Psychiatry After Freud

The Vital Balance

by Karl Menninger and Martin Mayman and Paul Pruyser
Viking, 531 pp., $10.00

The Revolution in Psychiatry

by Ernest Becker
Free Press, 276 pp., $5.50

Sigmund Freud
Sigmund Freud; drawing by David Levine

It is not easy to work up much enthusiasm over the state of psychoanalysis since Freud ceased writing. Gone are the days when excitement ran high over the “revolution” released by the impact of Freud’s discoveries. To some they promised a great liberation; to others they posed a great threat. Now the general feeling is more cautious, more sober, and more tired. Psychoanalysis has settled down as part of the Establishment; and neither the hopes of some nor the fears of others have come to pass. It used to be said that Freud marked the beginning of a new age in the study of man. In historical perspective. I think, he is more likely to be viewed as a voice from the past.

There have been two main trends in the development of psychoanalysis: post-Freudian and anti-Freudian. The authors of The Vital Balance are post-Freudians. The anti-Freudian reaction began with Jung and Adler, and was followed by the social revisionists (Horney, Fromm, etc.). The latest branch set up by the anti-Freudians is known as “existential analysis.” The Revolution in Psychiatry falls into this general category.

The post-Freudian trend consists, partly, in mopping-up operations, partly—as in the case of The Vital Balance—in shifting the focus of psychoanalytic work to an analysis of “the ego and its mechanisms of defense.” Ego-psychology serves several functions. In one sense. It is a strategic retreat before the anti-Freudians. The latter have been ego-psychologists all along, either because they revised Freud’s libido theory beyond recognition (Jung) or because they discarded it altogether (Adler, Sullivan, Fromm, and the existentialists). The literature of ego-psychology in post-Freudian psychoanalysis shows a similar trend. The rise of ego-psychology corresponds to a decline of libido theory. The libido theory tends to be modified or reduced; in fact, it may be whittled down to a point where the literature of ego-psychology becomes indistinguishable from anti-Freudian revisionism.

This is not true of The Vital Balance: on the contrary, its authors belong to the dwindling number of post-Freudians who accept the basic outline of Freud’s theory of instincts, with love and hate being separate and contrary drives. Thus there are other reasons for a shift to ego-psychology. The concept of the ego was a weak link in Freud’s topology of the psyche, for it was asked to do an impossible job. It was supposed to account for all the adaptive and adjustive functions of the self on the one hand, and for its autonomous, self-regulative functions on the other. It was, on the one hand, the product of “socialization.” and the seat of “self-identity” on the other. That’s asking too much. Post-Freudian psychoanalysis tends to be conformist—i.e., to make its peace with the reality-principle prevailing in society—when it is enamored by the ego as an instrument of adjustment; it tends to be receptive to existential revisions (as in the case of Erik Erikson) when it is puzzled…

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