Freud's Case Load

Sigmund Freud's theory of the psyche developed substantially from his own practice--which, in turn-of-the-century Vienna, obviously had its limitations. How, if at all, did those limitations affect the theory, which continues to nourish all of psychiatry today? This question has been explored by Benjamin Brody, 50, a New York psychologist. Brody's provocative suggestions, published in Psychotherapy magazine: some of psychoanalysis' most widely accepted canons can perhaps be traced to the unrepresentative nature of the Freudian case load. Since Freud went to great lengths to protect his patients' identities, Brody was able to piece together only 145 case histories, most of them fragmentary. Still, that was enough to suggest some tentative conclusions.

For example, Brody notes, only two of Freud's patients were over 45. "One wonders," he writes, "to what extent his limited experience with older patients is responsible for the dictum that psychoanalysis is not indicated with older people"--a position still maintained by some contemporary analysts.

Freud diagnosed half his "major" cases as hysteria, most of the rest as neuroses or phobias susceptible to treatment. Only 7% of his "minor" patients did he consider to be suffering from psychosis, the most serious class of psychological disorder. Brody speculates that this may have led to the belief, still current, that psychoanalysis does not work with most psychotics.

There are other implications in Brody's findings. He noted that "Freud's patients were drawn exclusively from the upper and middle class." Brody asks: "Is it possible that something in the ideology and technique of analysis makes it difficult for lower-class people to use successfully?"

This file is automatically generated by a robot program, so reader's discretion is required.