Charlotte Scott, Lee Harris, and Owen Leddy
Freud posits that the human mind is deterministic, yet seeks agency over the individual’s mental world in order to treat mental illness. In Freud’s psychoanalytic method, how is this agency achieved?
Early in his lectures, Freud reprimands his audience for their reluctance to accept that psychical processes—thoughts, dreams, their determinants and the behaviors and symptoms they produce—could be ‘facts’ in the same way chemistry produces predictable, determined results. In his discussion of parapraxes, he scolds,
“faced with the psychical fact that a particular thing occurred to the mind of the person questioned, you will not allow the fact’s validity: something else might have occurred to him! You nourish the illusion of there being such a thing as psychical freedom” (59).
This aversion to the notion of psychic determination is rooted in the human desire to know one’s own mind and control one’s own behavior. Although Freud’s tip-of-the-iceberg, stratified model of consciousness is more palatable one hundred years later, his claims about latent impulses would have been radical and troubling to a Victorian post-Enlightenment individuals who thought their minds and actions were as controlled as the civilization they had erected.
Freud’s model of mental determination is the product of two factors: external, social triggers and latent instincts and memory-complexes. In his discussion of perversions’ roots in infant sexual impulses, Freud explains that “increased difficulty in obtaining normal sexual satisfaction… brings out perverse inclinations in people who had not shown any previously, [so] we must suppose that there was something in these people which came half-way to meet the perversions; or, if you prefer it, the perversions must be present in them in a latent form” (384). By calling attention to the presence of dormant mental associations that can be brought forth by an individual’s experience in the world–for example, sexual frustration–Freud advances a theory of psychic life that privileges forces acting on the individual, and problematizes ‘free will’.
Freud brings in the therapeutic method to respond to the problem of mental determination, to help the individual claim control over his psychic life and its behavioral manifestations. His model of the determination of mental processes makes it clear that without introducing the external stimulus of psychiatric therapy, neurotic individuals cannot override their neuroses by sheer force of will. Individuals gain control of their actions by changing the latent psychic determinants of their behavior.
The possibility for gaining control over concealed mental processes lies in the specific act of talk therapy. In order to change an individual’s actions in the world, or to rid her of neurotic symptoms, it is necessary for the psychoanalyst to summon her latent thoughts from the ‘unconscious’ into the conscious, and by restructuring her mental processes, to encourage her to engage in a new kind of world-making.
Freud describes his model of the mind with a spatial metaphor. He describes the mind as the interior of a house, in which the unconscious thoughts reside in a large foyer. Meanwhile, the conscious is another room in the house entirely. Between the two, Freud describes a metaphorical watchman who decides which unconscious ideas can enter the room of the conscious thoughts. The act of repression is the act of the watchman stopping an idea from moving from unconscious to conscious. Our mental model, or our system of world making, is based solely off of the unrepressed ideas in the conscious room, because those are the ideas we have conscious access to. However, the ideas in the unconscious still can influence our actions and existence in the world. So in order to better understand our actions and our existence in the world, Freud argues that we should engage in talk therapy to bring the unconscious ideas into the conscious mind, so that we can construct a more accurate model of the world and of ourselves. The action of bringing an idea from the unconscious into the conscious is an act of remaking the mental landscape that defines our world, and so our world is remade when we make changes to our mental model.
Freud uses multiple case studies to demonstrate the ability of unconscious thoughts to shape our actions despite our lack of awareness of them. In his case study on Anna O., he explains that Anna had been unconsciously reliving the previous year out mentally day by day. Anna was unconscious of this fact, despite the fact that it was deeply affecting her behavior in the world. In bringing this idea to her conscious through talk therapy, Anna was able to better understand her actions in the world. As such, her symptoms (the reliving of the previous year) were eliminated, because the symptoms were the result of her repression, so her actions in the world also changed based on her new access to previously unconscious thoughts. In essence, she engaged in a process of remaking her model of the world.
Similarly, Freud describes his experience with a patient who has dreams about going to the opera with her husband (150). In engaging in talk therapy with her, Freud is able to attach meaning to multiple symbols or aspects of the dream, and bring their significance to the consciousness of the patient. Clearly these ideas were affecting her life, as she was dreaming about them, but because they were not conscious they manifested themselves in obscure symbols through the process of dreamwork. When the meaning of the symbols is brought to consciousness, the patient gleaned a new understanding of her relationship with her husband and so was brought to a better understanding of her world.
Mental Determinism and Cognitive-Behavioral Therapy (CBT):
Freud’s method seeks agency over the external world of behaviors and symptoms by remaking the patient’s internal, mental world. Present-day clinical psychology has since discovered that this practice can work in the opposite direction — instead of Freud’s mental changes producing behavioral changes, CBT changes behavior to produce mental changes. Through the process of cognitive-behavioral therapy, changing the external habits and behaviors of an individual facilitates the alteration of distorted beliefs and faulty schemas that perpetuate mental health problems. For example, if a patient holds an erroneous, irrational belief (e.g. that lethally infectious microbes are ubiquitous) that leads them to engage in a pathological behavior or thought process (e.g. washing their hands compulsively and panicking if they are unable to do so), then the patient would, under the guidance of a therapist, consciously go against the behavior or thought process (e.g. avoid washing their hands for a set period of time) and consciously observe that the negative consequence the distorted belief predicts does not result. This facilitates a conscious and deliberate process of recognizing the distorted belief as irrational and identifying the fallacious reasoning and the prior experiences or associations that support it. Through repeated exposures of this kind, the patient undermines the distorted belief and becomes able to tolerate avoiding the pathological behavior or thought process.
CBT is premised on the same belief in psychic determinism as is Freud’s theory – namely that symptomatic behaviors and thoughts have a basis in specific unconscious mental determinants – but acts on the relationship between the determinant and the determined in the opposite direction. Whereas Freud’s method seeks to identify and alter mental determinants in order to achieve agency over external symptoms, CBT forces a change in behavior in order to deliberately remake the individual’s mental world and change the mental determinants associated with that behavior.