The psychoanalytic movement introduced the study of unconscious processes that influence human activity. The movement was fully consistent with the German model of mental activity, going back to the writings of Leibniz and Kant. Although act psychology and the Gestalt movement were also modern expressions of the German model, psychoanalysis emphasized the goal of a homeostatic balance of unconscious energies within personality. Its founder, Sigmund Freud, used his keen powers of observation to devise much-needed therapeutic approaches, and later expanded his formulations to a psychodynamic theory of personality growth dependent on tension reduction. Other theorists modified Freud’s model to include cultural influences (Jung) and social needs (Adler and Horney). In addition, scholars have integrated the psychoanalytic model with a field approach (Sullivan) and existential assumptions (Fromm). As a contemporary movement, psychoanalysis still exerts considerable influence in psychiatry and clinical psychology, although the movement is fragmented owing to a lack of methodological agreement. In addition, Freud’s statements on the unconscious have led to new interpretations of artistic expression. However, as a viable model for psychology, psychoanalysis has departed from the empirical foundations of psychology and shares little with other systems of psychology that rely on that methodological approach.

Fromm-Reichmann was one of the most famous and respected therapists specializing in the psychoanalytical treatment of schizophrenic patients. In popular culture, she has been enshrined as the heroic and talented psychoanalyst in the book and film I Never Promised You a Rose Garden. The author of the book, Joanne Greenberg, indeed was a patient of Fromm-Reichmann’s, who not only completely recovered from her devastating illness, but went on to lead an extremely successful and productive life. In contrast, Fromm-Reichmann’s life was laden with trauma, disappointment, and loneliness. As the oldest child of a domineering mother and an ineffectual father, she grew up at a time of great social upheaval. She was raped in the street as a teenager. Her marriage to Erich Fromm, possibly the only person she had ever loved, proved a disaster due to Erich’s betrayal. The role of her “woundedness” in making her an effective therapist is explored in this chapter. Also discussed are questions regarding the prognosis of schizophrenia and the effect of psychotherapy, especially psychoanalysis, with severely mentally ill patients.