Part of a series of articles on
Psychoanalysis
Most of psychoanalysis forms around the use of a sofa for the patient where the psychologist is behind the patient.
Concepts Psychosexual development Psychosocial development Unconscious · Preconscious Consciousness Psychic apparatus Id, ego and super-ego Libido · Drive Transference Countertransference Ego defenses · Resistance Projection · Denial
Important figures Alfred Adler · Michael Balint Wilfred Bion · Josef Breuer Nancy Chodorow · Erik Erikson Ronald Fairbairn · Sándor Ferenczi Anna Freud · Sigmund Freud Erich Fromm · Harry Guntrip Karen Horney · Ernest Jones Carl Jung · Melanie Klein Heinz Kohut · Jacques Lacan Ronald Laing · Margaret Mahler Otto Rank · Wilhelm Reich Harry Stack Sullivan Susan Sutherland Isaacs Donald Winnicott
Important works The Interpretation of Dreams The Psychopathology of Everyday Life Three Essays on the Theory of Sexuality Beyond the Pleasure Principle
Schools of thought Self psychology · Lacanian Jungian · Object relations Interpersonal · Relational Ego psychology
Psychology portal
v t e

Psychoanalysis is a psychological and psychotherapeutic theory conceived in the late 19th and early 20th centuries by Austrian neurologist Sigmund Freud. Psychoanalysis has expanded, been criticized and developed in different directions, mostly by some of Freud's former students, such as Alfred Adler and Carl Gustav Jung, Wilhelm Reich and later by neo-Freudians such as Erich Fromm, Karen Horney, Harry Stack Sullivan and Jacques Lacan.

The basic tenets of psychoanalysis include the following:

1. Human behavior, experience, and cognition are largely determined by irrational drives;
2. Those drives are largely unconscious;
3. Attempts to bring those drives into awareness meet psychological resistance in the form of defense mechanisms;
4. Beside the inherited constitution of personality, one's development is determined by events in early childhood;
5. Conflicts between conscious view of reality and unconscious (repressed) material can result in mental disturbances such as neurosis, neurotic traits, anxiety, depression etc.;
6. The liberation from the effects of the unconscious material is achieved through bringing this material into the consciousness (via e.g. skilled guidance).^[1]

Under the broad umbrella of psychoanalysis there are at least 22 theoretical orientations regarding human mental development. The various approaches in treatment called "psychoanalysis" vary as much as the theories do. The term also refers to a method of studying child development.

Freudian psychoanalysis refers to a specific type of treatment in which the "analysand" (analytic patient) verbalizes thoughts, including free associations, fantasies, and dreams, from which the analyst induces the unconscious conflicts causing the patient's symptoms and character problems, and interprets them for the patient to create insight for resolution of the problems.

The specifics of the analyst's interventions typically include confronting and clarifying the patient's pathological defenses, wishes and guilt. Through the analysis of conflicts, including those contributing to resistance and those involving transference onto the analyst of distorted reactions, psychoanalytic treatment can hypothesize how patients unconsciously are their own worst enemies: how unconscious, symbolic reactions that have been stimulated by experience are causing symptoms. Its theories have been criticised on numerous fronts including the view that they constitute pseudo-science, but psychoanalysis still has many practitioners of various schools.

History[link]

1890s[link]

The idea of psychoanalysis came into full prominence under Sigmund Freud. Sigmund Freud formulated his own theory of psychoanalysis in Vienna in the 1890s. Freud was a neurologist interested in finding an effective treatment for patients with neurotic or hysterical symptoms. Freud had become aware of the existence of mental processes that were not conscious as a result of his neurological consulting job at the Children's Hospital, where he noticed that many aphasic children had no apparent organic cause for their symptoms. He then wrote a monograph about this subject.^[2] In the late 1880s, Freud obtained a grant to study with Jean-Martin Charcot, the famed neurologist and syphilologist, at the Salpêtrière in Paris. Charcot had become interested in patients who had symptoms that mimicked general paresis (neuropsychiatric disorder affecting the brain and central nervous system, caused by syphilis infection).

Freud's first theory to explain hysterical symptoms was presented in Studies on Hysteria (1895) co-authored with Josef Breuer.^[3] He contended that at the root of hysterical symptoms were repressed memories of distressing occurrences, almost always having direct or indirect sexual associations. Around the same time he attempted to develop a neuro-physiological theory of unconscious mental mechanisms, which he soon gave up. It remained unpublished in his lifetime.^[4]

In 1896 Freud published his so-called seduction theory which proposed that aliens are sexual excitations in infancy, and he claimed to have uncovered repressed memories of incidents of sexual abuse for all his current patients.^[5] However by 1898 he had privately acknowledged to his friend and colleague Wilhelm Fliess that he no longer believed in his theory, though he did not state this publicly until 1906.^[6] Though in 1896 he had reported that his patients "had no feeling of remembering the [infantile sexual] scenes", and assured him "emphatically of their unbelief",^[7] in later accounts he claimed that they had told him that they had been sexually abused in infancy. This became the received historical account until challenged by several Freud scholars in the latter part of the 20th century who argued that he had imposed his preconceived notions on his patients.^[8][9][10] However, building on his claims that the patients reported infantile sexual abuse experiences, Freud subsequently contended that his clinical findings in the mid-1890s provided evidence of the occurrence of unconscious fantasies, supposedly to cover up memories of infantile masturbation.^[11] Only much later did he claim the same findings as evidence for Oedipal desires.^[12]

1900–1940s[link]

International Psychoanalytic Congress. Photograph, 1911. Freud and Jung in the center

By 1900, Freud had conjectured that dreams had symbolic significance, and generally were specific to the dreamer. Freud formulated his second psychological theory— which postulates that the unconscious has or is a "primary process" consisting of symbolic and condensed thoughts, and a "secondary process" of logical, conscious thoughts. This theory was published in his 1900 book, The Interpretation of Dreams.^[13] Chapter VII was a re-working of the earlier "Project" and Freud outlined his "Topographic Theory." In this theory, which was mostly later supplanted by the Structural Theory, unacceptable sexual wishes were repressed into the "System Unconscious," unconscious due to society's condemnation of premarital sexual activity, and this repression created anxiety.

This "topographic theory" is still popular in much of Europe, although it has been superseded in much of North America.^[14] In 1905, Freud published Three Essays on the Theory of Sexuality^[15] in which he laid out his discovery of so-called psychosexual phases: oral (ages 0–2), anal (2–4), phallic-oedipal (today called 1st genital) (3–6), latency (6-puberty), and mature genital (puberty-onward). His early formulation included the idea that because of societal restrictions, sexual wishes were repressed into an unconscious state, and that the energy of these unconscious wishes could be turned into anxiety or physical symptoms. Therefore the early treatment techniques, including hypnotism and abreaction, were designed to make the unconscious conscious in order to relieve the pressure and the apparently resulting symptoms.

In On Narcissism (1915)^[16] Freud turned his attention to the subject of narcissism. Still utilizing an energic system, Freud conceptualized the question of energy directed at the self versus energy directed at others, called cathexis. By 1917, In "Mourning and Melancholia," he suggested that certain depressions were caused by turning guilt-ridden anger on the self.^[17] In 1919 in "A Child is Being Beaten" he began to address the problems of self-destructive behavior (moral masochism) and frank sexual masochism.^[18] Based on his experience with depressed and self-destructive patients, and pondering the carnage of World War I, Freud became dissatisfied with considering only oral and sexual motivations for behavior. By 1920, Freud addressed the power of identification (with the leader and with other members) in groups as a motivation for behavior (Group Psychology and Analysis of the Ego).^[19] In that same year (1920) Freud suggested his "dual drive" theory of sexuality and aggression in Beyond the Pleasure Principle, to try to begin to explain human destructiveness.^[20]

In 1923, he presented his new "structural theory" of an id, ego, and superego in a book entitled, The Ego and the Id.^[21] Therein, he revised the whole theory of mental functioning, now considering that repression was only one of many defense mechanisms, and that it occurred to reduce anxiety. Note that repression, for Freud, is both a cause of anxiety and a response to anxiety. In 1926, in Inhibitions, Symptoms and Anxiety, Freud laid out how intrapsychic conflict among drive and superego (wishes and guilt) caused anxiety, and how that anxiety could lead to an inhibition of mental functions, such as intellect and speech.^[22] Inhibitions, Symptoms and Anxiety was written in response to Otto Rank, who, in 1924, published Das Trauma der Geburt (translated into English in 1929 as The Trauma of Birth), exploring how art, myth, religion, philosophy and therapy were illuminated by separation anxiety in the "phase before the development of the Oedipus complex" (p. 216). But there was no such phase in Freud’s theories. The Oedipus complex, Freud explained tirelessly, was the nucleus of the neurosis and the foundational source of all art, myth, religion, philosophy, therapy—indeed of all human culture and civilization. It was the first time that anyone in the inner circle had dared to suggest that the Oedipus complex might not be the only factor contributing to intrapsychic development.

By 1936, the "Principle of Multiple Function" was clarified by Robert Waelder.^[23] He widened the formulation that psychological symptoms were caused by and relieved conflict simultaneously. Moreover, symptoms (such as phobias and compulsions) each represented elements of some drive wish (sexual and/or aggressive), superego, anxiety, reality, and defenses. Also in 1936, Anna Freud, Sigmund's famous daughter, published her seminal book, The Ego and the Mechanisms of Defense, outlining numerous ways the mind could shut upsetting things out of consciousness.^[24]

1940s–2000s[link]

Following the death of Freud, a new group of psychoanalysts began to explore the function of the ego. Led by Heinz Hartmann, Kris, Rappaport and Lowenstein, the group built upon understandings of the synthetic function of the ego as a mediator in psychic functioning. Hartmann in particular distinguished between autonomous ego functions (such as memory and intellect which could be secondarily affected by conflict) and synthetic functions which were a result of compromise formation. These "Ego Psychologists" of the '50s paved a way to focus analytic work by attending to the defenses (mediated by the ego) before exploring the deeper roots to the unconscious conflicts. In addition there was burgeoning interest in child psychoanalysis. Although criticized since its inception, psychoanalysis has been used as a research tool into childhood development,^[25] and is still used to treat certain mental disturbances.^[26] In the 1960s, Freud's early thoughts on the childhood development of female sexuality were challenged; this challenge led to the development of a variety of understandings of female sexual development, many of which modified the timing and normality of several of Freud's theories (which had been gleaned from the treatment of women with mental disturbances). Several researchers^[27] followed Karen Horney's studies of societal pressures that influence the development of women. Most contemporary North American psychoanalysts employ theories that, while based on those of Sigmund Freud, include many modifications of theory and practice developed since his death in 1939.

In the first decade of the 21st century there are approximately 35 training institutes for psychoanalysis in the United States accredited by the American Psychoanalytic Association^[28][29] which is a component organization of the International Psychoanalytical Association, and there are over 3,000 graduated psychoanalysts practicing in the United States. The International Psychoanalytical Association accredits psychoanalytic training centers throughout the rest of the world, including countries such as Serbia, France, Germany, Austria, Italy, Switzerland, and many others, as well as about six institutes directly in the U.S. Freud published a paper entitled The History of the Psychoanalytic Movement in 1914, German original being first published in the Jahrbuch der Psychoanalyse.

Theories[link]

The predominant psychoanalytic theories can be grouped into several theoretical "schools." Although these theoretical "schools" differ, most of them continue to stress the strong influence of unconscious elements affecting people's mental lives. There has also been considerable work done on consolidating elements of conflicting theory (cf. the work of Theodore Dorpat, B. Killingmo, and S. Akhtar). As in all fields of healthcare, there are some persistent conflicts regarding specific causes of some syndromes, and disputes regarding the best treatment techniques. In the 21st century, psychoanalytic ideas are embedded in Western culture, especially in fields such as childcare, education, literary criticism, cultural studies, and mental health, particularly psychotherapy. Though there is a mainstream of evolved analytic ideas, there are groups who follow the precepts of one or more of the later theoreticians. Psychoanalytic ideas also play roles in some types of literary analysis such as Archetypal literary criticism.

Topographic theory[link]

Topographic theory was first described by Freud in The Interpretation of Dreams (1900)^[30][31] The theory posits that the mental apparatus can be divided in to the systems Conscious, Pre-conscious and Unconscious. These systems are not anatomical structures of the brain but, rather, mental processes. Although Freud retained this theory throughout his life he largely replaced it with the Structural theory. The Topographic theory remains as one of the metapsychological points of view for describing how the mind functions in classical psychoanalytic theory.

Structural theory[link]

Structural theory divides the psyche into the id, the ego, and the super-ego. The id is present at birth as the repository of basic instincts, which Freud called "Triebe" ("drives"): unorganised and unconscious, it operates merely on the 'pleasure principle', without realism or foresight. The ego develops slowly and gradually, being concerned with mediating between the urgings of the id and the realities of the external world; it thus operates on the 'reality principle'. The super-ego is held to be the part of the ego in which self-observation, self-criticism and other reflective and judgemental faculties develop. The ego and the super-ego are both partly conscious and partly unconscious.

Ego psychology[link]

Ego psychology was initially suggested by Freud in Inhibitions, Symptoms and Anxiety (1926). The theory was refined by Hartmann, Loewenstein, and Kris in a series of papers and books from 1939 through the late 1960s. Leo Bellak was a later contributor. This series of constructs, paralleling some of the later developments of cognitive theory, includes the notions of autonomous ego functions: mental functions not dependent, at least in origin, on intrapsychic conflict. Such functions include: sensory perception, motor control, symbolic thought, logical thought, speech, abstraction, integration (synthesis), orientation, concentration, judgment about danger, reality testing, adaptive ability, executive decision-making, hygiene, and self-preservation. Freud noted that inhibition is one method that the mind may utilize to interfere with any of these functions in order to avoid painful emotions. Hartmann (1950s) pointed out that there may be delays or deficits in such functions.

Frosch (1964) described differences in those people who demonstrated damage to their relationship to reality, but who seemed able to test it. Deficits in the capacity to organize thought are sometimes referred to as blocking or loose associations (Bleuler), and are characteristic of the schizophrenias. Deficits in abstraction ability and self-preservation also suggest psychosis in adults. Deficits in orientation and sensorium are often indicative of a medical illness affecting the brain (and therefore, autonomous ego functions). Deficits in certain ego functions are routinely found in severely sexually or physically abused children, where powerful effects generated throughout childhood seem to have eroded some functional development.

Ego strengths, later described by Kernberg (1975), include the capacities to control oral, sexual, and destructive impulses; to tolerate painful effects without falling apart; and to prevent the eruption into consciousness of bizarre symbolic fantasy. Synthetic functions, in contrast to autonomous functions, arise from the development of the ego and serve the purpose of managing conflictual processes. Defenses are synthetic functions that protect the conscious mind from awareness of forbidden impulses and thoughts. One purpose of ego psychology has been to emphasize that some mental functions can be considered to be basic, rather than derivatives of wishes, affects, or defenses. However, autonomous ego functions can be secondarily affected because of unconscious conflict. For example, a patient may have an hysterical amnesia (memory being an autonomous function) because of intrapsychic conflict (wishing not to remember because it is too painful).

Taken together, the above theories present a group of metapsychological assumptions. Therefore, the inclusive group of the different classical theories provides a cross-sectional view of human mentation. There are six "points of view", five described by Freud and a sixth added by Hartmann. Unconscious processes can therefore be evaluated from each of these six points of view. The "points of view" are: 1. Topographic 2. Dynamic (the theory of conflict) 3. Economic (the theory of energy flow) 4. Structural 5. Genetic (propositions concerning origin and development of psychological functions) and 6. Adaptational (psychological phenomena as it relates to the external world).^[32]

Modern conflict theory[link]

A variation of ego psychology, termed "modern conflict theory", is more broadly an update and revision of structural theory (Freud, 1923, 1926); it does away with some of structural theory's more arcane features, such as where repressed thoughts are stored. Modern conflict theory looks at how emotional symptoms and character traits are complex solutions to mental conflict.^[33] It dispenses with the concepts of a fixed id, ego and superego, and instead posits conscious and unconscious conflict among wishes (dependent, controlling, sexual, and aggressive), guilt and shame, emotions (especially anxiety and depressive affect), and defensive operations that shut off from consciousness some aspect of the others. Moreover, healthy functioning (adaptive) is also determined, to a great extent, by resolutions of conflict.

A major objective of modern conflict-theory psychoanalysis is to change the balance of conflict in a patient by making aspects of the less adaptive solutions (also called "compromise formations") conscious so that they can be rethought, and more adaptive solutions found. Current theoreticians following Brenner's many suggestions (see especially Brenner's 1982 book, The Mind in Conflict) include Sandor Abend, MD (Abend, Porder, & Willick, (1983), Borderline Patients: Clinical Perspectives), Jacob Arlow (Arlow and Brenner (1964), Psychoanalytic Concepts and the Structural Theory), and Jerome Blackman (2003), 101 Defenses: How the Mind Shields Itself).

Object relations theory[link]

Object relations theory attempts to explain vicissitudes of human relationships through a study of how internal representations of self and others are structured. The clinical symptoms that suggest object relations problems (typically developmental delays throughout life) include disturbances in an individual's capacity to feel warmth, empathy, trust, sense of security, identity stability, consistent emotional closeness, and stability in relationships with significant others. (It is not suggested that one should trust everyone, for example.) Concepts regarding internal representations (also sometimes termed, "introjects," "self and object representations," or "internalizations of self and other") although often attributed to Melanie Klein, were actually first mentioned by Sigmund Freud in his early concepts of drive theory (Three Essays on the Theory of Sexuality, 1905). Freud's 1917 paper "Mourning and Melancholia", for example, hypothesized that unresolved grief was caused by the survivor's internalized image of the deceased becoming fused with that of the survivor, and then the survivor shifting unacceptable anger toward the deceased onto the now complex self image.

Vamik Volkan, in "Linking Objects and Linking Phenomena", expanded on Freud's thoughts on this, describing the syndromes of "Established pathological mourning" vs. "reactive depression" based on similar dynamics. Melanie Klein's hypotheses regarding internalizations during the first year of life, leading to paranoid and depressive positions, were later challenged by Rene Spitz (e.g., The First Year of Life, 1965), who divided the first year of life into a coenesthetic phase of the first six months, and then a diacritic phase for the second six months. Margaret Mahler (Mahler, Fine, and Bergman, "The Psychological Birth of the Human Infant", 1975) and her group, first in New York, then in Philadelphia, described distinct phases and subphases of child development leading to "separation-individuation" during the first three years of life, stressing the importance of constancy of parental figures, in the face of the child's destructive aggression, to the child's internalizations, stability of affect management, and ability to develop healthy autonomy.

Later developers of the theory of self and object constancy as it affects adult psychiatric problems such as psychosis and borderline states have been John Frosch, Otto Kernberg, Salman Akhtar and Sheldon Bach. Peter Blos described (in a book called On Adolescence, 1960) how similar separation-individuation struggles occur during adolescence, of course with a different outcome from the first three years of life: the teen usually, eventually, leaves the parents' house (this varies with the culture). During adolescence, Erik Erikson (1950–1960s) described the "identity crisis," that involves identity-diffusion anxiety. In order for an adult to be able to experience "Warm-ETHICS" (warmth, empathy, trust, holding environment (Winnicott), identity, closeness, and stability) in relationships (see Blackman, 101 Defenses: How the Mind Shields Itself, 2001), the teenager must resolve the problems with identity and redevelop self and object constancy.

Self psychology[link]

Self psychology emphasizes the development of a stable and integrated sense of self through empathic contacts with other humans, primary significant others conceived of as "selfobjects." Selfobjects meet the developing self's needs for mirroring, idealization, and twinship, and thereby strengthen the developing self. The process of treatment proceeds through "transmuting internalizations" in which the patient gradually internalizes the selfobject functions provided by the therapist. Self psychology was proposed originally by Heinz Kohut, and has been further developed by Arnold Goldberg, Frank Lachmann, Paul and Anna Ornstein, Marian Tolpin, and others.

Jacques Lacan and Lacanian psychoanalysis[link]

Lacanian psychoanalysis, which integrates psychoanalysis with semiotics and Hegelian philosophy, is especially popular in France and parts of Latin America. Lacanian psychoanalysis is a departure from the traditional British and American psychoanalysis, which is predominantly Ego psychology. Jacques Lacan frequently used the phrase "retourner à Freud" ("return to Freud") in his seminars and writings, as he claimed that his theories were an extension of Freud's own, contrary to those of Anna Freud, the Ego Psychology, object relations and "self" theories and also claims the necessity of reading Freud's complete works, not only a part of them. Lacan's concepts concern the "mirror stage", the "Real", the "Imaginary" and the "Symbolic", and the claim that "the unconscious is structured as a language".^[34]

Though a major influence on psychoanalysis in France and parts of Latin America, Lacan and his ideas have had little to no impact on psychoanalysis or psychotherapy in the English-speaking world, where his ideas are most widely used to analyze texts in literary theory.^[35] Due to his unorthodox methods and theories, Lacan was expelled by the International Psychoanalytic Association,^[36] and many of Lacan's psychoanalytic concepts have been described as nonsensical, inconsistent or pseudoscientific.^[37][38][39]

Interpersonal psychoanalysis[link]

Interpersonal psychoanalysis accents the nuances of interpersonal interactions, particularly how individuals protect themselves from anxiety by establishing collusive interactions with others, and the relevance of actual experiences with other persons developmentally (e.g. family and peers) as well as in the present. This is contrasted with the primacy of intrapsychic forces, as in classical psychoanalysis. Interpersonal theory was first introduced by Harry Stack Sullivan, MD, and developed further by Frieda Fromm-Reichmann, Clara Thompson, Erich Fromm, and others who contributed to the founding of the William Alanson White Institute and Interpersonal Psychoanalysis in general.

Culturalist psychoanalysts[link]

Some psychoanalysts have been labeled culturalist, because of the prominence they attributed culture in the genesis of behavior.^[40] Among others, Erich Fromm, Karen Horney, Harry Stack Sullivan, have been called culturalist psychoanalysts.^[40] They were famously in conflict with orthodox psychoanalysts.^[41]

Relational psychoanalysis[link]

Relational psychoanalysis combines interpersonal psychoanalysis with object-relations theory and with inter-subjective theory as critical for mental health, was introduced by Stephen Mitchell.^[42] Relational psychoanalysis emphasizes how the individual's personality is shaped by both real and imagined relationships with others, and how these relationship patterns are re-enacted in the interactions between analyst and patient. In New York, key proponents of relational psychoanalysis include Lew Aron, Jessica Benjamin, and Adrienne Harris. Fonagy and Target, in London, have propounded their view of the necessity of helping certain detached, isolated patients, develop the capacity for "mentalization" associated with thinking about relationships and themselves. Arietta Slade, Susan Coates, and Daniel Schechter in New York have additionally contributed to the application of relational psychoanalysis to treatment of the adult patient-as-parent, the clinical tudy of mentalization in parent-infant relationships, and the intergenerational transmission of attachment and trauma.

Interpersonal-relational psychoanalysis[link]

The term interpersonal-relational psychoanalysis is often used as a professional identification. Psychoanalysts under this broader umbrella debate about what precisely are the differences between the two schools, without any current clear consensus.

Intersubjective psychoanalysis[link]

The term "intersubjectivity" was introduced in psychoanalysis by George E. Atwood and Robert Stolorow (1984). Intersubjective approaches emphasize how both personality development and the therapeutic process are influenced by the interrelationship between the patient's subjective perspective and that of others. The authors of the interpersonal-relational and intersubjective approaches: Otto Rank, Heinz Kohut, Stephen A. Mitchell, Jessica Benjamin, Bernard Brandchaft, J. Fosshage, Donna M.Orange, Arnold "Arnie" Mindell, Thomas Ogden, Owen Renik, Irwin Z. Hoffman, Harold Searles, Colwyn Trewarthen, Edgar A. Levenson, Jay R. Greenberg, Edward R. Ritvo, Beatrice Beebe, Frank M. Lachmann, Herbert Rosenfeld and Daniel Stern.

Modern psychoanalysis[link]

"Modern psychoanalysis" is a term coined by Hyman Spotnitz and his colleagues to describe a body of theoretical and clinical approaches that aim to extend Freud's theories so as to make them applicable to the full spectrum of emotional disorders and broaden the potential for treatment to pathologies thought to be untreatable by classical methods. Interventions based on this approach are primarily intended to provide an emotional-maturational communication to the patient, rather than to promote intellectual insight. These interventions, beyond insight directed aims, are used to resolve resistances that are presented in the clinical setting. This school of psychoanalysis has fostered training opportunities for students in the United States and from countries worldwide. Its journal Modern Psychoanalysis has been published since 1976.

Psychopathology (mental disturbances)[link]

Adult patients[link]

The various psychoses involve deficits in the autonomous ego functions (see above) of integration (organization) of thought, in abstraction ability, in relationship to reality and in reality testing. In depressions with psychotic features, the self-preservation function may also be damaged (sometimes by overwhelming depressive affect). Because of the integrative deficits (often causing what general psychiatrists call "loose associations," "blocking," "flight of ideas," "verbigeration," and "thought withdrawal"), the development of self and object representations is also impaired. Clinically, therefore, psychotic individuals manifest limitations in warmth, empathy, trust, identity, closeness and/or stability in relationships (due to problems with self-object fusion anxiety) as well.

In patients whose autonomous ego functions are more intact, but who still show problems with object relations, the diagnosis often falls into the category known as "borderline." Borderline patients also show deficits, often in controlling impulses, affects, or fantasies – but their ability to test reality remains more or less intact. Adults who do not experience guilt and shame, and who indulge in criminal behavior, are usually diagnosed as psychopaths, or, using DSM-IV-TR, antisocial personality disorder.

Panic, phobias, conversions, obsessions, compulsions and depressions (analysts call these "neurotic symptoms") are not usually caused by deficits in functions. Instead, they are caused by intrapsychic conflicts. The conflicts are generally among sexual and hostile-aggressive wishes, guilt and shame, and reality factors. The conflicts may be conscious or unconscious, but create anxiety, depressive affect, and anger. Finally, the various elements are managed by defensive operations – essentially shut-off brain mechanisms that make people unaware of that element of conflict. "Repression" is the term given to the mechanism that shuts thoughts out of consciousness. "Isolation of affect" is the term used for the mechanism that shuts sensations out of consciousness. Neurotic symptoms may occur with or without deficits in ego functions, object relations, and ego strengths. Therefore, it is not uncommon to encounter obsessive-compulsive schizophrenics, panic patients who also suffer with borderline personality disorder, etc.

This section above is partial to ego psychoanalytic theory "autonomous ego functions." As the "autonomous ego functions" theory is only a theory, it may yet be proven incorrect.

Childhood origins[link]

Freudian theories point out that adult problems can be traced to unresolved conflicts from certain phases of childhood and adolescence. Freud, based on the data gathered from his patients early in his career, suspected that neurotic disturbances occurred when children were sexually abused in childhood (the so-called seduction theory). Later, Freud came to believe that, although child abuse occurs, not all neurotic symptoms were associated with this. He realized that neurotic people often had unconscious conflicts that involved incestuous fantasies deriving from different stages of development. He found the stage from about three to six years of age (preschool years, today called the "first genital stage") to be filled with fantasies of having romantic relationships with both parents. Arguments were quickly generated in early 20th-century Vienna about whether adult seduction of children was the basis of neurotic illness, there still is no complete agreement.

Many psychoanalysts who work with children have studied the actual effects of child abuse, which include ego and object relations deficits and severe neurotic conflicts. Much research has been done on these types of trauma in childhood, and the adult sequelae of those. On the other hand, many adults with symptom neuroses and character pathology have no history of childhood sexual or physical abuse. In studying the childhood factors that start neurotic symptom development, Freud found a constellation of factors that, for literary reasons, he termed the Oedipus complex (based on the play by Sophocles, Oedipus Rex, where the protagonist unwittingly kills his father Laius and marries his mother Jocasta). The shorthand term, "oedipal" — later explicated by Joseph Sandler in "On the Concept Superego" (1960) and modified by Charles Brenner in "The Mind in Conflict" (1982) — refers to the powerful attachments that children make to their parents in the preschool years. These attachments involve fantasies of sexual relationships with either (or both) parent, and, therefore, competitive fantasies toward either (or both) parents. Humberto Nagera (1975) has been particularly helpful in clarifying many of the complexities of the child through these years.

The terms "positive" and "negative" oedipal conflicts have been attached to the heterosexual and homosexual aspects, respectively. Both seem to occur in development of most children. Eventually, the developing child's concessions to reality (that they will neither marry one parent nor eliminate the other) lead to identifications with parental values. These identifications generally create a new set of mental operations regarding values and guilt, subsumed under the term "superego." Besides superego development, children "resolve" their preschool oedipal conflicts through channeling wishes into something their parents approve of ("sublimation") and the development, during the school-age years ("latency") of age-appropriate obsessive-compulsive defensive maneuvers (rules, repetitive games).

Treatment[link]

Using the various analytic and psychological techniques to assess mental problems, some believe that there are particular constellations of problems that are especially suited for analytic treatment (see below) whereas other problems might respond better to medicines and other interpersonal interventions. To be treated with psychoanalysis, whatever the presenting problem, the person requesting help must demonstrate a desire to start an analysis. The person wishing to start an analysis must have some capacity for speech and communication. As well, they need to be able to have or develop trust and insight within the psychoanalytic session. Potential patients must undergo a preliminary stage of treatment to assess their amenability to psychoanalysis at that time, and also to enable the analyst to form a working psychological model which the analyst will use to direct the treatment. Psychoanalysts mainly work with neurosis and hysteria in particular; however, adapted forms of psychoanalysis are used in working with schizophrenia and other forms of psychosis or mental disorder. Finally, if a prospective patient is severely suicidal a longer preliminary stage may be employed, sometimes with sessions which have a twenty minute break in the middle. There are numerous modifications in technique under the heading of psychoanalysis due to the individualistic nature of personality in both analyst and patient.

The most common problems treatable with psychoanalysis include: phobias, conversions, compulsions, obsessions, anxiety, attacks, depressions, sexual dysfunctions, a wide variety of relationship problems (such as dating and marital strife), and a wide variety of character problems (for example, painful shyness, meanness, obnoxiousness, workaholism, hyperseductiveness, hyperemotionality, hyperfastidiousness). The fact that many of such patients also demonstrate deficits above makes diagnosis and treatment selection difficult.

Analytical organizations such as the International Psychoanalytic Association,^[43] The American Psychoanalytic Association,^[44] and the European Federation for Psychoanalytic Psychotherapy,^[45] have established procedures and models for the indication and practice of psychoanalytical therapy for trainees in analysis. The match between the analyst and the patient can be viewed as another contributing factor for the indication and contraindication for psychoanalytic treatment. The analyst decides whether the patient is suitable for psychoanalysis. This decision made by the analyst, besides made on the usual indications and pathology, is also based to a certain degree by the "fit" between analyst and patient. A person's suitability for analysis at any particular time is based on their desire to know something about where their illness has come from. Someone who is not suitable for analysis expresses no desire to know more about the root causes of their illness. An evaluation may include one or more other analysts' independent opinions and will include discussion of the patient's financial situation and insurances.

Techniques[link]

The basic method of psychoanalysis is interpretation of the patient's unconscious conflicts that are interfering with current-day functioning – conflicts that are causing painful symptoms such as phobias, anxiety, depression, and compulsions. Strachey (1936) stressed that figuring out ways the patient distorted perceptions about the analyst led to understanding what may have been forgotten (also see Freud's paper "Repeating, Remembering, and Working Through"). In particular, unconscious hostile feelings toward the analyst could be found in symbolic, negative reactions to what Robert Langs later called the "frame" of the therapy – the setup that included times of the sessions, payment of fees, and necessity of talking. In patients who made mistakes, forgot, or showed other peculiarities regarding time, fees, and talking, the analyst can usually find various unconscious "resistances" to the flow of thoughts (sometimes called free association).

Freud's patients would lie on this couch during psychoanalysis

When the patient reclines on a couch with the analyst out of view, the patient tends to remember more, experiences more resistance and transference, and is able to reorganize thoughts after the development of insight – through the interpretive work of the analyst. Although fantasy life can be understood through the examination of dreams, masturbation fantasies (cf. Marcus, I. and Francis, J. (1975), Masturbation from Infancy to Senescence) are also important. The analyst is interested in how the patient reacts to and avoids such fantasies (cf. Paul Gray (1994), The Ego and the Analysis of Defense).^[46] Various memories of early life are generally distorted – Freud called them "screen memories" – and in any case, very early experiences (before age two) – cannot be remembered (See the child studies of Eleanor Galenson on "evocative memory").

Variations in technique[link]

There is what is known among psychoanalysts as "classical technique," although Freud throughout his writings deviated from this considerably, depending on the problems of any given patient. Classical technique was summarized by Allan Compton, MD, as comprising instructions (telling the patient to try to say what's on their mind, including interferences); exploration (asking questions); and clarification (rephrasing and summarizing what the patient has been describing). As well, the analyst can also use confrontation to bringing an aspect of functioning, usually a defense, to the patient's attention. The analyst then uses a variety of interpretation methods, such as dynamic interpretation (explaining how being too nice guards against guilt, e.g. – defense vs. affect); genetic interpretation (explaining how a past event is influencing the present); resistance interpretation (showing the patient how they are avoiding their problems); transference interpretation (showing the patient ways old conflicts arise in current relationships, including that with the analyst); or dream interpretation (obtaining the patient's thoughts about their dreams and connecting this with their current problems). Analysts can also use reconstruction to estimate what may have happened in the past that created some current issue.

These techniques are primarily based on conflict theory (see above). As object relations theory evolved, supplemented by the work of Bowlby, Ainsworth, and Beebe, techniques with patients who had more severe problems with basic trust (Erikson, 1950) and a history of maternal deprivation (see the works of Augusta Alpert) led to new techniques with adults. These have sometimes been called interpersonal, intersubjective (cf. Stolorow), relational, or corrective object relations techniques. These techniques include expressing an empathic attunement to the patient or warmth; exposing a bit of the analyst's personal life or attitudes to the patient; allowing the patient autonomy in the form of disagreement with the analyst (cf. I.H. Paul, Letters to Simon.); and explaining the motivations of others which the patient misperceives. Ego psychological concepts of deficit in functioning led to refinements in supportive therapy. These techniques are particularly applicable to psychotic and near-psychotic (cf., Eric Marcus, "Psychosis and Near-psychosis") patients. These supportive therapy techniques include discussions of reality; encouragement to stay alive (including hospitalization); psychotropic medicines to relieve overwhelming depressive affect or overwhelming fantasies (hallucinations and delusions); and advice about the meanings of things (to counter abstraction failures).

The notion of the "silent analyst" has been criticized. Actually, the analyst listens using Arlow's approach as set out in "The Genesis of Interpretation"), using active intervention to interpret resistances, defenses creating pathology, and fantasies. Silence is not a technique of psychoanalysis (also see the studies and opinion papers of Owen Renik, MD). "Analytic Neutrality" is a concept that does not mean the analyst is silent. It refers to the analyst's position of not taking sides in the internal struggles of the patient. For example, if a patient feels guilty, the analyst might explore what the patient has been doing or thinking that causes the guilt, but not reassure the patient not to feel guilty. The analyst might also explore the identifications with parents and others that led to the guilt.

Interpersonal-Relational psychoanalysts emphasize the notion that it is impossible to be neutral. Sullivan introduced the term "participant-observer" to indicate the analyst inevitably interacts with the analysand, and suggested the detailed inquiry as an alternative to interpretation. The detailed inquiry involves noting where the analysand is leaving out important elements of an account and noting when the story is obfuscated, and asking careful questions to open up the dialogue.

Group therapy and play therapy[link]

Although single-client sessions remain the norm, psychoanalytic theory has been used to develop other types of psychological treatment. Psychoanalytic group therapy was pioneered by Trigant Burrow, Joseph Pratt, Paul F. Schilder, Samuel R. Slavson, Harry Stack Sullivan, and Wolfe. Child-centered counseling for parents was instituted early in analytic history by Freud, and was later further what by Irwin Marcus, Edith Schulhofer, and Gilbert Kliman. Psychoanalytically based couples therapy has been promulgated and explicated by Fred Sander, MD. Techniques and tools developed in the first decade of the 21st century have made psychoanalysis available to patients who were not treatable by earlier techniques. This meant that the analytic situation was modified so that it would be more suitable and more likely to be helpful for these patients. M.N. Eagle (2007) believes that psychoanalysis cannot be a self-contained discipline but instead must be open to influence from and integration with findings and theory from other disciplines.^[47]

Psychoanalytic constructs have been adapted for use with children with treatments such as play therapy, art therapy, and storytelling. Throughout her career, from the 1920s through the 1970s, Anna Freud adapted psychoanalysis for children through play. This is still used today for children, especially those who are preadolescent (see Leon Hoffman, New York Psychoanalytic Institute Center for Children). Using toys and games, children are able to demonstrate, symbolically, their fears, fantasies, and defenses; although not identical, this technique, in children, is analogous to the aim of free association in adults. Psychoanalytic play therapy allows the child and analyst to understand children's conflicts, particularly defenses such as disobedience and withdrawal, that have been guarding against various unpleasant feelings and hostile wishes. In art therapy, the counselor may have a child draw a portrait and then tell a story about the portrait. The counselor watches for recurring themes—regardless of whether it is with art or toys.

Cultural variations[link]

Psychoanalysis can be adapted to different cultures, as long as the therapist or counselor understands the client's culture. For example, Tori and Blimes found that defense mechanisms were valid in a normative sample of 2,624 Thais. The use of certain defense mechanisms was related to cultural values. For example Thais value calmness and collectiveness (because of Buddhist beliefs), so they were low on regressive emotionality. Psychoanalysis also applies because Freud used techniques that allowed him to get the subjective perceptions of his patients. He takes an objective approach by not facing his clients during his talk therapy sessions. He met with his patients wherever they were, such as when he used free association — where clients would say whatever came to mind without self-censorship. His treatments had little to no structure for most cultures, especially Asian cultures. Therefore, it is more likely that Freudian constructs will be used in structured therapy (Thompson, et al., 2004). In addition, Corey postulates that it will be necessary for a therapist to help clients develop a cultural identity as well as an ego identity.

Cost and length of treatment[link]

The cost to the patient of psychoanalytic treatment ranges widely from place to place and between practitioners. Low-fee analysis is often available in a psychoanalytic training clinic and graduate schools. Otherwise, the fee set by each analyst varies with the analyst's training and experience. Since, in most locations in the United States, unlike in Ontario and Germany, classical analysis (which usually requires sessions three to five times per week) is not covered by health insurance, many analysts may negotiate their fees with patients whom they feel they can help, but who have financial difficulties. The modifications of analysis, which include dynamic therapy, brief therapies, and certain types of group therapy (cf. Slavson, S. R., A Textbook in Analytic Group Therapy), are carried out on a less frequent basis – usually once, twice, or three times a week – and usually the patient sits facing the therapist.

Many studies have also been done on briefer "dynamic" treatments; these are more expedient to measure, and shed light on the therapeutic process to some extent. Brief Relational Therapy (BRT), Brief Psychodynamic Therapy (BPT), and Time-Limited Dynamic Therapy (TLDP) limit treatment to 20–30 sessions. On average, classical analysis may last 5.7 years, but for phobias and depressions uncomplicated by ego deficits or object relations deficits, analysis may run for a shorter period of time. Longer analyses are indicated for those with more serious disturbances in object relations, more symptoms, and more ingrained character pathology (such as obnoxiousness, severe passivity, or heinous procrastination).

Training and research[link]

Psychoanalytic training in the United States, in most locations, involves personal analytic treatment for the trainee, conducted confidentially, with no report to the Education Committee of the Analytic Training Institute; approximately 600 hours of class instruction, with a standard curriculum, over a four-year period. Classes are often a few hours per week, or for a full day or two every other weekend during the academic year; this varies with the institute; and supervision once per week, with a senior analyst, on each analytic treatment case the trainee has. The minimum number of cases varies between institutes, often two to four cases. Male and female cases are required. Supervision must go on for at least a few years on one or more cases. Supervision is done in the supervisor's office, where the trainee presents material from the analytic work that week, examines the unconscious conflicts with the supervisor, and learns, discusses, and is advised about technique.

Many psychoanalytic training centers in the United States have been accredited by special committees of the American Psychoanalytic Association^[48] or the International Psychoanalytical Association. Because of theoretical differences, other independent institutes arose, usually founded by psychologists, who until 1987 were not permitted access to psychoanalytic training institutes of the American Psychoanalytic Association. Currently there are between 75 and 100 independent institutes in the United States. As well, other institutes are affiliated to other organizations such as the American Academy of Psychoanalysis and Dynamic Psychiatry, and the National Association for the Advancement of Psychoanalysis. At most psychoanalytic institutes in the United States, qualifications for entry include a terminal degree in a mental health field, such as Ph.D., Psy.D., M.S.W., or M.D. A few institutes restrict applicants to those already holding an M.D. or Ph.D., and most institutes in Southern California confer a Ph.D. or Psy.D. in psychoanalysis upon graduation, which involves completion of the necessary requirements for the state boards that confer that doctoral degree.The first training institute in America to educate non-medical psychoanalysts was The National Psychological Association for Psychoanalysis., (1978) in New York City. It was founded by the analyst Theodor Reik.

Some psychoanalytic training has been set up as a post-doctoral fellowship in university settings, such as at Duke University, Yale University, New York University, Adelphi University, and Columbia University. Other psychoanalytic institutes may not be directly associated with universities, but the faculty at those institutes usually hold contemporaneous faculty positions with psychology Ph.D. programs and/or with medical school psychiatry residency programs.

The International Psychoanalytical Association (IPA) is the world's primary accrediting and regulatory body for psychoanalysis. Their mission is to assure the continued vigour and development of psychoanalysis for the benefit of psychoanalytic patients. It works in partnership with its 70 constituent organizations in 33 countries to support 11,500 members. In the US, there are 77 psychoanalytical organizations, institutes associations in the United States, which are spread across the states of America. The American Psychoanalytic Association (APSaA) has 38 affiliated societies, which have 10 or more active members who practice in a given geographical area. The aims of the APSaA and other psychoanalytical organizations are: provide ongoing educational opportunities for its members, stimulate the development and research of psychoanalysis, provide training and organize conferences. There are eight affiliated study groups in the USA (two of them are in Latin America). A study group is the first level of integration of a psychoanalytical body within the International Psychoanalytic Association (IPA), followed by a provisional society and finally a member society.

The Division of Psychoanalysis (39) of the American Psychological Association (APA) was established in the early 1980s by several psychologists. Until the establishment of the Division of Psychoanalysis, psychologists who had trained in independent institutes had no national organization. The Division of Psychoanalysis now has approximately 4,000 members and approximately 30 local chapters in the United States. The Division of Psychoanalysis holds two annual meetings or conferences and offers continuing education in theory, research and clinical technique, as do their affiliated local chapters. The European Psychoanalytical Federation (EPF) is the organization which consolidates all European psychoanalytic societies. This organization is affiliated with the IPA. In 2002 there were approximately 3,900 individual members in 22 countries, speaking 18 different languages. There are also 25 psychoanalytic societies.

The American Association of Psychoanalysis in Clinical Social Work (AAPCSW) was established by Crayton Rowe in 1980 as a division of the Federation of Clinical Societies of Social Work and became an independent entity in 1990. Until 2007 is was known as the National Membership Committee on Psychoanalysis. The organization was originally founded because although social workers represented the larger number of people who were training to be psychoanalysts, they were underrepresented as supervisors and teachers at the institutes they attended. AAPCSW now has over 1000 members and has over 20 chapters. It holds a bi-annual national conference and numerous annual local conferences.

Psychoanalysis in Britain[link]

The London Psychoanalytical Society was founded by Ernest Jones on 30 October 1913. With the expansion of psychoanalysis in the United Kingdom the Society was renamed the British Psychoanalytical Society in 1919. Soon after, the Institute of Psychoanalysis was established to administer the Society’s activities. These include: the training of psychoanalysts, the development of the theory and practice of psychoanalysis, the provision of treatment through The London Clinic of Psychoanalysis, the publication of books in The New Library of Psychoanalysis and Psychoanalytic Ideas. The Institute of Psychoanalysis also publishes The International Journal of Psychoanalysis, maintains a library, furthers research, and holds public lectures. The society has a Code of Ethics and an Ethical Committee. The society, the institute and the clinic are all located at Byron House.

The society is a component of the International Psychoanalytical Association, a body with members on all five continents that safeguards professional and ethical practice. The society is a member of the British Psychoanalytic Council (BPC); the BPC publishes a register of British psychoanalysts and psychoanalytical psychotherapists. All members of the British Psychoanalytical Society are required to undertake continuing professional development.

Through its work – and the work of its individual members – the British Psychoanalytical Society has made an unrivalled contribution the understanding and treatment of mental illness. Members of the Society have included Michael Balint, Wilfred Bion, John Bowlby, Anna Freud, Melanie Klein, Joseph Sandler, and Donald Winnicott.

The Institute of Psychoanalysis is the foremost publisher of psychoanalytic literature. The 24-volume Standard Edition of the Complete Psychological Works of Sigmund Freud was conceived, translated, and produced under the direction of the British Psychoanalytical Society. The Society, in conjunction with Random House, will soon publish a new, revised and expanded Standard Edition. With [The New Library of Psychoanalysis] the Institute continues to publish the books of leading theorists and practitioners. The International Journal of Psychoanalysis is published by the Institute of Psychoanalysis. Now in its 84th year, it has one of the largest circulation of any psychoanalytic journal.

Psychoanalysis in Argentina[link]

Psychoanalysis training is regulated by the UTN and grupo clarín.

Research[link]

Over a hundred years of case reports and studies in the journal Modern Psychoanalysis, the Psychoanalytic Quarterly, the International Journal of Psychoanalysis and the Journal of the American Psychoanalytic Association have analyzed efficacy of analysis in cases of neurosis and character or personality problems. Psychoanalysis modified by object relations techniques has been shown to be effective in many cases of ingrained problems of intimacy and relationship (cf. the many books of Otto Kernberg). As a therapeutic treatment, psychoanalytic techniques may be useful in a one-session consultation.^[49] Psychoanalytic treatment, in other situations, may run from about a year to many years, depending on the severity and complexity of the pathology.

Psychoanalytic theory has, from its inception, been the subject of criticism and controversy. Freud remarked on this early in his career, when other physicians in Vienna ostracized him for his findings that hysterical conversion symptoms were not limited to women. Challenges to analytic theory began with Otto Rank and Alfred Adler (turn of the 20th century), continued with behaviorists (e.g. Wolpe) into the 1940s and '50s, and have persisted. Criticisms come from those who object to the notion that there are mechanisms, thoughts or feelings in the mind that could be unconscious. Criticisms also have been leveled against the discovery of "infantile sexuality" (the recognition that children between ages two and six imagine things about procreation). Criticisms of theory have led to variations in analytic theories, such as the work of Ronald Fairbairn, Michael Balint, and John Bowlby. In the past 30 years or so, the criticisms have centered on the issue of empirical verification,^[50] in spite of many empirical, prospective research studies that have been empirically validated (e.g., See the studies of Barbara Milrod, at Cornell University Medical School, et al.^{[citation needed]}). Recently in scientific literature we can find research supporting many Freud's ideas, e.g. unconsciousness, repression etc.^[51][52]

Psychoanalysis has been used as a research tool into childhood development (cf. the journal The Psychoanalytic Study of the Child), and has developed into a flexible, effective treatment for certain mental disturbances.^[26] In the 1960s, Freud's early (1905) thoughts on the childhood development of female sexuality were challenged; this challenge led to major research in the 1970s and 80s, and then to a reformulation of female sexual development that corrected some of Freud's concepts.^[53] Also see the various works of Eleanor Galenson, Nancy Chodorow, Karen Horney, Francoise Dolto, Melanie Klein, Selma Fraiberg, and others. Most recently, psychoanalytic researchers who have integrated attachment theory into their work, including Alicia Lieberman, Susan Coates, and Daniel Schechter have explored the role of parental traumatization in the development of young children's mental representations of self and others.^[54]

Several meta-analysis have shown psychoanalysis and psychodynamic therapy to be effective, with outcomes comparable or greater than other kinds of psychotherapy or antidepressant drugs.^[55] Empirical research has shown also that "proper", long-term psychoanalysis, when patient lies on a coach and meets with analyst at least three times a week, is also effective.^[56] A 2005 review of randomized controlled trials found that "psychoanalytic therapy is (1) more effective than no treatment or treatment as usual, and (2) more effective than shorter forms of psychodynamic therapy".^[57] Empirical research on the efficacy of psychoanalysis and psychoanalytic psychotherapy has also become prominent among psychoanalytic researchers. Recently, however, the methodologies of some meta-analytic studies have been criticised^[58].

Research on psychodynamic treatment of some populations shows mixed results. Research by analysts such as Bertram Karon and colleagues at Michigan State University had suggested that when trained properly, psychodynamic therapists can be effective with schizophrenic patients. More recent research casts doubt on these claims. The Schizophrenia Patient Outcomes Research Team^[59] (PORT) report argues in its Recommendation 22^[60] against the use of psychodynamic therapy in cases of schizophrenia, noting that more trials are necessary to verify its effectiveness. However, the PORT recommendation is based on the opinions of clinicians rather than on empirical data, and empirical data exist that contradict this recommendation.^[61]

A 2001 systematic review of the medical literature by the Cochrane Collaboration concluded that no data exist demonstrating that psychodynamic psychotherapy is effective in treating schizophrenia, and cautioned that medication should always be used alongside any type of talk therapy in schizophrenia cases.^[62] Dr. Hyman Spotnitz and the practitioners of his theory known as Modern Psychoanalysis, a specific sub-specialty, still report (2007) much success in using their enhanced version of psychoanalytic technique in the treatment of schizophrenia. Further data also suggest that psychoanalysis is not effective (and possibly even detrimental) in the treatment of sex offenders.^[63] Experiences of psychoanalysts and psychoanalytic psychotherapists and research into infant and child development have led to new insights. Theories have been further developed and the results of empirical research are now more integrated in the psychoanalytic theory.^[64]

There are different forms of psychoanalysis and psychotherapies in which psychoanalytic thinking is practiced. Besides classical psychoanalysis there is for example psychoanalytic psychotherapy. Other examples of well known therapies which also use insights of psychoanalysis are Mentalization-Based Treatment (MBT), and Transference-Focused Psychotherapy (TFP).^[64] There is also a continuing influence of psychoanalytic thinking in different settings in the mental health care.^[65] To give an example: in the psychotherapeutic training in the Netherlands, psychoanalytic and system therapeutic theories, drafts, and techniques are combined and integrated. Other psychoanalytic schools include the Kleinian, Lacanian, and Winnicottian schools.

Criticism[link]

The theoretical foundations of psychoanalysis lay in the same philosophical currents that lead to interpretive phenomenology rather than in those that lead to scientific positivism, making the theory largely incompatible with scientific approaches to the study of the mind.^{[66][67][68][69][70]}

Early critics of psychoanalysis believed that its theories were based too little on quantitative and experimental research, and too much on the clinical case study method. Some even accused Freud of fabrication, most famously in the case of Anna O. (Borch-Jacobsen 1996). An increasing amount of empirical research from academic psychologists and psychiatrists has begun to address this criticism. A survey of scientific research suggested that while personality traits corresponding to Freud's oral, anal, Oedipal, and genital phases can be observed, they do not necessarily manifest as stages in the development of children. These studies also have not confirmed that such traits in adults result from childhood experiences (Fisher & Greenberg, 1977, p. 399). However, these stages should not be viewed as crucial to modern psychoanalysis. What is crucial to modern psychoanalytic theory and practice is the power of the unconscious and the transference phenomenon.

Numerous studies have shown that its efficacy is related to the quality of the therapist, rather than the psychoanalytic school or technique or training,^[71] while a French 2004 report from INSERM (study removed by decision of the French Health Minister Douste-Blazy), says instead, that psychoanalysis therapy is far less effective than other psychotherapies (among which cognitive behavioral therapy).

The idea of "unconscious" is contested because human behavior can be observed while human mental activity has to be inferred. However, the unconscious is now a popular topic of study in the fields of experimental and social psychology (e.g., implicit attitude measures, fMRI, and PET scans, and other indirect tests). The idea of unconscious, and the transference phenomenon, have been widely researched and, it is claimed, validated in the fields of cognitive psychology and social psychology (Westen & Gabbard 2002), though a Freudian interpretation of unconscious mental activity is not held by the majority of cognitive psychologists. Recent developments in neuroscience have resulted in one side arguing that it has provided a biological basis for unconscious emotional processing in line with psychoanalytic theory i.e., neuropsychoanalysis (Westen & Gabbard 2002), while the other side argues that such findings make psychoanalytic theory obsolete and irrelevant.

Both Freud and psychoanalysis have been criticized in very extreme terms.^[72] Exchanges between critics and defenders of psychoanalysis have often been so heated that they have come to be characterized as the Freud Wars. Karl Popper argued that psychoanalysis is a pseudoscience because its claims are not testable and cannot be refuted; that is, they are not falsifiable.^[73] Karl Kraus, an Austrian satirist, was the subject of a book written by noted libertarian author Thomas Szasz. The book Anti-Freud: Karl Kraus's Criticism of Psychoanalysis and Psychiatry, originally published under the name Karl Kraus and the Soul Doctors, portrayed Kraus as a harsh critic of Sigmund Freud and of psychoanalysis in general. Other commentators, such as Edward Timms, author of Karl Kraus – Apocalyptic Satirist, have argued that Kraus respected Freud, though with reservations about the application of some of his theories, and that his views were far less black-and-white than Szasz suggests. Grünbaum argues that psychoanalytic based theories are falsifiable, but that the causal claims of psychoanalysis are unsupported by the available clinical evidence. A prominent academic in positive psychology wrote that 'Thirty years ago, the cognitive revolution in psychology overthrew both Freud and the behaviorists, at least in academia. ... [T]hinking ... is not just a [result] of emotion or behavior. ... [E]motion is always generated by cognition, not the other way around.'^[74]

Michel Foucault and Gilles Deleuze claimed that the institution of psychoanalysis has become a center of power and that its confessional techniques resemble the Christian tradition.^[75] Jacques Lacan criticized the emphasis of some American and British psychoanalytical traditions on what he has viewed as the suggestion of imaginary "causes" for symptoms, and recommended the return to Freud.^[76] Together with Gilles Deleuze, Félix Guattari criticised the Oedipal structure.^[77] Luce Irigaray criticised psychoanalysis, employing Jacques Derrida's concept of phallogocentrism to describe the exclusion of the woman from Freudian and Lacanian psychoanalytical theories.^[78]

Shlomo Kalo explains that Materialism that flourished in the 19th Century severely harmed religion and rejected whatever called spiritual. The institution of the confession priest in particular was badly damaged. The empty void that this institution left behind was swiftly occupied by the newborn psychoanalysis. In his writings Kalo claims that psychoanalysis basic approach is erroneous. It represents the mainline wrong assumptions that happiness is unreachable and that the natural desire of a human being is to exploit his fellow men for his own pleasure and benefit.^[79]

Freud's psychoanalysis was criticized by his wife, Martha. René Laforgue reported Martha Freud saying, "I must admit that if I did not realize how seriously my husband takes his treatments, I should think that psychoanalysis is a form of pornography." To Martha there was something vulgar about psychoanalysis, and she dissociated herself from it. According to Marie Bonaparte, Martha was upset with her husband's work and his treatment of sexuality.^[80]

Gilles Deleuze and Félix Guattari, in their 1972 work Anti-Œdipus, take the cases of Gérard Mendel, Bela Grunberger and Janine Chasseguet-Smirgel, prominent members of the most respected associations (IPa), to suggest that, traditionally, psychoanalysis enthusiastically embraces a police state:^[81]

E. Fuller Torrey, writing in Witchdoctors and Psychiatrists (1986), stated that psychoanalytic theories have no more scientific basis than the theories of traditional native healers, "witchdoctors" or modern "cult" alternatives such as est.^[82] Frank Cioffi, author of Freud and the Question of Pseudoscience, cites false claims of a sound scientific verification of the theory and its elements as the strongest basis for classifying the work of Freud and his school as pseudoscience.^[83] Among philosophers, Karl Popper argued that Freud's theory of the unconscious was not falsifiable and therefore not scientific.^[73] Popper did not object to the idea that some mental processes could be unconscious but to investigations of the mind that were not falsifiable. In other words, if it were possible to connect every conceivable experimental outcome with Freud's theory of the unconscious mind, then no experiment could refute the theory. Noam Chomsky has also criticized psychoanalysis for lacking a scientific basis.^[84]

The philosopher Paul Ricoeur argued that psychoanalysis can be considered a type of textual interpretation or hermeneutics. Like cultural critics and literary scholars, Ricoeur contended, psychoanalysts spend their time interpreting the nuances of language. He classified psychoanalysis as a hermeneutics of suspicion. By this he meant that psychoanalysis searches for deception in language, and thereby destabilizes our usual reliance on clear, obvious meanings.

Jacques Derrida incorporated aspects of psychoanalytic theory into his theory of deconstruction in order to question what he called the 'metaphysics of presence'. Derrida also turns some of these ideas against Freud, to reveal tensions and contradictions in his work. For example, although Freud defines religion and metaphysics as displacements of the identification with the father in the resolution of the Oedipal complex, Derrida insists in The Postcard: From Socrates to Freud and Beyond that the prominence of the father in Freud's own analysis is itself indebted to the prominence given to the father in Western metaphysics and theology since Plato.

Some post-colonialists^[85] argue that psychoanalysis imposes a white, European model of human development on those without European heritage, hence they will argue Freud's theories are a form or instrument of intellectual imperialism.

See also[link]

• Chicago Institute for Psychoanalysis
• Psychoanalytic sociology
• Psychoanalysis and music

References[link]

Literature[link]

Book series

• Contemporary Psychoanalytic Studies, Rodopi, Amsterdam/New York.

Analyses, discussions, and critiques of psychoanalysis[link]

Responses to critiques[link]

External links[link]

Look up psychoanalysis in Wiktionary, the free dictionary.

• International Psychoanalytical Association (IPA) – world’s primary regulatory body for psychoanalysis, founded by Sigmund Freud

• Psychoanalysis – Division 39 – American Psychological Association

• Psychoanalytic_and_Psychodynamic at the Open Directory Project

Hyman Spotnitz (September 29, 1908 - April 18, 2008) was an American psychoanalyst and psychiatrist who pioneered an approach to working psychoanalytically with schizophrenics in the 1950s called modern psychoanalysis. He also was one of the pioneers of group therapy.

Background and education[link]

Born in Boston to immigrant parents, Spotnitz attended Harvard College and received a degree in medicine from Friedrich Wilhelms University in Berlin in 1934. He continued his medical studies at the College of Physicians and Surgeons, Columbia University, earning a Medical Science degree in neurology in 1939. His initial work on schizophrenia was conducted while a consulting psychiatrist for the Jewish Board of Guardians in New York City.

At the time, most psychoanalysts did not think that schizophrenia was treatable through therapy and group approaches were not popular. His approach was considered controversial, and he left the New York Psychoanalytic Institute to continue to develop his work.

On April 18, 2008 he died in New York City of natural causes.

Theory of technique[link]

Spotnitz's treatment approach emphasizes the development of the narcissistic transference in which the patient relates to the therapist as if he were part of his own mind, rather than a separate person. He theorizes that most neuroses and severe mental illnesses originate in the preoedipal period, before the development of language. The transference that develops with these patients then is largely enacted nonverbally through behavior, symptoms, symbolic communications and, importantly, the transmission of feeling states, otherwise known as induced feelings. Spotnitz feels that the "narcissistic defense" is central to most mental disturbances and is characterized by self-hate rather than self-love. Aggression is directed towards the self in order to protect the object. Treatment then emphasizes helping patients to better metabolize their aggressive drives, by gradually being able to express their aggression in treatment. Spotnitz emphasized initially joining with the patient's resistance, rather than challenging, and using the countertransference feelings of the therapist to help understand the patient. His central focus on the objective, and hence clinically useful nature of the therapist's countertransference was later taken up by self psychology and intersubjective approaches to psychoanalysis. Also foreshadowing later developments in other schools (as did schools in the U.K. that preceded him,) Spotnitz's approach to the analyst's interventions are primarily intended to provide an emotional-maturational communication to the patient, rather than to promote intellectual insight. With this technique he was able to cure many patients previously deemed incurable by the psychoanalytic world.

Group Therapy

Spotnitz began developing modern psychoanalysis and psychoanalytic group therapy during the time he served as consulting psychiatrist at the Jewish Board of Guardians in the mid-1940s and 50’s. His closest students and collaborators at the time were Yonata Feldman and Leo Nagelberg^[1]. The work centered on developing a new psychotherapeutic method for the treatment of narcissistic disorders, starting with schizophrenia and borderline conditions. The caseworkers who were employed by the JBG found that Spotnitz’s supervision helped them to achieve excellent results in treating severely emotionally disturbed children and their families^{[citation needed]}. They were the first to embrace the school that came to be known as Modern Psychoanalysis: Evelyn Abrams, Leslie Rosenthal, Sidney and Shirley Love, and others^{[citation needed]}. These early followers became the first teachers and supervisors. Not long thereafter they were followed by^{[citation needed]}Avivah Sayres, Selwyn Brody, Phyllis W. Meadow, Evelyn Liegner, Leonard Liegner, Fanny Milstein, Lou Ormont, Benjamin Margolis, Ethel Clevans, Marie Coleman Nelson, Arnold Bernstein, Murray Sherman, Stanley Hayden, Gerald M. Fishbein, Harold Stern, Jacob Kesten, Jacob Kirman, William Kirman, Robert Marshall, Harold Davis, Charles and Deborah Greene Bershatsky, Adrienne Fischer and many others too numerous to mention.

Spotnitz was also one of the first psychoanalysts to advocate the use of groups. His approach to group treatment, also originally developed with schizophrenic clients, emphasized the therapist's use of his or her feelings induced by the group, and joining and reflecting rather than directly challenging group resistances. Spotnitz's work in psychoanalytic group therapy and in modern psychoanalysis in general has been continued and furthered by^{[citation needed]}Stanley Hayden, Charles and Deborah Greene Bershatsky, Leo Nagelberg, Lou Ormont, Leslie Rosenthal, Phyllis Meadow, Michael Brook and Bob Unger, among many others. Spotnitz focused on analysis of group resistances rather than individual resistances. He is the honorary president of more than 10 psychoanalytic institutes throughout the United States, including the Academy of Clinical and Applied Psychoanalysis, Boston Graduate School of Psychoanalysis, California Graduate Institute, Center for Modern Psychoanalytic Studies, New Jersey Center for Modern Psychoanalysis, and The Mid-Manhattan Institute for Psychoanalysis.

See also[link]

• Sigmund Freud
• Psychoanalysis
• Group therapy

Works[link]

• The Couch and The Circle: A Story of Group Psychotherapy, Alfred A. Knopf, Inc., 1961, ISBN 978-0-9703923-6-7
• Modern Psychoanalysis of the Schizophrenic Patient: Theory of The Technique, Grune & Stratton 1969,YBK Publishers 2004, ISBN 0-9703923-6-2
• Treatment of the Narcissistic Neuroses, with Phyllis W. Meadow, Jason Aronson, 1976, 1995, ISBN 978-1-56821-416-0
• Psychotherapy of Preoedipal Conditions: Schizophrenia and Severe Character Disorders, Jason Aronson, 1976, 1995, ISBN 978-1-56821-633-1
• Just Say Everything: A Festschirft in Honor of Hyman Spotnitz, by Sara Sheftel, Assn for Modern Psychoanalysis, 1991, ISBN 978-0-9624534-0-3

External links[link]

• Schizophrenia, Alcoholism and Addiction Let's Talk Interviews Dr. Hyman Spotnitz, with photos
• Lou Ormont's site describing Ormont's method, based on Spotnitz's theories.

References[link]

Batman is a fictional character, a comic book superhero created by artist Bob Kane and writer Bill Finger. The character first appeared in Detective Comics #27 (May 1939), and since then has appeared primarily in publications by DC Comics. Originally referred to as "The Bat-Man" and still referred to at times as "The Batman", he is additionally known as "The Caped Crusader",^[2] "The Dark Knight",^[2] and "The World's Greatest Detective,"^[2] among other titles.

In the original version of the story and the vast majority of retellings, Batman's secret identity is Bruce Wayne, an American millionaire (later billionaire) playboy, industrialist, and philanthropist. Having witnessed the murder of his parents as a child, he swore revenge on criminals, an oath tempered with the greater ideal of justice. Wayne trains himself both physically and intellectually and dons a bat-themed costume in order to fight crime.^[3] Batman operates in the fictional American Gotham City, assisted by various supporting characters including his crime-fighting partner, Robin, his butler Alfred Pennyworth, the police commissioner Jim Gordon, and occasionally the heroine Batgirl. He fights an assortment of villains such as the Joker, the Penguin, the Riddler, Two-Face, Poison Ivy and Catwoman. Unlike most superheroes, he does not possess any superpowers; he makes use of intellect, detective skills, science and technology, wealth, physical prowess, martial arts skills, an indomitable will, fear, and intimidation in his continuous war on crime.

Batman became a very popular character soon after his introduction and gained his own comic book title, Batman, in 1940. As the decades wore on, differing interpretations of the character emerged. The late 1960s Batman television series used a camp aesthetic which continued to be associated with the character for years after the show ended. Various creators worked to return the character to his dark roots, culminating in the 1986 miniseries The Dark Knight Returns, by Frank Miller, while the successes of Tim Burton's 1989 film Batman and Christopher Nolan's 2005 reboot Batman Begins also helped to reignite popular interest in the character.^[4] A cultural icon, Batman has been licensed and adapted into a variety of media, from radio to television and film, and appears on a variety of merchandise sold all over the world such as toys and video games. The character has also intrigued psychiatrists with many trying to understand the character's psyche and his true ego in society. In May 2011, Batman placed second on IGN's Top 100 Comic Book Heroes of All Time, after Superman. Empire magazine also listed him second in their 50 Greatest Comic Book Characters of All Time.^[5]

Publication history[link]

Creation[link]

In early 1939, the success of Superman in Action Comics prompted editors at the comic book division of National Publications (the future DC Comics) to request more superheroes for its titles. In response, Bob Kane created "the Bat-Man."^[6] Collaborator Bill Finger recalled "Kane had an idea for a character called 'Batman', and he'd like me to see the drawings. I went over to Kane's, and he had drawn a character who looked very much like Superman with kind of ... reddish tights, I believe, with boots ... no gloves, no gauntlets ... with a small domino mask, swinging on a rope. He had two stiff wings that were sticking out, looking like bat wings. And under it was a big sign ... BATMAN."^[7]

Finger offered such suggestions as giving the character a cowl instead of a simple domino mask, a cape instead of wings, and gloves, and removing the red sections from the original costume.^{[8][9][10][11]} Finger said he devised the name Bruce Wayne for the character's secret identity: "Bruce Wayne's first name came from Robert Bruce, the Scottish patriot. Bruce, being a playboy, was a man of gentry. I searched for a name that would suggest colonialism. I tried Adams, Hancock ... then I thought of Mad Anthony Wayne."^[12] He later said his suggestions were influenced by Lee Falk's popular The Phantom, a syndicated newspaper comic-strip character with which Kane was familiar as well.^[13]

Various aspects of Batman's personality, character history, visual design, and equipment were inspired by contemporary popular culture of the 1930s, including movies, pulp magazines, comic strips, newspaper headlines, and even aspects of Kane himself.^[14] Kane noted especially the influence of the films The Mark of Zorro (1920) and The Bat Whispers (1930) in the creation of the iconography associated with the character, while Finger drew inspiration from literary characters Doc Savage, The Shadow, and Sherlock Holmes in his depiction of Batman as a master sleuth and scientist.^[15]

Kane, in his 1989 autobiography, detailed Finger's contributions to Batman's creation:

One day I called Bill and said, 'I have a new character called the Bat-Man and I've made some crude, elementary sketches I'd like you to look at'. He came over and I showed him the drawings. At the time, I only had a small domino mask, like the one Robin later wore, on Batman's face. Bill said, 'Why not make him look more like a bat and put a hood on him, and take the eyeballs out and just put slits for eyes to make him look more mysterious?' At this point, the Bat-Man wore a red union suit; the wings, trunks, and mask were black. I thought that red and black would be a good combination. Bill said that the costume was too bright: 'Color it dark gray to make it look more ominous'. The cape looked like two stiff bat wings attached to his arms. As Bill and I talked, we realized that these wings would get cumbersome when Bat-Man was in action, and changed them into a cape, scalloped to look like bat wings when he was fighting or swinging down on a rope. Also, he didn't have any gloves on, and we added them so that he wouldn't leave fingerprints.^[13]

Kane signed away ownership in the character in exchange for, among other compensation, a mandatory byline on all Batman comics. This byline did not, originally say "Batman created by Bob Kane"; his name was simply written on the title page of each story. The name disappeared from the comic book in the mid-1960s, replaced by credits for each story's actual writer and artists. In the late 1970s, when Jerry Siegel and Joe Shuster began receiving a "created by" credit on the Superman titles, along with William Moulton Marston being given the byline for creating Wonder Woman, Batman stories began saying "Created by Bob Kane" in addition to the other credits.

Finger did not receive the same recognition. While he had received credit for other DC work since the 1940s, he began, in the 1960s, to receive limited acknowledgment for his Batman writing; in the letters page of Batman #169 (February 1965) for example, editor Julius Schwartz names him as the creator of the Riddler, one of Batman's recurring villains. However, Finger's contract left him only with his writing page rate and no byline. Kane wrote, "Bill was disheartened by the lack of major accomplishments in his career. He felt that he had not used his creative potential to its fullest and that success had passed him by."^[12] At the time of Finger's death in 1974, DC had not officially credited Finger as Batman co-creator.

Jerry Robinson, who also worked with Finger and Kane on the strip at this time, has criticized Kane for failing to share the credit. He recalled Finger resenting his position, stating in a 2005 interview with The Comics Journal:

Bob made him more insecure, because while he slaved working on Batman, he wasn't sharing in any of the glory or the money that Bob began to make, which is why... [he was] going to leave [Kane's employ]. ... [Kane] should have credited Bill as co-creator, because I know; I was there. ... That was one thing I would never forgive Bob for, was not to take care of Bill or recognize his vital role in the creation of Batman. As with Siegel and Shuster, it should have been the same, the same co-creator credit in the strip, writer and artist.^[16]

Although Kane initially rebutted Finger's claims at having created the character, writing in a 1965 open letter to fans that "it seemed to me that Bill Finger has given out the impression that he and not myself created the ''Batman, t' [sic] as well as Robin and all the other leading villains and characters. This statement is fraudulent and entirely untrue." Kane himself also commented on Finger's lack of credit. "The trouble with being a 'ghost' writer or artist is that you must remain rather anonymously without 'credit'. However, if one wants the 'credit', then one has to cease being a 'ghost' or follower and become a leader or innovator."^[17]

In 1989, Kane revisited Finger's situation, recalling in an interview,

In those days it was like, one artist and he had his name over it [the comic strip] — the policy of DC in the comic books was, if you can't write it, obtain other writers, but their names would never appear on the comic book in the finished version. So Bill never asked me for it [the byline] and I never volunteered — I guess my ego at that time. And I felt badly, really, when he [Finger] died.^[18]

Early years[link]

The first Batman story, "The Case of the Chemical Syndicate," was published in Detective Comics #27 (May 1939). Finger said, "Batman was originally written in the style of the pulps,"^[19] and this influence was evident with Batman showing little remorse over killing or maiming criminals. Batman proved a hit character, and he received his own solo title in 1940, while continuing to star in Detective Comics. By that time, National was the top-selling and most influential publisher in the industry; Batman and the company's other major hero, Superman, were the cornerstones of the company's success.^[20] The two characters were featured side-by-side as the stars of World's Finest Comics, which was originally titled World's Best Comics when it debuted in fall 1940. Creators including Jerry Robinson and Dick Sprang also worked on the strips during this period.

Over the course of the first few Batman strips elements were added to the character and the artistic depiction of Batman evolved. Kane noted that within six issues he drew the character's jawline more pronounced, and lengthened the ears on the costume. "About a year later he was almost the full figure, my mature Batman," Kane said.^[21] Batman's characteristic utility belt was introduced in Detective Comics #29 (July 1939), followed by the boomerang-like batarang and the first bat-themed vehicle, the Batplane, in #31 (September 1939). The character's origin was revealed in #33 (November 1939), unfolding in a two-page story that establishes the brooding persona of Batman, a character driven by the death of his parents. Written by Finger, it depicts a young Bruce Wayne witnessing his parents' murder at the hands of a mugger. Days later, at their grave, the child vows that "by the spirits of my parents [I will] avenge their deaths by spending the rest of my life warring on all criminals."^[22][23][24]

The early, pulp-inflected portrayal of Batman started to soften in Detective Comics #38 (April 1940) with the introduction of Robin, Batman's kid sidekick.^[25] Robin was introduced, based on Finger's suggestion Batman needed a "Watson" with whom Batman could talk.^[26] Sales nearly doubled, despite Kane's preference for a solo Batman, and it sparked a proliferation of "kid sidekicks."^[27] The first issue of the solo spin-off series Batman was notable not only for introducing two of his most persistent antagonists, the Joker and Catwoman, but for a story in which Batman shoots some monstrous giants to death. That story prompted editor Whitney Ellsworth to decree that the character could no longer kill or use a gun.^[28]

By 1942, the writers and artists behind the Batman comics had established most of the basic elements of the Batman mythos.^[29] In the years following World War II, DC Comics "adopted a postwar editorial direction that increasingly de-emphasized social commentary in favor of lighthearted juvenile fantasy." The impact of this editorial approach was evident in Batman comics of the postwar period; removed from the "bleak and menacing world" of the strips of the early 1940s, Batman was instead portrayed as a respectable citizen and paternal figure that inhabited a "bright and colorful" environment.^[30]

1950s and early 1960s[link]

Batman was one of the few superhero characters to be continuously published as interest in the genre waned during the 1950s. In the story "The Mightiest Team in the World" in Superman #76 (June 1952), Batman teams up with Superman for the first time and the pair discovers each other's secret identity.^[31] Following the success of this story, World's Finest Comics was revamped so it featured stories starring both heroes together, instead of the separate Batman and Superman features that had been running before.^[32] The team-up of the characters was "a financial success in an era when those were few and far between";^[33] this series of stories ran until the book's cancellation in 1986.

Batman comics were among those criticized when the comic book industry came under scrutiny with the publication of psychologist Fredric Wertham's book Seduction of the Innocent in 1954. Wertham's thesis was that children imitated crimes committed in comic books, and that these works corrupt the morals of the youth. Wertham criticized Batman comics for their supposed homosexual overtones and argued that Batman and Robin were portrayed as lovers.^[34] Wertham's criticisms raised a public outcry during the 1950s, eventually leading to the establishment of the Comics Code Authority. The tendency towards a "sunnier Batman" in the postwar years intensified after the introduction of the Comics Code.^[35] It has also been suggested by scholars that the characters of Batwoman (in 1956) and the pre-Barbara Gordon Bat-Girl (in 1961) were introduced in part to refute the allegation that Batman and Robin were gay, and the stories took on a campier, lighter feel.^[36]

In the late 1950s, Batman stories gradually became more science fiction-oriented, an attempt at mimicking the success of other DC characters that had dabbled in the genre.^[37] New characters such as Batwoman, Ace the Bat-Hound, and Bat-Mite were introduced. Batman's adventures often involved odd transformations or bizarre space aliens. In 1960, Batman debuted as a member of the Justice League of America in The Brave and the Bold #28 (February 1960), and went on to appear in several Justice League comic series starting later that same year.

"New Look" Batman and camp[link]

By 1964, sales on Batman titles had fallen drastically. Bob Kane noted that, as a result, DC was "planning to kill Batman off altogether."^[38] In response to this, editor Julius Schwartz was assigned to the Batman titles. He presided over drastic changes, beginning with 1964's Detective Comics #327 (May 1964), which was cover-billed as the "New Look". Schwartz introduced changes designed to make Batman more contemporary, and to return him to more detective-oriented stories. He brought in artist Carmine Infantino to help overhaul the character. The Batmobile was redesigned, and Batman's costume was modified to incorporate a yellow ellipse behind the bat-insignia. The space aliens and characters of the 1950s such as Batwoman, Ace, and Bat-Mite were retired. Batman's butler Alfred was killed off (though his death was quickly reversed due to fan response) while a new female relative for the Wayne family, Aunt Harriet, came to live with Bruce Wayne and Dick Grayson.^[39]

The debut of the Batman television series in 1966 had a profound influence on the character. The success of the series increased sales throughout the comic book industry, and Batman reached a circulation of close to 900,000 copies.^[40] Elements such as the character of Batgirl and the show's campy nature were introduced into the comics; the series also initiated the return of Alfred. Although both the comics and TV show were successful for a time, the camp approach eventually wore thin and the show was canceled in 1968. In the aftermath, the Batman comics themselves lost popularity once again. As Julius Schwartz noted, "When the television show was a success, I was asked to be campy, and of course when the show faded, so did the comic books."^[41]

Starting in 1969, writer Dennis O'Neil and artist Neal Adams made a deliberate effort to distance Batman from the campy portrayal of the 1960s TV series and to return the character to his roots as a "grim avenger of the night."^[42] O'Neil said his idea was "simply to take it back to where it started. I went to the DC library and read some of the early stories. I tried to get a sense of what Kane and Finger were after."^[43]

O'Neil and Adams first collaborated on the story "The Secret of the Waiting Graves" (Detective Comics #395, January 1970). Few stories were true collaborations between O'Neil, Adams, Schwartz, and inker Dick Giordano, and in actuality these men were mixed and matched with various other creators during the 1970s; nevertheless the influence of their work was "tremendous."^[44] Giordano said: "We went back to a grimmer, darker Batman, and I think that's why these stories did so well... Even today we're still using Neal's Batman with the long flowing cape and the pointy ears."^[45] While the work of O'Neil and Adams was popular with fans, the acclaim did little to help declining sales; the same held true with a similarly acclaimed run by writer Steve Englehart and penciler Marshall Rogers in Detective Comics #471–476 (August 1977 – April 1978), which went on to influence the 1989 movie Batman and be adapted for Batman: The Animated Series, which debuted in 1992.^[46] Regardless, circulation continued to drop through the 1970s and 1980s, hitting an all-time low in 1985.^[47]

[edit] The Dark Knight Returns and later

Frank Miller's limited series The Dark Knight Returns (February–June 1986), which tells the story of a 55-year old Batman coming out of retirement in a possible future, reinvigorated the character. The Dark Knight Returns was a financial success and has since become one of the medium's most noted touchstones.^[48] The series also sparked a major resurgence in the character's popularity.^[49]

That year Dennis O'Neil took over as editor of the Batman titles and set the template for the portrayal of Batman following DC's status quo-altering miniseries Crisis on Infinite Earths. O'Neil operated under the assumption that he was hired to revamp the character and as a result tried to instill a different tone in the books than had gone before.^[50] One outcome of this new approach was the "Year One" storyline in Batman #404–407 (February–May 1987), in which Frank Miller and artist David Mazzucchelli redefined the character's origins. Writer Alan Moore and artist Brian Bolland continued this dark trend with 1988's 48-page one-shot Batman: The Killing Joke, in which the Joker, attempting to drive Commissioner Gordon insane, cripples Gordon's daughter Barbara, and then kidnaps and tortures the commissioner, physically and psychologically.

The Batman comics garnered major attention in 1988 when DC Comics created a 900 number for readers to call to vote on whether Jason Todd, the second Robin, lived or died. Voters decided in favor of Jason's death by a narrow margin of 28 votes (see Batman: A Death in the Family).^[51] The following year saw the release of Tim Burton's Batman feature film, which firmly brought the character back to the public's attention, grossing millions of dollars at the box office, and millions more in merchandising. However, the three sequels, Tim Burton's Batman Returns and director Joel Schumacher's Batman Forever and Batman & Robin, did not perform as well at the box office. The Batman movie franchise was rebooted with director and co-writer Christopher Nolan's Batman Begins in 2005 and The Dark Knight in 2008. In 1989, the first issue of Legends of the Dark Knight, the first new solo Batman title in nearly fifty years, sold close to a million copies.^[52]

The 1993 "Knightfall" story arc introduced a new villain, Bane, who critically injures Bruce Wayne. Jean-Paul Valley, known as Azrael, is called upon to wear the Batsuit during Wayne's convalescence. Writers Doug Moench, Chuck Dixon, and Alan Grant worked on the Batman titles during "Knightfall," and would also contribute to other Batman crossovers throughout the 1990s. 1998's "Cataclysm" storyline served as the precursor to 1999's "No Man's Land", a year-long storyline that ran through all the Batman-related titles dealing with the effects of an earthquake-ravaged Gotham City. At the conclusion of "No Man's Land", O'Neil stepped down as editor and was replaced by Bob Schreck.

Another writer who rose to prominence on the Batman comic series, was Jeph Loeb. Along with longtime collaborator Tim Sale, they wrote two miniseries ("The Long Halloween" and "Dark Victory") that pit an early in his career version of Batman against his entire rogue's gallery (most notably Two-Face, whose origin was re-envisioned by Loeb) while dealing with various mysteries involving serial killers Holiday and the Hangman, of which the former was the subject of intense debate and speculation amongst Batman fans. In 2003, Loeb teamed with artist Jim Lee to work on another mystery arc: "Batman: Hush" for the main Batman book. The twelve issue storyline saw Batman and Catwoman running the gauntlet against Batman's entire rogue's gallery, including an apparently resurrected Jason Todd, while seeking to find the identity of the mysterious supervillain Hush. While the character of Hush failed to catch on with readers, the arc was a sales success for DC. As the storyline was Jim Lee's first regular comic book work in nearly a decade, the series became #1 on the Diamond Comic Distributors sales chart for the first time since Batman #500 (October 1993) and Jason Todd's appearance laid the groundwork for writer Judd Winick's subsequent run as writer on Batman, with another multi-issue epic, "Under the Hood," which ran from Batman #637–650.

In 2005, DC launched All-Star Batman and Robin, a stand-alone comic series set outside the existing DC Universe. Written by Frank Miller and drawn by Jim Lee, the series was a commercial success for DC Comics^[53][54] though widely panned by critics for its writing.^[55][56]

Starting in 2006, the regular writers on Batman and Detective Comics were Grant Morrison and Paul Dini, with Grant Morrison reincorporating controversial elements of Batman lore (most notably, the science fiction themed storylines of the 1950s Batman comics, which Morrison revised as hallucinations Batman suffered under the influence of various mind-bending gases and extensive sensory deprivation training) into the character. Morrison's run climaxed with "Batman R.I.P.", which brought Batman up against the villainous "Black Glove" organization, which sought to drive Batman into madness. "Batman R.I.P." segued into Final Crisis (also written by Morrison), which saw the apparent death of Batman at the hands of Darkseid. In the 2009 miniseries Batman: Battle for the Cowl, Wayne's former protégé Dick Grayson becomes the new Batman, and Wayne's son Damian becomes the new Robin.^[57][58] In June 2009, Judd Winick returned to writing Batman, while Grant Morrison was given his own series, titled Batman and Robin.^[59]

In 2010, the storyline Batman: The Return of Bruce Wayne saw Bruce travel through history, eventually returning to the present day. Although he reclaimed the mantle of Batman, he also allowed Grayson to continue being Batman as well. Bruce decided to take his war on crime globally, which is the central focus of Batman Incorporated. DC Comics would later announce that Grayson would be the main character in Batman, Detective Comics and Batman and Robin, while Wayne would be the main character in Batman Incorporated. Also, Bruce appeared in another ongoing series, Batman: The Dark Knight.

2011 The New 52 relaunch[link]

In September 2011, DC Comics' entire line of superhero books, including its Batman franchise, was canceled and relaunched with new #1 issues as part of The New 52 reboot. Bruce Wayne is the only character to be identified as Batman and will be featured in Batman, Detective Comics, Batman and Robin, and Batman: The Dark Knight. Dick Grayson returns to the mantle of Nightwing and appears in his own ongoing series. While many characters have their histories significantly altered to attract newer, younger readers, Batman's history remains mostly intact. Batman Incorporated will be relaunched in 2012 to complete the "Leviathan" storyline.

Fictional character biography[link]

Batman's history has undergone various revisions, both minor and major. Few elements of the character's history have remained constant. Scholars William Uricchio and Roberta E. Pearson noted in the early 1990s, "Unlike some fictional characters, the Batman has no primary urtext set in a specific period, but has rather existed in a plethora of equally valid texts constantly appearing over more than five decades."^[60]

The central fixed event in the Batman stories is the character's origin story.^[61] As a little boy, Bruce Wayne is horrified and traumatized to see his parents, the physician Dr. Thomas Wayne and his wife Martha, being murdered by a mugger in front of his very eyes. This drives him to fight crime in Gotham City as Batman. Pearson and Uricchio also noted beyond the origin story and such events as the introduction of Robin, "Until recently, the fixed and accruing and hence, canonized, events have been few in number,"^[61] a situation altered by an increased effort by later Batman editors such as Dennis O'Neil to ensure consistency and continuity between stories.^[62]

Golden Age[link]

In Batman's first appearance in Detective Comics #27, he is already operating as a crimefighter.^[63] Batman's origin is first presented in Detective Comics #33 (Nov. 1939), and is later fleshed out in Batman #47. As these comics state, Bruce Wayne is born to Dr. Thomas Wayne and his wife Martha, two very wealthy and charitable Gotham City socialites. Bruce is brought up in Wayne Manor, with its wealthy splendor, and leads a happy and privileged existence until the age of eight, when his parents are killed by a small-time criminal named Joe Chill while on their way home from a movie theater. Bruce Wayne swears an oath to rid the city of the evil that had taken his parents' lives. He engages in intense intellectual and physical training; however, he realizes that these skills alone would not be enough. "Criminals are a superstitious cowardly lot," Wayne remarks, "so my disguise must be able to strike terror into their hearts. I must be a creature of the night, black, terrible..." As if responding to his desires, a bat suddenly flies through the window, inspiring Bruce to take on the persona of Batman.^[64]

In early strips, Batman's career as a vigilante earns him the ire of the police. During this period Wayne has a fiancée named Julie Madison.^[65] Wayne takes in an orphaned circus acrobat, Dick Grayson, who becomes his sidekick, Robin. Batman also becomes a founding member of the Justice Society of America,^[66] although he, like Superman, is an honorary member,^[67] and thus only participates occasionally. Batman's relationship with the law thaws quickly, and he is made an honorary member of Gotham City's police department.^[68] During this time, butler Alfred Pennyworth arrives at Wayne Manor, and after deducing the Dynamic Duo's secret identities joins their service.^[69]

Silver Age[link]

The Silver Age of Comic Books in DC Comics is sometimes held to have begun in 1956 when the publisher introduced Barry Allen as a new, updated version of The Flash. Batman is not significantly changed by the late 1950s for the continuity which would be later referred to as Earth-One. The lighter tone Batman had taken in the period between the Golden and Silver Ages led to the stories of the late 1950s and early 1960s that often feature a large number of science-fiction elements, and Batman is not significantly updated in the manner of other characters until Detective Comics #327 (May 1964), in which Batman reverts to his detective roots, with most science-fiction elements jettisoned from the series.

After the introduction of DC Comics' multiverse in the 1960s, DC established that stories from the Golden Age star the Earth-Two Batman, a character from a parallel world. This version of Batman partners with and marries the reformed Earth-Two Catwoman, Selina Kyle (as shown in Superman Family #211) and fathers Helena Wayne, who, as the Huntress, becomes (along with Dick Grayson, the Earth-Two Robin) Gotham's protector once Wayne retires from the position to become police commissioner, a position he occupies until he is killed during one final adventure as Batman. Batman titles however often ignored that a distinction had been made between the pre-revamp and post-revamp Batmen (since unlike The Flash or Green Lantern, Batman comics had been published without interruption through the 1950s) and would on occasion make reference to stories from the Golden Age.^[70] Nevertheless, details of Batman's history were altered or expanded upon through the decades. Additions include meetings with a future Superman during his youth, his upbringing by his uncle Philip Wayne (introduced in Batman #208, January/February 1969) after his parents' death, and appearances of his father and himself as prototypical versions of Batman and Robin, respectively.^[71][72] In 1980 then-editor Paul Levitz commissioned the Untold Legend of the Batman limited series to thoroughly chronicle Batman's origin and history.

Batman meets and regularly works with other heroes during the Silver Age, most notably Superman, whom he began regularly working alongside in a series of team-ups in World's Finest Comics, starting in 1954 and continuing through the series' cancellation in 1986. Batman and Superman are usually depicted as close friends. Batman becomes a founding member of the Justice League of America, appearing in its first story in 1960s Brave and the Bold #28. In the 1970s and 1980s, Brave and the Bold became a Batman title, in which Batman teams up with a different DC Universe superhero each month.

In 1969, Dick Grayson attends college as part of DC Comics' effort to revise the Batman comics. Additionally, Batman also moves from his mansion, Wayne Manor into a penthouse apartment atop the Wayne Foundation building in downtown Gotham City, in order to be closer to Gotham City's crime. Batman spends the 1970s and early 1980s mainly working solo, with occasional team-ups with Robin and/or Batgirl. Batman's adventures also become somewhat darker and more grim during this period, depicting increasingly violent crimes, including the first appearance (since the early Golden Age) of the Joker as a homicidal psychopath, and the arrival of Ra's al Ghul, a centuries-old terrorist who knows Batman's secret identity. In the 1980s, Dick Grayson becomes Nightwing.^[3]

In the final issue of Brave and the Bold in 1983, Batman quits the Justice League and forms a new group called the Outsiders. He serves as the team's leader until Batman and the Outsiders #32 (1986) and the comic subsequently changed its title.

Modern Batman[link]

After the 12-issue limited series Crisis on Infinite Earths, DC Comics retconned the histories of some major characters in an attempt at updating them for contemporary audiences. Frank Miller retold Batman's origin in the storyline "Year One" from Batman #404–407, which emphasizes a grittier tone in the character.^[73] Though the Earth-Two Batman is erased from history, many stories of Batman's Silver Age/Earth-One career (along with an amount of Golden Age ones) remain canonical in the post-Crisis universe, with his origins remaining the same in essence, despite alteration. For example, Gotham's police are mostly corrupt, setting up further need for Batman's existence. While Dick Grayson's past remains much the same, the history of Jason Todd, the second Robin, is altered, turning the boy into the orphan son of a petty crook, who tries to steal the tires from the Batmobile.^[74] Also removed is the guardian Phillip Wayne leaving young Bruce to be raised by Alfred Pennyworth. Additionally, Batman is no longer a founding member of the Justice League of America, although he becomes leader for a short time of a new incarnation of the team launched in 1987. To help fill in the revised backstory for Batman following Crisis, DC launched a new Batman title called Legends of the Dark Knight in 1989 and has published various miniseries and one-shot stories since then that largely take place during the "Year One" period. Various stories from Jeph Loeb and Matt Wagner also touch upon this era.

In 1988's "Batman: A Death in the Family" storyline from Batman #426–429 Jason Todd, the second Robin, is killed by the Joker.^[3] Subsequently Batman begins exhibiting an excessive, reckless approach to his crime-fighting, a result of the pain of losing Jason Todd. Batman works solo until the decade's close, when Tim Drake becomes the new Robin.^[75] In 2005, writers resurrected the Jason Todd character and have pitted him against his former mentor as the murderous vigilante the Red Hood.