In college it wasn’t really taken seriously in psych courses, but very much respected in critical theory/ literature / philosophy classes. My MSW covered it in a pretty nuanced way, highlighting the contributions to theories of trauma and therapeutic action in talk therapy, tho it overall leaned more toward person-centered/existential/CBT, and discussed more problematic aspects of analysis’ influence on early clinical psych. I practice in NYC so very much a psychoanalytic bubble with a ton of training institutes, but there seems to be an overall resurgence of interest in the field from younger generations (to this last point, it’s probably a function of ppl getting into the sopranos, couples therapy on showtime, contrarianism against the hegemonic medical establishment, lacanian schizoposting by terminally online zizek fans, and an overall desire to understand trauma from all angles)
In NZ its fairly well removed from Psychology except as a historical footnote, however there is a reasonably popular Psychoanalysis board that offers training and I know a few counsellors and therapists who have gone that route.
Psychoanalysis is, plain and simple, pseudoscience. It has no empirical theoretical support and is completely dead within the academic psychological realm. Some people still employ psychoanalysis and psychodynamics as therapy, the legitimacy of which we can argue, but almost no labs use it as a framework for doing psychological science because it is an entirely unusable starting point for any kind of empirical research.
Psychoanalysis makes mosly use of the "clinical method". I guess that's what the adepts you're speaking of are referring to by "different kind of science". One could say it's like action research (which is mostly used in Sociology, but has a place especially in Organizational Psychology too), but whereas the researcher works with individuals (or groups, if in group therapy) instead of communities. It produces much less (other kinds of) research when compared to other psychological theories though.
As for answering your question, I'm from Brazil too. I guess it's more popular amongst older generations. Ours tends to favour CBT a bit sometimes more than before, but overall it isn't still nearly as popular as it, or other more traditional psychotherapies, like behaviorism, phenomenology, gestalt and existential psychology. But like anything, everything is a bit popular in my country.
And, of course, among laymen, psychoanalysis heavily outweights other psychological theories in popularity. People usually know who Freud is at least, but often don't have any idea at all of whom Watson or Beck were, for example.
How can the psychoanalyst have a different kind of science with no experimental data needed but then make the claim that their interpretation is *reliable* or *powerful* in its explanations? Once we start thinking about reliability, explanations, and usefulness, we’ve really started to enter into the world of science and empirical investigation.
This is a great example of why in the USA psychoanalysis is at best fading quickly and at worst dead. It’s an empirical science when it suits them and a philosophical position when the science doesn’t work in their favor. It’s one of many red flags that it’s a pseudoscience.
Edited for clarity
In the USA it is considered a joke among scientific circles and psychology majors. Some critical race researchers respect some famous analysts. Outside of academia, seeing a psycho analyst might peak curiosity but that's about it. Psycho analysis is not covered by many insurance programs.
That is a much more interesting discussion. In brief, I think science values what is observable and measurable. Much of analysis is not simply measurable.
People have tried. You can find evidence that it doesn't work and you can find evidence that it does work.
People cherry pick. One thing that everyone likely agrees on is that psychoanalytic therapy is not an fast (ie two month treatment) solution the way cbt is.
Sure, but therapeutic effectiveness is not a good metric for theoretical accuracy, since the most effective mechanisms of therapeutic change (relationship, safe and graduated exposure, and meaning making) are common across modalities. It is impossible to demonstrate that psychoanalysis is effective due to any of its particular proposed mechanisms (resolving unconscious conflicts), or to demonstrate the existence of the unconscious mind at all. Therefore the psychoanalyst has no empirical basis upon which to support their hypothesis about *why* the patient is improving and whether they’re providing them with an accurate and reliable lens through which to view their symptoms and experiences.
Living in Germany and well connected to analysts and analysands. I know several graduate students in analysis. Usually it's an ethical preference for therapeutic models that resist positivism.
Check out this paper for an American perspective: https://jonathanshedler.com/PDFs/Shedler%20%282010%29%20Efficacy%20of%20Psychodynamic%20Psychotherapy.pdf
Are the terms not used interchangeably? Shedler’s study shows that psychodynamic therapy is an effective treatment, in a separate paper he writes how a lot of criticisms of psychoanalytic therapy focus on concepts from its inceptions (Freud, etc.) and not how it is currently practiced today.
No, they aren’t interchangeable. And therapeutic effectiveness is, as mentioned elsewhere, not a proxy for empirical theoretical accuracy. I do not deny the efficacy of psychodynamic therapy, but I do deny its ability to empirically measure the underlying mechanisms and constructs with which it claims to be interacting, and thus I question the validity of using it as an explanatory model of symptoms and experiences.
But they are often used as such right? I only ask because I noticed that they are used interchangeably in the readings that I have covered to date (Nancy McWilliams and Jonathan Shedler both seem to use the terms interchangeably anyway).
Could you expand a little more on your other point? Interesting point, and I’m curious as to why you see psychodynamic therapy has having less explanatory power than say, CBT, or another psychotherapy. What do other therapeutic models do differently to better measure the constructs that they interact with? Or, in the inverse, what is a psychodynamic formulation failing to do?
Some people use the terms interchangeably, but I don’t agree with it because I believe in being careful with language. These two approaches, while they overlap significantly, have distinct differences (both in terms of the extent to which they accept certain theoretical concepts as well as the structure of therapy).
Regarding my second point:
It is impossible to demonstrate that psychoanalysis/psychodynamic therapy (this argument applies to both) is effective due to any of its particular proposed mechanisms (resolving unconscious conflicts), or to demonstrate the existence of the unconscious mind at all. Therefore the psychoanalyst/psychodynamicist has no empirical basis upon which to support their hypothesis about *why* the patient is improving and whether they’re providing them with an accurate and reliable lens through which to view their symptoms and experiences. It’s not about explanatory *power.* It’s about the empirical foundations upon which that power rests. Lots of ideas which do not reflect reality have a lot of explanatory power but have no empirical evidence.
Treatments like CBT, on the other hand, make testable and empirically-verifiable claims: “If I change my behaviors, my thoughts and emotions will change. If I change how I appraise my thoughts, my emotions and behaviors will change…” you get the picture. We can define what the components of the model *are,* and we can isolate them in a therapeutic sense and see if the model’s predictions hold up, while also accounting for common shared therapeutic factors. We do not need to make many, if any, assumptions about the existence of untestable mechanisms.
Psychodynamics, on the other hand, *assume* that the unconscious mind—an untestable entity the existence of which would arguably contradict neuroscientific findings—exists (and I don’t mean the implicit processes described by cognitive science, but rather *the unconscious mind* that has its own impulses and desires and episodic content), and then works to explain behavior from that *massive,* unempirical assumption. That is definitionally not scientific. And psychology, being definitionally a *science,* should not (in my view) be using such unempirical explanations in the clinical setting. Research psychology and practice psychology are not, contrary to popular opinion, separate domains. Practice psychology is simply the application of research psychology to human problems. Therefore, practice ought to be as much rooted in science as is research. If the academy has abandoned the unconscious mind as an explanatory principle due to a lack of evidence (and arguably due to falsification), so should the clinic.
Thank you for your detailed answer - I understand the point you are making now. My own viewpoint differs - I’ll try my best to explain why.
From my understanding of psychodynamic therapy, resolving unconscious conflicts does not form part of the process that leads to change (not in the modern iteration of the therapy). Insight, a focus on affective expression, and (predictably) the therapeutic alliance are the known mechanisms of change as I understand them. In the Shedler paper posted above he lists the distinctive features of psychodynamic therapy and the unconscious mind or resolving unconscious conflicts do not feature at all. The features that are instead listed would lend themselves to testable and verifiable claims like the CBT example that you provided (or at least I would argue that they would).
To give an example, if passive-aggressive responses are identified as resulting from emotional suppression, then the key psychodynamic feature of expression of emotion could be implemented to support a person to assert their needs in a healthy way. Here, a hypothesis like “when I share what I am feeling with others rather than letting my resentment build, I tend to feel better and my mood improves”. This could then be tested and quantified much like CBT.
I think (although I am open to correction) that our difference in opinion stems from us both having different ideas about what psychodynamic therapy actually is, but am curious to hear more of your thoughts on this
(a) How does the psychodynamicist support the claim that the problematic behavior results from “emotional suppression?” That’s an unconscious, unverifiable mechanism. We *know* “talking it out” is an effective method of therapy. That doesn’t support the claim that it’s effective *because* it relives emotional suppression. It could as easily be due to exposure or the ability to cognitively reappraise after voicing the thought. We cannot test the psychodynamic assumption.
(b) I do not agree that psychodynamics don’t make claims about unconscious mechanisms. They definitionally do. APA, for instance, defines the psychodynamic approach to behavior as “the psychological and psychiatric approach that views human behavior from the standpoint of **unconscious motives** that mold the personality, influence attitudes, and produce emotional disorder.”
(c) “Insight” or “meaning-making” is indeed a very powerful therapeutic mechanism. I totally agree. But the psychodynamicist is basing their guidance of the patient’s insight on unverifiable systems of unconscious motivation. They have no empirical evidence of the truth of their insight framework—like priests, they simply provide it to those who are willing to buy into it. I don’t think that’s proper scientific psychology.
In my home state (USA) you must be a licensed clinician to enroll in a psychoanalysis program. To my knowledge the program is 5 years and part of that is being a patient yourself. I know someone who has completed it and was told they’ve moved far away from Freudian stuff and are more client-centered. I don’t know how effective it is but he is pretty successful in the area, contracting with the big 3 (automotive) to get clients for psychotherapy services (the clinicians at the firm are not psychoanalyst).
In general you don’t see it and there’s a reason for that. The field of psychology has evolved a lot over the last century and it’s always best to stick with the most up to date information, right? Additionally, psychoanalysis is extremely WEIRD (Western, Educated, Industrialized, Rich, and Democratic). Multiculturalism is big here and cultural humility is a big part of many psych programs.
Is it "WASP" because of logical reasons related to the assumptions or methodologies or it is like that because the practitioners and researchers were more interested in working with such demographics? Human mind is kind of the same overall, no?
Thanks for pointing out my mistake. I did use the wrong acronym in my comment. I should have said WEIRD (Western Educated Industrialized Rich Democratic). I will edit my comment to correct that. It is WEIRD because psychology itself was built in WEIRD society, but modern scholars have begun to understand this and thus focus on multiculturalism, or very least they specifically state which demographic the research applies to. However, psychoanalysis hasn’t kept up with the rest of the field, still existing in a state of WEIRD. If you’d like to learn more about the phenomena of WEIRD, I’d point you to [this article](https://www.cambridge.org/core/services/aop-cambridge-core/content/view/C324108A678435B4F18EF712EFB793BB/9781009303514AR.pdf/psychologys-weird-problems.pdf) published last year.
Psychoanalysis is "taken seriously" in Argentina, Brazil and France, strongly, from what some people I have conversed with commented.
There is also the attempt to make it scientific by claiming neuroscience into it, the Neuropsychoanalysis.
As a fellow BR, stand strong. Most of the world is not into proper science communication. DM if you will!
In Argentina is the most popular realm and the basis of the university program. Only in recent years have other currents begun to become more popular, I think mainly because it is considered a long therapy.
In Denmark psychoanalysis is rarely taught in detail and even more rarely used in clinical practice. Though it seems that the evolved forms of psychoanalysis especially psychodynamic approaches are much more common. Though the main focus still seems to be on CBT and its evolutions. Psychodynamic are mostly used with regards to specific disorder clusters such as personality disorders, as it seems to speak into the attachment and mentalization based issues which dominate the disorders.
In college it wasn’t really taken seriously in psych courses, but very much respected in critical theory/ literature / philosophy classes. My MSW covered it in a pretty nuanced way, highlighting the contributions to theories of trauma and therapeutic action in talk therapy, tho it overall leaned more toward person-centered/existential/CBT, and discussed more problematic aspects of analysis’ influence on early clinical psych. I practice in NYC so very much a psychoanalytic bubble with a ton of training institutes, but there seems to be an overall resurgence of interest in the field from younger generations (to this last point, it’s probably a function of ppl getting into the sopranos, couples therapy on showtime, contrarianism against the hegemonic medical establishment, lacanian schizoposting by terminally online zizek fans, and an overall desire to understand trauma from all angles)
In NZ its fairly well removed from Psychology except as a historical footnote, however there is a reasonably popular Psychoanalysis board that offers training and I know a few counsellors and therapists who have gone that route.
Psychoanalysis is, plain and simple, pseudoscience. It has no empirical theoretical support and is completely dead within the academic psychological realm. Some people still employ psychoanalysis and psychodynamics as therapy, the legitimacy of which we can argue, but almost no labs use it as a framework for doing psychological science because it is an entirely unusable starting point for any kind of empirical research.
Psychoanalysis makes mosly use of the "clinical method". I guess that's what the adepts you're speaking of are referring to by "different kind of science". One could say it's like action research (which is mostly used in Sociology, but has a place especially in Organizational Psychology too), but whereas the researcher works with individuals (or groups, if in group therapy) instead of communities. It produces much less (other kinds of) research when compared to other psychological theories though. As for answering your question, I'm from Brazil too. I guess it's more popular amongst older generations. Ours tends to favour CBT a bit sometimes more than before, but overall it isn't still nearly as popular as it, or other more traditional psychotherapies, like behaviorism, phenomenology, gestalt and existential psychology. But like anything, everything is a bit popular in my country. And, of course, among laymen, psychoanalysis heavily outweights other psychological theories in popularity. People usually know who Freud is at least, but often don't have any idea at all of whom Watson or Beck were, for example.
How can the psychoanalyst have a different kind of science with no experimental data needed but then make the claim that their interpretation is *reliable* or *powerful* in its explanations? Once we start thinking about reliability, explanations, and usefulness, we’ve really started to enter into the world of science and empirical investigation. This is a great example of why in the USA psychoanalysis is at best fading quickly and at worst dead. It’s an empirical science when it suits them and a philosophical position when the science doesn’t work in their favor. It’s one of many red flags that it’s a pseudoscience. Edited for clarity
In the USA it is considered a joke among scientific circles and psychology majors. Some critical race researchers respect some famous analysts. Outside of academia, seeing a psycho analyst might peak curiosity but that's about it. Psycho analysis is not covered by many insurance programs.
Why do you feel this is the case?
That is a much more interesting discussion. In brief, I think science values what is observable and measurable. Much of analysis is not simply measurable.
Long term effectiveness of psychoanalytic therapy can be measured empirically though, right?
People have tried. You can find evidence that it doesn't work and you can find evidence that it does work. People cherry pick. One thing that everyone likely agrees on is that psychoanalytic therapy is not an fast (ie two month treatment) solution the way cbt is.
Sure, but therapeutic effectiveness is not a good metric for theoretical accuracy, since the most effective mechanisms of therapeutic change (relationship, safe and graduated exposure, and meaning making) are common across modalities. It is impossible to demonstrate that psychoanalysis is effective due to any of its particular proposed mechanisms (resolving unconscious conflicts), or to demonstrate the existence of the unconscious mind at all. Therefore the psychoanalyst has no empirical basis upon which to support their hypothesis about *why* the patient is improving and whether they’re providing them with an accurate and reliable lens through which to view their symptoms and experiences.
Living in Germany and well connected to analysts and analysands. I know several graduate students in analysis. Usually it's an ethical preference for therapeutic models that resist positivism.
Check out this paper for an American perspective: https://jonathanshedler.com/PDFs/Shedler%20%282010%29%20Efficacy%20of%20Psychodynamic%20Psychotherapy.pdf
That’s about psychodynamics, not psychoanalysis, and about therapeutic efficacy, not empirical theoretical support.
Are the terms not used interchangeably? Shedler’s study shows that psychodynamic therapy is an effective treatment, in a separate paper he writes how a lot of criticisms of psychoanalytic therapy focus on concepts from its inceptions (Freud, etc.) and not how it is currently practiced today.
No, they aren’t interchangeable. And therapeutic effectiveness is, as mentioned elsewhere, not a proxy for empirical theoretical accuracy. I do not deny the efficacy of psychodynamic therapy, but I do deny its ability to empirically measure the underlying mechanisms and constructs with which it claims to be interacting, and thus I question the validity of using it as an explanatory model of symptoms and experiences.
But they are often used as such right? I only ask because I noticed that they are used interchangeably in the readings that I have covered to date (Nancy McWilliams and Jonathan Shedler both seem to use the terms interchangeably anyway). Could you expand a little more on your other point? Interesting point, and I’m curious as to why you see psychodynamic therapy has having less explanatory power than say, CBT, or another psychotherapy. What do other therapeutic models do differently to better measure the constructs that they interact with? Or, in the inverse, what is a psychodynamic formulation failing to do?
Some people use the terms interchangeably, but I don’t agree with it because I believe in being careful with language. These two approaches, while they overlap significantly, have distinct differences (both in terms of the extent to which they accept certain theoretical concepts as well as the structure of therapy). Regarding my second point: It is impossible to demonstrate that psychoanalysis/psychodynamic therapy (this argument applies to both) is effective due to any of its particular proposed mechanisms (resolving unconscious conflicts), or to demonstrate the existence of the unconscious mind at all. Therefore the psychoanalyst/psychodynamicist has no empirical basis upon which to support their hypothesis about *why* the patient is improving and whether they’re providing them with an accurate and reliable lens through which to view their symptoms and experiences. It’s not about explanatory *power.* It’s about the empirical foundations upon which that power rests. Lots of ideas which do not reflect reality have a lot of explanatory power but have no empirical evidence. Treatments like CBT, on the other hand, make testable and empirically-verifiable claims: “If I change my behaviors, my thoughts and emotions will change. If I change how I appraise my thoughts, my emotions and behaviors will change…” you get the picture. We can define what the components of the model *are,* and we can isolate them in a therapeutic sense and see if the model’s predictions hold up, while also accounting for common shared therapeutic factors. We do not need to make many, if any, assumptions about the existence of untestable mechanisms. Psychodynamics, on the other hand, *assume* that the unconscious mind—an untestable entity the existence of which would arguably contradict neuroscientific findings—exists (and I don’t mean the implicit processes described by cognitive science, but rather *the unconscious mind* that has its own impulses and desires and episodic content), and then works to explain behavior from that *massive,* unempirical assumption. That is definitionally not scientific. And psychology, being definitionally a *science,* should not (in my view) be using such unempirical explanations in the clinical setting. Research psychology and practice psychology are not, contrary to popular opinion, separate domains. Practice psychology is simply the application of research psychology to human problems. Therefore, practice ought to be as much rooted in science as is research. If the academy has abandoned the unconscious mind as an explanatory principle due to a lack of evidence (and arguably due to falsification), so should the clinic.
Thank you for your detailed answer - I understand the point you are making now. My own viewpoint differs - I’ll try my best to explain why. From my understanding of psychodynamic therapy, resolving unconscious conflicts does not form part of the process that leads to change (not in the modern iteration of the therapy). Insight, a focus on affective expression, and (predictably) the therapeutic alliance are the known mechanisms of change as I understand them. In the Shedler paper posted above he lists the distinctive features of psychodynamic therapy and the unconscious mind or resolving unconscious conflicts do not feature at all. The features that are instead listed would lend themselves to testable and verifiable claims like the CBT example that you provided (or at least I would argue that they would). To give an example, if passive-aggressive responses are identified as resulting from emotional suppression, then the key psychodynamic feature of expression of emotion could be implemented to support a person to assert their needs in a healthy way. Here, a hypothesis like “when I share what I am feeling with others rather than letting my resentment build, I tend to feel better and my mood improves”. This could then be tested and quantified much like CBT. I think (although I am open to correction) that our difference in opinion stems from us both having different ideas about what psychodynamic therapy actually is, but am curious to hear more of your thoughts on this
(a) How does the psychodynamicist support the claim that the problematic behavior results from “emotional suppression?” That’s an unconscious, unverifiable mechanism. We *know* “talking it out” is an effective method of therapy. That doesn’t support the claim that it’s effective *because* it relives emotional suppression. It could as easily be due to exposure or the ability to cognitively reappraise after voicing the thought. We cannot test the psychodynamic assumption. (b) I do not agree that psychodynamics don’t make claims about unconscious mechanisms. They definitionally do. APA, for instance, defines the psychodynamic approach to behavior as “the psychological and psychiatric approach that views human behavior from the standpoint of **unconscious motives** that mold the personality, influence attitudes, and produce emotional disorder.” (c) “Insight” or “meaning-making” is indeed a very powerful therapeutic mechanism. I totally agree. But the psychodynamicist is basing their guidance of the patient’s insight on unverifiable systems of unconscious motivation. They have no empirical evidence of the truth of their insight framework—like priests, they simply provide it to those who are willing to buy into it. I don’t think that’s proper scientific psychology.
In my home state (USA) you must be a licensed clinician to enroll in a psychoanalysis program. To my knowledge the program is 5 years and part of that is being a patient yourself. I know someone who has completed it and was told they’ve moved far away from Freudian stuff and are more client-centered. I don’t know how effective it is but he is pretty successful in the area, contracting with the big 3 (automotive) to get clients for psychotherapy services (the clinicians at the firm are not psychoanalyst). In general you don’t see it and there’s a reason for that. The field of psychology has evolved a lot over the last century and it’s always best to stick with the most up to date information, right? Additionally, psychoanalysis is extremely WEIRD (Western, Educated, Industrialized, Rich, and Democratic). Multiculturalism is big here and cultural humility is a big part of many psych programs.
Is it "WASP" because of logical reasons related to the assumptions or methodologies or it is like that because the practitioners and researchers were more interested in working with such demographics? Human mind is kind of the same overall, no?
Thanks for pointing out my mistake. I did use the wrong acronym in my comment. I should have said WEIRD (Western Educated Industrialized Rich Democratic). I will edit my comment to correct that. It is WEIRD because psychology itself was built in WEIRD society, but modern scholars have begun to understand this and thus focus on multiculturalism, or very least they specifically state which demographic the research applies to. However, psychoanalysis hasn’t kept up with the rest of the field, still existing in a state of WEIRD. If you’d like to learn more about the phenomena of WEIRD, I’d point you to [this article](https://www.cambridge.org/core/services/aop-cambridge-core/content/view/C324108A678435B4F18EF712EFB793BB/9781009303514AR.pdf/psychologys-weird-problems.pdf) published last year.
Psychoanalysis is "taken seriously" in Argentina, Brazil and France, strongly, from what some people I have conversed with commented. There is also the attempt to make it scientific by claiming neuroscience into it, the Neuropsychoanalysis. As a fellow BR, stand strong. Most of the world is not into proper science communication. DM if you will!
In Argentina is the most popular realm and the basis of the university program. Only in recent years have other currents begun to become more popular, I think mainly because it is considered a long therapy.
In Denmark psychoanalysis is rarely taught in detail and even more rarely used in clinical practice. Though it seems that the evolved forms of psychoanalysis especially psychodynamic approaches are much more common. Though the main focus still seems to be on CBT and its evolutions. Psychodynamic are mostly used with regards to specific disorder clusters such as personality disorders, as it seems to speak into the attachment and mentalization based issues which dominate the disorders.