The Applied Science of Psychoanalytic Therapy

In my previous post, I discussed essential concepts of Sigmund Freud’s theory of psychoanalysis, that is, his basic science. This month I want to present the practice or applied science of psychoanalytic therapy.
 
Engineers presuppose fundamental concepts of physics and chemistry, along with additional concepts unique to their specialty. Subsequently they apply all of this knowledge to specific cases to build particular, concrete machines and particular, distinct bridges to enhance human life. History, the concretes of a specific case, as well as theory, the universals of the science, are both involved in the practical application of concepts to achieve a specific goal.
 
Similarly, psychoanalytic therapists take Freud’s basic concepts of psychoanalysis, along with specific knowledge of each patient’s personality, character, and history, and apply these notions to help the individual patient become more independent and happy.
 
The essence of psychoanalytic therapy, according to Freud, is the process of talk therapy with the goal of making the unconscious conscious. It means unearthing or digging deep—he often uses archeology as a metaphor for psychotherapy—in the unconscious to find repressed ideas associated with disturbing events and to encourage the patient to re-experience the original emotions. This “abreaction,” which I suggested in my October post was an early form of derepression, became less important (33-34, 219) in Freud’s later years when he began to put more emphasis on the patient’s effort of overcoming resistance to recall and talk about what was painful and repressed.
 
The treatment method of talk therapy, as I mentioned last month, was learned from Josef Breuer (30) who encouraged his patient Anna O. to reminisce about early disturbing experiences that might have led to her conversion hysteria (paralyzed arm among other psychosomatic ailments). In the process of this therapy she said jokingly that she was chimney sweeping, but more seriously described the method as the talking cure. In the early years, Breuer and Freud called this the cathartic method, a cleansing or purifying of the soul. For some years, Freud used hypnosis to overcome resistance, gradually abandoning it in favor of the talk method of finding connections to early and forgotten events, thoughts, and emotions.
 
In the last two sentences of Lecture 31 in Freud’s 1933 New Introductory Lectures on Psycho-Analysis, he writes, “Where it was, there should become I. [Therapeutic effort] is a cultural achievement somewhat like the draining of the Zuyder Zee” (translation Bruno Bettelheim, 61, 62, my italics). That is, just as the Dutch reclaimed land from the sea, so also therapists help patients reclaim their conscious souls (the I) from the unconscious it.*
 
An important concept of therapy that Freud discovered by chance was transference, the idea that patients, as they improve, begin to associate the therapist with an important person from childhood, usually a parent, thus transferring their feelings about this person, both good and bad, to the therapist (An Outline of Psychoanalysis, 29-32). Often the patients feel an unconditional love (which Carl Rogers, 61-62, in later years called an “unconditional positive regard”) from the therapist that they likely did not experience from their parents. Sometimes, though, anger and hostility may be felt, depending on the type of childhood the patient experienced. And on occasion a patient of the opposite sex may fall in love with the therapist—one young female patient flung her arms around Freud’s neck, convinced that they were in love with each other, and Breuer’s patient, Anna O, at the end of her treatment persuaded herself that she was carrying his baby!
 
Once Freud identified these transference reactions, he identified their value in therapy. Once the patient realizes these feelings toward the therapist are displacements, the patient becomes more motivated to overcome resistance to probe more deeply into the unconscious to identify forgotten, repressed thoughts and feelings.**
 
The applied science of psychotherapy as developed and practiced by Freud does not differ much from what nearly all psychologists and psychiatrists do today. Freud’s so-called free association is more of a probing of the patient’s subconscious in an uncritical, unjudgmental manner to encourage thoughts and emotions to rise to consciousness. Freud’s technique, as becomes clear in his many discussions of therapy, is not the caricature we sometimes see today with the therapist saying repeatedly, “uh-huh, uh-huh,” and not much else. In fact, Freud often explores a patient’s line of thought and offers hypotheses about earlier unconscious ideation. His goal, after all, is to help patients gain or regain their independence—Freud’s word (Outline, 26).
 
The Freudian couch? Initially a gift from a patient in 1890; the carpet covering added by Freud “gave his patients a non-medical bed to lie on” and “the sense of being sheltered from one’s daily cares.” In addition, many patients were female and in his day understandably uncomfortable talking about sex while looking at a man. Freud also did not want his patients attempting to read his facial expressions, nor did her take notes, which he believed to be distracting.
 
Free association? Einfall, according to Bettelheim (94-96), a word that  means sudden or chance idea or thought, would lead Freud to ask, “What comes to mind?” or “What is connected with that?” Freie assoziation were words used by Freud only after the technique had become established and then Einfall was described and translated into English as such. The modifier “free” or  freie, Bettelheim writes, puts too much emphasis on the need for conscious effort, rather than emotional spontaneity coming from the unconscious.
 
The fundamental rule of psychoanalytic therapy, as Freud refers to it, is that nothing is off the table for discussion (Outline, 28-29). Whatever connections come to mind, including especially painful, nonsensical, or allegedly unimportant, thoughts must be expressed while on the couch. This includes the content and memory of dreams.
 
 
Assessment of Freud. Contributions to psychology? Nearly everything—from the nature of the conscious and subconscious mind to the cause of neurosis and its treatment in therapy. Talk therapy today is the dominant technique of psychotherapists (unless, unfortunately, they are the psychiatrists who prescribe psychotropic drugs to allegedly treat and cure psychological problems). What else would therapists do but talk to their patients? What nearly all today do not do is mention the words introspection, free will, or the sub- or unconscious, the former two because they are afraid of being accused of being “unscientific” or even religious, the latter, unless they are psychoanalysts, of being accused of Freudianism.
 
Over the years, ideation has become more explicit as thinking errors in cognitive psychology and in the work of Yochelson and Samenow on the criminal personality. It has become more precise as core evaluations in the psychology of Edith Packer (chap. 1).
 
As for Freud’s alleged weak ego—the I—let me quote him in Inhibition, Symptom, and Fear (162).*** In this work, Freud points out the “numerous voices” (other psychoanalysts) who seem to want to make the so-called weakness of the I one of the “central pillars” of psychoanalysis. Freud responds: “Shouldn’t their sheer awareness of how repression actually works deter psychoanalysts in particular from so enthusiastically embracing such an extreme and partisan position?” The whole point of therapy being to reclaim and support the I.
 
What does impinge on and reduce the power of the conscious mind to control our lives is Freud’s determinism. His search for non-volitional causes of behavior is what I believe led him to focus heavily on the drives, rather than ideation, and specifically on the alleged death or destructiveness drive to explain the harmful and detrimental behavior of his patients. Though the notion of a strong unconscious has a long history, going back to Plato, free will is what enables us to learn how to introspect to explain and change our feelings deriving from an un- (or sub-) conscious “chaos” or “cauldron full of seething excitations,” as Freud describes it (New Introductory Lectures, 91). The chaos is something we have put there, and this means we can, through introspection, clean up the mess.
 
With good parenting and teaching, one would hope, psychology of the future will help prevent the mess from occurring in the first place.
 
 
* The standard translation (100) of the first sentence is “Where id was, there ego shall be.” Or, as I rephrased it in an updated form in Independent Judgment and Introspection (176), using the psychology of Edith Packer, “Where subconscious, mistaken conclusions were, there confident and independent self-assertion shall guide.” See Bettelheim’s discussion (61-64) of Goethe’s Faust, which Freud knew well, and Faust’s struggles to reclaim his soul from the devil—an apt analogy to describe what many of Freud’s patient’s felt, and most likely, what many patients today feel.
 
** Edith Packer minimized the value of transference, but did describe herself as a “friend for hire,” which I would say was a strong motivating force for patients who likely, at the time, did not have many good, that is, understanding and helpful, friends.
 
*** This 2003 translation uses the word “fear” instead of the customary “anxiety” because, the translator notes, it is the typical German meaning of Angst. When Freud means anxiety, he uses the word Ängstlichkeit or Angstneurose for anxiety neurosis (note 3, 264-65).
 
 
Postscript to Students of Ayn Rand. I regret having to make the following comment about Ayn Rand and Leonard Peikoff. I see no evidence that either one read much or any of Sigmund Freud. Rand wrote that Freud was one of Europe’s “hand-me-downs” and Peikoff caricatured Freud’s view of man as an “ordure [excrement]-strewn pervert.” I believe that this post and my previous six about Freud speak for themselves. Ayn Rand said to both Nathaniel Branden and Edith Packer that she did not know anything about psychology. Having known Dr. Peikoff for many years, I do not believe he knows much about it either. A strong infusion of psychology into Ayn Rand’s philosophy is desperately needed today.

Reading Freud: In General and in English Translation in Particular

Reading Sigmund Freud is a challenge, something I have been doing for several months. One reason is his approach to the science of psychology and a second is the English translations.
 
Freud was trained as a medical doctor specializing in neurophysiology at the University of Vienna, though in his first year he attended the lectures of Aristotelian scholar Franz Brentano and was influenced by him. As a young man, Freud worked six years in a physiology lab and three more in a hospital where he focused on cerebral anatomy. In 1886, at age 30, he opened his medical practice and began treating patients for psychological problems. He did not close the practice until shortly before his death in 1939.
 
In 1895, Freud drafted a “Project for a Scientific Psychology,” premised entirely on neurophysiology, but it was never completed or published in his lifetime, most likely because his treatment of patients convinced him of the need to view psychology as a mental science. While Freud in his mature and later life was neither a materialist nor a reductionist, some neurophysiological jargon permeates his work, such as charge and discharge of energy, excitation, and innervation. He was a determinist his entire life, but the reader can overcome this obstacle by focusing on his conceptualizations of psychology and his methods of therapy.
 
The worst challenge in reading Freud is the translations. I do not know German, though I have frequently consulted several online and printed German-English dictionaries, and occasionally have looked at this website, freud2lacan.com, where many of Freud’s works are posted as bilingual texts, English on one side of the page, German on the other.
 
My references for criticism of the translations are three native German speakers: philosopher Walter Kaufmann (20-27), Austrian-born psychologist Bruno Bettelheim (all of his 112-page book, Freud and Man’s Soul), and Freud biographer Peter Gay (465-66). The three overlap in their critiques, though Bettelheim’s is the most extensive.
 
I will focus on mistranslations and neologisms, but let me first give Kaufmann credit for setting the tone by asserting that the English translations of philosopher Immanuel Kant improve Kant’s writing style (!), while the translations of Freud make him worse. He also says that Freud’s “style is so colorful that the best translations often cannot be more adequate than black-and-white photographs of great paintings.”
 
Kaufmann goes on to cite Peter Gay (see footnote in my August post) who said the translations make Freud more diffuse and verbose (prolix) and gentrified, scholarly, academic (genteel) than he really is. The word in my mind is sterile.*
 
Bettelheim (5-8, 108) says the translations make Freud impersonal and abstract with Latinized and Greekized words and sometimes translate him in the passive voice when Freud uses the active. Freud is even made to sound behavioristic, apparently in order to make him more “scientific,” which in philosophic terms means more positivistic, which Freud was not!
 
Bettelheim became aware of the problems with the English translations when he was at the University of Chicago’s Orthogenic School from 1944-73. His staff and students, as non-German speakers, read Freud in English, which made them view him and psychoanalysis “at a distance.”
 
The most egregious (my word) mistranslation is of the German word trieb, translated throughout as “instinct.” The real meaning is drive, the urge to act when a need is not being satisfied. The hunger drive is offered by Freud as analogous to his life and death drives. (More on these next month). Freud rarely uses the German equivalent for instinct (instinkt) and only to refer to the alleged automatic knowledge that guides animal behavior.**
 
The use of “instinct” makes Freud look unscientific and an advocate of innate knowledge. Freud uses the term “drive” as a cause that “makes somatic demands upon the mind,” but these demands are changeable and compete with one another (An Outline of Psycho-Analysis, 17). They are not instincts.
 
Indeed, Bettelheim (105) insists that the title of Instincts and Their Vicissitudes, one of Freud’s later works in English, should be translated as “Drives and Their Mutability.”
 
The most egregious neologism—this time “egregious” is Peter Gay’s word—is the Greek import  cathexis. Freud wrote using common German words, Besetzung being one of them with many connotations. The meaning of the word as Freud used it is occupation, as in military occupation. It is sometimes translated in other languages as load or investment (of emotion). Freud suggested the word “interest,” and in the 1926 Britannica.com summary of psychoanalysis, written by Freud, the words “affective charge” are used. Besetzung is a term of value and emotion and the “occupation” is a quantity—high or low, strong or weak—of emotional energy.
 
Thus, I might say I am highly “cathected” in the family dog, or rather, “occupied” with a lot of value and emotion in him. My brain, however, still freezes when I come upon cathexis or any of its word forms (hypercathexis, anticathexis, etc.) in the translations. I must pause to review the context of the word before continuing.
 
Another neologism, parapraxis, can be dispensed with quickly. Fehlleistungen means faulty action or achievement, or in common English parlance Freudian slip—of the tongue, pen, memory. Why the Greek?
 
Other mistranslations (Bettelheim, chap. 8): id, ego, and superego in German are das Es, das Ich, and das Über-Ich. They should be what they are, and are so translated in the French and Spanish editions, the it, the I, and the upper-I. “The it,” a word used by Friedrich Nietzsche and a contemporary physician of Freud’s, was chosen to describe the unconscious because Freud’s patients would say something like, “It got me again” or “It makes life unbearable.” “The I,” in German can mean the self or personality; “self” is the word I substitute when reading the English. Über can mean above or over, but I like Bettelheim’s “upper-I,” because it emphasizes that our conscience is a part of our minds (implying that we put it there), not some compartment separate from the self or mind. The Latinizations make Freud and our understanding of the mind sterile. Cold technical jargon, as Bettelheim says (53).
 
Though many more mistranslations can be found in Bettelheim’s book (chap. 10) and in Independent Judgment and Introspection (81n56), one final one is for the subject of psychology as Freud discusses it. The German word is Seele, which means soul, and Seele, Freud points out, is the German translation of the Greek word for soul, psyche. Thus, psychology is the science of the soul, not mind or consciousness, though it can include both, and soul is neither immortal nor related to religion. For Freud, according to Bettelheim (77), soul means “that which is most valuable in man while he is alive.” It is not just the seat of reason, but also, and perhaps more importantly, the seat of emotion. It defines who we are and what motivates us.***
 
To conclude and say something positive about the translations, James Strachey was editor and translator of what is called the Standard Edition of the Complete Psychological Works of Sigmund Freud. It was a major accomplishment, twenty-four volumes published between 1953 and 1974, every volume with an excellent index and an abundance of footnotes and bracketed comments that explain, for example, someone from Freud’s era whom we would not today recognize. It is still the most significant scholarly work in English on Freud. There is supposedly a “Revised Standard Edition” coming out soon, but I have not yet seen it.
 
Next month, “Freud as Scientist.”
 
 
* Kaufmann, I should further point out, makes it clear that Freud was neither dogmatic nor intolerant. The smears against him, aside from much suspicion, laughter, outrage, and disgust thrown at psychoanalysis by the local Viennese who had not read him, derive from the resentments and complaints of Freud’s former devotees, Alfred Adler and Carl Jung (Kaufmann, 195-204, 325-50). The former, in particular, referred to psychoanalysis as “filth and fecal matter” (Kaufmann, 199). Gay (410) acknowledges that Freud is a “determinist, [but] not a fatalist,” a reference to the misunderstanding that we are allegedly and completely controlled by the unconscious, which ignores Freuds frequent assertions that in therapy the unconscious must be made conscious.
 
** Today, the concept “instinct” should be dispensed with as invalid. Biologists have made great progress in explaining animal behavior, whether it is how to hunt (they learn from their parents, siblings, or by trial-and-error), to migrate to warmer weather (birds use information from the sun, stars, and magnetic field), or to find their way home (cats use the magnetic field and scent).
 
*** After completing this essay, I discovered H. F. Brull’s excellent 1975 paper, “A Reconsideration of Some Translations of Sigmund Freud.” A native German speaker, born in Berlin, Brull at age twelve, in 1933, emigrated to the United States. For most of his career he was a social worker with children and high school students. Brull asserts that psychoanalysis is “at once a scientific method for investigating the mind of man and a therapy for tortured souls.” I will be referring to this paper more in a later post.
 
And the more I read Freud, the more I discover additional criticisms of the standard translations, as well as improved contemporary ones (published within the last twenty-five years). Here are two: Beyond the Pleasure Principle and Other Writings (2003) and The Penguin Freud Reader (2006).

Freud on Neurosis and Psychotherapy as Illustrated in the Little Hans Case

The aim of psychotherapy, according to Sigmund Freud, is to make the unconscious conscious by uncovering repressed ideation, that is, ideas associated with the emotion of a triggering or traumatic event, and verbalizing the repressed ideas while also reexperiencing or reliving the emotions that were displaced to a symptom or symptoms. The process is called abreaction in the English translation.*
 
Psychological problems—neurosis—often result from repressed childhood injury, Freud discovered, but may also occur later in life. And not all such problems result from sexual trauma as a child, a view called “pan-sexualism,” which Freud’s critics accuse him of saying. (See Freud’s denial in Three Essays on the Theory of Sexuality, preface to fourth edition and elsewhere).
 
Freud wrote several case histories to exhibit his method of therapy, as well as his theory of the causes and cures of neurotic symptoms. Let me illustrate this with a summary of his “Little Hans” case about a five-year-old boy with a phobia of horses. The case was published in 1909.
 
Though Freud only met with the boy once, when he was not quite five, the case is an excellent example of why he thought psychoanalysts do not need to have an MD degree to practice psychoanalysis, which many of his medical critics thought, including especially American physicians.**
 
The parents in this case were not medical doctors, though they knew Freud. The father of Hans attended Freud’s Wednesday night group (which in 1910 became the Vienna Psychoanalytic Society) and Hans’s mother had been Freud’s patient. They were both encouraged by Freud to use minimal coercion in their parenting and neither laugh at nor bully Hans about his phobia. The father conducted most of the analysis by asking non-judgmental questions, taking Hans’s answers seriously, and sending letters with the answers to Freud. This occurred over the first five months of 1908 before and after Hans turned five.
 
Hans’s main symptom was the phobia of horses, which began as an anxiety of unknown origin while walking in the street with his father. At the time he wanted to go home to “coax” (cuddle) with his mother. On another occasion while walking with his mother, he became afraid that a white horse would bite him.  Upon questioning by his father, Hans recalled an event  some time earlier when he witnessed a large work horse fall and “make a row” with its feet. This frightened Hans considerably as he thought the horse might be dead. Subsequently, in early 1908, Hans was hesitant to go out into the busy street in front of his home where many horse-drawn carts and coaches would be seen. His anxiety had transformed into a mature phobia of horses.
 
The emotions of anxiety and fright that became the phobia are displacements from the repressed cause, according to Freud. Let us explore the possibilities. There were several.
 
From the age of three, Hans, like most boys his age, became interested in his “widdler” (penis, or wiwimacher in the German) and “widdling.” He also naturally became fascinated by the widdlers of others, including those of animals, and curious about whether his baby sister and mother had widdlers. He was especially fascinated by the largeness of the widdlers of giraffes and horses. He liked touching his.
 
At about three-and-a-half, his mother (apparently reverting to older methods of parenting) saw him in this activity and told him that if he keeps touching it she will call the doctor to have it cut off. Because it was implied by his mother that this “activity” was naughty and dirty, Hans acquired what Freud calls a castration complex with the fears becoming repressed. This was also about the time his sister Hanna was born, of whom he soon became jealous.
 
Other issues were relevant. His parents, unfortunately, told him that his baby sister was delivered by stork, which led to speculation of how that happens. More particularly, when it became obvious that babies somehow come from the mother, Hans wondered how. From the mom’s rear end, for example?
 
Freud was critical of the parents for not informing Hans about the differences in sex organs of boys and girls and for not enlightening him about sexual intercourse between his mother and father. This last is important for Freud because he found that children who witness or hear their parents having sex usually conclude that it is an act of violence with the dad harming the mother. Freud concluded that if the parents had been more open about these two issues, the phobia of Hans could have been resolved more quickly. According to the father, Hans never witnessed his parents having sex—although he did sleep in their bed until he was four.
 
The central issue for Hans revolves around what Freud calls the Oedipal complex, which does not mean that five-year old boys want to have sexual intercourse with their mothers. It is metaphor summing up common issues that arise between children and their parents, especially when there is an attachment to the mother and lesser feeling toward, and in some cases alienation from, the father. The Oedipal myth is about self-discovery, which is what psychoanalytic therapy is about.
 
Hans did show more attachment to his mother than to his father, but Hans’s dad was unusual—for dads then and now—by being so lovingly interested in and patient to help Hans with his phobia, or “nonsense,” as Hans referred to it, talking to him about widdlers, babies (his sister), large and small animals (and their widdlers), and often encouraging him to go out to the street where horses could be seen to test his “nonsense.” That Hans was aware of his nonsense as an issue indicates his eagerness to seek a remedy.
 
Sometimes, when the family was on summer vacation away from Vienna, the dad would have to return to the city for business. Hans once said, “When you’re away, I’m afraid you’re not coming home,” which was then followed by a benevolent emphasis by his father that he always comes home.
 
The attachment to his mother is shown as follows. The “seduction” scene, as Freud refers to it, using the word broadly, not literally, occurred when Hans’s mother was giving him a bath and he said to her, “Why don’t you put your finger there?” (on his widdler). His mother responded that that would be piggish and improper. On another occasion, which Freud describes as a second seduction, Hans said to his mother that his aunt recently said that he has a “dear little thin­­-gummy.” And once after an anxiety dream, Hans awoke crying, “I thought you were gone and I had no Mummy to coax with.” In addition to these issues of attachment to his mother, Hans was not able to see her during her confinement (last several weeks) of pregnancy. Much of this came out during the Q&A sessions with his father.
 
In early April, 1908, Hans and his father paid a brief visit to Freud. Observing the two sitting opposite him and listening to Hans describe how he disliked the black thing around the horses’ mouths (the bridle strap above the nose that usually holds a metal bit for control), Freud made a connection between the bridle and the father’s black mustache. Freud said that because Hans is so fond of his mother, he must think his father is angry with him. The father responded by asking why Hans would think such a thing, since he, the father, had never scolded or hit him. But yes, Hans intervened, you did hit me once, which happened as a reflex hit after Hans had head butted him in the stomach!
 
After this short visit to Freud, the father reported that Hans’s phobia began to retreat, as Hans was more open to talking about his repressed wishes. Many additional concrete details that cannot be summarized here, including associations between his feelings toward horses and his feelings toward his parents, followed in Hans’s life, but more intimate Q&A sessions occurred between Hans and his father, such as: Do you wish your sister had not been born? And on a different occasion, do you wish she would fall into the bath water and die? Both answers were yes, the psychological meaning being that his sister was robbing him of his parents’ love. And such an occurrence (her death) would leave more time for him to spend with his mother.
 
These verbalizations about his sister, father and mother, and his widdler (the castration complex) constitute the ideation Freud talks about that led to a gradual melting of his symptoms of anxiety and fright of horses.
 
Near the end of this period, Hans experienced and talked about a number of fantasies with his father, including his wish to marry his mummy and, sometimes, his wish that his father would go away. One day, Hans’s father saw him playing with imaginary children and said to him that boys cannot have children to which Hans responded, “I know. I was their Mummy before, now I’m their Daddy.” Who’s their Mummy? the father asked. “Mummy, and you’re their Grandaddy” (Freud’s italics).
 
To this, Freud concluded, “The little Oedipus had found a happier solution than that prescribed by destiny” (for Oedipus the King). Hans’s father wrote to Freud shortly afterwards, “A trace of his disorder still persists, though it is no longer in the shape of fear.”
 
It was the content of the Q&A sessions with the father, as well as the comments made by Freud during the visit with him, that constitute the ideation associated with Hans’s emotions, the emotions that troubled him sufficiently to transform them into a fear of horses. And it was this ideation that Freud asserts is necessary to be made explicit and conscious (which in an adult would likely have long since been deeply repressed). The various expressions in Hans’s words of his fears and anxieties were the “abreactions” Freud refers to as being essential for successful therapy. The job performed by Hans’s father got Hans to bring out or “work off and get rid of” the ideas and emotions of the triggering events, which then encouraged the displaced emotions in the symptoms to melt away.
 
Hans’s father was Max Graf (1873–1958), a Viennese musicologist. Hans was Herbert Graf (1903–73), a highly successful opera producer and director, including twenty-four years between 1936 and 1960 at the Metropolitan Opera in New York City (read interview in Opera News, 1972). At age nineteen, Herbert visited Freud, who described him as a “strapping youth” who seemed to have survived “puberty without any damage” and, though his parents had divorced and remarried, kept his emotional life intact by going through “one of the severest of ordeals” (the divorce).
 
In this post, I have deliberately used a minimum of Freud’s technical terms, including especially the many questionable English translations. Next month, I will address the challenge of reading Freud in general and in specific the English translations.
 
 
* Freud’s word in German is abreagieren, which means to work off or get rid of. As mentioned in the first post in this series, I prefer the word subconscious to Freud’s “un-,” but when quoting or citing Freud will use unconscious. I consider them similar, though not synonymous. Abreaction in modern terms seems close to derepression.
 
** From 1926–32, American psychoanalysts succeeded in getting a law passed making it illegal for anyone to practice psychoanalysis without the MD degree (Bettelheim, 33–34). Today, a master’s degree is the minimum, but a degree with “doctor” in it is still preferred. In 1926 Freud wrote The Question of Lay Analysis to argue why laypersons (non-doctors) should be allowed to practice his method and theory.