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"Doctor of the Mind"
Author: Meg Greene Malvasi
Published on: August 31, 1999

sigmund FreudSigmund Freud was a medical doctor of a different sort. He did not perform surgeries, give shots, or set broken limbs. Instead he focused on a part of the body that is often harder to understand and illnesses that are often harder to diagnose and treat than appendicitis, infections, or broken arms and legs. Freud was a “Doctor of the Mind.”

There are important differences between the human mind and the human brain. The brain aids thinking and learning. It enables the exercise motor control over other parts of the body such as hands and feet, arms and legs. At the same time, the brain controls involuntary functions like breathing. The mind is more sensitive. It tells us how we feel and affects how we behave. It was these kinds of feelings and behaviors that Sigmund Freud spent his life trying to understand.

When Freud began his studies of the mind in earnest, he was embarking on a journey that few others had attempted. During the nineteenth century, mental illnesswas still a mystery to most doctors. Although the medical profession had made certain improvements in the care and treatment of mental patients, for the most part doctors were still largely unsure about the causes and treatment of mental illness.

Among the most popular therapies was the use of hypnosis. By placing the patient in a state resembling deep sleep, doctors found they could sometimes distinguish ailments with a physical from those with a psychological cause. This was no easy task. Even if properly diagnosed, the patient remained dependent on the doctor to find a remedy and was often quite ignorant of the exact nature of the illness.

In 1880, Freud went to Paris to study with the celebrated French physician, Jean Martin Charcot, who was using hypnosis to study and treat patients suffering from hysteria. “Hysterics,” as they were called, manifested a wide array of symptoms that seemed to have no set pattern. Some patients acted wildly, running about, tearing at themselves, or shouting and screaming. Others, on the contrary, lost the power of speech or complained that they could not move their arms or legs. Doctors who examined these patients could find nothing physically wrong to explain their symptoms. The symptoms were real, but the illness originated in the mind. Under hypnosis, Dr. Charcot found that he could implant suggestions that enabled these patients to overcame their disabilities and behave normally. Freud could see, however, that the improvements were temporary. Once brought out of the hypnotic state, each patient exhibited the same symptoms as before. Charcot had not cured them; he had only succeeded in providing momentary relief from their suffering.

Freud noticed something else as well that ultimately proved more important than hypnosis in diagnosing and treating mental illness. When Dr. Charcot hypnotized a healthy person he could influence that person to behave like the hysteric. Moreover, when asked to recall what they had done while under hypnosis, neither the hysteric or the healthy person could do so. When hypnotized, the subjects of these experiments were completely unaware of the forces that controlled them. Perhaps, Freud thought, the afflictions of the mind were similar in that they, too, were stimulated by some hidden cause buried deep in the unconscious!

By 1888, Freud was back in Vienna, using hypnosis to treat his patients. He was, though, also trying other therapies as well. Urging his patients to lie on a couch that he had Freud's couch placed in his consulting room, Freud asked them a series of questions about when their symptoms began to appear. He discovered that some patients could recall their experiences without the use of hypnosis. This finding was a major breakthrough.

Freud now eagerly prodded his patients, asking them questions about their thoughts and feelings and how these might be connected to the physical symptoms of their illness. At last one patient told Dr. Freud to stop putting ideas in her head and instead to listen to her talk! Freud realized this patient was right. He began paying closer attention to what his patients were telling him in their own words, and did not press them with questions. With Freud’s guidance, patients could thus come to understand for themselves the origins of their problems. Once patients identified the root of their trouble, their symptoms began gradually to disappear. By using the idea of “free association,” in which the patient could say whatever they were thinking without prompting or interference, Freud finally began to undestand the complexity of the human mind.

Encouraging patients to speak freely about their fears, loves, and hatreds allowed Freud to glimpse how the unconscious influenced behavior and in many ways determined good or ill health. In developing his theory and treatment of mental illness, Freud also produced a new branch of medicine called “psychoanalysis,” which was the study of the unconscious mind. Although the public and many of his colleagues at first questioned Freud’s insights, in time his theories and therapies came to exert a vast influence over the diagnosis and treatment of mental illness.

Want To Know More? For a collection of links to learn more about Freud try Sigmund Freud and the Freud Archives. For an overview on Freud, his life, and his work visit Sigmund Freud.

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