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A very poor article that smells funny

This discussion has been partially archived. // Pathoschild 05:26, 11 October 2005 (UTC)

Reply

First off, the level of rigor you are asking for is fairly rare in any form of psychotherapy research. Second, there is a question about whether some of the standards you cite (such as randomanization) are even appropriate for psychotherapy research. link to article Those of us, for example, who do not believe in a medical model of psychotherapy are not particularly impressed with the medicalization of some psychotherapy research. If we bear in mind the fact that the key factor in outcome of any psychotherapy is the quality of the personal relationship between therapist and patient -a research finding that has been demonstrated many times over- then the medical assumption that psychotherapy (like medication) is an objective technique that can be applied by a random therapist to a random patient using a manual can seem fairly out of place.

Let me give an example. A first session with a patient. The psychodynamically trained therapist will usually begin, after looking at the intake information, diagnosis, etc. by simply asking the patient "What brings you here?" The patient may then respond in a variety of ways that can't be predicted by diagnosis or other intake information alone. Some patients may be extremely vague, unable to spell out their reasons for requesting treatment. Some may be extremely precise and emotionless, quantifying their own feelings and behaviors. Some may avoid the question, changing the subject. Some may ramble on in an apparently haphazard fashion, leaving the therapist to wonder whether they will ever get to answering the question. What the therapist says next will be largely dictated by how the patient reacted to the first question. Maybe, if the patient is being very precise and emotionless, and that behavior is making it hard for the therapist to connect with the patient empathically, the therapist will flag this phenomena for possible future examination: "I notice you are really being precise about what's bothering you." Maybe the patient replies "Yes, I'm very good at that." The therapist then has an indication that the patient's precision may be ego-syntonic- something that the patient is comfortable with and may not be interested in changing for some time if ever. If so, the therapist may still want to gather a little more information, but will know it is probably best to back off of that issue for now. But maybe the patient instead replies "Well, my wife sometimes tells me I'm like a robot- thorough and precise but emotionless." Then the therapist has an indication that the patient's precise style may be a problem that he or she is willing to work on. Maybe she says, "Tell me more about that." The patient then goes on to say "well, actually, I just am not much into all that touchy-feely feely stuff." The therapist says "Touchy-feely stuff." The patient then says, "Yes. You know, talking about feelings and all that." Then the patient stops. Because the patient is not offering any clarification and, given his apparent discomfort with feelings, may find it easier to be more concrete, the therapist might then say "Could you give me an example?" The patient then says, "Last night my wife said she wanted to talk about our relationship. I said that our relationship is fine. She said that's what I always say, that it is fine. She said talking to me is like talking to a block of wood. I just don't understand what the problem is..." and so forth.

What is important to note about the brief interaction I've described is that it is an interaction, not a matter of simply administering a procedure or a drug. At each moment of the session, the therapist is tailoring her interventions to how the patient is talking and reacting to what she has said. There is no fixed sequence of interventions the therapist uses, rather, she molds what she is doing to the patient's reactions. The therapist is working on helping the patient open up and connect, building a relationship, not merely applying a procedure. How the therapy proceeds will continue to depend on how the patient responds. Although outcome research is important, the therapy process is only minimally comparable to a medical procedure. How it unfolds, and ought to unfold, can't be predicted by the patient's diagnosis. It is simply much messier, much more fuzzy, than your purist standards of medical research allow for.

Moving on, I want to note that by accusing me of projection, you implicitly acknowledge the validity of the psychoanalytic construct of projection, and thus of the general notion of defense mechanisms- operations of self-deception used to avoid mental discomfort. Since you also implicitly agree that projection is not a good thing, here you are already on the verge of assuming that something ought to be done about one's projections, if one has them. Apparently without knowing it, you are already endorsing key psychoanalytic ideas. I think this illustrates how useful psychodynamic ideas are even in everyday interpersonal interactions.

Regarding my ad hominimen arguments, I make them because of the authoritarian tone of your postings. I think you really need to take a step back and acknowledge that you may not yet know all that you need to know to provide a cogent critique of psychoanalysis. So far, your arguments have been out of sequence: You offer a criticism of psychoanalysis (for example, that it is expensive) before, rather than after, verifying the information on which the criticism is based. To put the sequence right, you would need to recognize that you may not have all the information you need to start with, so that you could then go and find it before, rather than after, making your criticisms. But to do this would require letting go of your assumption that you already know what psychoanalysis is, what research has been done, what research is appropriate, etc.

More importantly, however, the whole issue is really a somewhat moot point in terms of its relevance to the wikipedia article. The research papers cited are considered by the psychoanalytic community to be papers about research. And the article is an article on psychoanalysis, not on your personal opinions of psychoanalysis.

So at this juncture we are engaging in a debate that, however interesting, has little direct bearing on the article itself. -- (unsigned comment by Leo Bolero at 14:49, October 9, 2005)

Response Again, you make factually untrue claims about research. Such rigorous research of psychotherapy is now routine--except among psychoanalysis. For example, a quick PubMed search using the terms "randomized" and "CBT" generates 230 hits. A more thorough search would turn up more research. Obviously,doing research on any behavior modification technique is difficult. All original is research has difficulties.

I realize that it is difficult to design any study to prove the effectiveness of analysis. I am familiar with the arguments. Nevertheless, unless you can show it is beneficial, then there is no point in doing it? For all we know, psychoanalysis is harmful. The arguments of its effectiveness relying on biased observers and such result in making psychoanalysis no more scientific than creationism or scientology. The only major difference is that analysis manage to gain acceptance in the field of behavioral health where it is now being discarded as ineffective and unscientific, just as Moniz's theories on lobotomy are now discarded.

The problems, which I will again restate, is that that article does not address the lack of efficacy in psychoanalysis and the lack of any objective evidence to support psychoanalytic theories. These are core issues in any discussion of any treatment modality, and they remain marginally addressed. This would be the same if the entry on homeopathy did not address the pseudoscientific claims about this.

If analysis is about the relationship betweeen the analyst and analysand, rather than being a medical intervention, then the article should address this. (Also, that would raise the issue of why analysis should not be covered by health insurance.) The Wiikipedia should note that in the face of the medical model, that psychoanalysis is more of a spiritual event (or whatever the consensus is of its status). I realize that many analysts feel that analysis should move away from the mental health model. Last spring I read an article from an analyst and a former professor at Wayne State on this. I have been unable to find it, so I do not raise it the WIkipedia entry. A major point that I recall is that analysis should move outside the health care system and be viewed as an intellectual event. If this is a common view, then it should be addressed. People need to know if the analytic community no longer view analysis as a healthcare therapy but an intellectual event.

My reference to projection was sarcasm, another, a subtle intellectual idea, such as randomized studies. Apparently, the idea of sarcasm escaped your view. It is so much subtler than the name calling ad hominem attacks some folks are reduced to using when they run into ideas they don't understand. I should also note, that while unscientific, that does not mean some of the observations made analysts are not correct. There explanations of why behavior such as projection occurs still may be wrong, but the observations that such behavior exists may be right.

You personalize and conflate about my person opinion on analysis. My opinion on psychoanalysis is not the issue. The issue is the failure of the article to address the numerous flaws in psychoanalytic theory. Instead, the article focuses on a pro-psychoanalysis view of analysis. The lack any meaningful research and evidence of the effectiveness of psychoanalysis and psychoanylitic theories are the issues--and these issues are not addressed.

Consequently, the article lacks a neutral point of view. -- (unsigned comment by 24.225.95.253 at 16:34, October 9, 2005)

Reply

Lots of results on a pubmed search of the words "randomized" and "CBT" comprises a somewhat ambiguous finding, as there are any number of reasons the word "randomized" could show up in an abstract (for example, a literature review may say that "more research with randomized subjects is needed"). But, nevertheless, if you'd also done a pubmed search with the words "randomized" and "psychodynamic" you'd notice that 41 citations show up. Not as many as for CBT, but not few enough to make data from these searches count as a cogent criticism of psychodynamic treatment. Also, if you do a search with the words "psychodynamic" and "outcome" 344 entries come up, as opposed to 588 with "CBT" and "outcome." "CBT" and "efficacy" yields a result of 284 entries, and "psychodynamic" and "efficacy" gets a result of 87 entries. All that these searches suggest is that CBT has more outcome research than psychodynamic treatment (a fairly well-known fact), and they do not show that psychodynamic treatment has some egregiously small amount of outcome research.

Incidently, other non-CBT approaches such as client-centered therapy and gestalt therapy, get entries of, respectively, 56 ("client centered" and "outcome") or 9 ("client-centered" and "randomized"), and 9 ("gestalt" and "randomized") or 41 ("gestalt" and "outcome"). As for existential therapy, it gets 53 ("existential" and "outcome") or 7 ("existential" and "randomized.") Family therapy gets a higher 134 ("family therapy" and "randomized") or 713 ("family therapy" and "outcome"). And the currently popular dialectical behavior therapy gets 25 for "DBT" and "outcome" and 17 for DBT and "randomized." As for Rational-Emotive Behavior Therapy (REBT or, formerly, RET) it gets 110 ("outcome" and "RET") or 7 ("RET" and "randomized").

So even on your terms, without using other databases, these searches offer little support for a criticism of psychoanalytic outcome research. Essentially, at the most, they suggest that psychodynamic treatment has a body of outcome research that is in the upper middle range compared to other therapies. It doesn't have as much as CBT or family therapy, but considerably more than client-centered, gestalt, DBT, REBT, or existential therapies. There is no support here for an argument that tries to single out psychodynamic treatment for a supposed lack of outcome research.

On the first page of the pubmed results for "psychodynamic" and "randomized," by the way, I find the following abstract:

"Are psychodynamic and psychoanalytic therapies effective?: A review of empirical data.

Leichsenring F.

Clinic of Tiefenbrunn and University of Gottingen, von Sieboldstr 5, D-37075, Gottingen, Germany. fleichs@gwdg.de

There is a need for empirical outcome research in psychodynamic and psychoanalytic therapy. However, both the approach of empirically supported therapies (EST) and the procedures of evidence-based medicine (EBM) have severe limitations making randomised controlled trials (RCTs) an absolute standard. After a critical discussion of this approach, the author reviews the empirical evidence for the efficacy of psychodynamic psychotherapy in specific psychiatric disorders. The review aims to identify for which psychiatric disorders RCTs of specific models of psychodynamic psychotherapy are available and for which they are lacking, thus providing a basis for planning further research. In addition, results of process research of psychodynamic psychotherapy are presented. As the methodology of RCTs is not appropriate for psychoanalytic therapy, effectiveness studies of psychoanalytic therapy are reviewed as well. Studies of psychodynamic psychotherapy published between 1960 and 2004 were identified by a computerised search using Medline, PsycINFO and Current Contents. In addition, textbooks and journal articles were used. Twenty-two RCTs were identified of which 64% had not been included in the 1998 report by Chambless and Hollon. According to the results, for the following psychiatric disorders at least one RCT providing evidence for the efficacy of psychodynamic psychotherapy was identified: depressive disorders (4 RCTs), anxiety disorders (1 RCT), post-traumatic stress disorder (1 RCT), somatoform disorder (4 RCTs), bulimia nervosa (3 RCTs), anorexia nervosa (2 RCTs), borderline personality disorder (2 RCTs), Cluster C personality disorder (1 RCT), and substance-related disorders (4 RCTs). According to results of process research, outcome in psychodynamic psychotherapy is related to the competent delivery of therapeutic techniques and to the development of a therapeutic alliance. With regard to psychoanalytic therapy, controlled quasi-experimental effectiveness studies provide evidence that psychoanalytic therapy is (1) more effective than no treatment or treatment as usual, and (2) more effective than shorter forms of psychodynamic therapy. Conclusions are drawn for future research."

Gee. Guess you must've missed that one.

There is also another more important issue here, your claim that other therapies are more effective than psychodynamic treatment. Perhaps the most widely accepted work on comparative psychotherapy outcome is Smith and Gene V Glass's paper "Meta-analysis of psychotherapy outcome studies," published in Am Psychol. 1977 Sep;32(9):752-60. This paper was the first to demonstrate the so-called Dodo problem in psychotherapy outcome research: the fact that outcome studies show little difference in effectiveness for different psychotherapies, including psychodynamic approaches. Despite several replications of the study and the passage of over 25 years, research has yet to supersede these authors' conclusion.

Here is a description of the article:

"Results of 375 controlled evaluations of psychotherapy and counseling were coded and integrated statistically. The findings provide convincing evidence of the efficacy of psychotherapy. On the average, the typical therapy client is better off than 75% of untreated individuals. Few important differences in effectiveness could be established among many quite different types of psychotherapy. More generally, virtually no difference in effectiveness was observed between the class of all behavioral therapies (e.g., systematic desensitization and behavior modification) and the nonbehavioral therapies (e.g., Rogerian, psychodynamic, rational-emotive, and transactional analysis)."

Many have concluded from this that outcome research on psychotherapy is incapable of capturing the differences between psychotherapies, and have focused instead on researching the relation between different sorts of psychotherapy process and outcome, rather than the relation between modality and outcome.

But the point is, despite the fact that there isn't as much research on psychodynamic treatment as on, say, CBT, there is adequate research supporting the claim that for the most part, psychodynamic treatment helps people. Does it help people more, or less, than CBT? Who knows. On this, the outcome research is ambiguous. Let's also keep in mind that contemporary CBT, with its sub-approaches such as schema therapy and alliances with dialectical behavior therapy, is in many ways beginning to overlap profoundly with psychodynamic treatment. Is there any real, operational difference between making a (CBT) process comment on a maladaptive schema and making a (psychodynamic) process comment on a resistance? Or between making a (DBT) challenge to a patient's cognitive polarization and a (psychodynamic) confrontation of a patient's use of the defense of splitting? I doubt it. Maybe in twenty years psychodynamic therapists will be doing exactly the same thing as they do now but be calling themselves "schema therapists" so that they can more easily collect insurance payments. Who knows? schema therapy link

The notion that "meaningful" research is "lacking" on psychodynamic treatment is your opinion, not a fact, for it is you who are arbitrarily defining what counts as meaningful and what counts as research. I happen to consider the research meaningful. Most psychoanalysts I know do as well. The Smith and Glass study is considered meaningful by enough people for it to be cited as a classic study in most intro to psychology textbooks. The peer-reviewed journals in your own pubmed database consider the research meaningful enough to to publish it. Clearly, many others hold different opinions on the issue than you do. You are welcome to yours, but don't present it as a fact.

My view that psychoanalysis ought not to be considered a form of medical treatment, at least one like pharmacotherapy, is my own bias, my own view, and is by no means an objective fact. That is why I have not included it in the article, because to do so would be non-NPOV. The same goes for presenting it as a medical treatment (good or bad), which would also be non-NPOV.

I would not, by the way, call it "spiritual" or an "intellectual event" merely because it is not a medical procedure. The social worker who helps a homeless, schizophrenic patient by managing her case, linking her to treatment, and finding her government-subsidized housing is not offering medical treatment, but is not engaging in a spiritual practice either, and what she is doing is probably not best considered an "intellectual event." Similarly, the psychotherapist who helps a patient understand herself, learn better coping skills, and a greater range of choices about how to manage her emotional life is not necessarily doing anything spiritual. A helping profession remains a helping profession even if not medical. That does not necessarily make it a "spiritual" or merely "intellectual" practice.

By the way, if your reference to projection was purely sarcastic, then you concede that I am not projecting. -- (unsigned comment by Leo Bolero at 11:37, October 10, 2005)

Response: What I concede is you really don't understand the issues of effective treatment of mental health as it currently stands. There are few if any studies that demonstrate that psychoanalysis is effective. You continue to be unable to cite any. While you have a passion for defending psychoanalysis, citing a 28 year year old paper shows the depthj of you lack of understanding. That paper pre-dates most effective study techniques for psychotherapies, as well as the advent of such therapies as DBT. While historically valuable, the conclusions is suspect as the studies examined in the meta-analysis lacked the rigor considered essential today. -- (unsigned comment by 24.225.95.253 at 03:48, October 11, 2005)

Reply

You asked me to do pubmed searches on psychoanalytic research, and here they are. Above are the results, and they don't jibe with what you say here. Even when I do precisely what you tell me to do (provide search data from pubmed) you then do not acknowledge that I have done so, and continue to claim that there are "few if any studies that demonstrate that psychoanalysis is effective" despite the fact that in the very text to which you are replying, I cite data that falsifies your assertion, data that I've gathered using your very own standards and technique (searches for pubmed-cited research on outcome and randomization). Regarding the 28-year old study, as I said, my understanding is that its results are still accepted, they have been replicated, and have not been superseded. You are welcome to check these conclusions.

Incidently, you have offered no evidence that psychodynamic treatment is less effective than other treatments. It is hard to avoid the impression that there are some double standards operating here. You say that I ought to provide more evidence and avoid ad hominem arguments, but you provide no evidence for some of your own key statements, ignore the evidence I offer, and then continue to make ad hominem arguments yourself ("what I concede is you really don't understand...etc.").

I'm baffled. I guess you are either not fully reading the bits of the above text that undercut your own claim, or are reading them and ignoring them, or you are reading them and consciously misrepresenting them. Whichever it is, I don't know what you think this will accomplish, as all readers need to do is to scroll upward to verify that your statement that there are "few if any studies" is incorrect.

As for your effort to continually re-introduce into the article the study about the ineffectiveness of psychodynamic treatment with sex offenders, it is non-NPOV to cite this study without also citing the studies in which psychodynamic treatment has been supported with other populations. So we now have two options to maintain NPOV: either removing the business about sex offenders, or additionally citing all the populations for which your randomized controlled studies have supported the efficacy of psychodynamic therapy. I didn't want to do the latter, because I think it makes the article too long. But as you insist on retaining the sex offenders study, then I guess I'll just have to do that.

Regarding DBT, as I said above there is substantial overlap between DBT and psychodynamic treatment. Indeed, the very concept of borderline personality disorder that DBT is designed to treat was originally a psychodynamic concept. Reading descriptions of DBT treatment, I haven't yet seen many major differences from psychodynamic work. The basic Dialectical Behavior Therapy areas of focus -emotion regulation, distress tolerance, mindfulness, and interpersonal effectiveness- are, as far as I can tell, no different from the basic areas of focus of psychodynamic treatment of borderline personality. Many wonder if this sort of phenomenon -the fact that therapists who hail from different theoretical schools often just have different terminology for pretty much the same techniques- could partly account for why differences in efficacy between therapy approaches are hard to spot. Some also wonder if many of the seemingly newer therapy approaches are merely reinventing the psychodynamic wheel.

By the way, the word "data" is plural, not singular. --Leo Bolero 21:41, 11 October 2005 (UTC)—preceding unsigned comment by Leo Bolero (talk • contribs) 11:04, October 11, 2005

No no. I saw Data on Star Trek and there was only one of him. --DanielCD 05:02, 4 February 2006 (UTC)

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On a side-note, I find it highly amusing that no reference is made to the socio-cultural conditions in which psychoanalysis was born, as they highly influenced the practice. Indeed, one of the main reason sex is often depicted as something which causes traumas in one way or another is because psychoanalysis was born during the victorian era in England, one of the most sexually repressed place of all during one of the most sexually repressed time periods of all. Though I dare not edit the article itself as I do not have a lot of knowledge about the subject, someone who does possess that degree of knowledge probably should. Dali 03:34, 8 December 2005 (UTC)

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I'm not so sure that the above would be appropriate. The article is already quite long, and I'm not sure why there is a special necessity for discussing the sociocultural context of the development of the original Freudian theory here, as it currently is only one of a multiplicity of psychoanalytic theories. Given that the present article is on psychoanalysis in general and not just on Freud, to be consistent, wouldn't we then have to describe the sociocultural contexts of the development of all of the subsequent psychoanalytic theories- Lacanian, self-psychological, etc..?

This kind of discussion of Freud's contexts might be more appropriate for the Freud article, rather than this general psychoanalysis article.--172.155.184.80 18:32, 10 December 2005 (UTC)

Whoosh !!! What a can of worms you folks have collected !! I was looking for a relatively straight forward article giving the basics for someone who had never heard of psychoanalysis. Maybe the article on Sigmund Freud, if there is one, would do that. But I'm afraid this article is beyond repair. The original author has allowed himself to get lost in two unresolvable issues : 1. the myriad of changes made by Freud, by his colleagues , competitors, devoted followers, and more recent theorists ; and 2. the totally unresolvable issue of effectiveness, and comparisons with other therapies.

This is an important topic. Perhaps some power at WP could ask the NY Psychoanalytic Institute, or The American Psychoanaltic Association, or the American Psychiatric Association to make an authoritative but simple contribution. That contribution could act as a stub, and a variety of other contributors could add brief and to the point components about specific points that might even or probably would contain dissenting views.Islandsage 03:16, 19 February 2006 (UTC)

Don't blame the original author, that was me and the article I wrote was relatively straightforward, although it could have been improved. Someone did add a great mass of material I can hardly stand to read, but I assume they meant well. We welcome experts, and one is welcome to offer a revision, however, the wiki process will continue. Perhaps we should do some disambiguation: psychoanalysis (therapy, the psychoanalytic movement, psychoanalysis (Freudian), etc. My interest is in psychoanalysis as a research technique as Wilfred Bion utilized it but that may be too specialized a topic for us. Fred Bauder 18:39, 19 February 2006 (UTC)

Short note re: Victorian era. Do check your history on this. I'm not at present able to recollect any good sources, but I remember from undergraduate studies that it was the Edwardian era that was sexually repressive. The Victorians not so much. A look through any decent history of the period will identify as much. If anyone is still reading these things, that is.--Slenney (talk) 22:17, 17 December 2007 (UTC)

An even more belated comment. Freud developed psychoanalysis in Vienna at the very end of the nineteenth century, so effectively from the beginning of the twentieth century. This has nothing to do with England. Far from sexual repression being a feature of that era in Vienna, sexual matters were openly discussed, and featured in popular books and plays.Esterson (talk) 08:16, 11 December 2010 (UTC)

Cultural Adaptations

Please correct this at cultural adaptations, the author or anyone who is sure of the meaning of the sentence. "For example, Corey states, that Ellis, the founder of Rational Emotive Behavioral Therapy (REBT) would allow his clients to experience depression over a loss, such an emotion would be rational—often people will be irrational deny their feelings." --Pmpfe 20:27, 21 December 2005 (UTC)

I believe this relates to Catharsis, a technique that Frued used. But the term is not listed in the article.whicky1978 ^talk 04:06, 31 August 2006 (UTC)

Training

Is the section on training, specifically the requirement of medical training, accurate outside of the U.S.? In the UK for example, a degree, some experience and the right temperament are often the only requirements before commencing training, and I'm unsure as to the practices in other areas where psychoanalysis is common. --Phnord 12:20, 24 January 2006 (UTC)

This is one of those tough areas of Wikipedia where many editors have written an article that is not full enough (has info gaps), and no one really has the time or interest yet in cleaning it up. This article probably needs to be tagged for special attention. I wish I had time to go and fill out all those areas, but many other things need it as well. Hopefully we will find a way to get all the information included. Do you think the article needs an attention tag? --DanielCD 16:32, 24 January 2006 (UTC)

Yes, I agree the article needs attention. It lacks a decent history of psychoanalysis and so the theory section is confused and partial. Perhaps sections on the different areas of psychoanalysis would improve it, with a section on freud's ideas as a general introduction. The criticisms section could be split into criticisms from a scientific/medical psychology perspective and from social theory e.g. feminism. Perhaps also some responses from modern psychoanalysis would be useful, e.g. that it has 'moved on' since freud, neuropsychoanalysis, the difficulties of the brain/mind debate and perhaps some of lacan's comments on science. This seems a difficult task though, unless someone has more experience from within psychoanalysis. --Phnord 13:04, 25 January 2006 (UTC)

It is possible in Canada not to be a medical doctor. For example, the Toronto Institute of Psychoanalysis training program, applicants typically need to be either a physician (MD), social worker (MSW), psychologist (PhD), or have a PhD in the social sciences or humanities. The Vancouver Institute of Psychoanalysis typically requires that candidates be a mental health professional. Although general comments are not recommended, my impression is that traditionally psychoanalysts have been medical doctors (ex. Sigmund Freud), but that in recent times training programs have allowed applicants into their programs without a medical degree. Writerz (talk) 02:27, 16 August 2008 (UTC)

non-NPOV

Apart from the unclear paragraph about schizophrenia, the article does not even mention that the therapy can't show to be effective and is harmful. Instead the article shows a bias favoring the unproven claims of psychoanalysis. Tiaguito

That criticism could be made, there are a number of sources which express that opinion. Please find a reliable source and include the information in the article. There is a criticisms section. Fred Bauder 13:29, 31 January 2006 (UTC)

My English isn't that good, so I'd rather not edit the article. Tiago

-the article cites a number of studies supporting the effectiveness of psychoanalytic treatment. These studies are real, thus it is flatly untrue that the "therapy can't show to be effective."--172.155.211.212 03:19, 4 February 2006 (UTC)

I don't think anyone is meaning for it to be biased or anything, I just think the article has grown organically and has been neglected. All the concerns being voiced are legitimate. Perhaps it should be nominated for the Wikipedia:Article improvement drive. --DanielCD 05:00, 4 February 2006 (UTC)

"These studies are real, thus it is flatly untrue that the therapy can't show to be effective."
That's debatable. Those studies are often accused of lack of rigor. There are also a number of meta-analysis showing that effectiveness of psychodynamic treatment is close to placebo.

e.g. Smith & Glass (1977)
Effect: placebo (0.56), psychodynamic therapy (0.69), cognitive-behavioral therapy (1.13), other cognitive therapies (2.38).

Tiago

I have no doubt that for some people it lives up to expectations: "The rise of psychoanalytic thought cleared the way for an authentically active view of man. According to psychoanalytic theories, man is able, if at great pain and great endeavor, not only to understand himself but also to transform himself, to free himself from his own past and to set a new course of action", page 2 The Active Society: A Theory of Societal and Political Processes, Amitai Etzioni, The Free Press, 1968. --Fred Bauder 17:58, 13 February 2006

A fine example of the non-neutral POV is the section on cost. This simply is hilarious--analysis is expensive. Even if sessions are only $10, if the analysand goes 5.7 years (using the given figure) and only twice a week, that is nearly $6,000 in fees. In reality, the fees would probably much higer, as there few trainee slots open, and as a trainee progresses in the training, the rates go up. Further, the cost to the analysand in terms of time is ignored. And of course, if analysis is ineffective, which much data shows it to be, then it is a total waste of time and money.24.225.94.77 22:51, 18 February 2006 (UTC)

Any therapist with experience and competence can pretty much say that the methods can definitely be effective if the situation seems to call for the approach. Perhaps the formal documentation may be wanting in some detail, but arguing that it's completely ineffective or the same as a placebo seems a little lame. All treatments are next to useless anyway unless they can be tailored by someone sensitive enough to recognize a patient's specific needs. No competent therapist applies it in its purest form, and no system can benefit from completely withdrawing it from the toolbox.

However, as to what can actually be documanted in the article, who knows. I'm not ready to dig into the literature at this point so just consider this my 2 cents worth. --DanielCD 18:50, 19 February 2006 (UTC)

New NYT summary of status

This article in the February 14 2006 New York Times discusses current thought on the present status of psychoanalysis. The gist of the article is that universities and insurance companies have largely turned to Cognitive behavioral therapy in recent decades. This is partly because advocates of psychoanalysis and psychodynamic therapy, unlike advocates of CBT, had declined to submit to randomized controlled tests of their technique. But this has changed in the last three years. Recent studies (uncited by the article) have shown "psychodynamic therapy exploring the past can be as effective as cognitive work". It now seems that both sides admit the usefulness of the other techniques, along with caveats for the use of their own preferred methods. --Blainster 22:14, 16 February 2006 (UTC)

That article does nothing to prove that psychoanalysis is effective, and the claim that it does is represenative of the problem with this article. There is total lack of good, rigorous data in that article supporting the effectiveness of dynamic therapy. Of course, one of the major problems with psychoanalysis is the absence of consensus of what it is.24.225.94.77 20:32, 18 February 2006 (UTC)

Still, it is quite helpful to post such things here on the talk page, and it is appreciated. --DanielCD 20:35, 18 February 2006 (UTC)

It is helpful to post stories--but not to make false, misleading, or biased claims about the conclusions or contents of the stories. All that is add heat rather than light. And this entry has a tremendous amount of heat with little light. . 24.225.94.77 22:34, 18 February 2006 (UTC)

The article cites recent research that psychoanalysis can be effective. There was never any doubt about that in any event. The issues are cost in money and time and the ridiculous rigamarole that can be involved even in a successful analysis when a number of equally effective and much less expensive techniques are available. Fred Bauder 23:22, 18 February 2006 (UTC)

My personal opinion is that if the analyst is willing to respond to the actual issues which exist in the psychic life of the client (rather than imposing whatever cookie cutter theory they ascribe to) psychoanalysis is both effective and liberating. I'm afraid this is rather rare in practice. And quite time and energy consuming. Fred Bauder 23:22, 18 February 2006 (UTC)

Even if it's totally bogus, it does no harm here on the talk page. On the contrary, even if things are bogus, they can help give perspective. But I think any intelligent person can filter out the BS (perhaps I should bite my tongue when I say this!) I like to see recent commentary on this material to get a pulse on what people are thinking out there. Still, it should be evaluated carefully like 24.225.94.77 is saying. --DanielCD 00:48, 19 February 2006 (UTC)

And besides, I think that after reading it, whoever wrote it has a fundamental misunderstanding of the psych, as well as human nature. This cognitive thing is important, but it is getting to the point where it has fad aspects. Cognitive therapy works a lot of the time, but it's by no means a panacea; it's only one tool among many. I don't know why we still haven't gotten over the idea that only one way of seeing things can be right, and by default makes everything else wrong. --DanielCD 00:53, 19 February 2006 (UTC)

The article on Sigmund Freud is far superior to this one in presenting the general theory, history, development of psychoanalysis, as well as an interesting biography. It is comprehensive, detailed, and well documented.The author of this article should profoundly revise the purpose of the article or remove it.This article takes on two tremendously complicated, and endless issues: 1.the various additions and modifications of the theory and techniques of psychoanalysis; and 2.the disputation about research and effectiveness. Both are wonderful topics for several long books.Islandsage 17:45, 20 February 2006 (UTC)

Expensivie

Psychoanalysis is a very expensive treatment as I understand. It cost hundreds of dollars per hour, and requires many daily sessions for years on end. So, it's not difficult to understand why insurance companies would pay for it. Brief counseling techniques are favored for managed care.--whicky1978 06:24, 19 March 2006 (UTC)

It's not a bad article, but really doesn't cover Freudian psychoanalysis or what a reader might expect should they enter it. Fred Bauder 14:38, 21 February 2006 (UTC)

Psychoanalysis is no longer expensive. This is completely incorrect. Anybody can apply for treatment at a psychoanalytic institute and receive treatment at a low rate of $10-30 per sesson. I have been in analysis with an analyst from the NYU postdoctoral program in psychoanalysis for several years at $10 per session. But apparently according to this article my analysis did not occur.

Sounds like a reasonable amount, however, the statement in the article applies to the general case, not to exceptions. Fred Bauder 07:13, 19 August 2006 (UTC)

-These are not exceptions. There are hundreds of analytic institutes all over the world that provide such low-cost treatment. Moreover, even if one goes to a graduate analyst who is no longer in training, most analysts currently offer sliding scale fees commensurate with those of other mental health professionals.

6 years vs. Free. Same results. Which is cheaper? 52X3X10 = $1560 at the absolute cheapest for something that hasn't been proven anymore effective than talking to your friends. Please, explain how this is cheap to me. I hear leech therapy is making a comeback, too. Shamanism and trepanning, too. Might want to get in on that.

Insurance companies will pay for therapies that have been shown to be effective, but they are increasingly reluctant to pay for anything that doesn't have demonstrable (by ordinary standards) efficacy. That is why it is hard to get them to pay for psychoanalysis. —Preceding unsigned comment added by 209.77.137.57 (talk) 18:39, 19 March 2009 (UTC)

Effectiveness

"The different forms of psychoanalytic therapy are generally considered as effective as other types of psychotherapy" ¿Source? Cognitive and evolutionary psychology and modern psychiatry reject psychoanalysis as a pseudoscience.

"scientific evidence for the theoretical foundations of psychoanalysis is generally lacking" ¿Source? There is much investigation on the hypotheses of psychoanalysis, although the investigation doesn't support them.

From the article, "However, a survey of scientific research by Seymour Fisher and R. P. Greenberg showed that while personality traits corresponding to Freud's oral, anal, Oedipal, and genital phases can be observed, they cannot be observed as stages in the development of children, nor it be confirmed that such traits in adults result from childhood experiences. Likewise there is failure to demonstrate that insight, expressed in Freudian terms as making the unconscious conscious, improves a person's behavior or increases their level of functioning, there being strong indications that other factors are involved." Fred Bauder 01:10, 11 March 2006 (UTC)

---

P. has one big disadvantage. This therapy needs a very long time. --Fackel 17:15, 3 June 2006 (UTC)

Fishers book: Seymour Fisher, The Scientific Credibility of Freud's Theories and Therapy, Columbia University Press (October, 1985), trade paperback, ISBN 023106215X Fred Bauder 01:10, 11 March 2006 (UTC)

---

"Psychologists have recently renamed psychoanalysis to psychodynamic. This was done because the term psychoanalysis with reference to Freud was misleading, making many believe he was the founder of it, while in fact, he was not. Although it was renamed, few know about this and the term psychoanalysis is still the most common term used today, but the two words are basically synonyms of each other."

It is true that sometimes psychoanalysis is considered to be a form of psychodynamic therapy and psychoanalysis and psychodynamic therapies are usually grouped together in RCTs, but psychoanalysis and psychodynamic therapies are NOT synonyms. Psychodynamic and psychoanalysis are different psychotherapies. The text should be refrased.

---

"Re-analysis of previous randomized controlled trials have suggested that psychodynamic treatment is more effective than the absence of treatment in cases of clinical depression (4 randomized controlled trials (RCTs)), anxiety disorders (1 RCT), post-traumatic stress disorder (1 RCT), somatoform disorder (4 RCTs), bulimia nervosa (3 RCTs), anorexia nervosa (2 RCTs), borderline personality disorder (2 RCTs), Cluster C personality disorders (1 RCT), and substance-related disorders (4 RCTs)."[1]

The paragraph mixes the results of psychoanalysis and psychodynamic therapies. I cite the papper:

The review aims to identify for which psychiatric disorders RCTs of specific models of psychodynamic psychotherapy are available and for which they are lacking, thus providing a basis for planning further research. In addition, results of process research of psychodynamic psychotherapy are presented. As the methodology of RCTs is not appropriate for psychoanalytic therapy, effectiveness studies of psychoanalytic therapy are reviewed as well.
Studies of psychodynamic psychotherapy published between 1960 and 2004 were identified by a computerised search using Medline, PsycINFO and Current Contents. In addition, textbooks and journal articles were used. Twenty-two RCTs were identified of which 64% had not been included in the 1998 report by Chambless and Hollon. According tothe results, for the following psychiatric disorders at least one RCT providing evidence for the efficacy of psychodynamic psychotherapy was identified: depressive disorders (4 RCTs), anxiety disorders (1 RCT)...
With regard to psychoanalytic therapy, controlled quasi-experimental effectiveness studies provide evidence that psychoanalytic therapy is (1) more effective than no treatment or treatment as usual, and (2) more effective than shorter forms of psychodynamic therapy.

Here is an Meta-analysis from a german psychiatrist:

• Leichsenring, F., Leibing, E.: The effectiveness of psychodynamic psychotherapy and cognitive-behavioral therapy in personality disorders: A meta-analysis. American Journal of Psychiatry 160, 1223-1232

Result: The psychodynamic psychotherapy is more effektiv than the kognitiv behavioral therapie in personality disorders.

Bulleted list, Missing links

• JA: All but the last of the bracketed items in that first bulleted list are "red links", that is, have no articles at the other ends. If somebody is in the process of writing articles for them, they can be left a few days, otherwise they should be unbracketed or maybe redirected temporarily to some generic catch-all article. Also, that form of list, with incomplete sentences, is what they call "deprecated" hereabouts, so it is probably best to rephrase it with complete sentences, perhaps with italic leaders, like: "Item 1. This is a gloss of Item 1." Jon Awbrey 16:12, 15 March 2006 (UTC)

At one time about half of the links on Wikipedia were red links. A red link is a signal that we need an article on the subject. If you feel you can write better, by all means do so, but don't remove the links to articles which need to be written. Fred Bauder 17:55, 15 March 2006 (UTC)

• JA: Okay, thanks for the history lesson, I was just repeating what some other WikiPundits have advised me about some of my own erythropoia. Jon Awbrey

Pseudoscience?

JA: Re:

Behaviourism, evolutionary psychology, and cognitive psychology reject psychoanalysis as a pseudoscience. [2]. Humanistic psychology maintains that psychoanalysis is a demeaning and incorrect view of human beings.
Cognitive and evolutionary psychology reject psychoanalysis as a pseudoscience cause the theories are based on claims which cannot be verified or falsified and claims that are false. Why was this erased? [3] —Preceding unsigned comment added by Apehx (talk • contribs) 00:37, 18 March 2006

JA: The reason that I gave in the edit line was this: "(del anthropomorphisms & unsourced generalizations)". There are several things wrong with a statement like the one quoted above, somewhat closely related to each other:

JA: The statement as a whole conjoins four assertions, to wit:

1. Behaviourism (B-ism) rejects psychoanalysis (Ψ-ism) as a pseudoscience.
2. Cognitive psychology (C-ism) rejects psychoanalysis as a pseudoscience.
3. Evolutionary psychology (E-ism) rejects psychoanalysis as a pseudoscience.
4. Humanistic psychology (H-ism) maintains that psychoanalysis is a demeaning and incorrect view of human beings.

JA: Problem 1. Each of the four claims has the form of an anthropomorphism (A-ism), that is, their subjects are not the sorts of things that can take the verb "rejects" or the verb "maintains".

JA: Problem 2. The grammatical problem would normally be solved by rephrasing. Most likely, a person who says "B-ism rejects Ψ" may intend to say that most all B-ists reject Ψ, or that there is a certain tenet of B-ism, adopted by all B-ists, that contradicts Ψ. However, in each of these cases, the A-ism is used to cover an extremely broad generalization, as if to claim that all B-ists share a tenet that contradicts the tenets that all Ψ-ists share, and respectively for C-ists, E-ists, and H-ists. First of all, these generalizations are simply false. I know this from my personal acquaintance with many B-ists, C-ists, E-ists, H-ists, and Ψ-ists.

JA: Problem 3. More signficantly with respect to the WikiPedia policy of WP:VERIFY, none of the above broad-brush, big-blanket claims is sourced, nor are they likely to be possible to source, since there is enough literature that would provide counterexamples, that is, solid evidence of B-ists, C-ists, E-ists, and H-ists who worked with at least some of the ideas of at least some of the very diverse field of Ψ-ism. At any rate, WP:VERIFY states that the burden of proof is on the editor who makes the claim, not on anyone else to provide contrary evidence.

JA: Problem 4. The fact that, say, some Φ-ists reject some of the tenets of some Ψ-ists still does not mean that those Φ-ists reject Ψ-ism "as a pseudoscience". All sorts of folks reject each others axioms and maxims without necessarily calling each other pseudo-anything, indeed, B-ists, C-ists, E-ists, and H-ists are notorious for rejecting each others' principles, sometimes flinging pejoratives like "Pseudoscientist!" about, but most of the time not saying it even if they may be thinking it. The charge of pseudoscience involves something more than mere dispute — it involves a charge of deliberate fraud. Jon Awbrey 04:36, 18 March 2006 (UTC)

But also the behavior and kognitiv psychology can't falsified there theories. Behaviorism: it is not possible to falsified that learning expiriences in childhood are the couse of psychological diseases. In Konitivism: the konzept of Schemes is not exactly enough def. to proof it.

The term of pseudosiences is based on the theorie of critical rationalism. This is not the only theorie of sience. I hope ist also in england and USA that psychoananlyses ist still a part of the medical and psychological studies (Pardon for my broken english) —Preceding unsigned comment added by Jon Awbrey (talk • contribs) 04:44, 18 March 2006

Expert ?

You'll have a hard time finding a psychoanalyst to consult with. In order to be a psychoanalyst you have to go through psychoanalysis yourself. Freud psychoanalysed himself since no else was around to do it :P I hold a degree in psychology and a degree in counseling. I have a few books that go in depth on the subject which were written by experts in talk therapy/counseling. I still plan to add a stub about its uses in groups. I have a power point presentation on psychoanalysis in groups. I've not reread the article in the last few months. What specific questions does it need to address? Are there conflicting sources on the subject? I would suggest citing both sources, and point out that they conflict.--whicky1978 06:06, 19 March 2006 (UTC)

I don't think it that hopeless. Several years ago I participated in several mailing lists which had psychoanalytic participants. There were a few cranks, but most were friendly and helpful. The situation is simply that no one who would be willing and able to help organize the article has noticed it. Fred Bauder 14:00, 19 March 2006 (UTC)

I think the complaint about the article is that it is rather disorganized, and tries to cover too much diverse material. I have added the disambiguation section at the top. That disambiguation designates this article as concerning psychoanalysis as a psychotherapy. Some of the information now in the article is about other aspects of the subject and needs to be removed from this article and integrated into other articles. Use of psychoanalytic techniques in groups is another subject we could have an article about. Fred Bauder 14:00, 19 March 2006 (UTC)

I agree, we should have another article on psychoanlaysis in groups. That topic and others like it can have a brief statement in this article but go in depth in another article.--whicky1978 04:07, 20 March 2006 (UTC)

Intro

The intro says:

"Psychoanalysis is a type of psychodynamic therapy or insight-oriented therapy, a therapeutic technique for the treatment of neuroses and some psychoses."

While the psychodynamic psychotherapy article intro says:

"Psychodynamic psychotherapy is a type of psychotherapy, usually meeting about once or twice a week. It is different from other systems of psychotherapy, for instance psychoanalysis or cognitive therapy in that it uses a range of different techniques, applied to the client considering his or her needs."

The link for psychodynamic therapy in this article goes to psychodynamic psychotherapy. Which is it? 129.241.11.201 13:44, 4 April 2006 (UTC)

I see the problem, but I think it is psychodynamic psychotherapy which needs to be modified or disambiguated as psychoanalysis does seem to be a type of psychodynamic psychotherapy, unless psychodynamic psychotherapy is a "brand name" for a specific type of therapy. Fred Bauder 02:45, 13 April 2006 (UTC)

Greetings from germany. My english is not good enough to edit an english page. But I miss in the english version some important themes. In Germany also Heinz Kohut´s "school" or "theory" the self psychology is an important part of the psychoanlytical movement. Erik H. Erikson and Anna Freud found the "Ich-Psychologie" (transl. ego psychology in psychoanalysis). Often you will finde the describtion that the (sorry I´m not sure if this ist the right transl.) "attachment theory" (in german: Bindungstheorie) bonding from Bowlby and Ainsworth is an school of psychoanalysis. These theorys should also have an exceptionally part in the Article. All I heard about the anglo-american situation in psychology makes me sure that the analytical psychology from Carl Gustav Jung isn't an part of Freudian psychoanalysis. It counts as an indipendent school of psychotherapy like Adlers individual psychology. Schöne Grüsse

Comment I think a lot of this CBT vs dynamic therapy effectiveness debate has been reviewed fairly thoroughly in:

What Works for Whom?, Second Edition : A Critical Review of Psychotherapy Research by Anthony Roth and Peter Fonaghy

I'm working on this area in terms of real investment in the treatment of mental illness and await my copy of the book with interest, as it attempts to resolve the war that broke out between different talking therapies in the past few decades. My understanding is that while it does find good RCT evidence for CBT style therapies for anxiety disorders, depression and pyschosis, it remains equivocal about psychodynamic, but gives it the benefit of the doubt for now on the basis that although there is no real evidence of harm done, neither is their scientific evidence of benefit, as a rule, and (the answer to all research questions) more research is needed. As a lay person, while it seems that quite ill people do benefit from psychodynamic therapy, it is difficult to get a sense of whether a cup of coffee and a chat with a sympathetic $50,000 a year nurse twice a week would be any less effective than a cup of coffee and chat twice a week with a $250,000 a year psychotherapist. Whilst either option is apparently quite effective in keeping borderline personality disorder patients more stable, less self harming and out of acute wards and ER depts, the added value of the pyschodynamic element isn't particularly evident. Happy to be contradicted....

You are invited to visit and read "A Fundamental Revision" in Psychoanalytic Theory Islandsage 18:54, 21 May 2006 (UTC)

Removed paragraph

I took this paragraph out of the Criticism section. It may have been over-hasty. But it the way it reads at present is, I think, over-rambling and could use more concision. Bacchiad 14:35, 14 June 2006 (UTC)

Psychoanalysts have often complained about the significant lack of theoretical agreement among analysts of different schools. Many authors have attempted to integrate the various theories, with limited success. An important consequence of the wide variety of psychoanalytic theories is that psychoanalysis is difficult to criticize as a whole. Many critics have attempted to offer criticisms of psychoanalysis that were in fact only criticisms of specific ideas present only in one or more theories, rather than in all of psychoanalysis. For example, it is common for critics of psychoanalysis to focus on Freud's ideas, even though only a fraction of contemporary analysts still hold to Freud's major theses. As the psychoanalytic researcher Drew Westen puts it, "Critics have typically focused on a version of psychoanalytic theory—circa 1920 at best—that few contemporary analysts find compelling...In so doing, however, they have set the terms of the public debate and have led many analysts, I believe mistakenly, down an indefensible path of trying to defend a 75 to 100-year-old version of a theory and therapy that has changed substantially since Freud laid its foundations at the turn of the century." link to Westen article

Although I agree the criticism section is bad and needs cleanup, not sure there is real improvement there. We should probably keep the section on philosophical and theoretical objections in the hope that someone will clean it up. Popper should stay in the subsection on scientific method. Also, I would keep at least some ideas from the paragraph you mention. The fact that "An important consequence of the wide variety of psychoanalytic theories is that psychoanalysis is difficult to criticize as a whole" is important. I suggest reverting to the previous version and address problems one by one. Dragice 15:40, 14 June 2006 (UTC)

I have restored deleted content. Much more than that one paragraph was removed. I agree the section could be vastly improved. Fred Bauder 15:58, 14 June 2006 (UTC)

Some was re-written. No more than that was removed outright. Bacchiad 20:30, 14 June 2006 (UTC)

Attachment theory

Is also a part of the psychoanalyses.

Unclear

I suppose this makes sense if it were clarified:

Some more recent forms of psychoanalysis seek, among other things, to help patients gain self-esteem through greater trust of the self, overcome the fear of death and its effects on current behavior, and maintain several relationships that appear to be incompatible.

Fred Bauder 17:34, 30 June 2006 (UTC)

Under the "Research" section, this sentence appears: "In the past 30 years or so, the criticisms have centered on the issue of empirical verification,[37] in spite of many empirical, prospective research studies that have been empirically validated." This doesn't make sense as written, to refer to empirical studies that have been empirically validated. —Preceding unsigned comment added by 99.133.188.104 (talk) 15:11, 14 February 2010 (UTC)

Give the controversy its own page

Suggestion: As a simple layman who's been in therapy for 1.5 years, I came to this page for more information regarding psychoanalysis, not for the controversy over it. It's hard to follow a discussion regarding the controversies over a subject when you are not fully knowledgeable over the various different types of therapies in the controversy, not all of which are defined in this page (for example, CBT is not defined here so how can a layman reader truly appreciate the controversy regarding psychoanalysis vs CBT therapy?).

My suggestion is to move the controversy regarding the different therapies to another page. Have each of the therapies described in their own pages, and then have a separate page for the controversies of each of these different therapies in its own separate page.

Otherwise, I must ask why the controversy is not stated in each and every therapy related page, such as CBT? Why would the controversy be given only in the psychoanalysis page? I think this is not only poor organization, but it is also highly biased to single out one therapy among them all to state the controversy. The controversy is a subject, in an of itself, and should be given its own page rather than piggy-backed on just one of the many therapies included in the controversy. --24.242.210.144 14:56, 3 July 2006 (UTC)

I gather CBT is Cognitive therapy. I suppose we could create an article comparative effectiveness of psychotherapy. I know that HMO's have tried to figure this question out. Perhaps some published research has come out of their efforts. Fred Bauder 18:00, 3 July 2006 (UTC)

Yes, I intended CBT to refer to Cognitive Behavior(al) Therapy.

HMO's are inherently biased as they have one primary goal in mind: pay as little, if any at all, as possible. I would not trust any source with such a strong bias. Further, the whole process of comparing the effectiveness of the various methods of psychotherapies is riddled with so many variables that it makes it seemingly impossible to truly pin down.

How about a basic pro's and con's page of the various therapies? It could list the arguments between all the various therapies, both good and bad, with an introduction explaining why it is so difficult determine any single therapy as "the best."

I guess the first question is who is the intended audience? I believe I'm just one step above what I think is the intended audience: a layman who knows little about psychotherapy, but has an interest or need to know (professionals in the business would not turn to wiki for their information). From that perspective, I think it is most important to inform a person seeking information that not all therapists are alike and they do not all practice the same types of therapy. It is an easy misconception. After all, when you go to most other doctors, they generally do the same thing as their fellow doctors in their same field. Psychotherapy is one area in which a person who doesn't know better won't have any idea that different therapist offer very different therapies, all offered under the same basic heading of "therapy."

Therefore, as a consumer, I would find it very helpful to have a source that first explained why there is no one, single best therapy, and then offer the various pro's, con's and arguments of the various methods of therapy available, including whatever data can be found (but, let's watch out for biases such as with HMO's). By doing this, it would also clean up this page and remedy the bias of having this page be the page to hold that info when all other pages regarding therapy do not. It seems like a win/win/win situation to me. --24.242.210.144 05:47, 4 July 2006 (UTC)

Ego Psychology comment

I am confused about the current phrasing of the ego psychology subheading under History. It states that Freud was opposed to ego psychology (its definition seems to be a little shaky to me anyway). The idea that Freud was opposed to a psychology concerning defense mechanisms and unconscious fantasies has me puzzled. While I am no expert on psychoanalysis, doesn't this seem like a completely contradictory position to impute to Freud? His Ucs./Pcs.-Cs., topographic model of the mind is built upon fantasy and its role in the formation of symptoms (and this element seems to me to be carried over into his structural theory of mind), and certainly its included concepts of displacement, symbolization and condensation, by which the raw content of the Ucs. system is disguised, bear similarities to the general idea of 'defense mechanisms'. Am I just hopelessly confused or is the current phrasing of this part of the article problematic?--Calamus 2308 EDT, 9 July 2006

External links?

The external links section here seems a little out of control. Jkelly 18:20, 16 July 2006 (UTC)

But they all seem relevant to the article. Perhaps there is another way to format that section? DPeterson^talk 00:50, 15 August 2006 (UTC)

Maybe there is some way to create a subpage for external links...or maybe set up the external links into sections? JonesRD_talk 18:01, 20 August 2006 (UTC)

Adaptations

I have re-added the adapations that were placed originally. Someone deleted this large section without much discussion. Specifically, there is no mention of play therapy.whicky1978 ^talk 03:45, 31 August 2006 (UTC)

What a mess

The article is a mess. All this discussion but no one that is good with formatting articles has bothered to touch this thing?

I'd suggest you to ask Jeffrey Moussaieff Masson to do this work. He is brilliant.

Literature about training analysis'

• Final Analysis: The Making and Unmaking of A Psychoanalyst, Addison-Wesley Publishing Company, Inc., 1990, ISBN 0-201-52368-X, by Jeffrey Moussaieff Masson

• Flowers on Granite. One Woman's Odyssey Through Psychoanalysis, Creative Art Book Co., 1986, by Dörte von Drigalski, ISBN 0887390137

• `` The Analysand's Tale, by Robert Morley, Karnac Books, 2007,

    ISBN-13;978 1 85575 437 9  yelrrom

Cost and length lack common units

Some psychodynamic approaches, ... limit treatment to 20-30 sessions. Full-fledged psychoanalysis, however, generally lasts longer, with an average of 5.7 years,

Common units would make this comparison more useful. That is, readers aren't told how many sessions occur in the average 5.7 years. 250? 500? And how long would 20-30 session take? Months? Years?

Also, the positive sounding adjective "full-fledged" doesn't seem too neutral, as it implies, that longer (or "fuller") treatment is somehow better than those shorter (presumably "sparser") ones.

--AC 09:46, 23 October 2006 (UTC)

Views of religions on Psychoanalysis

As this article does not mention religous views on Psychoanalysis in the article or in the external links section, I would like to have the opinion of others of where this should go. There is for example the popes views on this at http://query.nytimes.com/gst/fullpage.html?sec=health&res=9F0CEED7173EF930A35752C0A965958260 and a Jewish view from Chabad on this at http://www.chabad.org/article.asp?AID=3035 and I'm sure there is much more. Would this go in this article, or a new article on this? And either way would it be appropriate to have these links in the external links section? --PinchasC | £€åV€ m€ å m€§§åg€ 22:54, 24 October 2006 (UTC)

Hi, I have made some changes to the remarks on Derrida in the 'Theoretical Criticism' section. What motivated me to make these changes was initally that there was no real account of how Derrida criticizes Freud, but merely an account of how Derrida was influenced by him. I have extended (and slightly corrected) the paragraph in order to succinctly, yet I hope accurately, give an account of the double-edged theoretical relationship between the thinkers. I need to add a few references. Oh, and it seems to appear in italics on the page, I am not sure why. SF Italics problem solved! SF

List of current schools

I made some changes to the list of current schools, which is for some reason under history (i will edit that too). I combined melanie klein and object relations theory, since they are they same. i wasn't sure what to do with the margaret mahler reference so i took it out- if someone very much wants to put it back there in a non-awkward fashion that would be fine.Acornwithwings 22:55, 16 December 2006 (UTC)

I would rename the "current schools" to "current schools of thought." This is to differentiate it from places where people can get training in psychoanalysis. Writerz (talk) —Preceding undated comment was added at 02:06, 13 August 2008 (UTC)

History of Psychoanalysis

[4] Does this link work here? It is about history of Psychoanalysis connected with New York City. Austerlitz 88.72.24.127 08:44, 5 February 2007 (UTC) Now it is working at the main page, too. (Has been my fault because of wrong typing.)

I have not read the whole thing. Perhaps if you do it is only a rant, but the vision of the true faith being guarded by a few is sound enough. In fact, it was this aspect which permitted Jeffrey Moussaieff Masson to penetrate the inner circle based on a personal relationship with Kurt Eissler. Fred Bauder 14:05, 5 February 2007 (UTC)

==This discussion seems to be rather sterile, confusing two different issues ie the truth claim of psychoanalytic theory, and the effectiveness of psychoanalysis/psychotherapy. The first of these questions is discussed by Gomez (2005) in her book, `Freud Wars'. She discusses three major critiques of psychoanalysis by Grunbaum, Nagel and Habermas. She dismisses each as offering a distorted version of psychoanalysis. She argues that Grunbaum's claim that psychoanalysis can be tested by the scientific hypothetic-deductive method, but that it cannnot pass that test, ignores an important and central aspect of psychoanalysis, namely the psychical(of which more later). Nagel's more friendly approach, which asserts that objective knowledge may osbe established by other than sientific methods,is also dismissed because he fails to say what those methods might be. The evidence of comon sense is not sufficient. Equally Habermas's claim that the truth of psychoanalysis is to be found in the hermeneutic is also dismissed. Psychanalysis is not merely symbolic but its essence lies between the physical and the mental, linking the two in the realm of the psychical, which lies midway between the hermeneutic subjectivities and the empirical-scientific sense of independence from the mind. It offers a foundation where these two differing types of explanation may in principle converge. She leaves the question of how this convergence can occur open, in favour of a search for where they converge. Almost any discussion of thr truth claims for psychoanalysis leaves as many questions as it answers, but this is a brave attempt to disentangle some of those complexities.

The effectivenes of psychoanalysis as a treatment is much more difficult to establish, but it seems clear that at least some medical or psychiatric have unconscious foundations which can at least be approached by the psychoanalytic method of free association. "yelrrom".== \

all his thoughts reffered to sex. —Preceding unsigned comment added by 68.122.80.219 (talk) 04:32, 6 September 2007 (UTC)

Relation with Psychology

It was my impression that there was some degree of reconciliation between mainstream psychology and some parts of psychoanalysis, has this happened? —Preceding unsigned comment added by 204.52.215.67 (talk) 22:43, 7 November 2007 (UTC)

Certain elements of psychoanalytic paradigm have slowly been incorporated into "mainstream" psychology. Most apparent is the Freudian psychodynamics of the tripartite model of human personality utilised in Transactional Analysis wherein the Analysand is taught responsible methods of balancing interaction of the Adult, Child, and Parent (Ego, Id, and Superego). Although this is obviously not psychoanalysis the borrowing is obvious.

CWatchman (talk) 04:14, 8 March 2008 (UTC)

Many other paradigms have used Freuds pschodynamic model but it is much less obvious. Freuds contribution to modern Psychology has not been accurately aknowledged.

76.76.5.103 (talk) 23:05, 8 March 2008 (UTC)

Concerns about Related Articles

Would people who watch this page please check out the articles Psychohistory and Early infanticidal childrearing? They seem to claim or suggest some relation to Freud. But I have concerns that they marginalize notable (let alone majority or mainstream) views in favor of one person's fringe view, and may present pseudoscience as science. I was once involved in a flame war with one of the principle authors and it would be inappropriate for me to speedy delete or even nominate for deletion either of these. This may not be apparent as someone recently archived most of the talk history. Be that as it may, these are two articles that have somehow been off the radar. I would appreciate it if well-infrmed editors would look at them and comment, or discuss the appropriate course of action. thanks, Slrubenstein | Talk 23:57, 30 January 2008 (UTC)

Plato

The article says that unconscious functioning was discussed by Plato. This is, to the best of my understanding, wrong. Plato did not have a concept of the 'unconscious' in the same sense that Freud did. I will probably remove this. Skoojal (talk) 08:13, 9 March 2008 (UTC)

the unconscious comes from Hartmann, if memory serves Guinness4life (talk) 00:43, 13 August 2009 (UTC)

And we're back to the intellectual illiteracy again: you can't say *anything* comes from Hartmann without stating precisely what he thought he meant and what his unstated assumptions were. Was Hartmann's 'unconscious' (if any) dynamically repressed, like Freud's? Or was it more like Janet's 'subconscient' -- in which case it's irreconcilably different? What was the word Hartmann used for it? Where did he get that word from? How did his concept find its way into English? What philosophical or/and scientific tradition did he start from? And so on...

The reason these articles are all so appallingly naff is because intellectual illiterates just lump things together because they vaguely sound like each other if you use the same English words for them... Pfistermeister (talk) 09:44, 13 August 2009 (UTC)

E.V. Hartmann's concept of the unconscious (Philosophy of the Unconscious, much?) was the precursor to Jung's (J even mentions it in his autobio) and draws from the synthesis of Hegel and Schopenhauer, German Idealism and the early psychological tradition. Thanks for playing, but I actually know what I'm talking about. I was assuming the people editing this page had enough familiarity with the history of psychology to know the basic concept presented in E.V. Hartmann and how he was a notable direct forerunner to Jungian concepts and due to its popularity at the country at the time - it's quite likely it had some influence on Freud as well. What we do not know we must pass over in silence. Try it. Guinness4life (talk) 20:03, 18 October 2009 (UTC)

Lead

I deleted the following paragraph from the lead:

21st century psychoanalysis comprises several interlocking theories concerning the development, throughout childhood, adolescence, and adulthood of the functioning of the mind. The theories include: Ego psychology (Hartmann, 1939; Gay, Busch, 2005); Conflict theory (Brenner, 2006); Object relations theory (Edith Jacobson, 1960; Margaret Mahler, 1975; Akhtar, 1998); Identity theory (Erikson, 1960s); Defense theory (Blackman, 2003); Affect theory (Brenner, 1982); Drive theory (Freud, 1920); Compromise formation theory (Waelder, 1936, Brenner 2006); Self-psychology (Kohut, 1971); Attachment theory (Bowlby, 1944 et seq); Superego theory (Kernberg, 1975; Sandler, 1960); Relational theory (Mitchell, 2000); and Intersubjective Theory (Inderbitzen, Renik).

because I thought it was too detailed for the lead, and the info all appears later, and it's really a list as opposed to a paragraph - but I'm leaving it here in case anyone objects, has a comment, etc. Dawn Bard (talk) 18:38, 22 April 2008 (UTC)

Noam Chomsky a critic of psychoanalysis? So what?

You can see what I'm saying. I'm aware that Chomsky is a famous psychologist; I still wonder what makes his criticisms of psychoanalysis important enough that he has to be mentioned here. The article doesn't mention any of his specific criticisms. Skoojal (talk) 09:38, 25 June 2008 (UTC)

Indeed. It's another familiar tactic in the 'Freud Wars': find someone who's said something against p/a, and throw it all in. Chomsky's psychological expertise is in theoretical linguistics and certain branches of cognitive psychology: none of that qualifies him to comment in detail on p/a; and in fact I doubt that he has. From this we may conclude that he needn't be mentioned here. Pfistermeister (talk) 18:33, 30 June 2008 (UTC)

I removed the mention of Chomsky. Since none of Chomsky's specific criticisms of psychoanalysis were mentioned in the article, lisiting him as a critic of psychoanalysis serves no obvious purpose (except to make that list longer for the sake of it maybe). Skoojal (talk) 05:27, 17 July 2008 (UTC)

Noam Chomsky's area of expertise is Linguistics. That's what he did his PhD in. That's it. He has not ever been a psychologist. —Preceding unsigned comment added by Guinness4life (talk • contribs) 01:44, 8 May 2009 (UTC)

Where has this link gone?

• [5]

Austerlitz -- 88.72.12.22 (talk) 10:15, 30 June 2008 (UTC)

Refs/cites

I have endeavoured to put all the refs into template form and showing on the reflist rather than scattered throughout the article. However, there is still a large number of inline citations with insufficient information to create an accessible ref. This article is full of densly packed, scholarly information and I do not have the knowledge to hunt down all the inline refs. If whoever wrote this would like to give me details of the inline cites I am happy to covert them to Wiki type citations. Fainites ^barley 18:03, 9 November 2008 (UTC)

Comments

I agree this article is very poor article and appears to take a very biassed view. I added what must be true, that psycho-analysis was an expensive procedure , and that it was untested and this was removed almost immediately. There is no such thing as a low cost treatment that requires upwards of 120 hours of a professionals time for some years and it is silly to suggest otherwise.

The article also contains statements to the effect that the lack of empirical research has and is being rectified. This is just plain untrue. —Preceding unsigned comment added by 121.210.161.133 (talk) 10:53, 26 February 2008 (UTC)

Yeah I had a friend who had to undergo it to become a child psychotherapist and it was weekly for 5 years at £125 a week. Actually it took her 7 years as the analyst said she was "stuck". Thats why its not available on the NHS! Fainites ^barleyscribs 20:44, 9 May 2009 (UTC)

Because of Your friend? Really?95.89.164.91 (talk) 21:07, 18 October 2010 (UTC)

I agree that the article is biased in favor of p/a. afaik it is commonly accepted in mainstream scientific psychology that p/a is pseudoscience. As this is only mentioned in the criticism section, it creates the appearance that p/a is commonly accepted as true but has just a few critics. O.mangold (talk) 08:48, 11 December 2010 (UTC)

Irrelevant Criticisms

While, obviously, an article on the subject of Sigmund Freud himself might be enlightened by noting the allegations of an inherent fascistic element to his ideas, I fail to see their relevance in regards to the subject of Psychoanalysis itself. In fact, arguments could be presented identifying the both the quotation and its inclusion in the article as one of several species of Ad Hominem. Neither the political disposition and attitudes of the discipline's practitioners, or the postulated compatibility of the discipline itself to an ill-favored political system have any significance on an objective judgment of it's validity regardless of their validity otherwise. A Science, however disputed in it's legitimacy, can only judged on its provability-- criticisms of it's application are attached to those who have applied it. I would, however, be willing to accept that I simply failed to comprehend this argument in some way. In this case I would only protest that some nuance or ambiguity in the phrasing be rethought. Lky 76.214.49.166 (talk) 22:52, 14 February 2010 (UTC) Appended to reflect newly registered account.... Badfolk (talk) 22:59, 14 February 2010 (UTC)

Copyright infringement

See here: http://www.psychotherapy.ro/resources/mental-disorders/psychoanalysis-theories/ —Preceding unsigned comment added by Ilikeliljon (talk • contribs) 16:47, 8 May 2009 (UTC)

Looks like it started being added here and here. Of course it may be that the resources web is a copy of the wiki article rather than the other way round and that User:Profjsb is the author as he seems to say here.Fainites ^barleyscribs 21:58, 29 May 2009 (UTC)

Micropsychoanalysis and Silvio Fanti

I would like to let anyone know about my intention of including micropsychoanalysis in the theories section. Micropsychoanalysis was founded by Silvio Fanti in Switzerland in the 1950s. It is a very innovative school of psychoanalysis popular in Switzerland, France and norther Italy. I will wait a few days for comments and reactions and then I will add the entry. I hope anyone agrees and the entry is welcomed. Thank you. --Thespanishdub (talk) 17:27, 18 July 2010 (UTC)

The following link may deserve your attention es:Wikipedia:Consultas_de_borrado/Micropsicoanálisis This article has been deleted from es because of not being neutral and being a primary source instead.--Rapel (talk) 22:08, 5 October 2010 (UTC)

Jung

Jung has not been mentioned in the article. Neither have other psychoanalysts been mentioned. Fellowscientist (talk) 17:40, 14 October 2010 (UTC)

History 1890s

Some paragraphs in the History 1890s section contained inaccurate information, and I have replaced them with three new paragraphs. Esterson (talk) 18:01, 10 December 2010 (UTC)