Guide to Psychoanalytic Developmental Theories

By Joseph Palombo, Harold K. Bendicsen and Barry J. Koch

As the foundational theory of modern psychological practice, psychoanalysis and its attendant assumptions predominated well through most of the twentieth century. The influence of psychoanalytic theories of development was profound and still resonates in the thinking and practice of today’s mental health professionals. Guide to Psychoanalytic Developmental Theories provides a succinct and reliable overview of what these theories are and where they came from. Ably combining theory, history, and biography it summarizes the theories of Freud and his successors against the broader evolution of analytic developmental theory itself, giving readers a deeper understanding of this history, and of their own theoretical stance and choices of interventions. Along the way, the authors discuss criteria for evaluating developmental theories, trace persistent methodological concerns, and shed intriguing light on what was considered normative child and adolescent behavior in earlier eras.

Each major paradigm is represented by its most prominent figures such as Freud’s drive theory, Erikson’s life cycle theory, Bowlby’s attachment theory, and Fonagy’s neuropsychological attachment theory. For each, the Guide provides:

• biographical information








• a conceptual framework








• contributions to theory








• a clinical illustration or salient excerpt from their work.

The Guide to Psychoanalytic Developmental Theories offers a foundational perspective for the graduate student in clinical or school psychology, counseling, or social work. Seasoned psychiatrists, analysts, and other clinical practitioners also may find it valuable to revisit these formative moments in the history of the field.

• Language: English
• Publisher: Springer
• Release date: May 28, 2009
• ISBN: 9780387884554

Book preview

Part 1

Drive Theory

Barry J. Koch, Harold K. Bendicsen and Joseph PalomboGuide to Psychoanalytic Developmental Theories10.1007/978-0-387-88455-4_1© Springer Science+Business Media, LLC 2009

1. Sigmund Freud (1856–1939)

Publishing Era (1888–1950)

Joseph Palombo¹ , Barry J. Koch² and Harold K. Bendicsen²

(1)

626 Homewood Ave, Suite 307, 60035 Highland Park IL, USA

(2)

1117 Rosedate St., 80104 Castle Rock CO, USA

(3)

640 E. Belmont Ave., 60101 Addison IL, USA

Abstract

Sigismund Schlomo Freud was born in Freiberg, Moravia (now Pribor, Czechoslovakia) on May 5, 1856. He began using the shortened Sigmund after entering the University of Vienna in 1873 at age 17. Freud’s Hasidic Jewish family history was complicated by early deaths and frequent remarriages, common at the time. Freud’s father, Jacob, a poor wool merchant, married Amalia Nathanson, when he was 40 and she was 20. This was his third marriage, which produced seven children of which Sigmund was the oldest. When Sigmund Freud was four, the aspiring middle-class family moved from Leipzig to Vienna, where the Freud’s family life centered on helping the brilliant Sigmund actualize his academic potential. In 1873, he graduated Gymnasium with distinction at age 17 and then entered the University of Vienna. The University’s liberal atmosphere was remarkably free of anti-Semitism and he flourished in its stimulating environment.

Keywords

Anal phaseAnxietyCastration anxietyCathartic methodCathexesConsciousConstancy principleDefense mechanismsDriveDrive theoryDynamic hypothesisEconomic hypothesisFixationFree associationHypothesisEgoEgo-idealEros - the life instinctGenetic hypothesisGenital/oedipal phaseidIdentificationIntrojectionIsolationLatency phaseLate genital or adolescent phaseLaw of entropyLibidoOedipus phaseOral phasePenis envyPhallic/urethral/narcissistic phasePleasure-unpleasure principlePolymorphous perverse sexualityPreconsciousPrimary narcissismPsychic determinismProjectionReaction formationRegressionRepressionReversalSecondary narcissismStructural hypothesisSuperegoThanatos – the death instinctTopographic hypothesisTurning against the selfUnconsciousUndoingUnpleasure

1.1 Biographical Information

Sigismund Schlomo Freud was born in Freiberg, Moravia (now Pribor, Czechoslovakia) on May 5, 1856. He began using the shortened Sigmund after entering the University of Vienna in 1873 at age 17. Freud’s Hasidic Jewish family history was complicated by early deaths and frequent remarriages, common at the time. Freud’s father, Jacob, a poor wool merchant, married Amalia Nathanson, when he was 40 and she was 20. This was his third marriage, which produced seven children of which Sigmund was the oldest. When Sigmund Freud was four, the aspiring middle-class family moved from Leipzig to Vienna, where the Freud’s family life centered on helping the brilliant Sigmund actualize his academic potential. In 1873, he graduated Gymnasium with distinction at age 17 and then entered the University of Vienna. The University’s liberal atmosphere was remarkably free of anti-Semitism and he flourished in its stimulating environment.

1.1.1 Laboratory Research, Military Service and Medicine

While still living at his parent’s home, Freud studied in the physiology laboratory of Ernst Wilhelm von Brucke from 1876 to 1882, where he cultivated his keen curiosity as an investigator. Freud was influenced especially by two professors who were known as Darwinians (Ritvo, 1965), Carl Claus, who taught zoology, and Brucke, whom Freud considered a fatherly figure, and whose commitment to medical positivism had the single greatest impact on his intellectual life. Freud served 1 year of compulsory service in the Austrian military from 1879 to 1880 where he tended sick soldiers. To counter the boredom during that period, he translated John Stuart Mills’ essays into German. Freud earned his medical degree at the age of 25 in 1881. In 1882, he secured a junior post at Vienna’s General Hospital, which he held until 1886 when he resigned to open his private practice in psychiatry. With this move, he shifted his professional interests to psychiatry from research in neuroanatomy (Gay, 1988, pp. 30–37; Sulloway, 1979, pp. 13–21).

1.1.2 Jean Martin Charcot and Josef Breuer

To satisfy his insatiable curiosity about developments in related fields, from 1885 to 1886, Freud studied hypnosis in Paris at the Salpetriere with Jean Martin Charcot, whose lectures on the Diseases of the Nervous System (1881) he translated into German. Charcot believed hypnosis was an organic pathological condition seen only in hysterics and neurotics. Freud began using hypnosis in 1887 in his collaboration with Josef Breuer (1842–1925), whom he met in 1887 through Ernst Brucke’s circle of highly respected colleagues. Eventually, Freud gave up hypnosis altogether in 1897, considering it ineffective and preferring to use Breuer’s cathartic method, which consisted in letting patients freely associate by reporting whatever crossed their minds. Breuer became Freud’s fatherly mentor, close professional collaborator, coauthor of Studies on Hysteria (1895c), and financial supporter. By 1898, the collaboration with Breuer was all but over as Breuer expressed persistent doubts about Freud’s conclusions on hysteria and the theory of neuroses that Freud was promoting. He could not accept Freud’s conjectures that these disorders stemmed from infantile sexuality.

1.1.3 Martha Bernays

Freud met Martha Bernays (1861–1951) in 1882 when she was visiting one of his sisters at his house. Freud quickly fell in love and was engaged 2 months later. They married in 1886. Martha gave birth to three sons and three daughters in an 8-year period. The first child born to the Freuds was Mathilde in 1887, followed by Jean Martin, named after Charcot, in 1889, Oliver in 1891, Ernst in 1892, and Sopherl (Sophie) in 1893. Annerl or Anna, the youngest was born in December 3, 1895 in Vienna (see the biographical statement in the Anna Freud section for additional family details). In 1896, Freud had turned 40 and the need to earn a living to support his family inexorably shaped his career decisions.

1.1.4 Wilhelm Fliess: The Project, Freud’s Self-Analysis, and The Cocaine Episode

In 1887, Freud met Wilhelm Fliess (1858–1928), a visiting Berlin physician, who was part of Josef Breuer’s circle. In some ways, Fliess started out as Freud’s unrestrained creative muse or, as Freud put it in a letter to Fliess, his Publicum, i.e., his audience (Nunberg, 1969/1970, p. 103). Their close friendship grew stronger as the friendship with Breuer faded. Fliess is credited with the concepts of latency, the sexual significance of olfaction, and bisexuality, which Freud used selectively.

Freud never published the Project for a Scientific Psychology (1895a). Its significance lies in the ambitious effort it represents to uncover the neurobiological mechanisms that undergird our mental lives. It was an ambitious excursion, which he communicated to Fliess through an exchange of letters during 1895–1896. Freud had encountered three problems he could not solve: (1) What factors entered into the choice of a specific set of neurotic symptoms? (2) Why does sexuality always seem to be the ubiquitous cause of neurotic disorders? In addition, (3) what physiological mechanisms does the ego employ to activate repression? Freud found the solutions to these problems, in particular the last one, to be elusive and refractory. Eventually, he was forced to abandon his Project and the quest for a neurophysiological explanation for the functioning of the mental apparatus. Freud asked Fliess to destroy the copy of the Project he had sent for review, but Fliess never did so. However, the ideas contained in the Project continued to exert a heuristic influence on Freud. He translated many of its constructs into his psychoanalytic framework, including such ideas as reality testing, the formal distinction between primary and secondary processes, and the wish-fulfillment theory of dreams.

During 1897–1898 Freud, using free association to access personal dream material, wrote frequently to Fliess about his self-analysis. Free association is the technique of letting patients state whatever comes to mind, unrestrained by any effort to inhibit thoughts and feelings. In these communications, he credited this heroic experiment with a number of seminal discoveries that became central to psychoanalytic theory. These included (a) his abandonment of the seduction theory of the etiology of the neuroses, (b) the Oedipus complex, that is, the family romance, (c) unconscious guilt, (d) the phases of sexual development, later characterized as the psychosexual synthesis (Makari, pp. 85–125), (e) the revelatory nature of parapraxes or slips of the tongue, (f) the power of repressed aggressive feelings, (g) dream mechanisms, and (h) a psychological explanation for addiction as a form of displaced masturbation (Gay, 1988, pp. 96–102).

Between 1884 and1885, what has became known as the Cocaine Episode took place. A German army physician had prescribed cocaine on a limited basis to bolster the endurance of the troops. Freud encountered the then little known substance called cocaine while working in Theodor Meynert’s Psychiatry Department of the General Hospital in Vienna and became impressed with its simultaneously painkilling, soothing, and stimulating properties. Freud conducted research on this remarkable substance and published his findings in 1884 in a paper entitled On Coca. He grew to lament that he had not published first the fact of its anesthetizing qualities, about which he had told colleagues, and lost out to Carl Koller, who is credited as the discoverer of the use of cocaine as an important local anesthetic in minor surgery. He wrote of the cocaine business in a letter to Martha on October 29, 1884, lamenting that he had missed out on the lion’s share of recognition for its use in surgery and implying that his love struck interests distracted him and caused him to do sloppy research. Freud, however, was still an enthusiastic proponent of its use for relief of depression, exhaustion, and enhancing overall well-being. He continued to use it in ever-decreasing amounts until he discontinued it all together in the mid 1890s, appreciating more fully its addictive features (Gay, 1988, pp. 42–45).

Although the collaboration with Fliess initially was intense, leading Freud to believe that a homosexual dimension colored the relationship, after 1900, the reliance on Fliess diminished substantially and ended unhappily in 1904, in a dispute primarily over ownership and originality of ideas (Gay, 1988, pp. 274–277). The publication of The Interpretation of Dreams in 1900 had marked a turning point in Freud’s effort to establish a new path for himself.

1.1.5 Professorship and Relocation

Since 1885, Freud had been stuck in the lowly rank of Privatdozent in the department of psychiatry, which was a position as an unsalaried university lecturer remunerated directly by students’ fees. Only political connections could guarantee promotions. In 1902, after a long wait, Emperor Franz Josef awarded Freud the prestigious rank of Professor Extraordinarius, which meant that he would use the title Herr Professor. This was the ticket to social prestige and higher fees (Gay, 1988, pp. 136–137). Freud felt that psychoanalysis became legitimized with his acceptance into the academic community. In 1891, Freud moved his office and family into Berggasse 19 where he worked and lived until 1938.

1.1.6 Study Groups

As the relationship with Fliess faded, Freud confronted the need for a new audience and sounding board. In the fall of 1902, at the suggestion of Wilhelm Stekel (1886–1940), a former psychoanalytic patient of Freud’s, Freud initiated the Wednesday Psychological Society. Freud invited four physicians, including Alfred Adler and Stekel, to the meeting. Later, interested lay people were invited. It convened in Freud’s apartment and was later renamed the Wednesday Evening Meetings. Early in1908, the Wednesday Psychological Society became the more formal, collegial, and professional Vienna Psychoanalytic Society. In 1910, the meetings were moved to the Doktoren Collegium (the College of Physicians). Freud attended the meetings regularly, hardly ever missing a meeting until his illness in 1923 (Gay, 1988, 1988, pp. 173–179; Nunberg, 1965, pp. 153–156).

1.1.7 Visit to America

Having been invited to lecture by Granville Stanley Hall, President of Clark University in Worchester, Massachusetts, Freud in September 1909 paid his only visit to America. Hall, with J. J. Rousseau, was one of the coinventors of the concept of adolescence (Esman, 1993; Kaplan, 1984; Ross, 1972; Sulloway, 1979, p. 263). Freud sailed from Bremen, Germany on August 20, 1909 with Sandor Ferenczi and Carl Jung. Once in New York, Ernest Jones and A. A. Brill met him. On September 10, Hall presented Freud with an honorary degree of Doctor of Laws. Freud delivered five improvised lectures on psychoanalysis, which were well received (Five Lectures on Psychoanalysis, 1910a, SE Vol. 11). During his stay, Freud met William James, the celebrated American psychologist. Freud considered the American trip as the most successful celebration of psychoanalysis growing appeal and acceptance. It was an enthusiasm soon to be tempered by growing ambivalence toward the unruly Jung, Freud’s heir apparent (Gay, 1988, pp. 206–213).

1.1.8 The Committee

In the summer of 1912, due to the painful theoretical disagreements with Wilhelm Stekel, Alfred Adler, and Carl Jung, Freud accepted an idea from Ernest Jones, an orthodox psychoanalytic loyalist, to form a secret committee that would guard psychoanalytic orthodoxy. Members included Freud, Jones, Sandor Ferenczi, Otto Rank, Karl Abraham and Hanns Sachs. A wealthy Budapest beer baron, Anton von Freund, who had been Freud’s patient, funded the Committee’s activities, along with the psychoanalytic publishing enterprise. Max Eitingon and Anna Freud joined the group in 1919. The members swore their unswerving loyalty to Freud and to three fundamental tenets of psychoanalysis, the unconscious, repression, and infantile sexuality. To seal the membership, Freud gave a signet ring to each of the participants. Freud wrote later, The idea of a united small body, designed, like the Paladins of Charlemagne, to guard the kingdom and policy of their master, was a product of my own romanticism (Gay, 1988, pp. 229–230). Bitter rivalries broke out usually with Ferenczi and Rank on one side, Jones and Abraham and the rest on the other side as group cooperation became impossible. By 1925, the Committee ceased to exist, its watchdog functions absorbed into the international training commission established at the Eighth International Psychoanalytic Congress in Bad Homburg (Grosskurth, 1992, pp. 341–355).

1.1.9 Karl Abraham (1877–1925)

¹

Karl Abraham was born on May 3, 1887 in Bremen, Germany, into a small insular Orthodox Jewish community. Abraham decided at about age 18 to become a dental student. After a semester, he changed to medicine and in 1896 transferred to the University of Freiburg where he graduated in 1901 at age 24. At the University of Freiburg, Abraham came under the influence of Dr. Keibel, then a young lecturer in histology and embryology. Abraham developed a lifelong interest in embryology and later combined this curiosity with Freud’s theory of libido and infantile psychosexual development; libido being the psychological representation of the sexual drive.

After a brief period as an assistant brain pathologist at the Berlin Municipal Asylum at Dalldorf, in 1904, Abraham accepted a position at the Burgholzli, the Mental Hospital of Zurich University. Eugene Bleuler, who extended Emile Kraepelin’s work on schizophrenia, held the chair in psychiatry at that institution. At the time, Carl G. Jung was Bleuler’s first assistant and the chief resident physician. This event represents a turning point in Abraham’s life. Bleuler was one of the first to demonstrate an interest in Freud’s work, an interest that bucked the dominant trend in academic psychiatry.

Freud was 50 and Abraham was 30 when they met. Abraham and Freud rapidly established a cordial, trusting relationship, which with Freud’s encouragement in December 1907, led Abraham to settle in Berlin and begin a private psychiatric practice. Abraham founded the Berlin Psychoanalytic Society in August 1908 and the Berlin Psychoanalytic Institute in 1920. The first graduate was Franz Alexander in 1921, who later became the first Director of the Chicago Institute for Psychoanalysis. At the 1918 Congress in Budapest, Hermann Nunberg had advanced the position that all future psychoanalysts should undergo a personal analysis (Nunberg, 1965, p. 157). Significantly, there is no evidence that Abraham himself ever underwent either a personal or a training analysis. Abraham became a sought after training analyst with notable patients such as Alix Strachey, Edward and James Glover, Helene Deutsch, Karen Horney, and Melanie Klein. She, in turn, credited him with influencing her ideas on the significance of the destructive impulse and tracing its roots and its relationship to mental development. However, she rejected his developmental theory of the vicissitudes of libido.

While all the members of the psychoanalytic community were enthusiastic about their participation in psychoanalytic activities, Abraham had an abundance of vitality that he brought to his involvement. The energy Abraham poured into spreading psychoanalysis became legendary. In addition to attending to his considerable practice, Abraham wrote papers, presided over meetings, and enlisted recruits to the cause. Of particular consequence for psychoanalysis was his series of papers on manic-depression, now known as bipolar affective disorder (BPAD), written during his Zurich period, and later the development of libido. In addition, he kept a wary eye on the political storm centers in Zurich and Vienna for deviation from orthodoxy. His wise counsel to Freud during these turbulent and formative years was substantial and, after the storms subsided, fully appreciated.

In the summer of 1925, Abraham was writing to Freud from bed due to apparent symptoms of bronchitis. In actuality, he seems to have been suffering from undiagnosed lung cancer and was to die within 6 months. He steadily weakened and on Christmas Day Abraham died at the age 48. Abraham has the distinction of being one of Freud’s most loyal followers beginning with their first meeting in 1907 at the December meeting of the Wednesday Psychological Society through to his death. Freud took Abraham’s death very hard; and the loss was a profound shock to the entire psychoanalytic community. Freud applied to Abraham’s obituary notice the famous phrase that Horace lavished on a man of integrity: integer vitae scelerisque puru, Blameless of life and free of vice (Abraham, 1974; Gay, 1988, pp. 178–483).

Makari states, …Karl Abraham offered a newly nuanced, unified psychosexual theory. Abraham connected libido, childhood experience, character structure, love relations and social adaptation, all of which made possible a richer description of a human life. Rado remembered: ‘Abraham invented a use of Freudian language, combined with the ordinary clinical terms of psychiatry, to be able to tell the essential story of a patient (2008, p. 378).

1.1.10 The First World War and The Emergence of The Death Instinct

Partly in response to the atrocities and misery of the Great War (1914–1918), Freud began to lay additional emphasis on Thanatos, the death wish. Freud reluctantly acknowledged Wilhelm Stekel as the first to use the term in 1910 through an examination of the death wish (later in 1920 Freud referred to the death instinct) and death symbolism in dreams (Roazen, 1974, pp. 211–222). Freud, however, in his early formulation, understood aggression as a dimension inherent in the ego (life preservative) and not an independent drive. Freud was reluctant to accord aggression, specifically the death instinct, a status equal to that of libido until the formulation of the dual instinct theory in 1920 (Freud, 1905b, 1920b). He was well aware of the complexities of this antithesis and even questioned the theoretical usefulness of such a dichotomy because of their mixed and uneven developmental trajectories (Fenichel, 1945, pp. 58-61). Originally, Freud posited that Eros, the life instinct, was the primary life force whose energy or libido is directed toward the enhancement or reproduction of life. In this framework, aggression was viewed simply as a reaction to the blocking or thwarting of libidinal impulses and was neither an automatic nor an inevitable part of life (Kaplan and Sadock, 2003a, p. 151). In 1915, with the publication of Instincts and Their Vicissitudes aggression began to play a more significant role in instinctual life (Nunberg, 1965, pp. 157–161).

In Beyond the Pleasure Principle (1920b) Freud put forth the final stage of his views on the hypothesis of the death instinct, a self-destructive force, and, with that, a truly independent aggressive drive came into existence. He posited the existence of Eros and Thanatos, the life instinct and the death instinct. This formulation became known as the dual instinct theory. Both instincts undergo repression as a general form of social control necessary now to save people from themselves.

The World War I left a deep imprint on Freud, having seen three of his sons serve in the military and been exposed to the appalling daily display of human beastliness (Gay, 1988, p. 197). In addition, Freud was impressed with a presentation he heard Sabina Spielrein make to the Vienna Psychoanalytic Society in 1911 entitled Destruction as the Cause of Becoming. Subsequent personal experiences may well have contributed to his belief in the existence of a death instinct. Freud was deeply affected by the loss in 1920 of his first and much beloved daughter, Sophie, to influenza. In 1923, Freud was diagnosed with cancer of the palate. Furthermore, in 1923, Freud lost his beloved grandson, Heinele, Sophie’s younger son, to tuberculosis, a death that left him deeply depressed. The horror of World War I, the Spielrein presentation along with Freud’s three personal confrontations with the frailty of life probably contributed to his laying additional emphasis to his conviction of the existence of Thanatos and destructive aggression (Gay, 1988, pp. 396–408; Mitchell & Black, 1995, pp. 18–19).

1.1.11 Psychoanalysis of Anna Freud (1895–1982)

As we discuss later in the chapter on Anna Freud, Freud took on the analysis of his youngest daughter between the years 1918 and 1922, when Freud was 62 and Anna was 23. This analysis, along with that of the Wolf Man, was among Freud’s longest analyses to have occurred at the time. It took place six times per week. Both he and Anna considered it successful from the standpoint of deepening her capacity for sublimation. Specifically, Anna’s masculinity complex, in which girls turn away from their incestuous love for their fathers and easily abandon their sexual feminine role, was understood not as a move toward homosexuality, but rather as an escape from sexuality. The vestal Anna transformed her sexuality and her oedipal interest in masturbation, into the desire to communicate, to be understood, and to seek not sexual pleasure but the social pleasure of praise. Her father rejected eligible male suitors as she developed female companionships with Dorothy Burlingham and Eva Rosenfeld, whose trust and lifelong devotion filled her with great joy (Peters, 1985, p. 47). In 1921, Freud invited Lou Andreas-Salome, who had been practicing psychoanalysis for a decade, to mentor Anna. A second analysis with Freud took place during 1924–1925. This analysis was interrupted due to Freud’s spreading cancer. With Freud less available, Max Eitingon in Berlin was the second mentor to whom Anna turned to help her with the decisive next step career decisions (Young-Bruehl, 1988, pp. 103–139).

1.1.12 Cancer

In September 1922, Freud was diagnosed with a tumor of his palate. The first operation in April 1923 confirmed the suspicion of cancer, leaving him in considerable pain and with an uncomfortable prosthesis. Freud could not give up smoking his strong cigars, which greatly aggravated his mouth cancer and led directly to his death 17 years later (Gay, 1988, pp. 417–446). Incredibly, Freud had delayed getting the swelling treated for months. Freud’s surgeon, Dr. Hajek, and Felix Deutsch, an internist and Freud’s personal physician, trivialized the first operation and conspired to conceal the true diagnosis from Freud. Deutsch was concerned that the diagnosis of a malignancy and the radical nature of the second surgery might prompt Freud to prefer a Stoic suicide. Accordingly, he consulted the members of the Committee, who concurred in keeping the cancer diagnosis secret from both Freud and Anna. Both Freud and Anna then went off to their eagerly anticipated trip to Rome. Upon their return Freud was told of the cancer and its concealment, he was furious at the concealment and dismissed Deutsch as his physician but kept him as Anna’s doctor (Young-Bruehl, 1988, p. 119). When Jones told Freud about the Committee’s deception 15 years later, he was incensed and said Mit welchem Recht? (Freely translated as, By what right did you make that decision? (Schur, 1972, p. 361).

1.1.13 The Goethe Prize and The Final Years

Frustrated at not having won a Nobel Prize, Freud found some consolation in 1930, with the award of the coveted Goethe Prize for literature by the city of Frankfurt. As he was too ill to attend, Anna Freud accepted for him on August 30 (Gay, 1988, pp. 571–572). Germany, under Adolf Hitler, declared a union (Anschluss) with Austria through annexation on March 13, 1938. Direct and indirect attacks on Austrian Jews started immediately. One year later, by March 1939, all of Czechoslovakia was under German control. In September of that year, Germany declared war on Poland. In Vienna, the eminent surgeon Hans Pichler exerted his considerable influence to protect the Freud family. However, on March 22, 1939, the Nazis Gestapo took Anna Freud in for questioning on the nature of the Vienna Psychoanalytic Society. She was released later that evening after reassuring the Gestapo that the Society as a scientific organization was nonpolitical. This event overcame all of Freud’s resistance to leaving Vienna. On June 4, with the considerable assistance of Princess Marie Bonaparte, Freud finally received his passport to leave Austria. Freud arrived in London on June 6 with his family and possessions. In his final year, he saw a few patients and worked principally on the manuscript of Moses and Monotheism. When the pain, fatigue, and gangrene became unbearable, at Freud’s direction and with notification to Anna, he instructed his personal physician to proceed with their contract. After three morphine injections over 2 days, Freud died under the care of Dr. Max Schur, on September 23, 1939 at 20 Maresfield Garden, in Hampstead (Gay, 1988, p. 651; Schur, 1972, pp. 504–529).

1.2 Conceptual Framework

Albert Einstein (1879–1955), Charles Darwin (1809–1882), and Sigmund Freud (1856–1939) are arguably three of the most profound, creative, and influential intellectual minds of the past 150 years. Each is responsible for a revolution in thinking that allowed for enormous leaps in explanatory power, having created separate and monumental paradigm shifts in their respective fields (Kuhn, 1962; Mayr, 1991, pp. 1–3). Each was concerned with discovering the laws of nature: Einstein (Albert Einstein Archives, http://www.albert-einstein.org/head2.html), with the laws of the physical world from the cosmos to subatomic particles, Darwin, with the laws of evolutionary biology, and Freud, with the laws of the unconscious mind.

The underpinnings to Freud’s paradigm were complex in that Freud relied on a mix of evolutionary ideas that included three components. First, it drew on Jean Lamarck’s (1744–1829) principle of the inheritance of acquired characteristics in reaction to special environmental conditions. Lamarck advocated that a supreme being guided the ever more complex changes that occur in organisms leading them toward a state of perfection (Mayr, 1982. p. 353). For example, giraffes grew longer necks because leaves were harder and harder to reach. Second, Freud’s paradigm relied on Ernst Haeckel’s (1834–1919) extension of the embryological hypothesis that ontogeny recapitulates phylogeny; that is, in individual development the stages of the history of the species are repeated. Third, it acknowledged Charles Darwin’s (1809–1882) principle of common descent through natural selection and survival of the fittest. Whereas Freud originally was a committed Darwinian, later in life he relied more on the discredited Lamarckian notions (Mayr, 1991, p. 134) as evidenced in these works: Totem and Taboo (1912b–1913), Group Psychology and the Analysis of the Ego (1921), The Future of an Illusion (1927a), Civilization and Its Discontents (1930) and Moses and Monotheism (1939).

For Freud, the sexual and aggressive drives were the fundamental driving forces for all human behavior. Human beings are born with untamed instinctual forces that push for discharge. Each child is born in a state of primary narcissism with a fixed and immutable quantity of libidinal and aggressive energy. This energy is at first directed toward the erogenous zones, the oral, anal, and genital areas. As caregivers provide gratification in the form of nurturance, infants transfer libidinal energy to their caregivers, and a cathexis of those objects follows. The investment of the caregivers results from the satisfaction of the instinctual drives. When the object does not provide the necessary satisfaction, which can occur with the loss of or disappointment in the object, the drive energies are withdrawn from the object and are reinvested in the ego. This produces the state of secondary narcissism, which may be accompanied by a variety of symptoms. Society’s role is to tame those drives, and to transform them into energies that are usable for constructive purposes.

From a developmental perspective, Freud considered children to be energy processing organisms, whose urges to discharge are subject to the pleasure principle. Children are incapable of delaying the discharge of their urges. The primary aim of the organism is to reduce the buildup of tension that results from the constant pressure of the drives. The libidinal drives follow a prescribed form of expression, and unfold in a predictable sequence, the sequence being the familiar one of the oral, anal, and phallic/oedipal phases. The issues that each child faces during these phases are set by the history of the species. The psychic contents of each phase are also ontogenetically determined.

An outcome of the pressures that drives exert on the ego is that conflict is inherent in all development. The forces that lead the child to wish to discharge drive energies are antithetical to the reality the child faces. The demands of society are contrary to the demands of the instincts. Consequently, for a child to move on developmentally, that child must learn to postpone the pleasures of discharge, and to find less direct and more realistic ways of attaining gratification. Since postponement and delay entail frustration, conflict must ensue. Every developmental phase, therefore, presents children with a set of conflicts that they must resolve before it becomes possible for them to move ahead developmentally.

The ego activates defenses to protect itself against the onslaught of the drives. The defenses serve not only as shields against the more intense drives but also as regulators of discharge of drive energies. The other component of the ego’s structure is derived from the neutralized drive energies that result from conflict resolution. These energies are transformed into identifications the child makes with parental figures and which eventually constitute the ego’s executive functions.

In turn, the superego, or the conscience, emerges out of the resolution of the child’s oedipal strivings at around the ages of four to six. The superego results from the internalization of the parental prohibitions, especially those of the father. What begins as the introjection of aspects of parent relationships becomes consolidated into the superego with the postponement of the hope for gratification of oedipal desires.

Freud believed that the myth of Oedipus best characterized the issues confronting the child in this phase of development. The onset of this phase is ontogenetically determined. He saw in that myth the key with which to explain not only neurotic phenomena manifested by troubled people, but also the normal expression of the psychological conflicts that children face. Conflict, which is central to all development and psychopathology, reflects the struggle between the person’s primitive drive needs and the demands of society. The corollary issues that emerge in that phase are indicative of the vicissitudes of the instinctual drives. The issue of activity and passivity, of masculinity and femininity, of phallic intrusiveness or castrated receptivity are all part of the achievement of dominance in this phase. Anatomy plays a central role in the evolution of the