Although some of his theories are still hotly debated, Sigmund Freud, (1856–1939) is widely regarded as a trailblazer in the realm of psychiatry and psychology. The Austrian psychiatrist and neurologist, who was allegedly the first to offer a comprehensive explanation of how human behavior is determined by the conscious and unconscious forces, is regarded as the founder of psychoanalysis.
Along with the “talk therapy” that remains the staple of psychiatric treatment to this day, Freud popularized, among other notions, such concepts as the psychosexual stages of development; Oedipus complex; transference; dream symbolism; Ego, Id, and Super-Ego; and the one that has become part of the colloquial English more than any other psychiatric term—the Freudian slip.
Malcolm Macmillan is an Australian psychologist who has been a clinician (intellectual disability, childhood psychoses), a university teacher in the area of psychopathology and has researched topics such as hypnosis, self-change, and depression. He has made critical, historically-based evaluations of psychoanalysis and has investigated aspects of the history of the development of the doctrine of localization of brain function. He has published on most of these topics and is also the author of the award-winning An Odd Kind of Fame: Stories of Phineas Gage and the highly regarded Freud Evaluated: The Completed Arc, both MIT Press.
Simply Charly: Sigmund Freud was responsible for popularizing the idea that a person’s interior life merited not just attention but dedicated exploration—a notion that has since propelled tens of millions of people into psychotherapy. Do you think this effort was misguided? Or do you feel there is merit to the path he paved?
Malcolm Macmillan: I’d agree that interior lives warrant attention, but I’d put severe qualifications on how they should be explored. Freud’s free association and interpretation are completely inadequate for the navigational task.
Free association is too much influenced by the expectations of the analyst, and the interpretation of the data recovered by it is too indeterminate to tell us anything reliable about what goes on in the interior of the continent; These conclusions of mine are not mere opinions; they follow with iron logic from equally iron-cast therapeutic facts and are confirmed by the opinions of a number (unfortunately small) of self-critical psychoanalysts.
Free association. Like contemporary psychoanalysts, Freud asked his patients to speak whatever came into their minds as they roamed their interior pathways. According to him, the method recovered the trains of ideas or associations linking symptoms and unconscious causes. Freud paid special attention to those parts of the patients’ journey in which they seemed to lose direction, or could not explain where they were going. He believed those gaps indicated the presence of unconscious forces that repressed the ideas that should have provided the next step, and that free association uncovered it.
Until the end of his life, Freud believed the method was as reliable as the microscope and that what it found was uninfluenced by the psychoanalyst’s expectations. Almost all his modern followers take the same view, although a very small number of them grudgingly admit that the basic data of psychoanalysis might not be anywhere as reliable. Studies of one-to-one verbal psychotherapies show that what patients talk about and how they come to think about themselves is a function of the therapist’s theoretical framework rather than the ideas of the patient.
Interpretation. The data recovered by free association are given meaning by being interpreted. The meaning of the elements of a dream and the dream’s overall meaning, for example, are supposed to be built up or constructed from the patient’s associations. Formal comparative studies of the interpretations of the same dreams, symptoms, and the like by different psychoanalysts show there is little agreement among them. Without interpretations being compared with what actually is the case, they can only be judged by their plausibility, and unless interpretations are widely outlandish, there is no way to judge which among them is the most correct. Given this fundamental indeterminism, the disagreement among analysts is not surprising.
Indeterminism is particularly acute when the modern psychoanalyst follows Freud and constructs or reconstructs some part of the patient’s hidden past. Although the correctness of these kinds of construction ought to be judged by what really happened, neither Freud nor his modern followers usually make such comparisons. As a consequence, much of what passes for a Freudian developmental history is little more than speculation.
It is only the basic unreliability of the data obtained by free association and the indeterminism of the interpretations and constructions based on them that explains the existence of the widely disparate and conflicting “schools” of psychoanalysis.
SC: In your book, Freud Evaluated: The Completed Arc, you state that it was central to your argument when judging Freud’s theories that they are placed within their historical context? Can you tell us why?
MM: I meant more than usual by this phrase. I justified Freud’s evidence for his theoretical ideas and assessed how well he used the standards of his time to draw his conclusions. I also put his ideas into a developmental framework. At each stage of his theorizing, I assessed how well his clinical observations and other relevant evidence supported his theory and its associated theoretical concepts and tried to determine the effects of those conclusions on his later theorizing.
Let me cite an example that illuminates the sources of Freud’s emphasis on and conceptualization of libido, the sexual drive. The first neuroses for which Freud tried to find the causes were anxiety neurosis and neurasthenia. His observations were the frequency of one of two specific sexual practices in each neurosis, and he evaluated the causal status of these practices by using what he claimed was a standard procedure for identifying the specific bacteria that caused physical diseases. But Freud’s use of the method was faulty, and he mistakenly concluded that each neurosis was caused by its own specific sexual practice.
A few months later Freud used the same equally faulty method to “identify” the sexual causes of neuroses like hysteria and obsessional neuroses. The first mistake had laid the foundations for the exclusive causal role Freud gave sexuality; the second confirmed it for him. I believe my evaluation brings out this development and its consequences more clearly than other analyses.
SC: Freud has been analyzed more than he analyzed others. Indeed, little, if any, of Freud’s work has survived the scrutiny of later research. Can you give us a few examples of Freudian theories that have been debunked?
MM: Debunked is not a word I would choose. Too many of his concepts have been disproved to discuss in this limited arena, and unfortunately, I must omit his concepts of repression and those of the division of the mental apparatus into ego, super-ego, and id, but here are three important ones:
i) Although we all have a sexual drive, Freud’s particular concept of it—libido—never found favor with many psychologists and has been abandoned by most psychoanalysts. One part is hardly controversial-the drive is based on physiological processes. The other part, that the drive consisted of the three oral, anal, and phallic components that sought perverse satisfaction through stimulation of the three related body zones, and that libidinal development was caused and controlled by a biological process, is. Freud himself had little direct evidence for libido having these three components when he formulated the concept and misrepresented what little he did have on the sexual nature of the pleasures children derived from thumb-sucking. Virtually no evidence confirming the drive or the personality traits supposed to develop from fixations of the three components of the drive has since been found.
ii) Clearly, the sexual and gender characteristics of males and females develop over time, but Freud’s explanation, especially for females, is so tortuous that it was controversial among his followers at the time, and few of them believe it today.
Freud assumed, incorrectly even then, that the libido was originally male for both sexes and was directed to females. According to his clinical observations and interpretations, the final adult choice of a female sexual object by the male child came only after the resolution of the Oedipus complex. Fear of castration by the father had deflected the boy’s libido from his mother to an unrelated female.
Up to the Oedipal stage, female children developed in the same way. Because there could be no castration threat, the Oedipus complex was unresolved, leaving the girl with a passive sexuality and a weaker superego and moral standards. In any case, many modern psychoanalysts deny the universality of the complex, and many also deny they find it even in “Western” families.
iii) Transference—the patients’ transferring to the analyst of the infantile sexual feelings they once had had toward their own parents—was an essential part of Freud’s own treatment and his theory of therapy. It no longer has that place.
Freud expected transference would revive the pattern of infantile feelings responsible for the adult patients’ neurosis by generating an infantile neurosis, the resolution of which was an essential part of therapy. Contemporary psychoanalysts have failed to find that that transference is an essential ingredient of successful therapy although, at the same time, they cannot agree on its manifestations. Nor have the main research projects on transference been able to establish its basis in infantile sexuality. Nevertheless, feelings of dependency toward the analyst are still called “transference” and are supposed to be worked through in therapy. All that even Freudian couch-carrying sympathizers now call transference is the platitude that one’s feelings toward others are based on one’s childhood experiences.
SC: Philosopher Karl Popper argued that Freud’s psychoanalytic theories were presented in untestable form. What do you make of Popper’s claim?
MM: Not a great deal. Partly this is because Popper’s claim is embedded in very debatable propositions about the nature of scientific inquiry and partly because, as you can see from the examples I have already mentioned, he was wrong about psychoanalytic propositions not being testable.
Scientific theories can only be confirmed by testing the logical consequences (the hypotheses) predicted from them. If the consequences aren’t observed, i.e., if the prediction fails, the particular hypothesis is disproved. But if the prediction is confirmed, the hypothesis is not necessarily correct—it merely tells one that the hypothesis might be true. Testing a whole theory is more complicated because it usually requires testing several related hypotheses of differing centrality to the theory. Even what happens after disproof is more complicated than Popper allows. Disconfirmations do not cause scientists to give up their theories or even their hypotheses. Usually, they modify them in small ways rather than abandon them.
A further limitation of Popper’s thinking is that it does not deal with the consequences of hypotheses being confirmed or the problem of how scientific theories come to be accepted. My favorite question to ask Popper (were that possible) is: “At what point was Galileo Galilei’s theory that the earth revolved around the sun accepted as a more-or-less true reflection of the structure of our solar system?” I don’t know, but I doubt it was solely through the confirmations or disconfirmations of particular hypotheses. This limitation of Popper’s thinking means that he does not help us judge whether what psychoanalysis tells us is more or less true.
SC: Do you think it’s fair to assess and to justify Freud’s psychoanalytic theory within the framework of the natural sciences?
MM: Yes, primarily because that is where Freud always placed it. He frequently drew parallels between his work and the natural sciences even saying, right at the end of his life, that the inferences made by psychoanalysts filled gaps in the phenomena of consciousness in the same way that the inferences made by physicists filled the gaps in their observations of atomic particles. I see the assertions of some modern psychoanalysts that Freud’s endeavor is not a natural science, as an attempt to replace what might really be the case about people and the causes of their behavior with the merely plausible. And, to my knowledge, none has explained how Freud could have been so mistaken about his mission.
SC: Our notion of sex has never been the same after Freud pointed to its overarching significance. Do you think his contamination of our perceptions has been pernicious?
MM: Yes and no. I’m sure most people don’t know what Freud’s theory of sexuality really entails. So, even though they use such terms as “id” or “anal character,” I’m sure they don’t understand or accept the overarching significance he undoubtedly gave it. Nor do they know he was merely one of a number of late 19th century workers, mainly medical, who paved the way for the sexual revolution that took place in the 1920s. Recognizing the role sexuality plays in our lives cannot be pernicious. What really is pernicious are false notions about its nature and ramifications.
SC: Freud’s concept of the “unconscious” implies that the mind and body are two different kinds of entities or substances and that mental states are connected to physical events. Do you think his dualist stance led him astray as the mind/body problem remains insoluble?
MM: I doubt that the insolubility of the mind/body problem has much to do with dualism. In any case, Freud was not a dualist, and neither the acceptance of unconscious motives nor an unconscious mind, even when thought of as causing physical effects, makes one so. As early as in his 1891 book On Aphasia, Freud said explicitly: “The psychological is thus a parallel process to the physiological one (‘a dependent concomitant’).” This conceptualization is not a dualist one; a dualist would hold the psychological and physiological to be only concomitants. Freud’s is the materialist view that commonly underpins the work of natural scientists.
SC: If it is true that much of what Freud postulated is untrue and that psychoanalysis is nothing but a pseudo-science, then what do you make of psychoanalysts who stress that their enterprise has come a long way since the time of Freud—existing theories have evolved, new theories have emerged, and many of Freud’s ideas have been shown to be true through overwhelming, rigorous clinical observation?
MM: My question to those who make assertions like these is “Where is the evidence?” What supports the assertion that the new formulations are supported by clinical, observational, or experimentally established facts, and where is the evidence of the “overwhelming, rigorous clinical observation” that shows Freud to have been right?
Far from improving things, the new formulations have precipitated psychoanalysis into what seems to be its deepest theoretical and practical crises. Within the past five years, notable psychoanalysts like Bornstein, Rangell, Meissner, and Schacter have stressed this. As Fayek put it, “Analysts and candidates are unable to define what is considered psychoanalysis. Patients and the public, in general, do not know where to find it or what to look for.” In fact, so deep is the crisis that the International Psychoanalytic Association set up special research projects in 2003 to resolve it. So far, until 2007, all they have been able to do is attract a few more patients and trainee analysts by publicizing their efforts (often with the external assistance of governments and universities).
As for Freud’s ideas being “true,” apart from the clinical-observational basis of my published criticism, there is any number of compilations of clinical and experimental findings that show the central ones to be false and that only a few of the less important are supported (and then weakly at best).
SC: Freud was a prolific writer. His collected works comprise 24 volumes, not counting his voluminous correspondence. For someone who produced so much, is there any explanatory power left in any of his theories?
MM: One has only to turn to the 63 pages making up Albert Einstein’s four early annus mirabilis papers to see that explanatory power is not a function of how much a scientist writes. Yes, there is plenty of explanatory power in Freud’s theories, but it is a pseudo-explanatory power. If one accepts, for example, that the unconscious mind as conceived by Freud lacks a sense of logic, reality, or language, but can nevertheless generate the most logical, multi-lingual, and creative slips of the tongue and dreams, one can “explain” those kinds of everyday phenomena. Again, if one accepts—as did Freud—that humans come into the world equipped with a memory of fathers’ actually castrating their sons in pre-historic times, one can explain how a severe superego can develop even when children have actually not been punished for sexual play or sexual feelings toward their mothers.
SC: If Freud was so wrong, if his methods remain dubious and if he was a poor and possibly unethical practitioner, then why is he so irrepressible?
MM: I’m not sure how much of the “unethical” and “poor” labeling I’d accept. “Dubious” is much more certain. It is almost certain that he assigned to others his own slips of the tongue and failures of memory, and “explained” them with unconscious causes—although they were most probably not brought about by his own unconscious motives. Psychoanalysts also concede that the central events in two of his most important published case histories (those of Ratman and the Wolfman) did not take place in the way Freud described. Nor was Anna O.’s case—the foundation case of psychoanalysis—as he and Breuer portrayed it. She was not cured, and her symptoms were not alleviated by emotional expression (catharsis).
“Irrepressible” is a word I’d accept and would argue there are four reasons for using it:
i) Psychoanalysis seems to offer explanations about precisely those things in which people have the greatest interest and about which no other psychology says anything very much. This is especially true of the twin topics of sex and the interpretation of dreams or faulty actions. But as I have argued, the explanations are not real but are pseudo-explanations.
ii) Because the most fundamental criticisms of Freud’s theories arise from within psychoanalysis itself, most people are completely unaware of them. Nor do they know that there is no agreement among analysts about the kind of psychoanalytic theory and practice that should replace Freud’s original.
iii) Almost everyone takes it for granted that psychoanalysis is an effective psychotherapy. However, although Freud said a successful outcome of a psychoanalysis depended on the generation and resolution of transference during it, almost all modern studies of therapy show transference is not at all necessary. Nor do people know there is no evidence that psychoanalysis has an outcome rate much better than the 66% Eysenck reported in the 1950s as the rate for minimally treated neuroses. The best that psychoanalysts can now say is that their results are not worse than those of the cognitive behavior therapies.
iv) Finally, there is the attraction of the irrational impulses that psychoanalysis seems to discover. Many people feel their lives are at the mercy of forces they can’t control, and Freudian theory seems to give them insight into those forces. Moreover, psychoanalysis has a particular appeal in that it draws on everyday psychological concepts like sexual drives or feelings of guilt. Although they are unconscious, these drives and feelings act in the same way as their conscious counterparts. Most psychoanalytic explanations are therefore easy to understand.
As Frank Cioffi has pointed out, this ease of understanding is part of what Wittgenstein called the “charm” of psychoanalysis. And how easy it is to apply psychoanalytic concepts to others! Because of the indeterminism of interpretation, almost any interpretation or reconstruction can, within limits, be matched by another equally as good. There is simply no way of judging the accuracy of an interpretation of a dream, a slip of the tongue, or the reconstruction of the significant events in one’s life or those of one’s friends. More, even an amateur’s efforts are likely to be as plausibly satisfying as that of a professional.
The reason we still argue about Freud, Cioffi also says, is this very indeterminism. There is no way of judging whether which of Freud’s or any of the later modifications of his theory are more or less correct. Not only that; with the possibility of seemingly profound knowledge immediately available to everyone, and with apparent minute-by-minute confirmation of one’s insights into one’s self and others, it will always be “irrepressible.”