Though not the first methodology in the practice of individual verbal psychotherapy, Freud's psychoanalytic system came to dominate the field from early in the twentieth century, forming the basis for many later variants. While these systems have adopted different theories and techniques, all have followed Freud by attempting to effect behavioral change through having patients talk about their difficulties. Psychoanalysis itself has, according to psychoanalyst Joel Kovel, declined as a distinct therapeutic practice, despite its pervasive influence on psychotherapy.
The neo-Freudians, a group including Alfred Adler, Otto Rank, Karen Horney, Harry Stack Sullivan and Erich Fromm, rejected Freud's theory of instinctual drive, emphasized interpersonal relations and self-assertiveness, and made modifications to therapeutic practice that reflected these theoretical shifts. Adler originated the approach, although his influence was indirect due to his inability to systematically formulate his ideas. In Kovel's view, neo-Freudian practice shares the same assumption as most current therapeutic approaches in the United States: "If what is wrong with people follows directly from bad experience, then therapy can be in its basics nothing but good experience as a corrective." Neo-Freudian analysis therefore places more emphasis on the patient's relationship with the analyst and less on exploration of the unconscious.
Carl Jung believed that the collective unconscious, which reflects the cosmic order and the history of the human species, is the most important part of the mind. It contains archetypes, which are manifested in symbols that appear in dreams, disturbed states of mind, and various products of culture. Jungians are less interested in infantile development and psychological conflict between wishes and the forces that frustrate them than in integration between different parts of the person. The object of Jungian therapy was to mend such splits. Jung focused in particular on problems of middle and later life. His objective was to allow people to experience the split-off aspects of themselves, such as the anima (a man's suppressed female self), the animus (a woman's suppressed male self), or the shadow (an inferior self-image), and thereby attain wisdom.
Jacques Lacan approached psychoanalysis through linguistics and literature. Lacan believed that Freud's essential work had been done prior to 1905 and concerned the interpretation of dreams, neurotic symptoms, and slips, which had been based on a revolutionary way of understanding language and its relation to experience and subjectivity. Lacan believed that ego psychology and object relations theory were based upon misreadings of Freud's work. For Lacan, the determinative dimension of human experience is neither the self (as in ego psychology) nor relations with others (as in object relations theory), but language. Lacan saw desire as more important than need and considered it necessarily ungratifiable.
Wilhelm Reich developed ideas that Freud had developed at the beginning of his psychoanalytic investigation but then superseded but never finally discarded. These were the concept of the Actualneurosis and a theory of anxiety based upon the idea of dammed-up libido. In Freud's original view, what really happened to a person (the "actual") determined the resulting neurotic disposition. Freud applied that idea both to infants and to adults. In the former case, seductions were sought as the causes of later neuroses and in the latter incomplete sexual release. Unlike Freud, Reich retained the idea that actual experience, especially sexual experience, was of key significance. By the 1920s, Reich had "taken Freud's original ideas about sexual release to the point of specifying the orgasm as the criteria of healthy function." Reich was also "developing his ideas about character into a form that would later take shape, first as "muscular armour", and eventually as a transducer of universal biological energy, the "orgone"."
Fritz Perls, who helped to develop Gestalt therapy, was influenced by Reich, Jung and Freud. The key idea of gestalt therapy is that Freud overlooked the structure of awareness, which, properly understood, is "an active process that moves toward the construction of organized meaningful wholes... between an organism and its environment." These wholes, called gestalts, are "patterns involving all the layers of organismic function – thought, feeling, and activity." Neurosis is seen as splitting in the formation of gestalts, and anxiety as the organism sensing "the struggle towards its creative unification." Gestalt therapy attempts to cure patients through placing them in contact with "immediate organismic needs." Perls rejected the verbal approach of classical psychoanalysis; talking in gestalt therapy serves the purpose of self-expression rather than gaining self-knowledge. Gestalt therapy usually takes place in groups, and in concentrated "workshops" rather than being spread out over a long period of time; it has been extended into new forms of communal living.
Arthur Janov's primal therapy, which has been an influential post-Freudian psychotherapy, resembles psychoanalytic therapy in its emphasis on early childhood experience, but nevertheless has profound differences with it. While Janov's theory is akin to Freud's early idea of Actualneurosis, he does not have a dynamic psychology but a nature psychology like that of Reich or Perls, in which need is primary while wish is derivative and dispensable when need is met. Despite its surface similarity to Freud's ideas, Janov's theory lacks a strictly psychological account of the unconscious and belief in infantile sexuality. While for Freud there was a hierarchy of danger situations, for Janov the key event in the child's life is awareness that the parents do not love it. Janov writes that primal therapy has in some ways returned to Freud's early ideas and techniques.
Frederick Crews considers Freud the key influence upon "champions of survivorship" such as Ellen Bass and Laura Davis, co-authors of The Courage to Heal, although in his view they are indebted not to classic psychoanalysis but to "the pre-psychoanalytic Freud, the one who supposedly took pity on his hysterical patients, found that they were all harboring memories of early abuse... and cured them by unknotting their repression." Crews sees Freud as having anticipated the recovered memory movement's "puritanical alarmism" by emphasizing "mechanical cause-and-effect relations between symptomatology and the premature stimulation of one body zone or another", and with pioneering its "technique of thematically matching a patient's symptom with a sexually symmetrical 'memory.'" Crews believes that Freud's confidence in accurate recall of early memories anticipates the theories of recovered memory therapists such as Lenore Terr, which in his view have led to people being wrongfully imprisoned or involved in litigation.
Ethan Watters and Richard Ofshe write that the psychodynamic conception of the mind may be at the end of its usefulness, which could affect "thousands upon thousands and therapists and their patients." They believe that due to "the massive investment the field of psychotherapy has made in the psychodynamic approach, the dying convulsions of the paradigm will not be pretty", even though uninformed or unsophisticated people may continue to accept the psychodynamic paradigm despite its lack of validity.
Research projects designed to test Freud's theories empirically have led to a vast literature on the topic. Seymour Fisher and Roger P. Greenberg concluded in 1977 that some of Freud's concepts were supported by empirical evidence. Their analysis of research literature supported Freud's concepts of oral and anal personality constellations, his account of the role of Oedipal factors in certain aspects of male personality functioning, his formulations about the relatively greater concern about loss of love in women's as compared to men's personality economy, and his views about the instigating effects of homosexual anxieties on the formation of paranoid delusions. They also found limited and equivocal support for Freud's theories about the development of homosexuality. They found that several of Freud's other theories, including his portrayal of dreams as primarily containers of secret, unconscious wishes, as well as some of his views about the psychodynamics of women, were either not supported or contradicted by research. Reviewing the issues again in 1996, they concluded that much experimental data relevant to Freud's work exists, and supports some of his major ideas and theories. Fisher and Greenberg's similar conclusions in their more extensive earlier volume on experimental studies have been strongly criticised for alleged methodological deficiencies by Paul Kline, who writes that they "accept results at their face value with almost no consideration of methodological adequacy", and by Edward Erwin.
Other viewpoints include that of Hans Eysenck, who believes that Freud set back the study of psychology and psychiatry "by something like fifty years or more", and that of Malcolm Macmillan, who concluded that "Freud's method is not capable of yielding objective data about mental processes". Morris Eagle states that it has been "demonstrated quite conclusively that because of the epistemologically contaminated status of clinical data derived from the clinical situation, such data have questionable probative value in the testing of psychoanalytic hypotheses". Richard Webster considers psychoanalysis perhaps the most complex and successful pseudoscience in history.
Allan Hobson believes that Freud, by rhetorically discrediting 19th century investigators of dreams such as Alfred Maury and the Marquis de Hervey de Saint-Denis at a time when study of the physiology of the brain was only beginning, interrupted the development of scientific dream theory for half a century. In a 1915 essay for The Journal of Abnormal Psychology, noted dream psychologist Lydiard H. Horton dismissed Freud's dream theory as "dangerously inaccurate" and claimed his approach to dream psychology "infinitely refined the guesses of earlier generations of thinkers as to the relationship of sleep-fancies to the waking life."
Karl Popper, who argued that all proper scientific theories must be potentially falsifiable, claimed that Freud's psychoanalytic theories were presented in unfalsifiable form, meaning that no experiment could ever disprove them. Adolf Grünbaum has maintained, in opposition to Popper, that many of Freud's theories are empirically testable. Whilst in agreement with Grünbaum regarding Popper, Donald Levy rejects Grünbaum's argument that therapeutic success is the empirical basis on which Freud’s theories stand or fall in that it rests on a “false dichotomy between intra- and extraclinical evidence". In his wider consideration of and response to philosophical critics of Freud’s scientific credibility Levy argues for the importance of clinical case material and the concepts related to it, notably resistance and transference, in establishing the evidentiary status of Freud's work. Crews believes that psychoanalysis has no scientific or therapeutic merit.
In a study of psychoanalysis in the United States, Nathan Hale reported on the "decline of psychoanalysis in psychiatry" during the years 1965-1985. The continuation of this trend was noted by Alan Stone: "As academic psychology becomes more 'scientific' and psychiatry more biological, psychoanalysis is being brushed aside." Paul Stepansky, while noting that psychoanalysis remains influential in the humanities, records the "vanishingly small number of psychiatric residents who choose to pursue psychoanalytic training" and the "nonanalytic backgrounds of psychiatric chairpersons at major universities" among the evidence he cites for his conclusion that "Such historical trends attest to the marginalisation of psychoanalysis within American psychiatry."
Researchers in the emerging field of neuro-psychoanalysis, founded by neuroscientist and psychoanalyst Mark Solms, have argued for Freud's theories, pointing out brain structures relating to Freudian concepts such as libido, drives, the unconscious, and repression. Solms's case frequently depends on the notion of neuro-scientific findings being "broadly consistent" with Freudian theories, rather than strict validations of those theories. More generally, the dream researcher G. William Domhoff has disputed claims of specifically Freudian dream theory being validated. There has also been criticism of the very concept of neuro-psychoanalysis by psychoanalysts. Neuroscientist and Nobel laureate Eric Kandel argues that "psychoanalysis still represents the most coherent and intellectually satisfying view of the mind."
Psychoanalysis has been interpreted as both radical and conservative. By the 1940s, it had come to be seen as conservative by the European and American intellectual community. Critics outside the psychoanalytic movement, whether on the political left or right, saw Freud as a conservative. Fromm had argued that several aspects of psychoanalytic theory served the interests of political reaction in his The Fear of Freedom (1942), an assessment confirmed by sympathetic writers on the right. Philip Rieff's Freud: The Mind of the Moralist (1959) portrayed Freud as a man who urged men to make the best of an inevitably unhappy fate, and admirable for that reason. Three books published in the 1950s challenged the then prevailing interpretation of Freud as a conservative: Herbert Marcuse's Eros and Civilization (1955), Lionel Trilling's Freud and the Crisis of Our Culture, and Norman O. Brown's Life Against Death (1959). Eros and Civilization helped make the idea that Freud and Marx were addressing similar questions from different perspectives credible to the left. Marcuse criticized neo-Freudian revisionism for discarding seemingly pessimistic theories such as the death instinct, arguing that they could be turned in a utopian direction. Freud's theories also influenced the Frankfurt School and critical theory as a whole.
Freud has been compared to Marx by Reich, who saw Freud's importance for psychiatry as parallel to that of Marx for economics, and by Paul Robinson, who sees Freud as a revolutionary whose contributions to twentieth century thought are comparable in importance to Marx's contributions to nineteenth century thought. Fromm calls Freud, Marx, and Einstein the "architects of the modern age", but rejects the idea that Marx and Freud were equally significant, arguing that Marx was both far more historically important and a finer thinker. Fromm nevertheless credits Freud with permanently changing the way human nature is understood. Gilles Deleuze and Félix Guattari write in Anti-Oedipus (1972) that psychoanalysis resembles the Russian Revolution in that it became corrupted almost from the beginning. They believe this began with Freud's development of the theory of the Oedipus complex, which they see as idealist.
Jean-Paul Sartre critiques Freud's theory of the unconscious in Being and Nothingness, claiming that consciousness is essentially self-conscious. Sartre also attempts to adapt some of Freud's ideas to his own account of human life, and thereby develop an "existential psychoanalysis" in which causal categories are replaced by teleological categories. Maurice Merleau-Ponty considers Freud to be one of the anticipators of phenomenology, while Theodor W. Adorno considers Edmund Husserl, the founder of phenomenology, to be Freud's philosophical opposite, writing that Husserl's polemic against psychologism could have been directed against psychoanalysis. Paul Ricœur sees Freud as a master of the "school of suspicion", alongside Marx and Nietzsche. Ricœur and Jürgen Habermas have helped create a "hermeneutic version of Freud", one which "claimed him as the most significant progenitor of the shift from an objectifying, empiricist understanding of the human realm to one stressing subjectivity and interpretation." Louis Althusser drew on Freud's concept of overdetermination for his reinterpretation of Marx's Capital. Jean-François Lyotard developed a theory of the unconscious that reverses Freud's account of the dream-work: for Lyotard, the unconscious is a force whose intensity is manifest via disfiguration rather than condensation. Jacques Derrida finds Freud to be both a late figure in the history of western metaphysics and, with Nietzsche and Heidegger, a precursor of his own brand of radicalism.
Several scholars see Freud as parallel to Plato, writing that they hold nearly the same theory of dreams and have similar theories of the tripartite structure of the human soul or personality, even if the hierarchy between the parts of the soul is almost reversed. Ernest Gellner argues that Freud's theories are an inversion of Plato's. Whereas Plato saw a hierarchy inherent in the nature of reality, and relied upon it to validate norms, Freud was a naturalist who could not follow such an approach. Both men's theories drew a parallel between the structure of the human mind and that of society, but while Plato wanted to strengthen the super-ego, which corresponded to the aristocracy, Freud wanted to strengthen the ego, which corresponded to the middle class. Michel Foucault writes that Plato and Freud meant different things when they claimed that dreams fulfill desires, since the meaning of a statement depends on its relation to other propositions.
Paul Vitz compares Freudian psychoanalysis to Thomism, noting St. Thomas's belief in the existence of an "unconscious consciousness" and his "frequent use of the word and concept 'libido' - sometimes in a more specific sense than Freud, but always in a manner in agreement with the Freudian use." Vitz suggests that Freud may have been unaware that his theory of the unconscious was reminiscent of Aquinas. Bernard Williams writes that there has been hope that some psychoanalytical theories may "support some ethical conception as a necessary part of human happiness", but that in some cases the theories appear to support such hopes because they themselves involve ethical thought. In his view, while such theories may be better as channels of individual help because of their ethical basis, it disqualifies them from providing a basis for ethics.
Literary critic Harold Bloom has been influenced by Freud. Camille Paglia has also been influenced by Freud, whom she calls "Nietzsche's heir" and one of the greatest sexual psychologists in literature, but has rejected the scientific status of his work in her Sexual Personae, writing, "Freud has no rivals among his successors because they think he wrote science, when in fact he wrote art."
The decline in Freud's reputation has been attributed partly to the revival of feminism. Simone de Beauvoir criticizes psychoanalysis from an existentialist standpoint in The Second Sex, arguing that Freud saw an "original superiority" in the male that is in reality socially induced. Betty Friedan criticizes Freud and what she considered his Victorian view of women in The Feminine Mystique. Freud's concept of penis envy was attacked by Kate Millett, whose Sexual Politics accused him of confusion and oversights. Naomi Weisstein writes that Freud and his followers erroneously thought that his "years of intensive clinical experience" added up to scientific rigor. Freud is also criticized by Shulamith Firestone and Eva Figes. In The Dialectic of Sex, Firestone argues that Freud was a "poet" who produced metaphors rather than literal truths; in her view, Freud, like feminists, recognized that sexuality was the crucial problem of modern life, but ignored the social context and failed to question society itself. Firestone interprets Freudian "metaphors" in terms of the literal facts of power within the family. Figes tries in Patriarchal Attitudes to place Freud within a "history of ideas". Juliet Mitchell defends Freud against his feminist critics in Psychoanalysis and Feminism, accusing them of misreading him and misunderstanding the implications of psychoanalytic theory for feminism. Mitchell helped introduce English-speaking feminists to Lacan. Mitchell is criticized by Jane Gallop in The Daughter's Seduction. Gallop compliments Mitchell for her criticism of "the distortions inflicted by feminists upon Freud's text and his discoveries", but finds her treatment of Lacanian theory lacking.
Some French feminists, among them Julia Kristeva and Luce Irigaray, have been influenced by Freud as interpreted by Lacan. Irigaray has produced a theoretical challenge to Freud and Lacan, using their theories against them to put forward a "psychoanalytic explanation for theoretical bias". Irigaray claims that "the cultural unconscious only recognizes the male sex", and "details the effects of this unconscious belief on accounts of the psychology of women". Feminist scholars such as Ranjana Khanna and Elizabeth Grosz have used Freud's work to try to create an understanding of sexual difference that accounts for the materiality of the body without reifying the biological and the neurological. They suggest that psychoanalysis can be put to work in ways which challenge anti-biologism and its reinforcement of binary oppositions such as human/animal, nature/the social, empirical reality/interpretation and man/woman.
Carol Gilligan writes that "The penchant of developmental theorists to project a masculine image, and one that appears frightening to women, goes back at least to Freud." She sees Freud's criticism of women's sense of justice reappearing in the work of Jean Piaget and Lawrence Kohlberg. Gilligan notes that Nancy Chodorow, in contrast to Freud, attributes sexual difference not to anatomy but to the fact that male and female children have different early social environments. Chodorow, writing against the masculine bias of psychoanalysis, "replaces Freud's negative and derivative description of female psychology with a positive and direct account of her own."