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Freud and Dreams

Sigmund FreudBecause Sigmund Freud (1856-1939) invented psychotherapy, he was one of the most influential people of the 20th century. He claimed that:
• depression and anxiety are influenced by factors that affect us in childhood;
• interpreting dreams can lead us to understand the causes; and
• psychotherapy can make emotionally sick people healthy by getting them to understand that events in childhood can cause their problems.

From Hysteria to Psychoanalysis
Freud graduated first in his class at the Spurling Gymnasium, and went on to study medicine at the University of Vienna. With his mentor, Dr. Josef Breuer, he treated a woman named Bertha Pappenheim for a nervous cough, loss of feeling in her fingers, and inability to walk. Since they could not find a physical cause for her symptoms, they looked for psychological causes and found plenty. The woman recalled several horrible experiences in her childhood. They felt that all her symptoms were psychological and diagnosed her as suffering from hysteria. They then spent many hours having her talk about her frightening experiences and all her symptoms improved markedly.

In 1895, Freud and Breuer published her case and called it Studies in Hysteria. The patient herself called the treatment: “the talking cure.” From this case, Freud created psychoanalysis, the treatment of emotional disease by talking to a psychiatrist.

• He developed “free association” in which patients report their thoughts to their therapist as they think of them.
• He discovered “transference”, the process in which patients communicate their sexual experiences and fantasies of their childhood.
• He felt that men suffer from the Oedipus complex in which they fall in love with their mothers and use their mothers to guide their behavior as adults.
• He felt that people are guided by their libidos, that their pleasures and a fear of death make them establish behavior patterns and feel hate and guilt.

Neurotransmitters Made Freud Obsolete?
For 50 years, Freud was one of the most revered scientists on earth. Then researchers discovered neurotransmitters, chemicals that pass messages from one nerve to another. They found that people who hallucinate and are not able to think clearly are schizophrenic because their brains make too much dopamine or glutamate; that people are depressed because their brains make too little norepinephrine and serotonin; that people who shake with Parkinson’s disease do so because their brains make too little dopamine; and that people who lose their ability to reason and remember (Alzheimer’s disease) have too little acetyl choline.

The Advent of Psychotropic Drugs
Now these diseases are treated with drugs that raise or lower brain levels of neurotransmitters. Drugs such as Mirapex, Levodopa, Sinemet, levodopa or carbidopa raise dopamine levels to treat Parkinson’s disease. Drugs such as Paxil, Prozac or Zoloft raise brain levels of serotonin to treat depression. Modern psychiatrists know that you cannot treat chemical depression, schizophrenia or anxiety just with talking. You treat mental disorders with drugs to correct abnormal brain levels of neurotransmitters.

REM Sleep
People cannot be talked out of mental illness. However, just because psychiatrists now treat depression, anxiety and schizophrenia with drugs does not mean that Freud was wrong. Scientific marvels such as pet scans, electroencephalograms and MRIs have given us new understanding of dreams. When you go to sleep at night, your eyes are still. After a while, your eyes dart from side to side rapidly. This is called Rapid Eye Movement sleep or REM for short. You dream, you cannot move, men may have erections and women have their pelvic organs fill with blood. If you wake up during REM you can report your dreams, but if you try to remember your dreams a few hours later, you usually can’t. During REM sleep, the part of your brain that governs emotions and visual imagery is activated, while the part of you brain associated with rational thought and reasoning is turned off. Dreams may uninhibit you so you can think about things that may be too painful to think about when you are awake. Or dreams may allow you to discover things about yourself that you would never tell directly to anyone, let alone to your doctor. Dreams can provide clues to why a person feels depressed, anxious or reasons poorly.

Freud’s Lasting Contribution
Psychotherapy, by itself, has not been shown in controlled studies to be an effective treatment for most cases of depression, anxiety or schizophrenia, but psychotherapy PLUS medication is more effective than medication alone. Psychotherapy can help people cope better with their problems, and interpreting dreams can help them understand why they are what they are. Even though many theories proposed by Freud 100 years ago appear to be wrong, Freud remains one of the most brilliant and contributing intellectuals of the 20th century.

May 12th, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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