Freud's story, like most people's stories, begins with others. In his case those others were his mentor and friend, Dr. Joseph Breuer, and Breuer's patient, called Anna O.

Anna O. was Joseph Breuer's patient from 1880 through 1882. Twenty one years old, Anna spent most of her time nursing her ailing father. She developed a bad cough that proved to have no physical basis. She developed some speech difficulties, then became mute, and then began speaking only in English, rather than her usual German.

When her father died she began to refuse food, and developed an unusual set of problems. She lost the feeling in her hands and feet, developed some paralysis, and began to have involuntary spasms. She also had visual hallucinations and tunnel vision. But when specialists were consulted, no physical causes for these problems could be found.

If all this weren't enough, she had fairy-tale fantasies, dramatic mood swings, and made several suicide attempts. Breuer's diagnosis was that she was suffering from what was then called hysteria (now called conversion disorder), which meant she had symptoms that appeared to be physical, but were not.

In the evenings, Anna would sink into states of what Breuer called "spontaneous hypnosis," or what Anna herself called "clouds." Breuer found that, during these trance-like states, she could explain her day-time fantasies and other experiences, and she felt better afterwards. Anna called these episodes "chimney sweeping" and "the talking cure."

Sometimes during "chimney sweeping," some emotional event was recalled that gave meaning to some particular symptom. The first example came soon after she had refused to drink for a while: She recalled seeing a woman drink from a glass that a dog had just drunk from. While recalling this, she experienced strong feelings of disgust...and then had a drink of water! In other words, her symptom -- an avoidance of water -- disappeared as soon as she remembered its root event, and experienced the strong emotion that would be appropriate to that event. Breuer called this catharsis, from the Greek word for cleansing.

It was eleven years later that Breuer and his assistant, Sigmund Freud, wrote a book on hysteria. In it they explained their theory: Every hysteria is the result of a traumatic experience, one that cannot be integrated into the person's understanding of the world. The emotions appropriate to the trauma are not expressed in any direct fashion, but do not simply evaporate: They express themselves in behaviors that in a weak, vague way offer a response to the trauma. These symptoms are, in other words, meaningful. When the client can be made aware of the meanings of his or her symptoms (through hypnosis, for example) then the unexpressed emotions are released and so no longer need to express themselves as symptoms. It is analogous to lancing a boil or draining an infection.

In this way, Anna got rid of symptom after symptom. But it must be noted that she needed Breuer to do this: Whenever she was in one of her hypnotic states, she had to feel his hands to make sure it was him before talking! And sadly, new problems continued to arise.

According to Freud, Breuer recognized that she had fallen in love with him, and that he was falling in love with her. Plus, she was telling everyone she was pregnant with his child. You might say she wanted it so badly that her mind told her body it was true, and she developed an hysterical pregnancy. Breuer, a married man in a Victorian era, abruptly ended their sessions together, and lost all interest in hysteria. Please understand that recent research suggests that many of these events, including the hysterical pregnancy and Breuer's quick retreat, were probably Freud's "elaborations" on reality!

It was Freud who would later add what Breuer did not acknowledge publicly - that secret sexual desires lay at the bottom of all these hysterical neuroses.

To finish her story, Anna spent time in a sanatorium. Later, she became a well-respected and active figure - the first social worker in Germany - under her true name, Bertha Pappenheim. She died in 1936. She will be remembered, not only for her own accomplishments, but as the inspiration for the most influential personality theory we have ever had.

Biography

Sigmund Freud was born May 6, 1856, in a small town - Freiberg - in Moravia. His father was a wool merchant with a keen mind and a good sense of humor. His mother was a lively woman, her husband's second wife and 20 years younger. She was 21 years old when she gave birth to her first son, her darling, Sigmund. Sigmund had two older half-brothers and six younger siblings. When he was four or five - he wasn't sure - the family moved to Vienna, where he lived most of his life.

A brilliant child, always at the head of his class, he went to medical school, one of the few viable options for a bright Jewish boy in Vienna those days. There, he became involved in research under the direction of a physiology professor named Ernst Brücke. Brücke believed in what was then a popular, if radical, notion, which we now call reductionism: "No other forces than the common physical-chemical ones are active within the organism." Freud would spend many years trying to "reduce" personality to neurology, a cause he later gave up on.

Freud was very good at his research, concentrating on neurophysiology, even inventing a special cell-staining technique. But only a limited number of positions were available, and there were others ahead of him. Brücke helped him to get a grant to study, first with the great psychiatrist Charcot in Paris, then with his rival Bernheim in Nancy. Both these gentlemen were investigating the use of hypnosis with hysterics.

After spending a short time as a resident in neurology and director of a children's ward in Berlin, he came back to Vienna, married his patient fiancée Martha Bernays, and set up a practice in neuropsychiatry, with the help of Joseph Breuer.

It is true that Freud experimented with cocaine, encouraged his fiancée and friends to try it, and wrote about its great restorative powers. He later came to regret his enthusiasm for the drug and withdrew his endorsement.

Freud's books and lectures brought him both fame and ostracism from the mainstream of the medical community. He drew around him a number of very bright sympathizers who became the core of the psychoanalytic movement. Unfortunately, Freud had a penchant for rejecting people who did not totally agree with him. Some separated from him on friendly terms; others did not, and went on to found competing schools of thought.

Freud emigrated to England just before World War II when Vienna became an increasing dangerous place for Jews, especially ones as famous as Freud. Not long afterward, he died of the cancer of the mouth and jaw that he had suffered from for the last 20 years of his life.

Theory

Freud didn't exactly invent the idea of the conscious versus unconscious mind, but he certainly was responsible for making it popular. The conscious mind is what you are aware of at any particular moment, your present perceptions, memories, thoughts, fantasies, feelings, what have you. Working closely with the conscious mind is what Freud called the preconscious, what we might today call "available memory:" anything that can easily be made conscious, the memories you are not at the moment thinking about but can readily bring to mind. Now no-one has a problem with these two layers of mind. But Freud suggested that these are the smallest parts!

The largest part by far is the unconscious. It includes all the things that are not easily available to awareness, including many things that have their origins there, such as our drives or instincts, and things that are put there because we can't bear to look at them, such as the memories and emotions associated with trauma.

According to Freud, the unconscious is the source of our motivations, whether they be simple desires for food or sex, neurotic compulsions, or the motives of an artist or scientist. And yet, we are often driven to deny or resist becoming conscious of these motives, and they are often available to us only in disguised form. We will come back to this.

The id, the ego, and the superego

Freudian psychological reality begins with the world, full of objects. Among them is a very special object, the organism. The organism is special in that it acts to survive and reproduce, and it is guided toward those ends by its needs -- hunger, thirst, the avoidance of pain, and sex.

A part - a very important part - of the organism is the nervous system, which has as one of its characteristics a sensitivity to the organism's needs. At birth, that nervous system is little more than that of any other animal, an "it" or id. The nervous system, as id, translates the organism's needs into motivational forces called, in German, Trieben, which has been translated as instincts or drives. Freud also called them wishes. This translation from need to wish is called the primary process.

The id works in keeping with the pleasure principle, which can be understood as a demand to take care of needs immediately. Just picture the hungry infant, screaming itself blue. It doesn't "know" what it wants in any adult sense; it just knows that it wants it and it wants it now. The infant, in the Freudian view, is pure, or nearly pure id. And the id is nothing if not the psychic representative of biology.

Unfortunately, although a wish for food, such as the image of a juicy steak, might be enough to satisfy the id, it isn't enough to satisfy the organism. The need only gets stronger, and the wishes just keep coming. You may have noticed that, when you haven't satisfied some need, such as the need for food, it begins to demand more and more of your attention, until there comes a point where you can't think of anything else. This is the wish or drive breaking into consciousness.

Luckily for the organism, there is that small portion of the mind we discussed before, the conscious, that is hooked up to the world through the senses. Around this little bit of consciousness, during the first year of a child's life, some of the "it" becomes "I," some of the id becomes ego. The ego relates the organism to reality by means of its consciousness, and it searches for objects to satisfy the wishes that id creates to represent the organisms needs. This problem-solving activity is called the secondary process.

The ego, unlike the id, functions according to the reality principle, which says "take care of a need as soon as an appropriate object is found." It represents reality and, to a considerable extent, reason.

However, as the ego struggles to keep the id (and, ultimately, the organism) happy, it meets with obstacles in the world. It occasionally meets with objects that actually assist it in attaining its goals. And it keeps a record of these obstacles and aides. In particular, it keeps track of the rewards and punishments meted out by two of the most influential objects in the world of the child - mom and dad. This record of things to avoid and strategies to take becomes the superego. It is not completed until about seven years of age. In some people, it never is completed.

There are two aspects to the superego: One is the conscience, which is an internalization of punishments and warnings. The other is called the ego ideal. It derives from rewards and positive models presented to the child. The conscience and ego ideal communicate their requirements to the ego with feelings like pride, shame, and guilt.

It is as if we acquired, in childhood, a new set of needs and accompanying wishes, this time of social rather than biological origins. Unfortunately, these new wishes can easily conflict with the ones from the id. You see, the superego represents society, and society often wants nothing better than to have you never satisfy your needs at all!

The stages

Freud noted that, at different times in our lives, different parts of our skin give us greatest pleasure. Later theorists would call these areas erogenous zones. It appeared to Freud that the infant found its greatest pleasure in sucking, especially at the breast. In fact, babies have a penchant for bringing nearly everything in their environment into contact with their mouths. A bit later in life, the child focuses on the anal pleasures of holding it in and letting go. By three or four, the child may have discovered the pleasure of touching or rubbing against his or her genitalia. Only later, in our sexual maturity, do we find our greatest pleasure in sexual intercourse. In these observations, Freud had the makings of a psychosexual stage theory.

The oral stage lasts from birth to about 18 months. The focus of pleasure is, of course, the mouth. Sucking and biting are favorite activities.

The anal stage lasts from about 18 months to three or four years old. The focus of pleasure is the anus. Holding it in and letting it go are greatly enjoyed.

The phallic stage lasts from three or four to five, six, or seven years old. The focus of pleasure is the genitalia. Masturbation is common.

The latent stage lasts from five, six, or seven to puberty, that is, somewhere around 12 years old. During this stage, Freud believed that the sexual impulse was suppressed in the service of learning. I must note that, while most children seem to be fairly calm, sexually, during their grammar school years, perhaps up to a quarter of them are quite busy masturbating and playing "doctor." In Freud's repressive era, these children were, at least, quieter than their modern counterparts.

The genital stage begins at puberty, and represents the resurgence of the sex drive in adolescence, and the more specific focusing of pleasure in sexual intercourse. Freud felt that masturbation, oral sex, homosexuality, and many other things we find acceptable in adulthood today, were immature.

This is a true stage theory, meaning that Freudians believe that we all go through these stages, in this order, and pretty close to these ages.

The Oedipal crisis

Here's how the Oedipal crisis works: The first love-object for all of us is our mother. We want her attention, we want her affection, we want her caresses, we want her, in a broadly sexual way. The young boy, however, has a rival for his mother's charms: his father! His father is bigger, stronger, smarter, and he gets to sleep with mother, while junior pines away in his lonely little bed. Dad is the enemy.

About the time the little boy recognizes this archetypal situation, he has become aware of some of the more subtle differences between boys and girls, the ones other than hair length and clothing styles. From his naive perspective, the difference is that he has a penis, and girls do not. At this point in life, it seems to the child that having something is infinitely better than not having something, and so he is pleased with this state of affairs.

But the question arises: where is the girl's penis? Perhaps she has lost it somehow. Perhaps it was cut off. Perhaps this could happen to him! This is the beginning of castration anxiety, a slight misnomer for the fear of losing one's penis.

To return to the story, the boy, recognizing his father's superiority and fearing for his penis, engages some of his ego defenses: He displaces his sexual impulses from his mother to girls and, later, women; And he identifies with the aggressor, dad, and attempts to become more and more like him, that is to say, a man. After a few years of latency, he enters adolescence and the world of mature heterosexuality.

The girl also begins her life in love with her mother, so we have the problem of getting her to switch her affections to her father before the Oedipal process can take place. Freud accomplishes this with the idea of penis envy: The young girl, too, has noticed the difference between boys and girls and feels that she, somehow, doesn't measure up. She would like to have one, too, and all the power associated with it. At very least, she would like a penis substitute, such as a baby. As every child knows, you need a father as well as a mother to have a baby, so the young girl sets her sights on dad.

Dad, of course, is already taken. The young girl displaces from him to boys and men, and identifies with mom, the woman who got the man she really wanted. Note that one thing is missing here: The girl does not suffer from the powerful motivation of castration anxiety, since she cannot lose what she doesn't have. Freud felt that the lack of this great fear accounts for fact (as he saw it) that women were both less firmly heterosexual than men and somewhat less morally-inclined.

Before you get too upset by this less-than-flattering account of women's sexuality, rest assured that many people have responded to it. I will discuss it in the discussion section.

Therapy

Freud's therapy has been more influential than any other, and more influential than any other part of his theory. Here are some of the major points:

Relaxed atmosphere. The client must feel free to express anything. The therapy situation is in fact a unique social situation, one where you do not have to be afraid of social judgment or ostracism. In fact, in Freudian therapy, the therapist practically disappears. Add to that the physically relaxing couch, dim lights, sound-proof walls, and the stage is set.

Free association. The client may talk about anything at all. The theory is that, with relaxation, the unconscious conflicts will inevitably drift to the fore. It isn't far off to see a similarity between Freudian therapy and dreaming! However, in therapy, there is the therapist, who is trained to recognize certain clues to problems and their solutions that the client would overlook.

Resistance. One of these clues is resistance. When a client tries to change the topic, draws a complete blank, falls asleep, comes in late, or skips an appointment altogether, the therapist says "aha!" These resistances suggest that the client is nearing something in his free associations that he - unconsciously, of course - finds threatening.

Dream analysis. In sleep, we are somewhat less resistant to our unconscious and we will allow a few things, in symbolic form, of course, to come to awareness. These wishes from the id provide the therapist and client with more clues. Many forms of therapy make use of the client's dreams, but Freudian interpretation is distinct in the tendency to find sexual meanings.

Parapraxes. A parapraxis is a slip of the tongue, often called a Freudian slip. Freud felt that they were also clues to unconscious conflicts. Freud was also interested in the jokes his clients told. In fact, Freud felt that almost everything meant something almost all the time - dialing a wrong number, making a wrong turn, misspelling a word, were serious objects of study for Freud. However, he himself noted, in response to a student who asked what his cigar might be a symbol for, that "sometimes a cigar is just a cigar." Or is it?

Other Freudians became interested in projective tests, such as the famous Rorschach or inkblot tests. The theory behind these tests is that, when the stimulus is vague, the client fills it with his or her own unconscious themes. Again, these could provide the therapist with clues.

Transference, catharsis, and insight

Transference occurs when a client projects feelings toward the therapist that more legitimately belong with certain important others. Freud felt that transference was necessary in therapy in order to bring the repressed emotions that have been plaguing the client for so long, to the surface. You can't feel really angry, for example, without a real person to be angry at. The relationship between the client and the therapist, contrary to popular images, is very close in Freudian therapy, although it is understood that it can't get out of hand.

Catharsis is the sudden and dramatic outpouring of emotion that occurs when the trauma is resurrected. The box of tissues on the end table is not there for decoration.

Insight is being aware of the source of the emotion, of the original traumatic event. The major portion of the therapy is completed when catharsis and insight are experienced. What should have happened many years ago - because you were too little to deal with it, or under too many conflicting pressures - has now happened, and you are on your way to becoming a happier person.

Freud said that the goal of therapy is simply "to make the unconscious conscious."

Discussion

The only thing more common than a blind admiration for Freud seems to be an equally blind hatred for him. Certainly, the proper attitude lies somewhere in between. Let's start by exploring some of the apparent flaws in his theory.

The least popular part of Freud's theory is the Oedipal complex and the associated ideas of castration anxiety and penis envy. What is the reality behind these concepts? It is true that some children are very attached to their opposite-sex parent, and very competitive with their same-sex parent. It is true that some boys worry about the differences between boys and girls, and fear that someone may cut their penis off. It is true that some girls likewise are concerned, and wish they had a penis. And it is true that some of these children retain these affections, fears, and aspirations into adulthood.

Most personality theorists, however, consider these examples aberrations rather than universals, exceptions rather than rules. They occur in families that aren't working as well as they should, where parents are unhappy with each other, use their children against each other. They occur in families where parents literally denigrate girls for their supposed lack, and talk about cutting off the penises of unruly boys. They occur especially in neighborhoods where correct information on even the simplest sexual facts is not forthcoming, and children learn mistaken ideas from other children.

If we view the Oedipal crisis, castration anxiety, and penis envy in a more metaphoric and less literal fashion, they are useful concepts: We do love our mothers and fathers as well as compete with them. Children probably do learn the standard heterosexual behavior patterns by imitating the same-sex parent and practicing on the opposite-sex parent. In a male-dominated society, having a penis - being male - is better than not, and losing one's status as a male is scary. And wanting the privileges of the male, rather than the male organ, is a reasonable thing to expect in a girl with aspirations. But Freud did not mean for us to take these concepts metaphorically. Some of his followers, however, did.

Sexuality

A more general criticism of Freud's theory is its emphasis on sexuality. Everything, both good and bad, seems to stem from the expression or repression of the sex drive. Many people question that, and wonder if there are any other forces at work. Freud himself later added the death instinct, but that proved to be another one of his less popular ideas.

First let me point out that, in fact, a great deal of our activities are in some fashion motivated by sex. If you take a good hard look at our modern society, you will find that most advertising uses sexual images, that movies and television programs often don't sell well if they don't include some titillation, that the fashion industry is based on a continual game of sexual hide-and-seek, and that we all spend a considerable portion of every day playing "the mating game." Yet we still don't feel that all life is sexual.

But Freud's emphasis on sexuality was not based on the great amount of obvious sexuality in his society -- it was based on the intense avoidance of sexuality, especially among the middle and upper classes, and most especially among women. What we too easily forget is that the world has changed rather dramatically over the last hundred years. We forget that doctors and ministers recommended strong punishment for masturbation, that "leg" was a dirty word, that a woman who felt sexual desire was automatically considered a potential prostitute, that a bride was often taken completely by surprise by the events of the wedding night, and could well faint at the thought.

It is to Freud's credit that he managed to rise above his culture's sexual attitudes. Even his mentor Breuer and the brilliant Charcot couldn't fully acknowledge the sexual nature of their clients' problems. Freud's mistake was more a matter of generalizing too far, and not taking cultural change into account. It is ironic that much of the cultural change in sexual attitudes was in fact due to Freud's work!

The unconscious

One last concept that is often criticized is the unconscious. It is not disputed that something like the unconscious accounts for some of our behavior, but rather how much and the exact nature of the beast.

Behaviorists, humanists, and existentialists all believe that (a) the motivations and problems that can be attributed to the unconscious are much fewer than Freud thought, and (b) the unconscious is not the great churning cauldron of activity he made it out to be. Most psychologists today see the unconscious as whatever we don't need or don't want to see. Some theorists don't use the concept at all.

On the other hand, at least one theorist, Carl Jung, proposed an unconscious that makes Freud's look puny! But we will leave all these views for the appropriate chapters.

Positive aspects

People have the unfortunate tendency to "throw the baby out with the bath water." If they don't agree with ideas a, b, and c, they figure x, y, and z must be wrong as well. But Freud had quite a few good ideas, so good that they have been incorporated into many other theories, to the point where we forget to give him credit.

First, Freud made us aware of two powerful forces and their demands on us. Back when everyone believed people were basically rational, he showed how much of our behavior was based on biology. When everyone conceived of people as individually responsible for their actions, he showed the impact of society. When everyone thought of male and female as roles determined by nature or God, he showed how much they depended on family dynamics. The id and the superego - the psychic manifestations of biology and society - will always be with us in some form or another.

Second is the basic theory, going back to Breuer, of certain neurotic symptoms as caused by psychological traumas. Although most theorists no longer believe that all neurosis can be so explained, or that it is necessary to relive the trauma to get better, it has become a common understanding that a childhood full of neglect, abuse, and tragedy tends to lead to an unhappy adult.

Third is the idea of ego defenses. Even if you are uncomfortable with Freud's idea of the unconscious, it is clear that we engage in little manipulations of reality and our memories of that reality to suit our own needs, especially when those needs are strong. I would recommend that you learn to recognize these defenses: You will find that having names for them will help you to notice them in yourself and others!

Finally, the basic form of therapy has been largely set by Freud. Except for some behaviorist therapies, most therapy is still "the talking cure," and still involves a physically and socially relaxed atmosphere. And, even if other theorists do not care for the idea of transference, the highly personal nature of the therapeutic relationship is generally accepted as important to success.

Some of Freud's ideas are clearly tied to his culture and era. Other ideas are not easily testable. Some may even be a matter of Freud's own personality and experiences. But Freud was an excellent observer of the human condition, and enough of what he said has relevance today that he will be a part of personality textbooks for years to come. Even when theorists come up with dramatically different ideas about how we work, they compare their ideas with Freud's.