Even though many of his theories are not accepted today by most experts in the field of psychiatry, Sigmund Freud invented psychotherapy and thus was one of the most influential people of the 20th century. He believed that:
• depression and anxiety are influenced by factors that affect us in childhood,
• interpreting dreams can lead to understanding of the causes, and
• psychotherapy can make emotionally sick people healthy by getting them to understand that events in childhood may have caused their problems.
From Hysteria to Psychoanalysis
Freud was 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. The doctors 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 Studien zur Hysterie (Studies in Hysteria). The patient herself called the treatment "the talking cure." Using this case as a base, 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 recommended that patients communicate their sexual experiences and fantasies of their childhood to explain some of their feelings and thoughts.
• He felt that men suffer from an 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 more than 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. For example, they theorized that:
• people who hallucinate and are not able to think clearly are schizophrenic because their brains make too much dopamine or glutamate
• depression occurs when the brain makes too little norepinephrine or serotonin
• people with Parkinson’s disease shake because their brains make too little dopamine
• people with Alzheimer’s disease may have markedly reduced concentration of acetylcholine in parts of their brains (Ugeskr Laeger, 1990 Jul 23;152(30):2165-8).
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 reduce the symptoms of 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, so they treat mental disorders also with drugs to correct abnormal brain levels of neurotransmitters.
Just because psychiatrists now treat depression, anxiety and schizophrenia mainly with drugs does not mean that Freud was wrong. Scientific marvels such as pet scans, electroencephalograms, MRIs and MRAs 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 (REM) sleep. 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 your 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
Today, the practice of psychiatry consists of prescribing antidepressants, antipsychotics, anti-anxiety and tranquilizing drugs, plus psychotherapy — guided listening to patients trying to work out their problems. These treatments can often help people to function more effectively in society. Even though many theories proposed by Freud 100 years ago now appear to be wrong, Freud remains one of the most influential and brilliant intellectuals in modern times.
May 6, 1856 – September 23, 1939