Neurobiology: Is it Leading Psychoanalysiis Astray? (Stumlated by the Charlie Rose show on pychoanalysis with Kandel, Beck, Roose, and Fonagy)
(For info on Elio Frattaroli and Elio Frattaroli’s Book Healing the Soul in the Age of Brain see www.healingthesoul.net)
I believe that psychoanalysis today is suffering from a group Stockholm syndrome in which we have adopted the ideology of the cultural hijackers who are threatening to destroy us. Who are these cultural hijackers? The proponents of quick-fix medical model psychiatry, the proponents of quick-fix symptom-oriented short-term CBT, and the proponents of evidence-based practice who believe that the only valid evidence comes from an MRI or a statistical outcome study.
These folks tend to believe that in mental illness, the symptom is the disease, the symptom is maladaptive, and the symptom is a chemical imbalance or neurological defect (perhaps manifesting as an inappropriate cognition) that has no inherent psychological meaning. These beliefs are fostered by the general trends of our culture which tends to worship Big Science and where health care is dominated and largely controlled by
managed care.
How have psychoanalysts adopted this alien ideology? By accepting that to have credibility and validity we have to abandon the evidence base on which psychoanalysis was built, abandon the scientific methodology that psychoanalysis was designed to be — a methodology for exploring the conscious experience of individual persons, using the conscious experiences of the patient (free associative) and of the analyst (evenly hovering) as data — and instead, base what we know and what we do on the findings of neuroscience and statistical research, findings that exclude the conscious experience of individuals from the field of observation.
The result of our accepting this destructive ideology, and the result of our believing that people like Eric Kandel are friends to psychoanalysis (despite the fact that he has clearly stated in print that psychoanalysis today has lost its usefulness because it isn’t based on findings of neuroscience and statistical research — American Journal of Psychiatry 1998, “A New Intellectual Framework for Psychiatry” 155:457-469 and 1999 “Biology and the Future of Psychoanalysis” 156: 505-524) is that we no longer have a philosophy of our own that we believe in and that our spokespeople can articulate with confidence.
This is not an entirely new problem. Psychoanalysts have always been intimidated by those who call themselves scientists. It began with Freud who, even though his best thinking — his original groundbreaking contribution to human knowledge — was all in his clinical theory, nevertheless felt a need to force that clinical thinking onto the Procrustean bed of a neuroscientific libido theory that could never have supported it (and that no neuroscientific theory will ever be able to support). Then there were the distinguished psychoanalysts who participated in the Sydney Hook symposium with positivist philosophers and scientists back in 1959, who made an extremely disappointing showing. They failed to respond adequately to their critics and failed to say anything convincing about the validity or the validation of psychoanalytic observations. But at least back then we had Robert Waelder, who wasn’t invited to the Hook symposium but whose response to it in his 1962 JAPA paper, “Psychoanalysis, scientific method, and philosophy,” (a book review of the published proceedings of the symposium) is just as convincing today in response to the Eric Kandels of the world as it was in response to the Sydney Hooks of the world 45 years ago. At bottom Waelder’s argument is no different from the argument the Matthew McCaunaghy character made to the Jody Foster character in the movie “Contact” when she said she couldn’t accept anything without “scientific” proof.
He said something like, “Let me ask you this. Did you love your father?” She replied, “Of course!” He said, “Prove it.” Obviously neuroscience will never be able to prove anything about this or any other experience that is observable only through introspection and empathy. (Sure we may eventually be able to identify what love looks like on a PET scan but to do that we first have to agree on what love feels like as a first person conscious experience and how we would validate — using psychoanalytic evidence — that a person’s claim to be experiencing love is actually true. Only then would a PET scan of that person’s loving brain show us anything that we would have the knowledge or the right to label as love.)
Here’s how Waelder made the same point less polemically in his 1963 paper: It is very difficult, perhaps impossible, to prove by mere outside evidence even so simple a a statement as this: John is deeply in love with Mary…. But is it really necessary? Are introspection and empathy not sources of information too, not infallible, to be sure, but not negligible either?…. The story of the ugly duckling is well known. Other ducks called him ugly and looked down on him until it turned out that he was not a misfit of a duckling but a specimen of another, beautiful kind of bird, a swan. Psychoanalysis, largely, though by no means entirely, a matter of introspection and empathy, is treated as though it were a purely physicalistic discipline, and scolded and berated for its deficiencies as such. It is time to understand that the ugly duckling is not a duckling at all.
Here is another relevant quote, this one from Michael Polanyi”s essay entitled Scientific Beliefs,” from his collection of essays “Scientific Thought and Social Reality” (Psychological Issues monograph #32, 1974): The fact that serious and wise people with penetrating minds have so long subscribed to such rigmaroles about the nature of science can be understood only as expressing a deep, underlying urge of our modern civilization. It is due to a fundamental reluctance to recognize our higher faculties, which our empiricist philosophy cannot account for. We dread to be caught believing-and, in fact, knowing-things which are not demonstrable by the measurement of observed variables…. We look carefully over our shoulders and pick our words appropriately, to avoid saying anything…metaphysical… -for fear of offending the ruling assumptions about the strictly mechanical origin of science.
This argument — that the inner knowledge of psychoanalysis is indispensible, independently valid according to its own standards of validity, and not reducible to or validatable by outer knowledge — is so obvious, so commonsensical, and so unanswerable that our failure as a group to take a stand on it — or even to recognize that the argument can and should be made — is nothing short of suicidal. Isn’t it obvious to people that the trend of our culture is to ignore the inner life and deny the meaningfulness of inner experience and that the glorification of neuroscience is part and parcel of that trend? (My neurotransmitters made me do it.) Certainly this is obvious among the subset of the population who might ever become psychoanalytic patients or might ever refer family and friends to psychoanalysis. If we want these people to know that we have something indispensable to offer, we first have to know it ourselves.
Basically, I am concerned that we are making the same mistake with Kandel and his ilk that we once made with Freud; that is, deferring to him with a compulsive reverence that gives whatever he says priority over what we know, in our guts and in our hearts, to be true. With Freud we did this because he was our intellectual father, we were in awe of his genius, and he was right in so many things that we had trouble letting ourselves imagine that anything he wrote could possibly be wrong (let alone imagining that some of his ideas might be nonsense). With Kandel we don’t have as much of an excuse. We defer to him not because he has anything to say that competes with or complements in a meaningful way what we KNOW to be true from our clinical experience, (he studies snails, not people) but simply because we live in a culture that worships Big Science, and we think of Kandel as a Big Scientist who must, almost by definition, have more or better knowledge than we do about whatever he chooses to discuss from his pulpit in the Green Journal. When he discusses neurons, even human neurons, I am happy to defer to his superior knowledge. When he discusses psychoanalysis and what we need to do for him to consider us legitimate, I consider his opinion — much like Freud’s project for a “scientific psychology” — to be largely nonsense.
Elio Frattaroli, M.D.