Why did the treatment get set aside, even disdained, among psychologists in the mid-1900s? Several factors were at play, says Nancy McWilliams, PhD, a psychology professor at Rutgers University and author of several books on psychoanalysis.
For one, in the 1950s and 1960s, the psychodynamic approach lost ground because those who were studying and practicing it were too dismissive of other methods, according to McWilliams.
"Psychoanalytic work got to be very prestigious in psychiatry, and it attracted a lot of people—mostly white, heterosexual males—to the field who were more interested in obtaining status as the head of a psychiatry department," says McWilliams.
At the same time, many psychoanalytic institutes moved out of university settings, cutting themselves off from broader intellectual work, and began including only psychiatrists in their training there, says Pratyusha Tummala-Narra, PhD, a professor of counseling, developmental and educational psychology at Boston College. In addition, psychoanalytic theorists did not attend adequately to the need for disseminating research on the effectiveness of psychoanalytic psychotherapy, while studies on CBT and other similar therapy approaches showed promising results more visibly.
No quick fix
Another turnoff for American psychologists was the method's less optimistic, more European orientation, McWilliams says. "Freud's belief that psychoanalysis can help people turn neurotic misery into ordinary human unhappiness doesn't fit well in a culture where we are given to utopian movements and self-help books and quick fixes," McWilliams says. "Americans have been ingrained with the idea that things should be fixable."
Also, unlike Europeans, Americans often emphasize the importance of individual independence, says McWilliams, and much of psychoanalytic theory is about letting yourself feel deeply attached to another person—the therapist—and then seeing what emotions that brings out.
Outdated theories
In addition, in their original form, many of the constructs that Freud introduced, such as the Oedipus complex and the idea of psychosexual stages, seem dated and peculiar and often do not resonate with people today, says Ken Levy, PhD, a clinical psychology professor at Penn State University who maintains a small psychodynamically oriented private practice.
"When you read some of the secondary sources, such as textbooks, that mention Freud, it does often seem silly, but many of his ideas have been integrated into broader psychology, often without sufficient recognition or credit," Levy says.
One such idea of Freud's that was developed by psychodynamic thinkers and that has become widely adopted is the therapeutic alliance, Levy says. "The concept is so useful and important in psychotherapy research that there are many attempts to recontextualize it from psychoanalysis or to usurp it," he says. —Amy Novotney
