Sigmund Freud is known as the father of psychology, and his ideas are immersed in our culture. But it seems like Freud was a disaster for every patient that ever worked with him. Were his ideas actually useful for treating patients, or was he just a good marketer of his ideas?

Sigmund Freud isn't really the father of psychology - though it depends on what you mean by psychology. The discipline of psychology usually traces itself back to Wilhelm Wundt, who is ultimately the reason there are scientifically-focused psychology departments around the world - Wundt really pumped out the PhDs, and many of them went to the US and Britain and other places and started psychology departments. And Wundt ultimately predates Freud by a generation. But Wundt was a researcher interested in the nature and structure of consciousness, who did experiments to try and understand things like visual perception - he wasn't a talk-therapist. But there was a lot of philosophically-minded writing about psychology and topics like the mind well before Wundt - his major innovation was to see it as a post-Scientific Revolution scientific discipline, rather than a branch of philosophy - and so there's pre-Socratic Greek philosophers who make claims about the mind, because of course philosophers are going to be very curious about that. But I digress.

Freud himself was ultimately a mix of a Wundt-styled scientific psychologist, a physiologist, a medical doctor and a philosopher. He first studied physiology, and published (pretty dry and scientific) papers on the nature of neurons, before ultimately deciding that he was too Jewish to get a job at a Vienna university and ultimately doing the training to become a medical doctor.

He clearly wasn't that excited by being a doctor, and wanted to become a big name in a field; apart from the infamous 'On Coca' paper, he wrote an unpublished manuscript a decade or so before he became known for The Interpretation Of Dreams, called Project for a Scientific Psychology, which was an attempt of sorts to make a contribution to the Wundt-derived scientific psychology literature. But ultimately it was his development of 'psychoanalysis', his talk therapy method, and the theory behind it, that became what made him famous. It's fairer to say that he's the father of talk therapy (as opposed to the kind of not-necessarily-about-mental-health research that is done on the way people think and behave).

Freud's ideas about trying to help people with mental illness by actually talking to them about their lives seem kind of obvious today - but they were surprisingly revolutionary at the time. It had generally been considered by theorists before Freud that mental illness was the result of genetics and biology, one way or another (whether based on the humoural explanations that led to words like 'melancholy' and 'sanguine', or based on more modern explanations based on the much smaller amount that was known about damaged brains). The fundamental idea in Freud that mental illness was a sort of symptom of a mismatch between biology and situation (i.e., we're animals that are not really designed to live in civilised society) is a very post-Darwinian way of thinking (though Freud read Haeckel rather than Darwin) - but more importantly, it offered a way forward, which was breaking the various mental defenses that we've accrued as a result of years of trying to deal with the situation. There certainly are also parts of Freudian psychoanalysis that take the implications of this basic equation to its extreme - all the Oedipus complex stuff that grosses everyone out, and the in-general focus on sex that lots of people are uncomfortable with.

In terms of how Freud's therapeutic ideas are judged today - yes, as a therapist, he was more interested in finding confirmation for his theoretical ideas than in actually helping his clients. Where the people that he gave pseudonyms to in his writings have been identified later, they don't particularly think he helped them, and often found the whole process frustrating. However, it's hard in some ways to know whether those particular clients were a bit out of the ordinary because they were the ones he was intent on writing about. And there's no particular reason why, as a talk therapist, that you have to be the kind of confirmation-bias-influenced bully that Freud was. Beyond the basic idea of talking to people and challenging some of the ways they are interpreting and dealing with the world in a systematic way, there are specific parts of Freudian thinking that are still respected by modern clinical psychologists - in particular the ideas of 'transference' and 'counter-transference', wherein the client projects their feelings about others onto the therapist, and vice versa, and the ideas of 'defense mechanisms' - all the ways we deflect uncomfortable thoughts and ideas.

In psychotherapy, there is a (still controversial) thesis called the 'Dodo Bird Verdict', which argues that all talk therapy techniques kind of work, whether it's Freudian psychotherapy, CBT, Rogerian techniques, dialectical behaviour therapy, or any other number of therapeutic styles. The extent of the Dodo Bird effect is controversial, but the fundamental insight the idea gives us, perhaps, is that the specific therapeutic techniques are all well and good, but there is something about the act of being in therapy that helps, whether your therapist is telling you about Oedipus complexes or not - having the space to talk through your problems to someone paid to listen to you is useful, as it allows you to find your own ways to reinterpret what has happened to you and how you should be feeling about it, which clearly can help a bunch of people. The specific help you get from individual treatment types is kind of icing on the cake, goes the argument. A bit like modern therapies!

I think that it is definitely more complex than the Dodo Bird verdict suggests - it's probably the case that different techniques will work better for different people, and that psychologists could do better at figuring out why that is and thus better targeting different treatments to different people. But what it suggests is that, for people in the era where psychotherapy was predominantly psychoanalytic in focus (i.e., based on Freudian ideas) it probably helped a few people a fair bit, helped a few people a little, but not to the extent they wanted, and didn't help some others.