Overview & History

Freud and the origins of modern psychology

Although there are precursors and prior influences, and the notion of psyche in Western culture goes back all the way to the Greeks, psychology in modern form can be said to originate with Sigmund Freud in the late 19th century. Although he was a physician (a neurologist) and saw the mind as a function of biology, throughout his life he held to the idea of psychology as a third domain between the body and rational thought. In other words: although he explained the workings of the mind through body-based instincts and drives (with mental processes dependent - as Freud's English translators like to phrase it - on the 'vicissitudes' of the instincts and drives), he resisted simple genetic or biological explanations - he refused to reduce the mind to the body, or psychology to biology. Instead, he was interested in the meaning and psycho-logic of his patient's irrational thoughts and feelings.

 

The workings of the 'unconscious' mind

Freud recognised the workings of an unconscious mind underneath and beyond conscious, deliberate mental processes. He trusted in the validity and meaningfulness of unconscious communication, through body symptoms, dreams, free association. He recognised that throughout life the mind develops mechanisms to cope with painful experiences, and is capable of 'repressing' traumatic memories, thoughts and feelings. When it comes to emotional pain, something more than simple forgetting or selective inattention is at work and 'makes' certain experiences unconscious. In the development of the mind, the early years are more basic and fundamental, and any repressions and mental mechanisms acquired during infancy and childhood are bound to be more pervasive and far-reaching.

 

Underlying repressive mechanisms are bound to generate problems

Depending on the nature of the pain or trauma, its severity and the developmental stage of the child, the functioning of the mind can be compromised to such an extent that problems persist into adulthood and interfere with being in the world and living a fulfilled life. With repression structured into the mind, anxiety, avoidances, denials, addictions, irrational thoughts and fears are guaranteed. According to Freud, this sets up a life-long internal war between the conscious and unconscious aspects of the personality, between rational and irrational forces. In his theory, this war is at the root of 'neurosis' and generates difficulties and symptoms.

Psychoanalysis was a way of tracing these symptoms to their origin, recovering what was repressed and denied and by bringing insight and understanding lessening the internal conflict and tension, thus reducing the symptoms. This apparently simple formula has been popularised over the last 100 years (see Hollywood films like "Analyze This") and is not so much wrong as oversimplified and partial. Freud's basic ideas have entered the culture and are now commonplace - that does not necessarily mean they are understood or fully accepted beyond the circle of the 'converted'. Few theories have aroused as much controversy and dissent, both from inside and outside the psychoanalytic community, and that dissent was bound to manifest in alternative theories being formulated. To a large extent the fragmentation of the psychotherapeutic field goes back to both personal and professional arguments between people (often students and their teachers). This now manifests in a bewildering multitude of approaches, each with competing 'truth claims', not least driven by a fight for 'market share'.

Without minimising the genius of Freud's paradigm-shifting achievement, his theorising was nevertheless embedded in the zeitgeist of his time. It has been convincingly argued (Totton 1998) that Freud would have needed some of the concepts, scientific categories and paradigms of our time (e.g. complexity and systems theory) to express his ideas appropriately (the 'information age' transcends Freud's materialism, e.g. mechanical metaphors). The history of psychoanalysis and of psychotherapy in general is rife with people trying to improve on the original formulations and deal with questionable assumptions structured into the theoretical edifice from the beginning (much in the same way that a child's early experience gets structured as a blueprint into their expectations of life and ways of coping with it or enjoying it). Psychoanalysis has its own painful history (of splits and conflict), its own unresolved past. As the history of psychotherapeutic ideas is built into the profession now, it is in need of some of its own 'medicine' and therapeutic attention.

The fragmentation of the field and the special situation in the UK

Psychoanalysis is famous for its divisive history, with some of Freud's greatest students and followers turning away and against him at some point (e.g. Jung, Adler, Ferenczi, Reich, Klein etc, etc), in the UK manifesting in the great conflict between Freud's daughter Anna and Melanie Klein. But just as these two branches of psychoanalysis managed to work out a compromise and modus vivendi with each other, psychotherapy in the UK generally seems to have a unique knack for dealing with the splits and fragmentation. The UK is in the special situation that psychotherapists in this country have formed an umbrella organisation (UKCP) since the late 1980's which now represents the bulk of practitioners (with some exceptions). The UK also has a strong tradition of psychotherapy integration which has emerged as a recognised branch of its own.

UKCP is organised into seven 'sections' which represents the spectrum of fundamental orientations (each of which comprises many specific approaches and schools).

The history of the field: psychoanalysis, behaviourism and humanistic approaches

Historically we can distinguish three major such fundamental orientations: psychoanalytic, behaviourism and humanistic. Both behaviourism and humanistic therapies can be seen as mid-20th century reactions against psychoanalysis, into opposite directions. Behaviourists like Skinner reacted against the subjectivism of psychoanalysis and wanted to root psychology more in biology, thus making it more scientifically rigorous. Humanistic therapists like Perls and Rogers reacted against the paternalistic and pessimistic aspects of psychoanalysis, and wanted to root psychology more in human potential and the revolution of the 1960's, thus making it less medical and more egalitarian, authentic and immediate.

During most of the 20th century these three fundamental orientations were in practice incompatible: as a therapist you subscribed to one of them. With few exceptions, you trained, read, thought, lived and practiced therapy within the parameters, beliefs, assumptions of one of these mutually exclusive paradigms. Equally as a patient or client: you would get the benefit (and the dogmatic fallout, sometimes approximating craziness) of each one of them in fairly pure form. It is only since the 1990's that we can begin to appreciate the incompatible and irreducible contradictions between them as useful and creative.

The major branches & traditions of the field

Following Wilber's (2002) maxim that nobody can be wrong all the time, we can see that the various orientations and schools counteract and balance each other's dogmatism and partiality. There is partial validity in all of them, and all of them 'work' to some extent, both in terms of appropriately describing 'reality' generally and suggesting a particular therapeutic practice specifically. All outcome research in psychotherapy has over and over again confirmed the Dodo-bird verdict (after 'Alice in Wonderland') which proclaims: "All of them are winners and all of them must have prizes!"

All forms of therapy 'work' and all of them deserve to exist and be practiced to some extent. This has never obviated the need for strife and conflict between the fundamental orientations, let alone the particular approaches; and much of that ongoing conflict is necessary and eventually productive. But in the meantime the implications for the clients of such a fragmented profession are difficult and often detrimental.

Whilst there is a richness and robustness in such diversity in the field as a whole, this does not in itself guarantee fluid or creative reflexivity on the part of the particular practitioner which a client is confronted with. Clients can suffer from the most well-intentioned dogmatism and blinkeredness in each and every of the approaches. I have written articles for practitioners on these themes, and my own original training was no exception in this regard

(see Soth, M. (2005) Body Psychotherapy today - an integral-relational approach, Therapy Today, November 2005, Vol 16 No 9 and Soth, M. (2006) “What therapeutic hope for a subjective mind in an objectified body? “ - in: Corrigall, J., Payne, H., Wilkinson, H. (2006) About A Body. London: Routledge)

psychoanalytic (psychodynamic)

Since its early splits and schisms, psychoanalysis has developed further and the last decades have seen the establishment of new perspectives. We cannot, therefore, speak of psychoanalysis as a homogenous discipline, but can think of it as a language of various analytic dialects. They all have in common the notion of unconscious processes as significant in human life, and that early developmental experiences are foundational and have a bearing on adult life. Early patterns of relating are structured into our way of perceiving the world, others and ourselves and how we respond and behave. This is seen as affecting all our relationships and therefore also as instrumental in how we organise ourselves and the therapeutic space as clients in relation to our therapists (what is called the 'transference'). The different analytic dialects diverge in their conception of early development and how it structures the mind, the role of biological drives and social environment, the intensity and pervasiveness of unconscious dynamics; they therefore draw different conclusions as to what constitutes a useful therapeutic presence and response. This then manifests to some extent around different notions of the therapeutic frame and boundaries (e.g. frequency of sessions, the analyst's degree of self-disclosure, what they focus on, etc). They also differ in terms of their engagement and what degree of mutuality between patient and analyst they consider advisable or 'proper'.

Generally speaking, most analysts would focus on understanding the unconscious workings of your mind, as it manifests inside the session and outside in your life (as reported by you), and would try and shed light on these processes. This involves balancing attention both to what goes on inside you (intra-psychically in terms of feelings, thoughts, conscious and unconscious processes), what goes on between you and the analyst (interpersonally in terms of the relationship with your analyst becoming an important facet of your life) and what goes on in your everyday life, and how these three areas of 'you' hang together and influence each other. You will notice that this invariably makes the analyst an 'important person' - a feature that has not escaped notice by the critics, and that may have disadvantages as well as a valid purpose.

The Jungian approach of Analytic Psychology places traditionally greater emphasis on the intra-psychic experience, and less attention to the dynamic with your analyst (although the UK especially has produced well-reputed hybrid forms). Jung originally argued against Freud's emphasis on sexual drives as crucial in childhood development, and postulated other dimensions of the human psyche. This gave rise to a whole other body of theory and practice, focussing on each person's individuation process which - as the term implies - works at the interface between the collective features of the psyche (which we all share) and our own idiosyncratic experience and relationship to the 'Self' - the totality or wholeness of our being. Jungians therefore pay attention to the collective patterns and 'archetypes' of unconscious process as revealed through imagination, stories and mythology and the individual manifestations as expressed through dreams, fantasies and creativity as well as our everyday functioning.

James Hillman is known for taking the Jungian notion of 'archetypes' further, bringing our attention to how even the most abstract and supposedly rational ideas and beliefs are structured by archetypal fantasy. All mental processes emerge - in his terms - in relation to the soul's imagination, what he calls the 'poetic basis of mind'. In simple terms, he is trying to find a non-religious language for experiences which humans down the ages have always considered precious: every person can find within themselves a meaningful connection with what they treasure about life (whether they consciously agree with this or not). These deep and meaningful experiences are not concocted by the mind and not manufactured by the ego, but we ignore them at our peril. Although they are highly individual, the way they operate in the psyche follows recognisable and long-established pathways and patterns.

behaviourism (cognitive-behavioural)

Behaviourism reacted against those aspects of psychoanalysis which appear to shroud the workings of the human mind in mystery, supposedly understandable only by the initiated (and 'fully analysed') analyst. Following the horrors of the holocaust and the Second World War, it needed an American 'can-do' attitude to try and change and improve the human condition. Where psychoanalysis had needed to distinguish itself from biology (and thereby neglected it), scientific observation and understanding could be brought to bear on repetitive patterns of behaviour. Rather than trying to get inside the mind, one could focus on its measurable and observable behavioural effects, treat it as a 'black box' and operate on it.

Learning theory recognises that all behaviour is acquired and conditioned by the environment. If one can use reward and punishment to help a laboratory rat 'learn' certain behaviours, one does not need to understand the inner workings of its mind in order to produce desirable outcomes. The advantages of this outlook are its pragmatic, common-sense attitude which manifests in a therapeutic approach that observes scientific criteria: it is replicable, structured, standardisable. To this day, the vast majority of scientific studies into therapy outcomes are based on the observable parameters and clearly defined procedures of the cognitive-behavioural approach. Client and therapist co-operate to establish the 'faulty thinking' and 'schemata' at work in the client's symptoms which - as they were 'learnt' at some point - can also be 'unlearnt' and be replaced with more functional patterns. The therapist helps the client to re-condition themselves into new and healthier habits. Official medical guidelines in the UK see CBT as the treatment of choice for a variety of psychological conditions, and often the only one where the expense can be scientifically justified in terms of established effectiveness.

We need to balance the preferred and privileged position which CBT is afforded (and which to some extent it deserves for its unquestionable cost-effective treatment and appropriateness for many people) by a perception of its limitations.

It's not always the case that if it works on rats, it'll work on you. The human mind and the human psyche are complicated and multi-dimensional - that's partly the beauty of it all. But CBT does imply that the healthy part of you can take control and re-condition the unhealthy part. But as we are dealing with a sophisticated mind, unfortunately the unhealthy part is 'in on the act' and always knows what you're up to - it therefore can sabotage and undermine the most well-intentioned efforts. The deeper we get into a psychological problem, the more difficult that distinction between healthy and unhealthy becomes. If life was that simple, sunny and straightforward, arguably we would not have any problems in the first place. Personally I do believe in the importance of rational thought and will do my utmost to deal with clients' self-sabotaging beliefs and thought patterns (and I will therefore draw on the principles of CBT if necessary). But in most cases the real issues lie deeper and require more heart and more emotional courage - from both client and therapist - than laboratory rats. For most people, the emotional issues are not just to do with having learnt the 'wrong' habits - although that may be a reassuring way of thinking about it.

humanistic

In many ways the humanistic paradigm is the opposite of the behaviouristic: it may at times sacrifice rational thought in favour of feeling and experience, but it has a reputation for reaching the parts that other approaches don't. Undeniably a child of the 60's, humanistic approaches emphasise the 'good' in people, their potential and creativity. Humanistic therapies encourage self-expression, spontaneity and freedom from rules and social constraints. Under the humanistic umbrella we find a plethora of approaches, from all kinds of body-oriented and holistic therapies to Gestalt and person-centred therapy, from rebirthing and breathwork to psychodrama, Transactional Analysis and dance and movement therapy.

These approaches have contributed much to the therapeutic field over the last few decades, and have given much help, hope and transformation to many clients. As many have found out painfully over the last few decades, there are also disadvantages to the humanistic attitudes, for all their aspirations and optimism: individual freedom can slide into individualism and narcissism; egalitarianism can become an avoidance of power issues; and spontaneity can become harmful without boundaries.

Humanistic approaches emphasise and to some extent rely on what they call an 'authentic meeting' between client and therapist. Arguing that the idea of the therapist as a doctor-like expert treating the otherwise helpless, disturbed and pathological 'patient' is mystifying and therefore itself unhelpful and disempowering, humanistic therapists intend to be more transparent, honest and immediate about their own human frailties and limitations. They therefore rely on the power of genuine contact between two fundamentally equal human beings as a transformative and therapeutic force. Here it is not so much professional expertise, knowledge and technique that makes the therapy 'work', but the therapist's empathy, acceptance and congruence, all ultimately rooted in the therapist's self-knowledge and self-acceptance) that makes a difference.

On the basis of these humanistic values, a wide range of theories and techniques can be used creatively to help the client explore, access and develop what humanistic therapies conceive of as the 'real self'. All of these techniques have elements of validity and power which can be tailored to a client's individual situation and needs, and therefore provide a rich source of therapeutic possibilities.

True to its creative and exploratory nature, humanistic philosophy has generated many hybrids and integrations, including attempts to re-integrate psychoanalytic and other perspectives into a humanistic paradigm. One example is Process-Oriented Psychology which incorporates body-oriented and Jungian approaches as well as drawing on NLP and traditional healing paradigms.

But there are many others, including Gestalt, Body Psychotherapy, Transactional Analysis, Psychosynthesis, Psychodrama, and those using creativity and the arts. All of them have a strong experiential element, and the more body-inclusive ones (like movement and dance, authentic movement), are also influenced by a wide range of bodywork techniques (e.g. massage, Rolfing, Postural Integration, Alexander, Feldenkrais, Bowen Technique, Somatic Experiencing, etc) and complementary therapies.

other approaches

humanistic-transpersonal

Some people prefer to reserve a special section to the transpersonal and spiritual approaches, like Psychosynthesis. Whilst basically affirmative of humanistic values, these approaches believe that forces larger than the human ego need to be taken into account for lasting and positive change.

 

existential

It could be said that existential therapies became a class of their own more by default because existential principles were neglected by the rest of the field, rather than by a concerted attempt to create a new approach. These approaches are based on an application of existentialist philosophy to the therapeutic endeavour.

systemic

The understanding of human beings within their social networks has benefitted from the application of systems theory. Family Therapy, for instance, pays attention to the roles that each person plays within the system, rather than to individual behaviours in isolation. This has been developed further and refined and an approach currently fashionable is Constellations based on the work of the German therapist Bert Hellinger.

constructivist

Based on the notion that 'the map is not the territory', these approaches are based on the recognition that human reality is 'constructed' rather than given. If I can recover my agency in this process of 'constructing', I am a long way towards a therapeutic and healthy engagement with my problems.

Neurolinguistic Programming was originally inspired by the revolutionary idea of modelling the behaviour and interventions of therapists recognised as extraordinary (Gestalt therapist Fritz Perls, family therapist Virginia Satir and hypnotherapist Milton Erickson). It has generated a broad and diverse field of approaches which have been applied to diverse fields including business. By modelling excellence, it promises effectiveness and short-term success, and therefore has an immediate appeal to anybody who values effectiveness and the financial bottom line and needs to be taken serious and included in a broad-spectrum integrative approach.

It needs to be said, however, that the psyche cannot be cheated and has its own pace, whatever our rational demands and ideas are. Unfortunately for those who have a one-sided bias towards the bottomline only, there is some correlation between how much energy and attention we are prepared to give and the depth or superficiality of the effects we can expect (as well as their long-term sustainability).

The field of therapy reflects the psyche

It may have become clear to you that I find great value in all of the orientations and approaches. And I also find great limitations, not to say dangers, in each of them. The onesidedness and excesses of one approach can be recognised, balanced and put into proportion by the equivalent opposite dogmatism and partiality of another. It seems apparent to me that the field of psychology mirrors and reflects the multi-faceted psyche. The many approaches each are fuelled by a particular sensitivity to a particular aspect of human reality, and they equally have their shadow aspects and areas of obliviousness.

 

In support of modesty, why should psychological practitioners, individually or as a whole profession, be any more coherent or open or flexible than the rest of the population ?

But then the psychological professions must be open to the accusation that they really have not got anything helpful to add to the general state of affairs. On what basis then are they taking good money ?

 

The challenge and potential of an integrative approach

But is this fragmented state of the therapeutic field the best we can hope for ?

I think it is apparent by now that I don't think so.

We may not have an over-arching theoretical model that is true and valid for all people at all times and in all circumstances, but we can find more wholesome ways of living with contradictions and conflict.

We can make good use of the wisdom and 'truths' of all the approaches, rather than playing them off against each other.

It is such an integrative attitude (which is committed to ongoing learning, partly through conflict and confrontation) which I take to be essential for psychological practitioners worthy of the title. Wholeness then becomes an experiential reality which is always already present rather than something we need to strive for.

For further details about my integrative approach, and the principal approaches I draw from, see the next section.