Psychiatric Theories

From psychology, we turn to psychoanalysis: to Freud, Erikson, Fanon, and Fromm. Freud’s answer as to why people are aggressive came in a response to a 1932 letter from Einstein.

Freud’s major legacy is the search for the “unconscious.” He theorized that by identifying and exploring repressed memories, a person could gain relief from a wide range of emotional problems. This led in turn to psychoanalysis as a means of treatment and later as a basis for prosecution, one reason it is relevant to conflict theory.² Freud's theories rest largely on outdated and falsified biological precepts. Sixty years of research has failed to confirm the existence of repressed memory. To the contrary, Elizabeth Loftus (1997) has demonstrated how easily false memories form, particularly under the suggestion of therapists asking the same leading question as few as three times.

Freud’s claims for originality are exaggerated (Stannard 1980). He re-worked the traditional Greek idea of the animal body, the human mind, and the divinely inspired soul into conscious behavior (the ego), blind impulses (the id) and moral imperatives (the superego). Interpretation of dreams is equally ancient. Joseph’s interpretation of pharaoh’s dreams has long been part of our heritage. Babylonians wrote books on interpreting dreams even earlier. Allan Hobson (1988, 2003) has demonstrated that dreams are the result of natural but random firing of brain cells, explaining why they sometimes take bizarre form. Applying Occam’s razor, there is no reason to believe that anyone needs special training to decipher dreams or even that they have any significance.

Freud evolved the idea of oral, anal, and genital phases from the work of Ernst Haeckel who thought that sex developed from saclike organisms called gastraea. He said they originally reproduced by division of cells like amoeba, but then evolved a joint gastrointestinal tract as in reptiles, and subsequently evolved true genitalia. Subsequent biologists proved Haeckel wrong. Similarly invalidated biological concepts underlie such fundamental Freudian concepts as latency, sublimation, fixation, regression, and repression (Sulloway 1979). The Freudians have kept the conclusions despite the destruction of the biological foundations on which they rest, which of course makes no sense.

Similarly, thanks to tools like PET scans and MRIs, and advances in pharmaceuticals, we now know that psychiatric illnesses such as autism, bipolar disorder, borderline personality disorder, schizophrenia, and Tourette’s syndrome are not psychological but physical in origin. Scans have identified specific areas of the brain that give rise to addiction, anger, anxiety, cheating, depression, eating disorders, obsessive-compulsive behavior, pathological lying, revenge, stuttering, and even cravings for chocolate. The successful use of drugs such as haloperidol for psychoses, lithium for bipolar disorder, Prozac for obsessive-compulsive disorder and depression, and Xanax for anxiety by non-Freudian, scientific psychiatrists reinforce recognition that mental disease usually results from physical or chemical causes rather than the “unconscious.” As Roger Scruton put it, “There is no greater error in the study of human things than to believe that the search for what is essential must lead us to something hidden.”

Freud claimed to be a scientist but many of his fundamental ideas have nothing to do with objective observation of clinical cases. An example of how he reached conclusions occurs in a letter to Fliess in which he wrote, “A single idea of general value dawned on me. I have found, in my own case the phenomenon of being in love with my Mother and jealous of my Father, and I now consider it a universal event in early childhood.” There are plenty of “Eureka” moments in science, but they cannot be taken on faith as Freud does.

Erik Erikson (1950) proposed a sequence of eight developmental stages that he associated with a crisis and a resulting pathology if it is not resolved correctly. Figure 4.2 summarizes the theory. With little credible evidence, Erikson argues that these stages are universal, that the crises must be resolved in the order and at the stage of life specified, and that mental health requires that they be resolved as he specifies. The pathologies exhibit systematic bias rather than discussing the circumstances when the behaviors are and are not appropriate. For example, Erikson asserts that failing to trust is pathological, but trusting too much is not. Parents wiser than Erikson teach their children not to trust strangers. Similarly, Erikson advocates cooperation and condemns competition, but competition improves performance across a wide range of human activity just as cooperation does in others. Erikson’s explanations often are incomprehensible jargon, and each stage is briefer and less specific than the one before.

Like Freud, Erikson seems to draw much from his own personal experience, actually admitting as much in the section on Old Age, in which he writes that he cannot say much because he “is only now experiencing it.”

Franz Fanon (1976) was both a psychoanalyst and a revolutionary involved in the Algerian war for independence against France.

Thomas Szasz (1984) witnessed firsthand the exploitation of medicine by Nazis and communists to control people by declaring them insane and institutionalizing them. A prominent critic of the moral and scientific foundations of his own profession, he opposed the use of psychiatry as a means of social control and in one of his books (1997) likened the mental health movement to the Inquisition. Against all contrary evidence, he insisted that mental illness simply does not exist, no matter how bizarre, disabling, or life-threatening a person’s delusions or behaviors were. He opposed all forms of involuntary treatment.

About the same time, R. D. Laing (1960) saw mental illness as a reasonable response to an irrational society and sometimes as evidence of a superior level of consciousness, adding fuel to the anti-psychiatry fires. The ACLU developed these lines of thought in court, leading to the dismantling of state hospital systems and the de-institutionalization of many people who now form a large portion of the US homeless population. That fit perfectly with the goals of conservatives searching for ways to cut state budgets. Many became victims or perpetrators of a wide range of violent and non-violent crimes (Kellerman 2007).