced his argument elaborating that psychoanalysts tend to accept only YAVIS clients for treatment. (YAVIS is the pneumonic for young, attractive, verbal, intelligent and successful). This group was considered most likely to recover anyway. Other research supports psychodynamic theories, for example, Smith and Glass (1977) assessed a series of psychotherapeutic effectiveness covering about 400 studies. Their conclusion was that, "psychotherapy is effective but no more so than any other therapies," as cited in Gross (1992:991).

The modern psychotherapist now tends to adopt various forms of eclectic psychotherapy, i.e., taking parts from whichever therapeutic school of thought seems most appropriate to a particular case. I hope that I will be able to operate under this model eventually. Traux (1963) studied eclectic psychotherapy, Rogerian client-centred psychotherapy and psychodynamics and concluded that a client who had been shown empathy and positive regard from the counsellor had improved regardless of the therapeutic model used. I question how one knows which portion of the counselling process aids recovery? Lomas (1987) argued that the psychoanalysis process coupled with transference may be instrumental in the cure but the meaningfulness of the process is not part of the effect.

I can see that the psychodynamic approach is successful and helps a wide range of clients. I personally have benefited from psychotherapy. The YAVIS argument suggests that clients are generally middle-class and of higher intellect and referrals reflect this. I know that it is difficult to obtain individual treatment from the National Health Service and as treatment can be costly working class clients find it difficult to fund their own treatment opting instead for group work, behaviour therapy or clinical psychology which are all available from the sick funds and private health care. This might dictate which groups are able to access treatment in the psychodynamic field and I would prefer to work with a variety of clients from all walks of life not just the middle-class. Many of the clients that I am seeing now are from working class families but currently the work I do is in the form of an integrative approach combining Cognitive Behaviural short term and focussed work with that of long term psychotherapy when appropriate.

It is important to remember that Freud was not the only psychodynamic therapist although his work has paved the way for extensions to his ideas. Examples of this are Erickson (1950) who expanded Freud's developmental stages 'throughout life' as a continuation of Freud's work. Jung (1913) thought of the unconscious as the source of potential and creativity rejecting Freud's ideas of the sexual instincts. Karen Horney criticised Freud's penis envy theory and made her own interpretation that it was a cultural phenomenon in a male dominated society. Fromm (1970) believed that social forces play a greater part than innate instincts within psychodynamics. It is this progressive change in attitudes which comes with greater knowledge and understanding of the mind that allows psychoanalysis to continue gaining recognition as a therapeutic treatment and one which encourages me to continue training psychodynamically.

I believe that psychodynamic therapy opens the door to understanding human mind and behaviour and that it forms the roots of most other theories, all of which are open to some criticism. More recent moves from the focus on sexuality and the centrality of instincts towards object relations makes more sense to me. Melanie Klein, for example, is concerned about how small children and infants relate to important people in their social network and how they respond to those people. The result affects their
personal development emotionally, mentally and in relationships with other people, throughout their lives changing the focus which we are used to accepting from Freud's Oedipus complex and psychosexual stages, as cited in Gomez (1997).

With the recent developments comes a greater understanding of psychodynamics as a whole and any criticism of Freud's work has to acknowledge the impact his theories have had on the people of Western civilisation and culture in the twentieth century. I have to accept that psychoanalysis does not stand up to criticism of the traditional scientific methodology and acknowledge that Freud's theories do form the basis of work being carried out by other therapists especially in the area of object relations which originated as the British based development of classic Freudian theory. It appears that psychodynamics will always have a place in the therapeutic process but will develop as a more widely accepted theory as ideas are challenged and exchanged and improved with the support of more scientific methods. The new onslaught of prospective counsellors will grow with the developments and hopefully future will see an influx of new therapists who will introduce ideas as successful and controversial as Freud's own.


References:
GOMEZ, Lavinia, (1997). An Introduction to Object Relations. Free Association Books, London.

GROSS, Richard D. (1992). 2nd Edition. Psychology. The Science of Mind and Behaviour. Hodder and Stoughton, Cambridge.

HAYES, Nicky, (1994). Foundations of Psychology, An Introductory Text. Routledge, London and New York.

WEBSTER, Richard, (1995). Sin, Science and Psychoanalysis. Harper Collins, London.