Provided by David Satcher, M.D., Ph.D.
Surgeon General of the United States of America
Chapter 2
Overview of Etiology
Psychodynamic Theories
Psychodynamic theories of personality assert that behavior is
the product of underlying conflicts over which people often have scant
awareness. Sigmund Freud (1856–1939) was the towering proponent of
psychoanalytic theory, the first of the 20th-century psychodynamic theories.
Many of Freud’s followers pioneered their own psychodynamic theories, but this
section covers only psychoanalytic theory. A brief discussion of Freud’s work
contributes to a historical perspective of mental health theory and treatment
approaches.
Freud’s theory of psychoanalysis holds two major assumptions: (1) that much of
mental life is unconscious (i.e., outside awareness), and (2) that past
experiences, especially in early childhood, shape how a person feels and behaves
throughout life (Brenner, 1978).
Freud’s structural model of personality divides the personality into three
parts—the id, the ego, and the superego. The id is the unconscious part that is
the cauldron of raw drives, such as for sex or aggression. The ego, which has
conscious and unconscious elements, is the rational and reasonable part of
personality. Its role is to maintain contact with the outside world in order to
help keep the individual in touch with society. As such, the ego mediates
between the conflicting tendencies of the id and the superego. The latter is a
person’s conscience that develops early in life and is learned from parents,
teachers, and others. Like the ego, the superego has conscious and unconscious
elements (Brenner, 1978).
When all three parts of the personality are in dynamic equilibrium, the
individual is thought to be mentally healthy. However, according to
psychoanalytic theory, if the ego is unable to mediate between the id and the
superego, an imbalance would occur in the form of psychological distress and
symptoms of mental disorders. Psychoanalytic theory views symptoms as important
only in terms of expression of underlying conflicts between the parts of
personality. The theory holds that the conflicts must be understood by the
individual with the aid of the psychoanalyst who would help the person unearth
the secrets of the unconscious. This was the basis for psychoanalysis as a form
of treatment, as explained later in this chapter.
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