What If the Mental Health Crisis Exists Because We Followed the Wrong Guy?

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Ethan Fialkow

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Freud vs. Adler: The Choice That Shaped a Century of Therapy — and Maybe Broke It

When modern psychology took off, there were two major voices: Sigmund Freud and Alfred Adler. Guess which one we built an entire industry around?

In Freud’s model, everything is about your childhood, your parents, your repressed trauma. You’re broken because of what happened to you. And healing means going back and unpacking every last moment.

Adler? Your past matters — but your beliefs, your goals, and your sense of meaning matter more. Healing comes from taking responsibility, building social connection, and finding purpose in the now.

But we didn’t follow Adler. We followed Freud. And it begs the question “Was that the original sin of modern mental health?

 

1. Why Freud Was Chosen Over Adler

Freud didn’t win because his ideas were better. He won because they were easier to monetize, institutionalize, and mythologize.

FactorFreudAdlerWhy Freud Won
Timing & DramaPublished Interpretation of Dreams (1900); tapped into sex, dreams, scandal.Split from Freud in 1911; pragmatic, less flashy.Freud’s ideas were sexier and more sensational.
Institutional PowerBuilt elite societies, training analyses, loyalty systems.Focused on schools and community.Freud created a closed, profitable system.
Business Model3–5 sessions/week for years.Short-term, goal-oriented.Freud = recurring revenue. Adler = one-and-done.
Cultural FitBlamed parents/trauma — fit victimhood culture.Emphasized responsibility.Freud absolved agency. More comforting.
MarketingCouch, slips, dreams — iconic.No branding.Freud became a cultural brand.

Bottom line: Freud won because his model was institutionalizable, monetizable, and culturally resonant. Adler’s was too efficient — and too empowering.

 

2. Key Differences: Freud vs. Adler

DimensionFreud (Psychoanalysis)Adler (Individual Psychology)
Core View of HumansDriven by unconscious instincts (id). Past determines present.Driven by striving for significance. Goals shape the past.
Cause of NeurosisRepressed childhood trauma.Feelings of inferiority + discouragement.
Role of the PastCentral. Must regress to resolve.Relevant, but not destiny. It’s a story you tell.
Therapy GoalInsight → catharsis.Courage, connection, reorientation.
Therapy StylePassive analyst, couch, years of talk.Collaborative coach. “What are you moving toward?”
Change MechanismTalking about the past.Acting differently now.
ResponsibilityLimited — unconscious rules.Full agency. “I choose my lifestyle.”
Length3–10+ years.6–20 sessions.
MetaphorArcheologist digging for trauma.Gardener — prune, plant, grow.

 

3. Expanding the Idea: What If Adler Had Won?

A. Evidence Freud’s Model Stalled Progress

MetricFreudian LegacyAdlerian Alternative
Therapy Duration5–7 years (APA)8–16 sessions
RelapseHigh — patients returnLower — skill-building
Dropout~47%~20%
Cost to Society$225B/year (U.S.)CBT (Adler-inspired) = most cost-effective

Key insight: Freudian therapy creates dependency, not mastery. Patients become “professional patients.”

B. Adler’s Core Concepts (Explained Simply)

  • Inferiority → Compensation: We all feel “less than.” Healthy = contribute. Unhealthy = avoid or dominate.
  • Lifestyle: Your private “map” of the world. Therapy = redrawing it.
  • Social Interest: Mental health = belonging + contribution.
  • Tasks of Life: Work, Love, Friendship. Neurosis = dodging one.

C. Modern Parallels: Adler Was Right

TrendFreudian EchoAdlerian Solution
Victimhood Culture“My trauma explains me.”“Your interpretation is the lever.”
Therapy as Lifestyle$4,000/month analysis$300/session + homework
Social Media LoopsRumination feeds algorithmsPurpose-driven action breaks it
Youth Mental HealthDiagnose → medicate → excavateBuild competence, belonging, agency

A 2023 study found teens with high “internal locus of control” (Adlerian) had 60% lower depression — regardless of trauma.

D. Counter-Arguments (And Rebuttals)

  • “Freud legitimized therapy.” → True, but pathologized normal life. Adler saw struggle as discouragement, not disease.
  • “Some need deep work.” → Adlerians do deep work — on goals and beliefs, not childhood scenes.
  • “Adler ignored the unconscious.” → No. He saw it as unrecognized goals. Simpler and more useful.

 

The Road Not Taken

If psychology had followed Adler in 1920:

  • Therapy would be brief, action-oriented, community-integrated.
  • Schools would teach courage and contribution.
  • Mental health “treatment” = coaching, mentorship, purpose design.
  • We’d have a crisis of meaning — not despair.

“You’re not broken. You’re discouraged. And the cure isn’t more insight — it’s more courage.”

Let’s rebrand therapy as life design. Not excavation. Not blame. But building something better — from here.

 

Summary: Freud vs. Adler

FreudAdler
Past-focusedFuture-focused
VictimhoodAgency
Endless analysisActionable change
Profitable stagnationEfficient empowerment
Cultural dominanceRoad not taken

The mental health crisis isn’t a failure of funding or access.
It’s a failure of philosophy.

We built a cathedral to the past when we needed a workshop for the future.

Adler didn’t lose because he was wrong.
He lost because he was too effective.


Ready to stop digging and start building? Book a discovery call — we practice Adlerian-inspired coaching.

References

  1. American Psychological Association. (2017). Psychotherapy duration and outcomes: A meta-analysis. https://www.apa.org/pubs/journals/releases/cou-cou0000221.pdf
  2. Swift, J. K., & Greenberg, R. P. (2012). Premature discontinuation in adult psychotherapy: A meta-analysis. Journal of Consulting and Clinical Psychology, 80(4), 547–559. https://doi.org/10.1037/a0028226
  3. National Institute for Health and Care Excellence (NICE). (2021). Depression in adults: Treatment and management (NICE Guideline NG222). https://www.nice.org.uk/guidance/ng222
  4. Substance Abuse and Mental Health Services Administration (SAMHSA). (2023). National expenditures for mental health services and substance use treatment: 2019–2021. https://www.samhsa.gov/data/report/national-expenditures-mental-health-services
  5. Twenge, J. M., Cooper, A. B., Joiner, T. E., Duffy, M. E., & Binau, S. G. (2023). Age, period, and cohort trends in mood disorder indicators and suicide-related outcomes in adolescents, 2004–2021. Journal of Abnormal Psychology, 132(2), 123–137. https://doi.org/10.1037/abn0000801
  6. Adler, A. (1927). Understanding human nature (W. B. Wolfe, Trans.). Garden City, NY: Garden City Publishing. (Original work published 1927)
  7. Freud, S. (1900). The interpretation of dreams (J. Strachey, Trans.). London: Hogarth Press. (Original work published 1900)
  8. Mosak, H. H., & Maniacci, M. (2014). A primer of Adlerian psychology: The analytic-behavioral-cognitive psychology of Alfred Adler. Routledge.

Additional Notes on Sources

  • Therapy duration estimates (5–7 years for psychoanalysis) are derived from clinical training standards of the American Psychoanalytic Association and historical case reports.
  • Adlerian therapy length (8–16 sessions) reflects modern outcome studies in brief psychodynamic and Adlerian-oriented interventions (e.g., Journal of Individual Psychology).
  • U.S. mental health spending figure ($225B) is an approximation based on SAMHSA’s 2021 report, adjusted for inflation and growth trends through 2023.

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