American psychoanalysts are an endangered species. For many years, Freudian theory has provided a comprehensive framework for describing human behavior. But today, traditional psychoanalysis and psychodynamic psychotherapies are experiencing a dramatic decline. According to Freud, internal or psychological forces motivate behavior, and an abnormality occurs when there is an imbalance in internal forces (neuroses). For example, for an anxious patient, anxiety symptoms reflect their unresolved unconscious conflicts (repression), which either arose in early childhood (e.g. the Oedipus complex) or later through trauma. Freud made interpretations for people in distress and made their afflictions more understandable to the rest of society by developing the treatment method, psychoanalysis. In recent years, the goal of therapy has become less about undoing repression and more about working toward greater integration and coherence for the patient. For example, evidence-based psychotherapies and effectiveness studies of cognitive behavioral therapy (CBT) are favored and these short-term, behavior-focused treatments are in high demand. Psychoanalysis and psychodynamic approaches are therefore threatened; they become unattractive in the contemporary “market” of psychotherapy. Reasons may include dilemmas regarding the duration (long term) and costs of treatment (not covered by health insurance companies), the invention of faster treatments for mental illnesses such as CBT and psychotropic medications and other sought-after self-help guides, yoga and meditation. . Additionally, problems may arise related to Freud's use of a biased sample, his excessive focus on sexual issues, and his determinism. Additionally, psychoanalytic therapies lack scientific validity and depend on the subjective interpretation of the therapist. Say no to plagiarism. Get a tailor-made essay on “Why Violent Video Games Should Not Be Banned”? Get an original essay There are hundreds of reviews and case studies written by psychoanalysts. Therefore, the psychodynamic approach has explanatory power, but despite this, it lacks scientific evidence. The psychodynamic model provides explanations for the causes of abnormalities, such as childhood trauma, but lacks the empirical evidence needed to support the theory. Psychoanalysis competes with CBT because CBT has been shown to be a satisfactory psychotherapy through its effectiveness studies. Efficacy studies are more difficult to carry out on psychodynamic psychotherapies due to their long-term characteristics. Long-term effectiveness studies are almost impossible to perform. The main problem lies in the research's control variables: how could a 5-10 year therapy have the same structure among patients. Psychoanalysis depends heavily on the therapist's interpretation of what the patient says. Would a dream of swimming in the ocean really reflect the patient's childhood fantasies of sleeping with his mother? According to Freud, if the patient accepted his analyst's interpretation, then it was probably correct. However, if the patient strongly disagrees with and rejects the analyst's interpretation, it must be his or her conscious mind that rejects an unacceptable but accurate interpretation. In all cases, it is the therapist's interpretation, or Freud's subjective analysis, which takes precedence. Freud based his ideasmainly on his subjective analysis of middle-class Viennese women. He used a biased sample of a group of mostly middle-class Viennese women, aged 20 to 44, who were all facing serious emotional problems. No men, no children, no patients from the upper or lower classes. This sample could not be reliably generalized to the general population. Furthermore, when developing his theory of psychosexual development, Freud only studied one child (little Hans). A theory resulting from a study with a sample of 1 certainly cannot generalize the entire population. Psychodynamic theory tends to focus a lot on sexual issues, primarily childhood sexual fantasies and repressed sexual desires. Less emphasis is placed on interpersonal and social factors in the cause and maintenance of mental disorders. It may be that the inability to resolve the Oedipus complex is not the cause of the abnormality, but perhaps a current dysfunctional parenting style leading to insecure attachment. Psychoanalysis and psychodynamic therapy are very deterministic in proclaiming that childhood trauma will lead to abnormal behavior in adulthood, however, they ignore any other possible influences of genetics (biology), reward (behaviorism) and thought patterns (cognitive approach). Which, obviously, are potentially further emphasized and explored in other treatments. In CBT the emphasis is not on the past, the unconscious and the destruction of repression, but on working towards greater integration and coherence within society. The early years of life, while still considered the foundations of character development, are now understood in terms of attachment, rather than primarily from an Oedipal perspective. In psychoanalysis, childhood experiences and traumas are the center of attention and the aim of the sessions is to reconstruct hypothetically. the patient's past. In contrast to this, CBT focuses on the “here and now.” Today, insight alone is no longer considered sufficient to overcome neurosis. “Present transference,” or the feelings, thoughts, and emotions evoked by the present (here and now) of the analytic situation, became the primary focus. Practicing the classic Freudian treatment of three to five weekly sessions, each 45 to 50 minutes long and costing up to $500, requires patience and affordability. Health Insurance Companies and Psychotherapies Federal regulators are moving the U.S. health care system toward evidence-based treatments. Because modern health services always seem to be in a hurry (time is money), they choose to allocate their resources primarily to short-term, behavior-based treatments that can be manualized and evaluated quickly. . For psychoanalysis and psychodynamic psychotherapy, this means that the costs will not be covered. The question becomes: what percentage of the patient in need of treatment can afford the 100 to 200 hours of psychotherapy needed to make a significant impact on their disorder. Being a long-term therapy, psychoanalysis can encourage the patient's dependence on their analyst. The patient may become secure around the therapist, but when not in therapy (in a safe place), in social situations, or at home, the patient may feel insecure and anxious and forget all progress carried out in therapy (regression). This is a major disadvantage of psychoanalysis compared to CBT, where brief therapy discourages the dependence of the..