On the Couch
On the Couch
Sigmund Freud, Reflex Therapy, and the Beginnings of Psychoanalysis
The chapter shows how Freud, working in the recesses of his apartment in Berggasse 19 in Vienna, was able to develop a new paradigm of disease and treatment that broke with central tenets of the localization tradition. Freud radicalized the associative elements of Meynert's connectivism in order to challenge the localizationist paradigm for which previously it was a support. First in On Aphasia, Freud used elements of Meynert's own system to challenge the then dominant theory of localization. Then in later works he challenged the lesion model upon which localization theory had been based. In doing so, Freud was able to re-evaluate the etiology of mental disturbance, moving from an emphasis on physical to one on psychological trauma, and he re-cast the reflex exam as a form of “talk therapy.” Freud's mature psychoanalytic practice, this chapter argues, can then be seen as the ultimate rejection of the lesion and pathological anatomical model, because by dispensing with the “cathartic method” and focusing on working through resistances, it was no longer structured by the identification and confrontation of an underlying “trauma.”
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