Justifying psychoanalysis

I coined the term neuropsychoanalysis in 1999 not to give psychoanalysis ‘a fashionable prefix’ but to describe the efforts of a group of scientists attempting to integrate our findings on the same part of nature, derived from different viewpoints. We believed integration was necessary because the capacity of the brain to feel subjective states has significant implications for how it works; feelings have causal effects and mean something. Freud was not the only scientist to explore this perspective, but he did so more systematically than anyone before him. The resulting body of hypotheses is called psychoanalysis. The advent of neuropsychoanalysis coincided with the emergence of new methods capable of correlating hypotheses derived from the objective and subjective perspectives, and thereby correcting viewpoint-dependent errors. Ramus ¹ suggests that this might be ‘dangerous’ for three reasons.

First, Freud's hypotheses (e.g. the unconscious, the ego/id dichotomy) were ‘borrowed shamelessly from predecessors without credit’ (e.g. Janet and Plato). The historical precursors of ideas are irrelevant to their scientific value. We use psychoanalytic ideas as the starting point of our investigations for the reason Kandel cited: taken as a whole they still represent ‘the most coherent and intellectually satisfying view of the mind’ that we have (p. 505). ²

Second, ‘The case for the importance of a cognitive level of description for any proper understanding of the mind/brain, and for its conceptual independence from the biological level has already been made long ago.’ Ramus must surely concede that the claims of psychoanalysis are different from those of cognitive psychology. But he goes further: ‘Psychoanalysis is not just a harmless set of ideas’. Many hypotheses and treatments in biological psychiatry were considered dangerous (e.g. opiates, frontal lobotomy), and many regrettable practices are perpetrated in its name. That is not a good reason to decry the future development of psychopharmacology or psychosurgery. The exclusion on moral grounds of certain ‘schools’ is a slippery slope in science. Competing claims must be contested empirically, with ethical abuses being handled by the appropriate review boards.

Third, ‘It is not enough for empirical research to tackle the influence of early life experiences, the neural correlates of unconscious processing, or the decoding of dream content using neuroimaging, to support psychoanalysis as such, even if Freud happened to use the same words’. As Guterl once wrote, in a popular context: ‘It's not a matter of proving Freud wrong or right, but of finishing the job’ (p. 51). ³ Neuropsychoanalysts will readily agree that ‘what is needed is to show that certain central psychoanalytical concepts […] can now be sufficiently precisely defined to make clear, testable predictions, that some of these predictions are indeed correct, and that they are not better explained by other, simpler theories’. That is precisely what we are doing; and we call it psychoanalysis.

I am not sure whether Ramus will be amused to know that neuropsychoanalysis has been similarly criticised by psychoanalysts, decrying the supposed dangers of neuroscience (e.g. Blass & Carmeli ⁴ ).