Dr. Freud Goes to Washington.

Debate over psychoanalysis takes an exhibitionistic turn

Sigmund Freud is back, once again immersed in the hidden motives, hysterical behavior, and power plays of affluent adults seemingly haunted by a host of unconscious childhood conflicts. The founder of psychoanalysis is rubbing shoulders with the political elite of Washington, D.C.

True, Freud died 60 years ago. But his intellectual legacy now stalks the stately halls of the Library of Congress in a much anticipated exhibit running through Jan. 16. Across the street looms the U.S. Capitol building, where legislators are considering whether to impeach the president.

It's a fitting setting for Freud, one of the most influential and controversial figures of the past century. He's the man who first made it possible to speak of sex and cigars in the same breath, who championed free association and fees for its interpretation, and who transformed Oedipus from a myth to a complex. He has a line of slips--that have nothing to do with lingerie--named after him, he launched the enduring genre of New Yorker cartoons featuring therapists and patients, and he inspired Woody Allen's success in movies, if not in his personal life.

Freud and his ideas have always attracted passionate backers and belittlers. Although no longer the dominant form of psychotherapy, psychoanalysis brought attention to themes that still inspire therapists and psychological research. Modern psychoanalysts, a diverse lot of therapists who form several warring camps, view the exhibit as a ratification both of major themes in Freud's work and of the clinical usefulness of psychoanalysis and related talk therapies.

The current group of detractors includes experimental psychologists, whose field also features abundant theoretical strife. They see the new Library of Congress exhibit as an opportunity to stage a public dethroning, if not impeachment, of the imperial Freud. Once the emperor of the unconscious goes into exile, the critics hope to raze what they consider to be a rotting psychoanalytic palace built on a swamp of repression and dream interpretation.

While the psychoanalysts diagnose Freud's critics as misguided, they reserve their deepest hostility for managed health care, in which cost controls often limit treatments for mental ailments to drugs and brief psychotherapy.

The Freud exhibit got off to as shaky a start as a psychoanalyst trying to launch a practice in a health maintenance organization. In 1995, about a year after work on the project began, nearly 50 scholars signed a petition claiming that the show's planning committee was unfairly stacked with psychoanalysis supporters. Many, but not all, of the petition's signers had published works critical of Freud.

Later that year, the library decided to postpone the exhibit's planned opening in 1996. Many observers attributed that move to a mix of petition-inspired intimidation and fear of further public controversy.

That assumption was incorrect, says the Freud exhibit's curator, cultural historian Michael S. Roth of the Getty Research Institute for the History of Art and the Humanities in Los Angeles. The delay occurred because of a more than $300,000 funding shortfall, which Roth does not blame on Freud critics, several of whom were cooperative and advised him behind the scenes. Controversy stemming from the postponement greatly aided subsequent fundraising efforts, he adds.

Roth sees the final product as an homage to Freud's pervasive influence on Western culture, regardless of the ongoing debates about his work's merit. "This exhibition is neither and apology for nor a criticism of Freud," he says. "It's intended as a historical account of Freud's ideas and the ways in which many portions of our culture have incorporated those ideas for their own ends."

Freud's thinking covered a wide range of topics and underwent major shifts during his lifetime. The new exhibit organizes his professional career into three sections. Each section features vintage photographs, prints, manuscripts, and first editions of books, as well as home movies of Freud and objects from his study and consulting room. Examples of the psychoanalytic influence on movies, television, and other aspects of modern culture are included.

The first section of the exhibit portrays Freud's early years in Vienna. His training in neurology led him to study in France with Jean-Martin Charcot, a neurologist who used hypnotism to treat patients suffering from a variety of emotional torments then called hysteria. Freud became convinced that hysterical symptoms and more ordinary features of mental life, such as dreams and slips of the tongue, contain hidden meanings that lie outside conscious, rational control.

The second section presents some of Freud's best-known patients, whose treatment he wrote about, and the concepts he developed to understand their behavior. For instance, Freud described a young lawyer he dubbed "the Rat Man," who had constant thoughts concerning rats, torture, and punishment. Treatment included having the man talk about the first things that came to mind as he considered his disturbing thoughts. Freud used this technique, which he called free association, to probe theorized unconscious conflicts that resist direct expression. The clinician eventually interpreted the man's symptoms as rooted in ambivalence about sexuality and about his hostile feelings toward his father.

Other clinical cases highlighted in the exhibit illustrate the notions of transference, in which patients unknowingly transfer feelings that they have for important figures in their lives onto the analyst, and countertransference, in which the analyst does the same to a patient.

Freud's clinical experiences also raised questions about the nature of memory. Several patients stated that they had been sexually molested. Freud at first accepted such accounts as true, but later he suspected that they reflected incestuous fantasies rather than reality.

Psychoanalytic theory took shape around Freud's clinical cases. Particularly disturbing conflicts flee the bright lights of awareness for unconscious cover in a process he called repression. Repressed sexual and aggressive desires act as perpetual sources of conflict, which unintentionally poke through their unconscious veil in the form of dreams, jokes, and slips of the tongue. Freud's arguments for the existence of repression and for the misleading nature of incest fantasies have contributed to the controversy over the accuracy of recovered memories of childhood sexual abuse (SN: 9/18/93, p. 184).

In his writings, Freud treated the unconscious as a single mental entity, the holding area for unacceptable desires and conflicts and the prime motivator of mental life. He later referred to it as the id, as distinct from both the ego, a partly conscious mechanism for redirecting or restraining the id's impulses in the service of daily functioning, and the superego, a person's accumulated moral precepts or conscience.

After the carnage of World War I, Freud granted greater importance to aggressive urges. He speculated that each person struggles to coordinate unconscious instincts for self-destruction and for sex.

The third section of the exhibit displays comments by Freud's critics, both within and outside psychoanalysis. It also alludes to the growth of psychoanalytic influence in medicine, art, the humanities, and popular culture during the first half of the 20th century--especially in the United States.

In the latter stage of his career, as portrayed in this part of the exhibit, Freud theorized that societies devise measures to rein in human instincts and control behavior. Prime among these are widespread injunctions against incest, he held. Freud had previously suggested that children progress through several stages of what he called psychosexual development, including a period in which boys have to resolve an Oedipal complex marked by sexual desire for the mother and rivalrous hatred of the father.

Incest taboos pay unacknowledged homage to the power of the Oedipal complex, he said (SN: 10/19/91, p. 248). However, Freud speculated, these injunctions have evolutionary roots in the guilt of prehistoric men who--at least according to some turn-of-the-century anthropologists--had killed their own powerful patriarch but still felt compelled to abide by the dictates he had set forth.

Religion, art, and science represented, from the psychoanalytic perspective, the redirected products of sexual and aggressive impulses, according to Freud.

Wars inevitably erupted out of underlying psychological conflicts in societies, Freud theorized. His personal experiences did not lend themselves to optimism about world peace. In 1938, Freud--a Jew living in Nazi-dominated Germany--reluctantly fled to London, where he died the next year.

Psychoanalysis also finds itself on the run these days, at least outside the confines of the Library of Congress exhibit. Insurance coverage for more than a handful of sessions of any type of talk therapy has dried up over the past 10 years. Moreover, a vocal group of academic critics has attacked psychoanalysis as devoid of scientific support, impossible to test with rigorous empirical methods, and overflowing with ill-founded and even deceitful Freudian speculations.

Freud's intellectual death has been heralded by various commentators since his first writings appeared. In 1905, for example, French psychiatrist Pierre Janet dismissed Freud as a reckless clinician who "suggests to his patients all sorts of notions (sexual for the most part) which are far more likely to be hurtful than helpful."

Frederick C. Crews, an English professor at the University of California, Berkeley, has ridden the crest of the new wave of Freud criticism. "Our great detective of the unconscious was incompetent from the outset--no more astute, really, than Peter Sellers' bumbling Inspector Clouseau-- and he made matters steadily worse as he tried to repair one theoretical absurdity with another," Crews contends in Unauthorized Freud (1998, Viking), a collection of Freud critiques that he edited.

He cites Freud Evaluated (1997, MIT Press) as a compelling documentation of Freud's failure to develop a coherent or scientific discipline. In that book, psychologist Malcolm Macmillan of Deakin University in Victoria, Australia argued that free association and other ambiguous procedures allowed Freud to jump to all sorts of unjustified conclusions about how minds work. Freud created a system in which he could theorize as he pleased without fear of being contradicted by independent tests of his ideas, Macmillan asserted.

Freud's blind assumption that regularly observed mental events always spring from unconscious conflicts caused him to downplay the tendency of all therapists to elicit symptoms and self-reports from patients that are consistent with their own theoretical views, the Australian psychologist said.

"There are still virtually no studies of the rules for reliable [psychoanalytic] interpretation and none at all of the robustness and validity of the method itself," Macmillan concluded.

Another critic, philosopher of science Adolf Grunbaum of the University of Pittsburgh, maintains that experimental psychology's examination of unconscious mental activities has failed to uncover a Freudian cauldron of conflicting desires. In the past 15 years, researchers have explored what they call implicit memory (SN: 11/17/90, p. 312), a type of unconscious recall that has nothing to do with Freud's theories, in Grunbaum's view.

Psychoanalysis supporters, including some research psychologists, readily acknowledge that many of Freud's original ideas are outdated. Like all bold, insightful theories in poorly understood areas, Freud's work revolved around central themes that remain powerful despite the need to revise many of his specific propositions, they contend.

These themes continue to inform the thinking of various psychoanalytic schools of thought. Most psychoanalysts and Freud-friendly psychotherapists do not lie in wait for phallic symbols, penis envy, incest fantasies, and so on.

Current psychoanalytic approaches typically focus on treating interpersonal problems that are thought to be related to personality disturbances. Examples include repeatedly forming brief, volatile relationships and latching on to destructive romantic partners. In such cases, sexuality is treated as an important, but not an exclusive, contributor to the problem.

According to Drew Westen, a Harvard University psychologist and clinician who takes a psychoanalytic approach, much scientific evidence indicates that Freud was right about several fundamental propositions still shared by his theoretical offspring.

These include assumptions that enduring facets of personality emerge during childhood; that mental frameworks for thinking about the self, others, and relationships develop early, guide social life, and contribute to many psychological ailments; that different mental processes operate simultaneously, so individuals can have conflicting feelings toward the same person or situation; that personality development requires learning not only to regulate sexual and aggressive feelings but to move from immature dependency on others to the give-and-take compromises of mature relationships; and that a bevy of unconscious processes--not the monolithic unconscious championed by Freud--shapes mental life.

In an upcoming Psychological Bulletin, Westen summarizes a large body of experimental findings that supports the existence of pervasive unconscious influences on emotional responses, social preferences, and habitual behaviors. He sees this line of research as a natural extension of experimental psychologists' explorations into the "comfortable unconscious" of implicit memory.

Despite support for Freud's assertions about mental life, no solid evidence exists for the effectiveness of psychoanalysis, or any other form of psychotherapy, beyond 2 years after completing treatment, Westen says. Even less is known about the elements that distinguish the most effective psychotherapists from the rest, wherever their theoretical sympathies lie.

Beyond the storm and fury over Freud's scientific credentials, supporters such as psychoanalyst Jonathan Lear of the University of Chicago say that the ongoing debate stems primarily from clashing assumptions about the mind.

Psychoanalysis advocates hold that a largely unconscious reservoir of meaning animates human thought and behavior; critics see no underlying symbolism in how people think, instead treating the mind as a highly malleable instrument open to suggestion and distortions of perception and memory.

This conflict is encapsulated in a discussion that the neuroscientist Gerald M. Edelman of the Scripps Research Institute in La Jolla, Calif., recalls having had with the late molecular biologist Jacques Monod. In Bright Air, Brilliant Fire (1992, Basic Books), Edelman recounts arguing that Freud was an intellectual pioneer, if not a scientist in the modern sense, and that advances in neuroscience support the concept of repression. Monod, however, viewed Freud as unscientific, uninsightful, and possibly a fraud.

"I am entirely aware of my motives and entirely responsible for my actions," Monod said. "They are all conscious."

Edelman facetiously replied: "Jacques, let's put it this way. Everything Freud said applies to me and none of it to you."

"Exactly, my dear fellow," Monod responded with satisfaction.