Freud’s ideas about the mind, evolution, and culture were revolutionary. Psychoanalytic theory was brought into service to treat mental illness because it was developed in a medical context. But the methods of psychoanalytic investigation, especially ‘free association’ and dream analysis, were most suited for learning about the mind, not ‘fixing’ the mind. The theory involved thinking objectively and scientifically about normal and pathological subjective experiences such as ‘feeling anxious’ and ‘feeling depressed’. Psychoanalytic ‘therapy’ involves largely telling a patient “this is how your mind works” and “this is why it works this way”.
But “interpretations” of subjective experience, regardless of their validity, do not work necessarily to change the way a person thinks, feels or behaves. Accordingly, medicine got more or less fed-up with psychoanalysis as a treatment and ‘threw the baby out with the bath’. What went wrong?
The justified enthusiasm about Freud’s ideas resulted in the sort of “wishful thinking” that usually accompanies new, deep insights. But devising potential applications of new, basic theory takes time and effort. For example, numerous applications of the ‘Germ Theory of Disease’ have emerged from 1890 to the present. Antibiotics, vaccines, diagnostic tests and other medically useful technologies did not just appear like Athena, fully formed, out of the heads of Koch and Lister. The followers are, of course, impatient. The new ideas are so promising, the needs are so great. But the applied work has to be done.
This phenomenon might be called ‘Symbolic Completion’ (cf. Wicklund & Gollwitzer, 1982: Symbolic Self-Completion Theory). Any new, valid theory immediately suggests a range of wonderful, useful applications. Psychoanalytic descriptions of mental processes indicated that we might be able to predict and control many aspects of mental life. The theory was quickly rushed into service before fully effective applications had been developed.
Using ‘half-baked’ ideas works to reduce the tension associated with the incomplete achievement of a theory’s potential. This sort of symbolic activity may be seen variously as ‘creative play’, ‘placebo effect’, ‘impatience’’ and ‘wishful thinking’. Some of the ‘symbolic’ operations are useful. Some of it stands in the way of making true progress. Part of our behavior in working with an original theory is driven by the Pleasure Principle, and part is motivated by the Reality Principle. Gratification is usually deeper if delayed somewhat.
The tendency to apply new ideas with primitive methods was exemplified by Alchemy, which took centuries to evolve into the modern science of Chemistry. It also describes the history of Christianity and other religions. New, powerful ways to think about life implicit in the Christ Story have been operationalized in some less than optimal ways by followers anxious to see ‘Christian Theory’ in action. The ‘religious’ followers of Freud too have behaved as if the story is already complete. This sort of assumption is explicit in the small, Hermeneutical branch of the Psychoanalytic School. But it also operates implicitly in the field at large. For example, most Psychoanalytic Literature does not cite work outside of the analytic ‘canon’.
Psychoanalytic Theory is valid, but it has not been amenable to integrating advances from cognitive-social theory nor biological theory. In part, this is because many people seem to assume that there are ‘zero-sum’ or ‘mutually exclusive’ relations between psychological and biological hypotheses; or between ideas studied in the laboratory and those developed in the clinic. This is expressed by those who say, “we don’t want to reduce psychology to biology”.
The fact is that it is impossible to reduce psychology to biology because there are no theoretical terms in biology for ‘subjective experiences’ of thought or feeling. In the formal sense, Reduction involves defining terms in the ‘to be reduced theory’ in terms of the ‘reducing theory’ (cf. Kemeny and Oppenheim, 1967). The best example of ‘reduction’ is how terms in Mendelian Genetics, e.g. “gene”, have been defined in terms of Molecular Biology, e.g. ‘‘strands of DNA’. Maybe it’s possible, but most people do not have direct sensory experiences of genes nor DNA molecules themselves. They do have subjective experiences of ‘joy’, ‘anxiety’, ‘depression’ and so on. Neuropsychoanalytic Theory involves study of the systematic relations between subjectively experienced mental states and contemporaneous, objectively measurable brain phenomena which support them. The biology is ‘in addition’ to the psychology. It does not ‘do away’ with it nor ‘reduce’ it.
My recent book, A Basic Theory of Neuropsychoanalysis, involves a ‘consolidation’ of ideas from the relevant fields, not a reduction of psychology to biology. And, the book tries to illustrate applications of the ‘basic theory’ to diagnosis and treatment of mental illness.
On a personal level, I wrote the book because I have knowledge of basic theory and applied methods in psychoanalysis, social psychology, medical psychology and psychopharmacology. Having various explanatory systems in mind creates a tendency to relate them, to organize a single system that can hold them all. One wishes to build a new house so that you can put “all your stuff” in one place. The house would be bigger than any of the separate systems but might use less space than the constituent systems considered separately. In my mind (and surely in the minds of others), aspects of the various theories were attempting to find their connections to each other. Such conceptual connections are made implicitly by a process something like “spreading activation” (Collins & Loftus, 1975), as well as conscious deliberation. The book was my attempt to spell-out explicitly important connections between the various schools. This would allow me to throw out junk I didn’t need, and build an effective and efficient, “conceptual house” that might be expanded sensibly over time.
This involved considering the most robust, non-controversial assumptions from the various fields together – “on the same page”. Theoretical paths were followed that were at least consistent with central tenets in psychology and neurobiology. Some new assumptions are added to link the basic ideas. Many of the integrating ideas seem logically obvious when the various fields are considered together rather than in isolation.
Not everyone will “buy” my system, but the goal was not to “have the last word”. Rather, the aim was to produce a framework that could contain comfortably advances made in psychology and neurobiology since psychoanalytic theory first emerged. The primitive wish to have the ‘perfect’, ‘complete’, ‘last word’ operates to inhibit theoretical integration, but it is also essential for motivating theoretical work. At some level, no one can get rid of this wish. It is akin to the desire to find the Logos. The best one can do is see it for what it is, and remain open to new points of view.
W.M. Bernstein trained in Biology, Social Psychology, Psychoanalysis and Psychopharmacology. He is a Diplomate of the American Board of Medical Psychology; and, was one of the first psychochologists in the US authorized to prescribe psychotropic medicines. He is the author of A Basic Theory of Neuropsychoanalysis and The Realisation of Concepts: Infinity, Cognition, and Health.