Some of Freud’s ideas are now discredited, particularly because of social attitudes he held which are now outdated, such as his take on sexual abuse which is outrageous and unacceptable to us. In spite of his insights into the social conditioning process, he did not see how his attitudes to women and sex were culturally conditioned – ironically.

However, Freud made many significant contributions to modern thinking about what a human being is and how we operate. He brought into common usage and understanding some incredibly important building blocks of psychology that are still relevant and important in understanding the human mind.

Here is a summary of nine of Freud’s key ideas and their relevance to psychotherapy

  1. The existence of the unconscious. We take this for granted now, but before Freud this was not a commonly held understanding. This is the idea that we say one thing, but do another, that different parts of ourselves are contradictory, or that we are driven by deeper emotions, needs and conflicts which we are unaware of, or only partially aware of. Human beings are not fully logical and coherent with what they say, they are inconsistent and their motivations are confused, and Freud’s window into the unconscious enables us to grasp this.
  1. Dreams are “the royal road to the unconscious”, along with jokes, accidents, slips of the tongue, forgetting, misplacing, and other behaviours where you reveal to yourself aspects of yourself you would prefer to keep hidden, but these aspects make their presence known in vivid ways, such as “losing” your keys, “forgetting” something important or making a joke about something that is in fact a veiled form of attack
  1. He brought to our attention a thorough study of psychological defences – such as denial, projection and displacement. These defences are commonly used and easily observable in any ordinary conversation. It does not matter whether you regard Freud as irrelevant and out of date, because humans have not yet grown out of the need for psychological defences! The basic idea is that when the early environment is not optimal for a small child, they cope with this by splitting off parts of themselves outside their conscious awareness. He called this repression, For example, if when you are small you feel angry with your mother, but she rejects you when you express angry feelings, you learn to internalise angry feelings and to become nice and placatory in your behaviour, as it is simply too dangerous to you to be rejected by your mother. .However the angry part is still there, and in fact it never goes away. There is a price that we all pay, and keep on paying, for being acceptable members of our so-called civilised society, and that is the consequences of repression and the need to conform.
  1. The return of the repressed. Nothing within the psyche goes away just because it is unwanted or unacceptable. It returns later in life, in the form of mental, emotional and psychosomatic symptoms. This is the basic neurosis which affects everyone to a greater or a lesser degree, and underlies persistent symptoms such as anxiety, depression, OCD, or psychosomatic complaints where the body is used to express a psychological conflict or unmet need.Freud stated that the aim of the therapy he practised, psychoanalysis, was to replace misery with ordinary unhappiness, by revealing to the patient the unconscious source of the unpleasant symptoms that were ruining their life, and thus alleviating them. He does not say you can get rid of them entirely, but you can relate to them much better through increased awareness, insight and working this through.

    Even today, people express surprise that something that happened to them long ago still affects them, as if the passing of time could eradicate the effects. The understanding that time does not exist in the subconscious or unconscious mind, and that everything we experienced is stored in the unconscious, is helpful when symptoms become more persistent as part of the maturational and aging process.
  1. The understanding of the self in three distinct parts, the id, the ego and the superego. Nowadays we regard these various parts of the self differently, but nonetheless this understanding enabled us to begin looking at the self as a community of different aspects of self, that are generally not unified. If we were unified we would not need symptoms and behaviours that express the aspects of ourselves we either reject or are unaware of or that are divided against each other. We would not need to be in conflict with ourselves and others.
  1. The basic psychoanalytic method Freud developed is still relevant, in that in order to understand what is going on inside yourself, you need to carefully and closely observe it, in the benevolent and attentive presence of another who is training their focus on the way you operate and the inconsistencies between what you say and do, and what you actually want in life. The basic therapeutic method of benevolent attention and bringing awareness to what you yourself are not fully conscious of is the basis of many therapeutic methods today.Freud got his patients to lie down on a couch behind him, because he did not want them looking at him while he was listening, thinking and writing notes. However most psychotherapists nowadays use a face to face method instead, where they are directly relational with the patient, and they mostly do not write a lot of notes in front of the patient, which nowadays we but engage in the relationship instead.
  1. The basic ideas of transference and countertransference were developed by Freud but were made useful by the large number of practitioners who followed him and refined these ideas much further. Transference and countertransference are fundamental in any depth understanding of how a therapeutic relationship operates. The mechanism of transference exists in every relationship, whereby we are only able to see our nearest and dearest through the lens of our previous formative relationships. Even though we strongly believe that what we are experiencing is happening in the present, and can be blamed on the other person’s bad behaviour, what we are really seeing is coloured by our own emotional history. This important study developed further after Freud and became known as object relations. In this approach, psychotherapists pay special attention to the very specific feelings and experiences they have with a client, that are unique to that relationship, known as contertransference. The feelings the client has towards the therapist are known as transference. The persistence of the past in the present can also be seen when we engage in repetition compuls
  1. Repetition compulsion is a way of describing how the past persists in the present, for example repeatedly choosing partners that demonstrate behaviours similar to one of your parents, and even though you replace a partner because of this behaviour, the next one will also exhibit it once the honeymoon period is over, because you are choosing partners based upon the way they unconsciously fit with your early emotional experience.
  1. Freud began an important and detailed inquiry into identifiable stages of child development, and how an adult’s development can be delayed or affected by neglect, interruptions and intrusions in the basic psychological processes that occur in our early formative years.This basic idea is critical to what came next, the very idea that child development is an important study in its own right, and that we can influence it for the better by applying scientifically and clinically informed childbearing practices, or that damage might be able to be partially repaired in therapy. This is still an ongoing and ever changing debate, now informed by attachment theory, neuropsychology, and observational studies of infant development. There have been many fads in child rearing practice, which are now discredited. This shows how our understanding of human psychology is still incomplete and inconsistent, and it remains essential for therapeutic practitioners to observe with an open mind without reaching conclusions too soon as we all have a conditioned cognitive bias.
Freud's consulting room in Vienna that he he had to leave when he moved to England

These ideas are some examples of Freud’s contribution, but they do not represent the whole of Freud’s thinking and his prodigious output.. He wrote well, and many of his books are enjoyable to read even now. He started a movement of psychoanalytic writers, thinkers and practitioners that had great energy and vigour and which is still ongoing. As the pioneer of modern therapeutic thinking, we owe him a debt of gratitude for making our own thinking possible by breaking apart some of the unquestioned “truths” and assumptions of his day.

Perhaps even now, his ideas are perceived as radical and threatening in some quarters! He was both a product of his place and time, middle class white Vienna, and being a Jew who was displaced by the war – he left Austria to live in England – and of his own ambitions. He desperately wanted to be accepted by the scientific establishment, although he never really was. He was prepared to sacrifice aspects of theory and thinking in order to gain acceptance for his overall model. It has taken a long time for scientific medical thinking and psychological thinking to come together in the service of human development, and really we are still in the early days of this process. Medical thinking and psychological thinking have distinct differences, In another 100 years, will our understanding have advanced as much as it did in the years after Freud?