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Psychoanalysis, according to Sigmund Freud, is the relationship in the psyche of a conscious ego to the source of inner drives (the id) and to external reality (reality). He argues that external reality has figures with characteristics of the ego. Then the three classifications of ego relationships become (1) ego-id; (2) ego-nature; and (3) ego-ego.
The ego-ego relationships are social relationships in which the ego strives to become happy and remain so in relation to mother, father, siblings, peers, adult authorities, social institutions, etc. Mirror neurons have been identified as a means to generate the ego-ego or social relations. Suffering in the context of psychoanalysis is the persistent pain or unpleasure experienced by any conscious ego. The ego strives to become happy and remain so in the context of ego-id, ego-nature, and ego-ego relationships but fails to do so.
Freud in essence develops a rational philosophy derived from his models of the ego, id, and reality. He argues that the id drives the ego to strive to become happy and remain so in the world of human affairs. He argues that ego is weak in early life. The id and reality, which includes the external egos, are far superior sources of cause compared to a newborn mammal ego. When the ego in early life incorporates attributes of the superior external egos into itself, this forms a separate category inside the ego, which Freud calls the superego. Then the poor ego in early life must contend with three superior sources of cause: the id, reality, and the superego (ego memories of superior external authorities). Freud argues that a human ego suffers in this context called the structural model of the psyche. Notice that this is philosophy, introspection, and the invention of terms by Freud. Psychoanalysis has nothing in common with the practice of medicine except that the suffering person complains to the analyst and the analyst wants to be paid to provide a remedy. But the suffering is the drama of human relationships and the only remedy is the ability to transcend suffering and/or to transform the internal subjective meaning of the drama.
Edit - The Philosophical Concept of Psychodynamic Paradigms
A psychodynamic paradigm is typically expressed in the fields of psychology or sociology. In psychodynamic theory each practioner (psychologist, sociologist) attempts to describe fundamental attributes of human relationships. The primary assumption is that all humans form and use cognitive maps in the context of social interactions.
Generic terms such as ego, self, objects, selfobject, etc., are applied in each psychodynamic model in the attempt to reduce perceptions of human social drama into analytical patterns. In these models there is an inherent effort to map meaning onto the behavior patterns of self and others in the social context.
APA Dictionary of Psychology
https://dictionary.apa.org/cognitive-map
Human beings and other animals have well-developed cognitive maps that contain spatial information enabling them to orient themselves and find their way in the real world (see spatial cognition); symbolism and meaning are also contained in such maps. See also environmental cognition; landmark; mental map. [introduced by Edward C. Tolman]
Major Psychodynamic Paradigms
https://www.psychologytoday.com/us/blog/freud-fluoxetine/202007/major-psychodynamic-paradigms-the-basics
Indeed, what we call psychodynamic or psychoanalytic theory (I use the terms interchangeably) is really a grouping of various different theoretical paradigms, each possessing its own conceptual framework, terminology, and method of working with patients. The theories comprising "psychoanalysis" are as varied as the personalities of their founders—Freud, Sullivan, Winnicott, Klein, Kohut, Kernberg, and others.
In ego psychology, the mind is comprised of warring factions—the sexual and aggressive drives—and reactions to these drives coming from the conscience, or superego. The ego attempts to arbitrate and make compromises between the drives seeking expression, the conscience, and the demands of reality. To deal with this conflict, the mind employs defense mechanisms, such as repression, displacement, and sublimation, to alleviate anxiety and manage these ostensibly clashing internal needs. When defense mechanisms become inadequate, or when certain pathological defenses are employed, psychiatric symptoms result.
Whereas the ego psychologist places emphasis on instinctual drives toward sex and war, the object relations psychologist emphasizes the primacy of the need for closeness and relationship. The word "object" is an unfortunately cold-sounding term for what really is a warm and well-organized theory of psychotherapy, focused on the patient's early experiences with parents and caregivers and how those relationships are internalized and replayed throughout life. Also central to the object relations approach is the development of a stable representation of self. When this developmental milestone is not achieved, psychopathology results, as Kernberg has demonstrated in his pioneering work on the narcissistic and borderline personality disorders.
Developed originally as an offshoot of object relations theory by the psychiatrist Heinz Kohut in Chicago, self psychology represents the newest of the three major psychodynamic paradigms. Self psychology is so named because of its recognition that the suffering in some patients is rooted in problems with self-esteem regulation and maintaining a solid, cohesive sense of self.
The Myth of Mental Illness
Thomas Szasz makes a philosophical argument in his essay and book The Myth of Mental Illness. Essay:
https://depts.washington.edu/psychres/wordpress/wp-content/uploads/2017/07/100-Papers-in-Clinical-Psychiatry-Conceptual-issues-in-psychiatry-The-Myth-of-Mental-Illness.pdf
Video Book Review:
https://youtu.be/-noS5vx_sG0
Self-identified philosopher's analysis of Thomas Szasz vs Psychiatry:
https://youtu.be/Gw5DfPlwVWU
Szasz' argument, based on cognitive maps, is summarized (from my memory) as follows. Medical disease is detected by observing physical signs and symptoms and by performing medical tests. Mental disease is detected by observing patterns of behavior and interpreting what these patterns mean. There exist no objective, non-normative, independent physical signs or symptoms of so-called mental illness. The cognitive maps of mental illness incorporate normative judgments concerning behavior which imitates patterns in religion, morality, and law.
Szasz does not deny that people can benefit from and solve their problems in living by talking to a therapist. However, he does not map or compare these social behaviors to medical efforts to "cure mental pathology".
