I was nervous about seeing the recently released film A Dangerous Method by David Cronenberg. Having spent much of the past ten years trying to demonstrate that psychoanalysis is modern, intellectually sound and more apt to be interested in psychological development and relationships than sex, I was really alarmed by the movie's trailer, which portrayed psychoanalytic patients (in the form of a screaming and muscularly contorted Keira Knightly) out to be screaming meemies due to their repressed sexual drives.

I was relieved to see that the film was merely dull, and not too damaging to the efforts many of us have been making as psychoanalysts to explain what our field really is about and what it has to offer. I can't think of any other endeavor that is so frequently assumed to have been stuck in a time warp, with the same ideas and procedures that belonged to its its founders 100 plus years ago.

Drs. Freud and Jung, played by Vitto Mortenstern and Michael Fassbender respectively, are singularly uncharismatic and stiff. Granted, using charisma to treat patients is a really bad idea, since it exploits the transference and substitutes manipulation for understanding. However, a certain amount of vitality in the therapist is necessary for a patient to feel connected and develop her own kind of engagement and vitality.

The film seems to suggest that Freud and Jung's personal rigidity and, well dullness, are due to sexual repression. Or at least the movie is presenting this as a historical view. In any case, we now know in psychoanalysis that constriction of the personality, lack of vitality, and just plain being boring have far more complicated causes than sexual repression. Today's psychoanalyst looks for multiple causes of such personality inhibitions including early attachment problems, trauma history, constricting fantasies, anxiety and a host of other potentially causal themes.

Jung himself, in the film, is deeply disturbed by Freud's reducing everything to sex and repression. Jung is right to insist that there has to be more to the genesis of human misery and the development of distinct personalities. But unfortunately he heads off in directions of mysticism and synchronicity that presage New Age thinking but aren't that helpful to those of us who want to help suffering patients, or understand humans better without mystical leaps.

One brief scene in the movie captures the true excitement of psychoanalysis. Sabina Spielrein (Keira Knightly) is visiting Dr. Freud in Vienna and passionately argues for her discovery that sex involves destruction of the separate selves, out of which something new is born, not just the pursuit of the pleasure principle as Freud had posited.

Freud listen's to Spielren's original ideas without breakong out of his commitment to avoiding any appearance of vitality

Freud listens and gives her halfhearted approval for her innovative thinking. In reality he goes on to develop the death instinct, and one gets the impression in the movie he's about to steal Spielrein's ideas.

Spielrein's idea is interesting, and pretty modern. But more important is her excitement. That's what it feels like in psychoanalysis when we're at our best-subtle discoveries of the stories and themes that guide people unconsciously. These discoveries, which occur in clinical sessions, in observation of human behavior, or working out a theory for a paper or article lead to immense excitement and a feeling of creativity and discovery that is unparalleled. A good psychoanalyst today does not impose a narrow theory on a patient, except the general belief there is a great deal of ones psychological life that is hidden and unconscious. Instead like Speilrein we share the infectious excitement of discovery and welcome the patient's search for the meaning of his or her own psyche.

About the Author

Prudence Gourguechon, M.D.

Prudence Gourguechon, M.D., served as President of the American Psychoanalytic Association from 2008-2010. She has a clinical and consulting practice in Chicago.

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