Psychoanalysis

Another student of Freud, Otto Rank, introduced a new theory of neurosis, attributing all neurotic disturbances to the primary trauma of birth. In his later writings he described individual development as a progression from complete dependence on the mother and family, to a physical independence coupled with intellectual dependence on society, and finally to complete intellectual and psychological emancipation. Rank also laid great importance on the will, defined as “a positive guiding organization and integration of self, which utilizes creatively as well as inhibits and controls the instinctual drives.”

Later noteworthy modifications of psychoanalytic theory include those of the American psychoanalysts Erich Fromm, Karen Horney, and Harry Stack Sullivan. The theories of Fromm lay particular emphasis on the concept that society and the individual are not separate and opposing forces, that the nature of society is determined by its historic background, and that the needs and desires of individuals are largely formed by their society. As a result, Fromm believed, the fundamental problem of psychoanalysis and psychology is not to resolve conflicts between fixed and unchanging instinctive drives in the individual and the fixed demands and laws of society, but to bring about harmony and an understanding of the relationship between the individual and society. Fromm also stressed the importance to the individual of developing the ability to fully use his or her mental, emotional, and sensory powers.

Horney worked primarily in the field of therapy and the nature of neuroses, which she defined as of two types: situation neuroses and character neuroses. Situation neuroses arise from the anxiety attendant on a single conflict, such as being faced with a difficult decision. Although they may paralyze the individual temporarily, making it impossible to think or act efficiently, such neuroses are not deeply rooted. Character neuroses are characterized by a basic anxiety and a basic hostility resulting from a lack of love and affection in childhood.

Sullivan believed that all development can be described exclusively in terms of interpersonal relations. Character types as well as neurotic symptoms are explained as results of the struggle against anxiety arising from the individual's relations with others and are a security system, maintained for the purpose of allaying anxiety.

An important school of thought is based on the teachings of the British psychoanalyst Melanie Klein. Because most of Klein's followers worked with her in England, this has come to be known as the English school. Its influence, nevertheless, is very strong throughout the European continent and in South America. Its principal theories were derived from observations made in the psychoanalysis of children. Klein posited the existence of complex unconscious fantasies in children under the age of six months. The principal source of anxiety arises from the threat to existence posed by the death instinct. Depending on how concrete representations of the destructive forces are dealt with in the unconscious fantasy life of the child, two basic early mental attitudes result that Klein characterized as a “depressive position” and a “paranoid position.” In the paranoid position, the ego's defense consists of projecting the dangerous internal object onto some external representative, which is treated as a genuine threat emanating from the external world. In the depressive position, the threatening object is introjected and treated in fantasy as concretely retained within the person. Depressive and hypochondriacal symptoms result. Although considerable doubt exists that such complex unconscious fantasies operate in the minds of infants, these observations have been of the utmost importance to the psychology of unconscious fantasies, paranoid delusions, and theory concerning early object relations.

See also Psychiatry.