Sigmund Freud

[erg923]

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... "However, competent practice also requires moving beyond and adjusting our work so that its fits into mainstream, evidence based, healthcare."

If Freud, Skinner, Horney, Beck, Rogers, Yalom, Hayes, Linnehan, etc. had "adjusted their work so that it fits into mainstream, evidence-based healthcare" then we would not be where we are today. That said, I do agree that we need to move beyond Frued and that an individual's theoretical orientation should be based on science... Is there room, in your opinion, for it to also be based on the therapist's worldview and culture? There is a lot of outcome research that demonstrates an orientation's congruence with their worldview is an effective "common factor" of effective therapy.

1.) They didn't have to get pre-auths prior to service.

2.) For psychotherapy, no. For life-coaching, yes.

 

[LivingOffLoans]

Science as we know it today, and the study and implementation of psychoanalytic technique, are two different entities (remembering that science is still a social construction here). The two are not entirely incompatible, but one side or the other may at times be better suited to address any particular issue, depending on your preference of view and the object of study. Let me make clear that I began my studies of the human mind, even prior to entering undergraduate school, in psychoanalysis. Once I entered into undergrad, I was made into a nice 'scientist practioner'. I disowned psychoanalytic theory entirely. But in graduate school, and beyond, I find myself more and more drawn toward questions that no one but contemporary (i.e. relational) psychoanalysts are exploring - ideas that are not even considered according to the 'science' model, because they fall outside of the scope of 'scientific investigation'. I do not consider myself an extremist in one or the other, and see the necessity in both philosophy and empiricism, and at the same time, I do think that polarized viewers miss the points and contributions of the other. It makes sense to me why academia has shifted more toward empiricism, but at least for me it feels that something is definitely lacking. Not that what we have in academia and the scientific method is bad; not at all. It just doesn't cover the entire terrain, you have to admit. But why has it become the only method? And not just one of many? Of course, part of the answer to that is political. Psychoanalysis gets too hard of a bad rep, and could have a more meaningful place in academia. For some reason, I believe that one day it will. Just not sure when.

 

[erg923]

Science as we know it today, and the study and implementation of psychoanalytic technique, are two different entities (remembering that science is still a social construction here). The two are not entirely incompatible, but one side or the other may at times be better suited to address any particular issue, depending on your preference of view and the object of study. Let me make clear that I began my studies of the human mind, even prior to entering undergraduate school, in psychoanalysis. Once I entered into undergrad, I was made into a nice 'scientist practioner'. I disowned psychoanalytic theory entirely. But in graduate school, and beyond, I find myself more and more drawn toward questions that no one but contemporary (i.e. relational) psychoanalysts are exploring - ideas that are not even considered according to the 'science' model, because they fall outside of the scope of 'scientific investigation'. I do not consider myself an extremist in one or the other, and see the necessity in both philosophy and empiricism, and at the same time, I do think that polarized viewers miss the points and contributions of the other. It makes sense to me why academia has shifted more toward empiricism, but at least for me it feels that something is definitely lacking. Not that what we have in academia and the scientific method is bad; not at all. It just doesn't cover the entire terrain, you have to admit. But why has it become the only method? And not just one of many? Of course, part of the answer to that is political. Psychoanalysis gets too hard of a bad rep, and could have a more meaningful place in academia. For some reason, I believe that one day it will. Just not sure when.

Sure. Doctoral training programs are also missing any significant courses/training in parapsychology as well. A subfield that is interesting, worthy of further exploration, and often looks at questions outside mainstream science.

Why do we think that is?

 

[chman]

No and no. I do not think heavy scrutiny of a person's methods, theories, and his subsequent conclusions sets us back. I think that's how science moves forward.[

Of course scrutiny is important in science. But there is a certain point where it becomes a bit ridiculous to scrutinize scientific work from past centuries as if they should have been informed by today's knowledge. Does that mean that we can't acknowledge someone's early contributions? Again, we don't pretend that Aristotle and Copernicus had a whole understanding of astronomy, but we can at least agree that they were great thinkers for their time and paved the way for later work. We don't scoff at Copernicus and say that because he didn't understand gravity that he was wrong about the earth rotating around the sun...

And no, I do not see any well informed psychologists cringing at the thought of unconscious cognitive processing. One must buy many other postulates in order to swallow Freud's kool aid.

Well, I disagree I guess. It kind of depends on what area of study in psychology we look at.

If we look at the number of times that the word "unconscious" has been used in psychology journals, only recently (that past 10 years or so) have we seen it start to return. There was a good 30 years were it was largely ignored.

Further, most of the work that has been done has been in cognitive psychology. Relatively little research has been done on unconscious processes and psychopathology compared to its probable importance. I mean, Bethany Teachman does some interesting work on it and anxiety disorders.. But even she is very limited by our current methodology which really only consists of Anthony Greenwald's implicit association test..

 

[Ollie123]

Unconscious exists under many names in contemporary psychology and has been a pretty active area for quite some time. There are TONS of people doing work on it now. Heck, my thesis arguably falls under that umbrella and we've had a number of other papers in that general topic area published in recent years. This is a fairly large research group doing well-funded research and publishing in major outlets so its not exactly something obscure that has to be done without funding and published in unknown journals. We're far from the only ones. It just depends what you are looking for - yeah if you are hoping to see unfalsifiable dream analysis-type papers in Journal of Abnormal Psychology you are going to be disappointed. You will see papers using things like psychophysiological tools, a range of implicit tasks (not just the IAT by any stretch of the imagination), etc. to study these topics with incredible regularity. I'm working on a manuscript right now parsing neural reactions to drug and emotional cues to determine if we can get better measures of "true" motivation for change than we do when we ask directly (due to the various social pressures and demand effects that go along with that).

All that said - I think focusing on this stuff misses the broader point. Mechanisms are great and I think failure to understand them has hindered our ability to move forward - we've been continuing to invent more things that are "just as good" but haven't done anything "better" in a long time (I'm talking in extreme generalities here). Efficacy/effectiveness matter more. Analysis has been around for longer than anything else but has the least support. We recently had a discussion on this topic and someone came up with a list (that still remains on my desktop for when I can actually find time to go through it) but even that was about half stuff that wasn't true analysis and had some tremendous gaps based on my perusal of abstracts (i.e. no evidence for at least half the disorders you are likely to see in practice). Is it the fault of programs for not teaching it? I'd argue its more the fault of modern analysts for not spending the time/effort to prove they bring something worthwhile to the table. They've certainly had enough time to do so. We can argue we lack the tools to understand mechanisms but we can compare interventions easy enough. Do I need to be fully up on the nuances of analytic theory to know that (last I checked) there were literally zero trials showing it could effectively treat OCD? Expecting that seems wildly out of touch with the realities of the amount of information a good psychologist needs to know. We can't learn everything and need to streamline somehow.

Anyways, big picture is that I think Freud made some solid contributions. I think its fine to acknowledge those and still acknowledge that we're way past that point now. I'm all for challenging the field and pushing the boundaries, but that should occur carefully. The number of people in the mental healthcare system who have been in therapy for years but have never once received anything that remotely approximates a standard evidence-based treatment is shocking and disturbing. I would fully support stripping the license of a dynamic practitioner/analyst who took on (for example) an OCD client who had never received ERP, never discussed treatment options with them or presented that information and then saw them for an extended period of time (or at least until their insurance ran out). Sadly, that does not seem to be uncommon practice in this field. I would equally condemn anyone who is so "CBT" or "Behaviorist" or whatever else they are unwilling to read and evaluate literature on other interventions with an open mind.

 

[ela]

Thread containing Psychodynamic/Psychoanalytic references:

http://forums.studentdoctor.net/showthread.php?t=998979

 

[Therapist4Chnge]

Some quick points:

1. As a physician (neurologist by training), Freud was a man of science. He developed hypotheses about the mind and associated processes. His work helped advance the field, though in more recent years science has proven many of his hypotheses to fall short. As a result, how and where the application of psychodynamic theories are utilized needs to be judiciously considered.

Short version: Freud offered and science responded. Some Freud supporters just keep on keepin' on.

2. Until EMDR supporters can prove via rigorous peer-reviewed study that the "eye movement" contribution (completely separate from the exposure therapy portion) is substantial and meaningful, I will continue to trust in the science that supports that EMDR is nothing more than exposure therapy and [insert ridiculous other intervention like moonbeams or fairy dust]. There have been a couple of good threads on here about EMDR, though both sides seem rather entrenched. Sadly there are some orgs that still choose to support the moonbeam/fairy dust approach, though at least the exposure therapy is still involved to do the heavy lifting.

Short version: EMDR offered and science responded. Most EMDR supporters just keep on keepin' on.

 

[PsyDr]

I got this:

Freud invented the gold chloride staining technique for neurons,and book about aphasia, and a book about paralysis. Psychoanalysis is literally the analysis of the mind. The gold stain and book about aphasia were the building blocks for Luria's work, which helped create neuropsychology, which has been demonstrated to have sufficient evidence. Freud's book about paralysis was the possibly the foundation for rehab psych, which has sufficient evidence. His study of cocaine was one of the first to propose its use as an anesthetic, and anesthesia has been repeatedly subjected to scientific "proof",


Ipso facto, QED, , Freud has been proven by thousands of articles.


If you believe that, I have a Nigerian millionaire dictator uncle who wants to pay you a million USD to use your bank account.