American psychoanalysts are an endangered species. For many years, Freudian theory has provided a comprehensive framework for describing human behavior. Nowadays, however, traditional psychoanalysis and psychodynamic psychotherapies are in dramatic decline. According to Freud, internal or psychological forces motivate behavior and abnormality occurs when there is an imbalance in internal forces (neurosis). For example, for a patient with anxiety, anxiety symptoms reflect his or her unresolved unconscious conflicts (repression), which began in early childhood (e.g. the Oedipus complex) or later following trauma. Freud provided interpretations for the afflicted and made their afflictions a little more understandable to the rest of society by developing a method of treatment, psychoanalysis. In recent years, the aim of therapy is becoming less and less focused on the cancellation of repression and more work is being done towards greater integration and coherence of the patient. For example, evidence-based psychotherapies and studies of the effectiveness of cognitive behavioral therapy (CBT) are favored, and such short-term, behavior-focused treatments are in high demand. Psychoanalysis and psychodynamic approaches are, consequently, in danger; are becoming unattractive in the contemporary psychotherapy “market.” Reasons may include dilemmas related to treatment duration (long-term) and costs (not covered by health insurance companies), the invention of faster treatments for mental illnesses such as CBT and psychotropic drugs, and other sought-after self-help, yoga and meditation. . Furthermore, problems may arise with Freud's use of a biased sample, his excessive focus on sexual issues, and determinism. Furthermore, psychoanalytic therapies lack scientific validity and depend on the therapist's subjective interpretation. Say no to plagiarism. Get a tailor-made essay on "Why Violent Video Games Shouldn't Be Banned"? Get an original essay There are hundreds of journals and case studies written by psychoanalysts, so the psychodynamic approach has explanatory power, but even so it lacks scientific evidence. The psychodynamic model provides explanations for the causes of abnormalities, such as childhood trauma, but lacks the empirical research evidence needed to support the theory. Psychoanalysis competes with CBT because CBT has "proven" to be a satisfactory psychotherapy with its effectiveness studies. Effectiveness studies are more challenging to conduct on psychodynamic psychotherapies due to their long-term characteristics. Long-term effectiveness studies are almost impossible to do. The main issue is control variables for research: how could a 5-10 year therapy have the same structure across 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, it was probably correct. However, if the patient strongly disagrees with the analyst's interpretation and rejects it, it must be the patient's conscious mind that rejects an unacceptable but accurate interpretation. In any case, the therapist's interpretation or Freud's subjective analysis prevails. Freud based his ideas primarily on the subjective analysis of middle-class Viennese women. It used a partial sample of a group of predominantly middle-class Viennese women between the ages of 20 and 44, all struggling withserious emotional problems. No men, no children, no upper class or lower class patients. This sample was unable to reliably generalize to the general population. Furthermore, when developing his theory of psychosexual development, Freud studied only one child (little Hans). A theory derived from a study with a sample size of 1 certainly cannot generalize to the entire population. Psychodynamic theory tends to focus heavily on sexual issues, primarily childhood sexual fantasies and repressed sexual desires. There is a de-emphasis on the importance of interpersonal and social factors in causing and maintaining mental disorders. It may be that the cause of the anomaly is not the failure to resolve the Oedipus complex, but perhaps a current dysfunctional parenting style that leads to an insecure attachment. Psychoanalysis and psychodynamic therapy are very deterministic in proclaiming that childhood traumas 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, evidently, are more emphasized and explored in other treatments. In CBT, the focus is not on the past, the unconscious and the removal of repression, but on working towards greater integration and coherence within society. The early years of life, while still seen as foundational to character development, are now understood in terms of attachment, rather than primarily in an Oedipal sense. In psychoanalysis, childhood experiences and traumas are the main focus and the aim of the sessions is to hypothetically reconstruct the patient's past. In contrast, CBT focuses on the “here and now.” Nowadays, intuition alone is no longer considered sufficient to overcome neurosis. The "present transference", that is, the feelings, thoughts and emotions evoked by the present (here and now) of the analytic situation have become the main focus. The practice for the classic Freudian treatment of three to five weekly sessions, each 45 to 50 minutes and costing up to $500, requires patience and convenience. Health Insurance Companies and Psychotherapy Federal regulators are shifting the American healthcare system toward evidence-based treatments. Because modern healthcare services always seem to be in a hurry (time is money), they choose to spend their resources predominantly on short-term, behavior-focused treatments that can be manualized and assessed quickly. For psychoanalysis and psychodynamic psychotherapy this means that the costs are not covered. The question becomes: what percentage of patients in need of treatment can afford the 100 to 200 hours of psychotherapy needed to make a significant impact on their disorder. As a long-term therapy, psychoanalysis can encourage the patient's dependence on his analyst. The patient may feel safe around the therapist, but when not in therapy (in a safe place), in social situations or at home he or she may feel insecure and anxious and forget all the progress made in therapy (regression). This is an obvious disadvantage of psychoanalysis compared to CBT, where brief therapy discourages the patient's dependence on the therapist and encourages the patient's self-sufficiency. Before the invention of psychotropic drugs, if the patient was not treated, their main option was to continue returning to therapy for further analysis. As science and research improves daily, pharmacological treatments for disorders are proving the effectiveness of psychological interventions. The increase in biological alternatives in the form of psychotropic drugs (e.g.