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Psychoanalysis: Freud's theories and their contemporary development 

Psychoanalysis: Freud's theories and their contemporary development
Chapter:
Psychoanalysis: Freud's theories and their contemporary development
Author(s):

Otto F. Kernberg

DOI:
10.1093/med/9780199696758.003.0038
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date: 18 August 2019

Psychoanalysis is: 1 A personality theory, and, more generally, a theory of psychological functioning that focuses particularly on unconscious mental processes; 2 A method for the investigation of psychological functions based on the exploration of free associations within a special therapeutic setting; 3 A method for treatment of a broad spectrum of psychopathological conditions, including the symptomatic neuroses (anxiety states, characterological depression, obsessive–compulsive disorder, conversion hysteria, and dissociative hysterical pathology), sexual inhibitions and perversions (‘paraphilias’), and the personality disorders. Psychoanalysis has also been applied, mostly in modified versions, i.e. in psychoanalytic psychotherapies, to the treatment of severe personality disorders, psychosomatic conditions, and certain psychotic conditions, particularly a subgroup of patients with chronic schizophrenic illness. All three aspects of psychoanalysis were originally developed by Freud whose theories of the dynamic unconscious, personality development, personality structure, psychopathology, methodology of psychoanalytic investigation, and method of treatment still largely influence the field, both in the sense that many of his central ideas continue as the basis of contemporary psychoanalytic thinking, and in that corresponding divergencies, controversies, and radical innovations still can be better understood in the light of the overall frame of his contributions. Freud's concepts of dream analysis, mechanisms of defence, and transference have become central aspects of many contemporary psychotherapeutic procedures. Freud's ideas about personality development and psychopathology, the method of psychoanalytic investigation, and the analytic approach to treatment gradually changed in the course of his dramatically creative lifespan. Moreover, the theory of the structure of the mind that he assumed must underlie the events that he observed clinically changed in major respects, so that an overall summary of his views can hardly be undertaken without tracing the history of his thinking. The present overview will lead up to summaries of his final conclusions as to the structure of the mind and how this is reflected in personality development and psychopathology. Psychoanalysis will then be described as a method of treatment, as seen from the point of view of resolution of conflict between impulse and defence, and from that of object-relations theory. We shall explore significant changes that have occurred in all these domains, and conclude with an overview of contemporary psychoanalysis, with particular emphasis upon the presently converging tendencies of contemporary psychoanalytic approaches, and new developments that remain controversial.

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