Tag Archives: Psychoanalytic Psychotherapy

Are There Really No Psychological Accidents?

Psychological Determinism

Psychological Determinism
Slip of the tongue?

Perhaps the single most representative concept of psychoanalysis is that of psychological determinism.  By this I mean a fundamental belief that human behavior, consciousness, and experience are determined or explainable.  Freud followed in a scientific tradition that was dedicated to uncovering the laws and mysteries of life, hopefully to lead to a comprehensive theory of the mind.  

Is Action Accidental or Random?

Such an approach would never be satisfied with a conclusion that suggested that a certain action was “accidental” or “random” or that a thought occurred strictly from a spontaneous, meaningless neurochemical action.  Unlike radical behaviorism or even social learning theory, which propose to account for some behaviors as incidental contingencies or fortuitous accidents, psychoanalytic thinking would tend to view such explanations as naïve, simplistic, or superficial.  

What Does Psychoanalysis Tell Us About Action?

Psychoanalysis proposes to describe mind and behavior as meaningful and understandable.  Thus, our lives are the products of our being.  Our intentions, as well as our accidents, are worthy of understanding.  While critics may argue that psychoanalytic theories make too much out of too little, the supposed error is committed in the pursuit of knowledge, with an implicit expectation and respect for the complexity of life.  It should also be noted that such an attitude is reflective of an appreciation for the humanism of psychology, not its mechanization or reduction to biochemistry.

What is the Focus of Psychoanalytic Explanation?

Even if one could demonstrate, once and for all, that the universe and life are random, nonsensical phenomena, this would not contradict the view of determinism.  The focus of psychoanalytic explanation is on the human experience of life.  What is characteristically human is our mind’s proclivity for making sense out of nonsense.  We cannot tolerate being in a state of uncertainty or confusion.  Psychological determinism addresses this characteristic of being human by suggesting that all human knowledge, no matter how sophisticated, abstract, or profound, is always, ultimately, human.

Freud and Breuer’s Studies in Hysteria

Freud’s and Breuer’s Studies in Hysteria are classic examples of the humanity inherent in a view of psychological determinism.  In their investigation and treatment of hysteria, they stressed how patients’ peculiar behaviors stemmed from important but forgotten episodes of their lives.  Hysteria, understood in the context of a person’s life, represents a meaningful continuity of being, such that the mental life of the patient is respected as relevant and the patient is further accepted as exhibiting psychological processes common to humankind.  The “logic” of symptoms soon led to an appreciation for the logic of dreams, mistakes, jokes, and slips of the tongue.  With acceptance of determinism, we can never take life’s events for granted again!

For more on psychological determinism and other psychoanalytic concepts, see the course Classical Psychoanalytic Theory.  If you would like to receive a specialization Certificate in Psychoanalytic Psychotherapy and learn more about issues of interest, please see our home study psychology continuing education courses, available online.

Psychoanalytic Psychotherapy with Adolescents

Psychotherapy with Adolescents


Psychotherapy with adolescents could help this young man.Psychotherapy with adolescents provides a unique opportunity to impact identity at a key time in development.  Understanding the roles of “self” and “identity” is helpful in this process.

Self and identity have been variously defined and, at times, viewed as synonymous.  It is clinically helpful to distinguish between the two in psychoanalytic psychotherapy with adolescents.  Compensatory identities are sometimes formed during this period, in response to profound psychic conflict.  Exploring the function of these identities as objectified processes to cope with psychic trauma must be balanced with respect for the “subjectivity of self as a vehicle for psychological truth.”  

In a recent article, Dr. Michael Gerson discussed such distinctions and their clinical implications, as they applied to his psychodynamic treatment of two adolescent patients.  The article is “Clinical Implications for the Expressions of Self and Identity in Adolescent Psychotherapy: Case Studies of a Vampiress and a Gangster,” published in volume 24, issue 6 (pp. 718-732) of Psychoanalytic Dialogues: The International Journal of Relational Perspectives.  

Struggles with self and identity impact the adolescent mind.  The adolescent’s experiences of self–as derived from bodily experiences and emotional confusions–can create an ineffable sense of alienation from others.  In adolescents, self-conflicts can also present with transient dissociative states.  Experiences of identity, by contrast, can provide a compensatory, reflective function.  

The article describes Dr. Gerson’s work with two troubled adolescents.  One had taken on the identity of a vampiress and the other of a gangster.  The psychodynamic treatment focused on exposing, understanding, and working through the internal conflict, thus helping the patients negotiate between the perspectives of self and identity.  By examining the contrast between identity and self, these patients were able find ways of living that, ultimately, felt more truthful, authentic, and integrated.

Please contact Dr. Gerson at to receive a free personal copy of the article.

For more background on self and identity, also see the courses Classical Psychoanalytic Theory or Ego Psychology.

“Self” and “Identity”

Neuroscience, Self, and Identity

Neuroscience, Self, and IdentityWhat do we mean when we refer to self?  Is self distinct from identity?  The constructs of self and identity have been understood and discussed historically in diverse ways.  Neuroscience research is now supporting that they are indeed distinct constructs.

Neuro-imaging research is consistent with self as reflecting right hemisphere, reflexive, nonlinguistic experience.  In contrast, identity involves left hemisphere, reflective, linguistically-mediated experience.  

Self and identity have distinct functions as well as developmental significance.  Self refers to how we experience the moment, from the perspective of “I”.  Feeling the exhilaration of reaching a mountain top, for example, would be engaging the self.  Identity reflects our experiences from the observer, or “me”, perspective.  Thinking of oneself as an adventurer would be an example of identity.  

Very young children are more likely than adults to be in touch with the self.  Clashes between self and identity are often particularly evident during adolescence–a stage of enormous neurological growth and changes.  As noted by Erikson and many other theorists, adolescence may be a time of turmoil as a life-long identity is forged.

Understanding the differences between self and identity can be helpful clinically.  To read more, view the fascinating article, “Reconsidering Self and Identity Through a Dialogue Between Neuroscience and Psychoanalytic Theory,” published in Psychoanalytic Dialogues, 24(2), 247-251, as well as the commentary with discussion, Gerson, M. J. (2014). “A meta-commentary: Response to the commentaries of Marks-Tarlow and Solow Glennon.”  Dr. Gerson discusses the empirical study of consciousness in terms of contemporary psychoanalytic concepts and argues for interdisciplinary research in which neuroscience and psychoanalysis may engage in a mutually informing dialogue.  Please contact him at to receive a free personal copy of the article.

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