Psychoanalysis seems is often looked down upon by psychologists today. It has gone out of style, being replaced with therapies whose efficacy can be more easily illustrated. Psychoanalysis has not, however, been completely forgotten. It is alive and well in the philosophy community with a revived interest during the last couple decades in the work of Jacques Lacan. While psychoanalysis itself may have been surpassed by techniques like Cognitive Behavioral Therapy (CBT) in modern psychological practice, these techniques still hold a strong foundation of the unconscious and our drives being responsible for our unproductive thought patterns which then cause us problems. Therefore, this review will serve the purpose of illustrating the literature on the subject of how modern clinical therapeutic tools, specifically in CBT, work upon a foundation of psychoanalytic tools regarding language and the unconscious. This essay will look at how the language of the unconscious functions from the perspective of Freud and Lacan. It will then discuss a modern linguists’ perspective on their work. Next, will come discussion regarding modern clinical tools within CBT and how those are rooted in psychoanalysis.

            While Sigmund Freud may be the name most well known in the field of psychoanalysis, Lacan took his ideas and built upon them, shifting the focus more specifically to language. Lacan famously espoused how the subconscious is structured like a language. By understanding and interpreting this language the psychoanalyst can assist the analysand in deciphering and then overcoming their neuroses. Most people have a simple understanding of Freud’s work, generally relegated to jokes regarding lying on a couch whilst talking about ones’ relationship with their mother, but Freud laid the foundation of understanding of how the unconscious, and our drives within that unconscious, affect our daily life and behaviors. The way to understand these drives were through many sessions over a long period with a psychoanalyst. During these sessions an analysand would recount dreams or utilize free association, whereby they would speak freely about whatever popped into their mind, ideally without much forethought or critique. The analyst, who was trained in finding the hidden meaning behind their words, would then assist the analysand in coming to realize what was driving their unconscious. The way they did this was to pay special attention to the words used and their alternate meanings. You may have heard the term “Freudian Slip” whereby someone means one thing but says another, which could be an indicator of what they are really feeling below the surface of conscious thought. It is through this symbolism that Freud believed we could do this. “It is in language (langue), and the various sorts of discourse derived from it, that symbolism has its roots – in language even more than in analogy. So much so, in fact, that there gradually emerges in Freud the hypothesis of a common source for language (langage) and symbolism.” (Arrivé et al. 1992, p. 103) These symbols Freud spoke of, when interpreted, can be a window to the unconscious drives and desires fueling neurosis. Lacan took this even further, focusing on the language of the unconscious. He believed that the unconscious itself was structured like a language, meaning it followed the same rules as a language does and could therefore be deciphered in that way. One way of doing this is through semiotics, and for that it is good to turn to a modern linguist perspective to gain some new insight.

 Semiotics is the study of signs and symbols and their meanings. According to Manuela Aragno, Distinguished Scholar in Residence at Washington Square Institute, one could visualize the unconscious as “…a semiotic tree depicting an ascending hierarchy of semiotic forms. Originating in underground roots from a medley of organic codes, the human use of codified meanings surfaces in the trunk, (in Latin Caudex or Codex), our simplest semiotic instrument. Ascending branches represent natural and man-made signals, and indicative and denotative signs, rising to more complex fully symbolic abstract forms in various sign systems. Each level corresponds to a different mental organization, determining the quality and nature of subjective experience and knowledge, epistemology and information being closely tied to semiotic and semantic factors.” (Aragno. 2019 p. 1) Basically, this describes a visualization of the semiotic structure of how symbols are arranged and grow from each other beginning at the roots with organic and natural codes like the roots of a tree, and become more abstract and metaphorical as they move up to the branches. This structure can be useful to enable the interpretation of signs and symbols from the language of the unconscious based on how they fall within this semiotic structure which can then have modern clinical uses.

Next, more discussion on that modern clinical perspective and how this theory, with the added benefit of the linguistic semiotic framework, can be useful in a clinical setting. Earlier in this essay, free association was mentioned briefly. This method is still utilized today, as is talking therapy, just as a smaller portion of overall sessions. Judy Gammelgaard from the Department of Psychology, University of Copenhagen, Denmark (2015), discussed this tool in more detail. An analyst trained in these techniques can “hear the expression of another story. In this way we may take a trivial narrative from everyday life as a story addressed to the one who has ears to listen with. Or we may take a long portrayal of a personality as a direct question, or conversely take a simple slip as an utterly complex statement, or interpret a silence as the expression of a long stream of unspoken thoughts. In other words, we open up to the multifariousness of language and are not satisfied with what is grammatically and syntactically obvious.” (Gammelgaard. 2015) This quote shows how by understanding the semiotic nature of language, described above, in conjunction with Freudian and Lacanian psychoanalysis, modern talking therapy with free association can be used to get to the root of the neurosis with the analysand by uncovering the alternative meanings behind their words. This is not incompatible with modern therapies like CBT. Although, CBT is done in much shorter sessions, with a focus on specific goals, some free association to assist the clinician in helping the client uncover what is fueling their unproductive thought patterns is utilized.

Cognitive Behavioral therapy has its roots in Rational Emotive Behavioral Therapy (REBT) developed by Albert Ellis and Cognitive Therapy developed by Aaron Beck. Beck himself was a student of psychoanalysis and “admits to [an] intellectual descent from ego psychology, a school of psychoanalysis that flourished in the 1950s and 1960s and that focused on the functions of the ego.” (Rosner. 2012) Beck, even though claiming to reject psychoanalysis in his development of what later became CBT, continued to draw on its theories even in his later writing. The ABC model developed by Ellis also has a strong focus on the unconscious. The “A” or Activating event, is the experience we are reacting to. The “B” or Belief is what actually fuels our reaction. The “C” are the Consequences, both physical and emotional. The main takeaway here being that it is actually the beliefs that affect a person’s reactions, not the event itself. These beliefs are based on unconscious underlying assumptions and a person’s understanding of the world. The iceberg analogy of consciousness is often used here as well to explain how what is recognized about these thoughts and views on the world are just the “tip of the iceberg” in comparison to everything that is going on in the unconscious, which are actually fueling our behaviors. With CBT, when behaviors and feelings are not lining up with the patient’s goals and/or values, or are hindering their relationships, this is when a review needs to be done to help amend behavior. There are many tools used in CBT built on this foundation which is rooted in these unconscious drives which have their root in the language of the unconscious. Thus, a comprehensive view of what tools are currently used will shed light on how psychoanalysis still plays a role in modern therapy. This will be illustrated further in subsequent essays. While it may not be possible to spend hours several times a week for months or years on the analysists couch, especially considering the cost, shorter more outcome directed tools of psychoanalysis have been incorporated into modern therapeutic resources. “The refusal [to entertain psychoanalysis] is often irrational. It is often motivated by phobic reactions to the real that shows through the old worn mirror reflecting the ‘distorted representations of psychoanalysis in psychology textbooks’.” (Cuellar. 2010 p. xvi) Much of the aversion to psychoanalysis is based on a misunderstood or farcical view of psychoanalysis. There is much that has already, apparently unbeknownst to many practitioners, been used as a basis for many methods in use today. As mentioned, with CBT, a focus on the unconscious is already present as a basis for understanding our behaviors in current clinical practice. “So many resources and so much rhetoric have been invested in keeping the wall between him [Beck] and Freud firm. The training of many cognitive therapists does not include psychoanalysis. Consequently, they may not be fully conversant in the psychoanalytic features of Beck’s theory from their own experience.” (Rosner. 2012) To this illuminate this misunderstanding, this review has illustrated the literature on the subject of how modern clinical therapeutic tools, specifically in CBT, work upon a foundation of psychoanalytic tools, specifically those regarding language and the unconscious. This was accomplished through looking at how the language of the unconscious functions from the perspective of Freud and Lacan, as well as discussing a modern linguists’ perspective on their work. Finally, a comprehensive discussion regarding modern clinical tools within CBT and how those are rooted in psychoanalysis has hopefully shed light on many ways these theories are in use today.