It should be evident from the foregoing why psychoanalysis in general, and Freud in particular, have exerted such a strong influence upon the popular imagination in the Western World over the past 90 years or so, and why both the theory and practice of psychoanalysis should remain the object of a great deal of controversy. In fact, the controversy which exists in relation to Freud is more heated and multi-faceted than that relating to virtually any other recent thinker (a possible exception being Darwin), with criticisms ranging from the contention that Freud's theory was generated by logical confusions arising out of his alleged long-standing addiction to cocaine (Cf. Thornton, E.M. Freud and Cocaine: The Freudian Fallacy) to the view that he made an important, but grim, empirical discovery, which he knowingly suppressed in favour of the theory of the unconscious, knowing that the latter would be more acceptable socially (Cf. Masson, J. The Assault on Truth).
It should be emphasised here that Freud's genius is not (generally) in doubt, but the precise nature of his achievement is still the source of much debate. The supporters and followers of Freud (and Jung and Adler) are noted for the zeal and enthusiasm with which they espouse the doctrines of the master, to the point where many of the detractors of the movement see it as a kind of secular religion, requiring as it does an initiation process in which the aspiring psychoanalyst must himself first be analysed. In this way, it is often alleged, the unquestioning acceptance of a set of ideological principles becomes a necessary precondition for acceptance into the movement - as with most religious groupings. In reply, the exponents and supporters of psychoanalysis frequently analyse the motivations of their critics in terms of the very theory which those critics reject. And so the debate goes on.
Here we will confine ourselves to: (a) the evaluation of Freud's claim that his theory is a scientific one, (b) the question of the theory's coherence, (c) the dispute concerning what, if anything, Freud really discovered, and (d) the question of the efficacy of psychoanalysis as a treatment for neurotic illnesses.
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(a) The Claim to Scientific Status
This is a crucially important issue, since Freud not alone saw himself first and foremost as a pioneering scientist, but repeatedly asserted that the significance of psychoanalysis is that it is a new science, incorporating a new scientific method of dealing with the mind and with mental illness. And there can be no doubt but that this has been the chief attraction of the theory for most of its advocates since then - on the face of it, it has the appearance of being, not just a scientific theory, but an enormously strong scientific theory, with the capacity to accommodate, and explain, every possible form of human behaviour. However, it is precisely this latter which, for many commentators, undermines its claim to scientific status. On the question of what makes a theory a genuinely scientific one, Karl Popper's criterion of demarcation, as it is called, has now gained very general acceptance: viz. that every genuine scientific theory must be testable, and therefore falsifiable, at least in principle - in other words, if a theory is incompatible with possible observations it is scientific; conversely, a theory which is compatible with all possible observations is unscientific (Cf. Popper, K. The Logic of Scientific Discovery). Thus the principle of the conservation of energy, which influenced Freud so greatly, is a scientific one, because it is falsifiable - the discovery of a physical system in which the total amount of energy was not constant would conclusively show it to be false. And it is argued that nothing of the kind is possible with respect to Freud's theory - if, in relation to it, the question is asked: 'What does this theory imply which, if false, would show the whole theory to be false?', the answer is 'nothing', the theory is compatible with every possible state of affairs - it cannot be falsified by anything, since it purports to explain everything. Hence it is concluded that the theory is not scientific, and while this does not, as some critics claim, rob it of all value, it certainly diminishes its intellectual status, as that was and is projected by its strongest advocates, including Freud himself.
A related (but perhaps more serious) point is that the coherence of the theory is, at the very least, questionable. What is attractive about the theory, even to the layman, is that it seems to offer us long sought-after, and much needed, causalexplanations for conditions which have been a source of a great deal of human misery. The thesis that neuroses are caused by unconscious conflicts buried deep in the unconscious mind in the form of repressed libidinal energy would appear to offer us, at last, an insight in the causal mechanism underlying these abnormal psychological conditions as they are expressed in human behaviour, and further show us how they are related to the psychology of the 'normal' person. However, even this is questionable, and is a matter of much dispute. In general, when it is said that an event X causes another event Y to happen, both X and Y are, and must be, independently identifiable. It is true that this is not always a simple process, as in science causes are sometimes unobservable (sub-atomic particles, radio and electromagnetic waves, molecular structures, etc.), but in these latter cases there are clear 'correspondence rules' connecting the unobservable causes with observable phenomena. The difficulty with Freud's theory is that it offers us entities (repressed unconscious conflicts, for example) which are said to be the unobservable causes of certain forms of behaviour, but there are no correspondence rules for these alleged causes - they cannot be identified except by reference to the behaviour which they are said to cause (i.e. the analyst does not demonstratively assert: 'This is the unconscious cause, and that is its behavioural effect'; he asserts: 'This is the behaviour, therefore its unconscious cause must exist'). And this does raise serious doubts as to whether Freud's theory offers us genuine causal explanations at all.
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(c) Freud's Discovery?
At a less theoretical, but no less critical level, it has been alleged that Freud did make a genuine discovery, which he was initially prepared to reveal to the world, but the response which he encountered was so ferociously hostile that he masked his findings, and offered his theory of the unconscious in its place (Cf. Masson, J. The Assault on Truth). What he discovered, it has been suggested, was the extreme prevalence of child sexual abuse, particularly of young girls (the vast majority of hysterics are women), even in respectable nineteenth century Vienna. He did in fact offer an early 'seduction theory' of neuroses, which met with fierce animosity, and which he quickly withdrew, and replaced with theory of the unconscious. As one contemporary Freudian commentator explains it, Freud's change of mind on this issue came about as follows:
Questions concerning the traumas suffered by his patients seemed to reveal [to Freud] that Viennese girls were extraordinarily often seduced in very early childhood by older male relatives; doubt about the actual occurrence of these seductions was soon replaced by certainty that it was descriptions about childhood fantasy that were being offered. (MacIntyre).
In this way, it is suggested, the theory of the Oedipus complex was generated.
This statement begs a number of questions, not least, what does the expression 'extraordinarily often' mean in this context? By what standard is this being judged? The answer can only be: by the standard of what we generally believe - or would like to believe - to be the case. But the contention of some of Freud's critics here is that his patients were not recalling childhood fantasies, but traumatic events in their childhood which were all too real, and that he had stumbled upon, and knowingly suppressed, the fact that the level of child sexual abuse in society is much higher than is generally believed or acknowledged. If this contention is true - and it must at least be contemplated seriously - then this is undoubtedly the most serious criticism that Freud and his followers have to face.
Further, this particular point has taken on an added, and even more controversial significance in recent years with the willingness of some contemporary Freudians to combine the theory of repression with an acceptance of the wide-spread social prevalence of child sexual abuse. The result has been that, in the United States and Britain in particular, many thousands of people have emerged from analysis with 'recovered memories' of alleged childhood sexual abuse by their parents, memories which, it is suggested, were hitherto repressed. On this basis, parents have been accused and repudiated, and whole families divided or destroyed. Unsurprisingly, this in turn has given rise to a systematic backlash, in which organisations of accused parents, seeing themselves as the true victims of what they term 'False Memory Syndrome', have denounced all such memory-claims as falsidical, the direct product of a belief in what they see as the myth of repression. (Cf. Pendergast, M. Victims of Memory). In this way, the concept of repression, which Freud himself termed 'the foundation stone upon which the structure of psychoanalysis rests', has come in for more widespread critical scrutiny than ever before. Here, the fact that, unlike some of his contemporary followers, Freud did not himself ever countenance the extension of the concept of repression to cover actual child sexual abuse, and the fact that we are not necessarily forced to choose between the views that all 'recovered memories' are either veridical or falsidical, are, perhaps understandably, frequently lost sight of in the extreme heat generated by this debate.
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(d) The Efficacy of Psychoanalytic Therapy
It does not follow that, if Freud's theory is unscientific, or even false, it cannot provide us with a basis for the beneficial treatment of neurotic illness, because the relationship between a theory's truth or falsity and its utility-value is far from being an isomorphic one. (The theory upon which the use of leeches to bleed patients in eighteenth century medicine was based was quite spurious, but patients did sometimes actually benefit from the treatment!). And of course even a true theory might be badly applied, leading to negative consequences. One of the problems here is that it is difficult to specify what counts as a cure for a neurotic illness, as distinct, say, from a mere alleviation of the symptoms. In general, however, the efficiency of a given method of treatment is usually clinically measured by means of a 'control group' - the proportion of patients suffering from a given disorder who are cured by treatment X is measured by comparison with those cured by other treatments, or by no treatment at all. Such clinical tests as have been conducted indicate that the proportion of patients who have benefited from psychoanalytic treatment does not diverge significantly from the proportion who recover spontaneously or as a result of other forms of intervention in the control groups used. So the question of the therapeutic effectiveness of psychoanalysis remains an open and controversial one.