From Abracadabra to Zombies
reader comments: psychoanalysis
26 Dec 2010
I am not a psychoanalyst, but I am an admirer of Freud. In fact, "hero worshipper" would be a better description. I don't appreciate your attack on psychoanalysis as a pseudoscience, because it really makes no sense. All Freud's published case histories follow strict rules of induction. They start out with a presentation of raw data in the form of observed symptoms and words spoken by his patients. At the end of each case history, this data is organized into an hypothesis. Eventually, enough data from other case studies confirmed the hypotheses so that a theory of universal principles could be established.
reply: What Freud does in his case studies is extremely interesting, but it is not science: it's speculative literature. I admit it is compelling reading, even addictive. I have stated my debt to Freud elsewhere:
Then there was Freud. His case studies fascinated me, especially his essay on a case of paranoia (1911), a psychological analysis of the memoir of Daniel Paul Schreber (1842-1911), a respected judge and political figure until his psychotic breakdown. Schreber’s memoir gives an account of the delusions that landed him in the asylum for several years. What struck me at the time was that I had studied very similar musings in the writings of various mystics such as Plotinus and had even believed similar notions to Schreber’s for many years--Virgin birth and impregnation of a human by a divinity, for example. Had Schreber lived in the 2nd century instead of the 19th would he have taken his place at the same table with Zarathustra instead of with the other patients in the asylum? Had he put forth his fantasies and delusions as metaphysical speculations or scientific insights would a cult have arisen around his ideas that would have led to an entry in The Skeptic’s Dictionary? When I consider the list of subjects I still have in my “to investigate further” file, I can only say yes, without a doubt.
However interesting Freud's account of Schreber, "Rat Man," etc., the process of detailing symptoms and providing explanations that seem to fit other cases as well is not science. This process is confirmation bias at its highest level. Never does Freud attempt to find data that would falsify his hypotheses. Always, he seeks to confirm his ideas. Worse (as far as being a scientist goes), his hypotheses aren't testable. Nothing can falsify them. They are consistent with any behavior his patients might engage in.
You would never know this unless you had read all of the published case histories for yourself. Representative case histories are still in publication in paperback and are available at all public libraries btw.
Anyway, here is an example of brief case history showing the presentation of data followed by an hypothesis. You can find it in Freud's "Rat Man" case history:
It not uncommonly happens that obsessional neurotics who are troubled with self-reproaches but have connected their affects with the wrong causes, will also tell the physician the wrong causes, without any suspicion that their self-reproaches have simply been disconnected from them. In relating such an incident they will sometimes add with astonishment, or even an air of pride: "But I think nothing of that." This happens in the first case which gave me insight many years ago into the nature of the malady. The patient, who was a government official, was troubled by innumerable scruples. He was the man whose compulsive act in connection with the branch in the park at Schonnbrun I have already described. I was struck by the fact that the florin notes with which he paid his consultation fees were invariably clean and smooth. (This was before we had silver coinage in Austria). I once remarked to him that one could always tell a government official by the brand-new florins that he drew from the State treasury, and then he informed me that his florins were by no means new, but that he had them ironed out at home. It was a matter of conscience with him, he explained, not to hand anyone dirty paper florins; for they harbored all sorts of dangerous bacteria and might do some harm to the recipient. At that time I already had a vague suspicion between the connection between neurosis and sexual life, so on another occasion I ventured to ask the patient how he stood in relation to that matter. "Oh that's quite all right" he answered airily, "Im not at all badly off in that respect. I play the part of a dear old uncle in a number of respectable families, and now and then I make use of my position to invite some young girl to go out with me for a day's excursion in the country. Then I arrange that we shall miss the train home and be obliged to spend the night out of town. I always engage two rooms--I do things most handsomely; but when the girl has gone to bed I go into her and masturbate her with my fingers." --"But aren't you afraid of doing her some harm, fiddling about in her genitals with your dirty hand?"--At this he flared up: "Harm? Why, what harm should it do her? It hasn't done a single one of them any harm yet, and they've all of them enjoyed it. Some of them are married now, and it hasn't done them any harm at all."--He took remonstrance in very bad part, and never appeared again.
But I could only account for the contrast between his fastidiousness with the paper florins and his unscrupulousness in abusing the girls entrusted to him by supposing that the self-reproachful affect had become *displacement.* The aim of this displacement was obvious enough: if his self reproaches had been allowed to remain where they belong he would have had to abandon a form of sexual gratification to which was probably impelled by some powerful infantile determinants. The displacement therefore assured his deriving a considerable advantage from his illness (paranoisic gain).
Larry D. Lyons
reply: Fascinating stuff, I agree, but not science.___________
11 Sep 2004
I think you are too hard on Freud, and by extension, talk therapy....
As for psychoanalysis taking depression and schizophrenia as "narcissistic" disorders: that, the way you put it, ranks right up there with Dick Cheney's contention that Republicans won't fight a namby pamby "sensitive" war against the terrorists like the Massachusetts liberal over there who will leave the doors open for another al Qaeda attack if you vote him in, I guarendamnTEE it!
In Freud's definition and use of narcissism, schizophrenia is narcissistic. But that didn't mean it had no physical cause. Freud never said that -- would never say that, being a neurologist -- even if some of his more eager followers may have. To docs at the time, schizophrenia was indeed a somatic disorder. It's original name was dementia praecox. The best translation for dementia praecox is premature senility. It was assumed that cumulative insult and/or injury to the brain over time was the cause. Freud, as you say, stated that he didn't think psychoanalysis would work on schizophrenics. And it is clear from Freud's letters that his position on the etiology of schizophrenia was more nuanced than you let on. One of the reasons Freud was interested in Jung -- besides a desperate urge to avoid psychoanalysis being dismissed as a Jewish science -- was that Jung had had some success with schizophrenics at the lunatic asylum where he worked. Jung's doctoral dissertation was On the Psychology of Dementia Praecox. Jung thought that Freud's method might be a way in to the twisted world of the schizophrenic, like Orpheus's lyre. Once in, Jung hoped he could lead the schizophrenic out of this world, or at least help them function in ours, by breaking through what Freud interpreted as resistance to treatment.
This shows what is meant by "narcissism." It's not an obsession with ones appearance, or even good old Republican selfishness. It's an unhealthy turning inward of the self.
And there is growing evidence that outside social stimuli acting on mood may have immediate and dramatic somatic consequences. A recent study of the social structure of vervet monkey troupes (I think at the Neuropsychiatric Institute at UCLA, specifically their Center for Primate Neuropathology) suggests that there may be some evolutionary advantage to keeping some members of the group agitated, depressed and paranoid. In just about every primate group that I've read about, the dominant males and females cluster in the middle of a group, with marginalized males orbiting like electrons. They're out there vulnerable, to be picked off at any time by predators. They gibber away whenever anything remotely threatening comes around, alerting the whole troupe to possible dangers. Being in this position was assumed to be the reason monkeys without status act nervous and paranoid, and exhibit odd, compulsive sexual behavior. (Monkeys don't just masturbate in zoos when you take your granny and your five year old to see them. Guard duty turns them into wanking machines. Throw in the Catholic church and you get your basic masterbatory conflict.) But things look different in light of the study.
The study tried to find out what was going on chemically within these males as they jockied for status. Researchers in the past found a cycle. A male would be dominant one day, lounging in relative ease, eating, sleeping and occasionally fucking when the females bugged him about being such a slug and not paying attention to them anymore. Then a low status male would get agitated enough and tired of polishing his joy stick enough to become outwardly aggressive. Pretty soon, he'd take on anything just to get a little cooze. These motivated males then got to lounge and eat and occasionally fuck for a while, until somebody else got fired up to the point of insanity by his Hawaiian disease.
What the new study found was an instant drop in serotonin levels in males who lost these fight, and thus status. Serotonin is what SSRIs and some neuroleptics keep in the synaptic fluid to keep patients for whom it is prescribed on an even keel. Something triggered the serotonergic neurons to suck it all up in the losers.
This means that an outside stimulus is causing the neurological system to react in a specific way. drugs are not a precision instrument. Specific stimuli from a therapist could be fine tuning the chemistry. The drugs stop any serotonin in the spinal fluid from being sucked up, so that there is no way for the neurological system to properly respond to social or any other stimuli. Thus, a flat affect and impotence result. The application of appropriate counterstimuli may be producing results.
So what would constitute a negative stimulus in Vienna at the end of the Holy Roman Empire? I'm betting that getting caught -- or fearing getting caught -- choking the chicken while looking at a painting of St. Sebastian would do nicely. Now that'll get you a show on HBO.
As for the assumptions behind free association and dream interpretation, its untestability has never been disputed. What it does is focus an individuals atention on an element of a dream or seemingly random event in their conscious mind. This will vary with individuals. The days of every baseball bat and cucumber -- or cigar -- being a phallic symbol and nothing more are past, if they ever really were, Bill Clintons Havanas be damned. The annalysand is the interpreter, not the doctor. This is so the subject can see what the problem is, and then deal with it if possible, accept it if necessary. Nobody talks about a "cure" that I've ever seen. Giving a patient a coping mechanism is what it's about.
First it's lumping cryptozoologists together with astral projectionists, now it's lumping Freud in with the repressed memory crowd. (By the way, it's not true that there's no fur. There has been fur collected more than once that came from an "unidentified primate." It's maybe unidentified because the lab doesn't recognize the species as existing.) As for infantile memories, Freud abandoned the seduction theory early on. (See Jeffrey Masson's Assault on the Truth.) There is no actual sexual trauma involved in these confabulations, said Freud. He doubted even from the beginning that these memories were real, he just had no real reason to doubt them until he figured out a more likely scenario. They are, in psychoanalytic theory, fantasies. This all happened well before 1900. That's why the repressed memory crowd is so down on Freud. They are as antipsychoanalysis as the Scientologists. (And why Masson called his book what he did. He was a freelance Sanskrit scholar and playboy who wrangled a job for himself working with Anna Freud cataloging her father's papers, and later took over as head of the Freud Archive. The book was a knife in his benefactress's back.Masson used this book to get into the pants of a very hot, highly thought of ultra-feminist academic. Now he writes books about the psychic life of cats. [Psychic in its original sense, not meaning they read your mind.] When she gets tired of him and takes up with a grad student, he'll be back writing attack pieces on dead academic icons, I would bet.)
Your penultimate paragraph
"In many ways, psychoanalytic therapy is based on a search for what probably does not exist (repressed childhood memories), an assumption that is probably false (that childhood experiences caused the patient's problem) and a therapeutic theory that has nearly no probability of being correct (that bringing repressed memories to consciousness is essential to the cure). Of course, this is just the foundation of an elaborate set of scientifically sounding concepts which pretend to explain the deep mysteries of consciousness and behavior. But if the foundation is illusory, what possibly could be the future of this illusion?"
describes a psychoanalysis that is unrecognizable to me.
I like the last paragraph, though.
17 Sep 1999
As a psychology student I have to say that the skeptic definition of "psychoanalysis" in your dictionary is mistaken, to say the least. Maybe American psychoanalysts may use hypnosis, or try to "cure" schizophrenia ( as if "regular" medicine could do it either), consider repressed memories and traumas the reasons for one's misfortunes ( along with the many other misconceptions exposed there) but it's not like this in the rest of the world. [The author is from Brazil.] Maybe a deeper research in the works of Freud would be suggestible [?] (reading the originals would help).
reply: Maybe your reading of the entry is not quite accurate. I nowhere say or imply that American psychoanalysts use hypnosis. (It is well known that Freud used hypnosis early in his development of analysis, but gave it up because it is unreliable.)
The belief that psychoanalysis could "cure" schizophrenia died out decades ago. (This point is clear in the quote from Dolnick's book at the head of the entry.) But you do shock me by saying that psychoanalysts in the rest of the world do not consider repressed memories and traumas as a cause of "misfortune."
The tendentious writing found in the dictionary definition of psychoanalysis gets to the point of comparing psychoanalysis to scientology and resources itself into suggesting that psychoanalysis can't cure a broken bone (by the way, it's a good point to look at as doctors don't "cure" broken bones - they merely reduce unnecessary "symptoms" such as pain - but the bone itself heals up, with, without or despite the procedures of the doctor, but, as it's widely known, the relationship or confidence between doctor and patient helps speeding up the healing process, and making a very long story short, maybe you should take a look at the findings of doctor Robert Ader on the immunological system and depression - an induced depression, not a "genetic". The concept of cure doesn't exist in psychoanalysis, and I defy anyone showing real cure even in medicine (except for some very few exceptions, not possible by any other means, while even a heart transplant is not a cure, it's a postergation [?], and we all know that the patient's quality of life has to be increased, or all will be lost). Try to cure a simple depression with Prozac and see what you get ("hide the baseball bat !!!") , and I mean CURE, not only making symptoms disappear, what seems to be the idea of "cure" for some doctors and some behavioral psychologists who may have never heard the word "methonymia", to say the least. If you could spare the time to take on some real research work, you could find yourself invited to many clinics around the world so as to check on their work. Furthermore, you could have a talk with some preeminent neuroscientists such as Antonio Damasio or Joseph Le Doux in order to have a "neutral" standpoint on psychoanalysis according to the latest findings in their fields. You could start by checking a site called "MEDLINE": , and searching for the topic "psychoanalysis and neuroscience" in order to read the most recent papers on the subject.
reply: I'm willing to grant that psychoanalysts don't cure anyone of anything.
We understand the feelings of anger towards psychoanalysis as it's a tried and tested form of therapy which returns a very good ratio of wellness to it's clients, despite all the attempts to prove it wrong ( all said but nothing proved...and believe me, they have tried their hardest) all of the eulogies already made to Freud and it's findings, as it's said "the more obits declared, the more alive one is", or, as Mark Twain said "the rumors about my death have been greatly exaggerated"...all in all Freud is still alive and well, and experimenting some boosting thanks to the findings of the neuroscientists. Maybe one should read "a candle in the dark "by Carl Sagan to compare what he says about Psychoanalysis there with what he said in Broca's Brain...as a very intelligent man, he was able to change ( also check Einstein's mail). I'm sorry if this email sounds a little too hard, but it's just that I would never expect intelligent people with such passionate blinding conceptions about something they have very scarce knowledge about, also, I think myself as a skeptic and I'm also an agnostic, while some skeptics aren't (well..one should read "The Future of an Illusion") so where does this leaves us ? It's ok to believe in something that is no more than a childish belief on nothing more than a wish ( like Santa Claus) but it's wrong to take part on a scientific research of why we are the way we are - do we have double standards operating here ? I like the skeptical point of view, but it scares me to think that if they are not at all that well informed about this subject, it's only licit to thing the same of all the other topics.
reply: Sagan doesn't mention psychoanalysis in The Demon-haunted World - Science as a Candle in the Dark. He only mentions Freud to note that he changed his belief about the cause of hysteria from repression of childhood sexual abuse to fantasies of such.
Sorry, but I don't have access to Einstein's mail.
01 Jun 1999
I have to say that I enjoyed many of the entries in your dictionary. There is too much sloppy thinking all about these days. I only found one entry rather irritating: the one on psychoanalysis. I agree that much of the psychoanalytic waffle is simply unreliable ad hoc theorising. This is bound to happen since a human life is a highly individual process and not an object that can be isolated from its environment.
That said it is no more proven that "mental illness" is caused by neurochemical disturbance than it is proven to be caused by the subject's experiences.
reply: I hope you are not insinuating that I think otherwise. Neurochemical imbalance can be caused by physical illness, diet, drugs, and certain experiences, such as extreme trauma, torture, or sleep deprivation. If the effects are long-lasting, and the person's behavior, thought processes or affective response is abnormal, the person, if diagnosed at all, is usually diagnosed as mentally ill.
The fact that a drug may make some one feel happy is not evidence that the lack of it (or it's effect) was the cause of their misery.
reply: That is true.
Much human suffering has its roots in a poor adaptation; that is, their model of the world doesn't serve them very well. The "mentally ill" are not simple victims of biochemistry. The failures of individual cognitive models are both individual and individually structured. It seems to be highly unlikely that a set of chemical aberrations could of them selves give rise to such specific and complex failures.
reply: You seem to suggest that being miserable or being unable to adapt to one's environment makes one "mentally ill." I disagree. If you are claiming that a delusional "model of the world" is simply a problem of adaptation, I think you're wrong. Maybe I don't understand what kind of "failures" you are referring to. However, a person may be unable to adapt to the world because of a brain disorder. Some brain disorders can be treated with medications that affect neurochemical production, reception or reuptake. The number of cases where this happens is too great to think it is an accident. For example, if a person with schizophrenia is hearing voices and a medication stops the voices, while stopping the medication brings the voices back, the likelihood that this is a problem of "adaptation" seems negligible.
Aspirin may alter the sensation of pain but it doesn't alter the high level concept of what this pain means to me, so why would some other biochemically active substance alter an individual's individual concepts of his world?
Neuroleptic medications may stop a schizophrenic's hallucinations by dulling down certain cognitive functions just as smashing the TV "gets rid of" bad programs.There undoubtedly are changes in brain chemistry involved in many "psychiatric disorders" but who is to say what is causative and what is mere correlation. There are real organic brain disorders which are an entirely separate kettle of fish. Autism cannot be bundled up with say schizophrenia or depression under the title of mental illnesses and treated as having common causes.
reply: Autism not only can, but is, "bundled up" with schizophrenia, bipolar disorder, depression, and other mental illnesses. See Bernard Rimland's Infantile Autism (1964). (Or see my review of Madness on the Couch.) The fact that schizophrenia, autism, and bipolar disorder tend to run in families, even if those families do not all live in the same environment, indicates that the diseases are not likely caused by environmental factors.
Psychiatry and the dodgy medical science that go with it are not more valid than psychoanalysis as you seem to suggest. To compare the measurable fact of a broken limb to the psychological pain of "mental illness" is a profound injustice. There are no easy answers, drugs do not fix broken lives. Try talking to some "mental patients" rather than just reading books!
Mental illness is a misnomer, you have been mislead, and you a philosopher too!
reply: Psychiatry has its share of pseudoscientific theorists and practitioners. I believe that biopsychiatry is not in the same league with psychoanalysis. Biopsychiatry may go overboard in its identification of all mental disorders with brain disorders or neurochemical imbalances that are biologically based in the same way as, say diabetes, is biologically based. But this science is correctable. Psychoanalysis has no way of weeding out errors, because it has no empirical checks besides purely subjective ones.
By the way, I have talked with mental patients, in addition to reading books on the subject. I have a great appreciation for the difficulties of persons who are psychotic at age three, not because of adaptive problems, but because of brain disorders. I know the anguish of parents who teens are suicidal because of the lack of control they have over their thoughts and actions, whose potent medications keep the voices away but do not "cure" them of their obsessions. These kids were not abused, except by Nature. Their adapting problems are an effect of their disorders, not a cause. Treating the effect by typical methods of disciplining, pleasure deprivation, physical punishment, kicking them out of school don't and won't help. Psychoanalysis would be about as useful as football practice or art lessons for these severely disturbed and physically diseased persons. I believe Dr. Freud would agree with me on this point. He did not think that psychoanalysis was useful for the treatment of psychotic disorders.
However, I agree that medication alone cannot help such people adapt to society. Special education and training programs, as well as community programs which involve local businesses and potential employers are also essential. Even cognitive therapy is appropriate in many cases. But not psychoanalysis.