Is Freud ‘Old Hat’?

The imagery of therapy is still the imagery of Freud. The client lying on a couch. (That almost never happens now). The therapist, an older white male. (Although the profession today is very diverse in terms of age, gender and ethnicity).

And yet the imagery persists. But what about the ideas?

In counselling and psychology courses today, Freud is little more than a footnote. And in practice, his central teaching – that psychological issues can be traced back to events in the client’s childhood – has fallen vastly out of favour. Cognitive behavioural therapists, for example, will not look to a patient’s past at all for ways to help them.

Newer approaches, like narrative therapy, can and do look to a client’s childhood, to see how their story began.

But it’s the exception, not the norm.

The inheritor of Freud’s philosophy in today’s therapy landscape is the psychodynamic psychotherapist. This approach is the ‘update’ of Freud, if you like. It doesn’t involve multiple sessions a week, and it doesn’t involve a therapist who is deliberately distant, or who places the same importance on sexual matters as Freud did.

But unlike cognitive behaviour therapists, the psychodynamic psychotherapist will – like Freud – seek to draw connections between the client’s childhood and whatever issues they are facing today. There may also be more of a focus on the growing relationship between the client and their psychodynamic psychotherapist than there would be with cognitive behavioural therapists.

Despite its relative lack of popularity, for many conditions, there is just as much evidence for the effectiveness of what a psychodynamic psychotherapist does as is there is for the approaches taken by cognitive behaivoural therapists.

In my view, it just makes intuitive sense that problems are best solved if you uncover their root cause.

Of course, that doesn’t mean a psychodynamic approach should go needlessly rooting through irrelevant details of a client’s childhood,

Rather, it means helping a client uncover how patterns established years ago may be affecting them in ways that no longer serve them today.

I believe that psychodynamic therapy can be particularly beneficial when it’s combined with the cognitive behavioural therapists approaches that generate practical strategies which the patient can employ to make things better for themselves in the here-and-now, as well as understanding their past.

So while Freud’s ideas may need a slight ‘wardrobe refresh’, in my view he’s definitely not old hat.