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Abstract
At regular intervals for over half a century, critiques of Freud and psychoanalysis have emerged in the popular media and in intellectual circles, usually declaring that Freud has died some new and agonizing death, and that the enterprise he created should be buried along with him like the artifacts in the tomb of an Egyptian king. Although the critiques take many forms, a central claim has long been that unconscious processes, like other psychoanalytic constructs, lack any basis in scientific research. In recent years, however, a large body of experimental research has emerged in a number of independent literatures. This work documents the most fundamental tenet of psychoanalysis--that much of mental life is unconscious, including cognitive, affective, and motivational processes. This body of research suggests some important revisions in the psychoanalytic understanding of unconscious processes, but it also points to the conclusion that, based on controlled scientific investigations alone (that is, without even considering clinical data), the repeated broadside attacks on psychoanalysis are no longer tenable.
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Biography |
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Abstract
Freud built his model of the mind and his hypotheses about dreaming directly on the structure of his neurobiological model of the brain, which was developed in the "Project for a Scientific Psychology", written in 1895. Among the concepts modeled in this work were ego, somatic drives as motivationally critical, cathexes of psychic energy, wish fulfillment, and primary and secondary process. From the vantage point of more than 80 years later, the authors indicate the areas in which many of Freud's neurobiological assumptions are inacurrate. Revisions are needed in the neurobiologically derived psychoanalytic concepts, especially those of Freud's wish fulfillment-disguise theory of dreams.
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Schore AN. A century after Freud's project: is a rapprochement between psychoanalysis and neurobiology at hand? J Am Psychoanal Assoc 1997; 45:807-40. [PMID: 9353707 DOI: 10.1177/00030651970450031001] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
In his 1895 "Project for a Scientific Psychology" Freud attempted to construct a model of the human mind in terms of its underlying neurobiological mechanisms. In this endeavor "to furnish a psychology which shall be a natural science," Freud introduced the concepts that to this day serve as the theoretical foundation and scaffolding of psychoanalysis. As a result, however, of his ensuing disavowal of the Project, these speculations about the fundamental mechanisms that regulate affect, motivation, attention, and consciousness were relegated to the shadowy realm of "metapsychology." Nonetheless, Freud subsequently predicted that at some future date "we shall have to find a contact point with biology." It is argued that recent advances in the interdisciplinary study of emotion show that the central role played by regulatory structures and functions represents such a contact point, and that the time is right for a rapprochement between psychoanalysis and neuroscience. Current knowledge of the psychobiological mechanisms by which the right hemisphere processes social and emotional information at levels beneath conscious awareness, and by which the orbital prefrontal areas regulate affect, motivation, and bodily state, allows for a deeper understanding of the "psychic structure" described by psychoanalytic metapsychology. The dynamic properties and ontogenetic characteristics of this neurobiological system have important implications for both theoretical and clinical psychoanalysis.
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Kandel ER. Biology and the future of psychoanalysis: a new intellectual framework for psychiatry revisited. Am J Psychiatry 1999; 156:505-24. [PMID: 10200728 DOI: 10.1176/ajp.156.4.505] [Citation(s) in RCA: 81] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The American Journal of Psychiatry has received a number of letters in response to my earlier "Framework" article (1). Some of these are reprinted elsewhere in this issue, and I have answered them briefly there. However, one issue raised by some letters deserves a more detailed answer, and that relates to whether biology is at all relevant to psychoanalysis. To my mind, this issue is so central to the future of psychoanalysis that it cannot be addressed with a brief comment. I therefore have written this article in an attempt to outline the importance of biology for the future of psychoanalysis.
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Abstract
The notion of professional boundaries is a relatively recent addition to psychoanalytic practice. Freud and his early disciples indulged in a good deal of trial and error as they evolved psychoanalytic technique. The study of these early boundary violations illuminates the study of the evolution of the concepts of transference and countertransference. The recent publication of the correspondence between Freud and Jung, between Freud and Ferenczi, and between Freud and Jones has provided us with extraordinary insights into the boundary transgressions that occurred in the early days of psychoanalysis. The boundary violations of the analytic pioneers have contributed to the legacy inherited by future generations of analysts. Institutional resistance to addressing these difficulties in contemporary psychoanalytic practice may relate in part to the ambiguities surrounding boundaries in the training analysis itself.
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Abstract
What I believe to be the essential contribution of this group of analysts may be summarized as follows. The role of object relations has always been a prominent theme in analytic thought and has become much more so in recent years. Instead of grafting the implications of relations onto a theory that started from a different standpoint, what the British group has done is to show that the development of the person has to be conceived as the progressive differentiation of a structure from a unitary matrix that itself interacts at a holistic personal level from the start. While Balint noted clinical data that required this step, he did not put forward a theoretical scheme. Winnicott, who suggested more specifically how the infant's relationships at the earliest stages patterned its whole subsequent personal development, also refrained from following through the theoretical logic of his observations. Fairbairn was the first analyst to expose the questionable logic of a developmental scheme based upon the energic concepts that Freud retained as his theoretical base. Fairbairn's scheme, however, did not account adequately for the earliest developmental stages as these were inferred from the study of regressive states. Guntrip, making full use of Winnicott's views, has sought to make good this limitation. The British group does not presume to have made anything like an adequate conceptual map for the development of the psyche. The theoretical problems are far too complex for that. They have, however, shown a fruitful direction and have influenced many areas of contemporary psychoanalytic thought.
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In the 16 years since its inception, self psychology has provided a comprehensive theory of psychopathology and treatment. It has articulated a new group of developmental needs and transferences: mirroring, idealizing, and alter ego. The failure of parental empathy to meet those needs during childhood results in the inability to develop intrapsychic structures that can reliably regulate self-esteem and calm the self, leaving the person overly dependent on those in the surround to provide those functions. Treatment requires careful understanding of the early failures and provides an environment in which the intrapsychic structures may belatedly and effectively develop.
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Abstract
BACKGROUND Opposition to homosexuality in Europe reached a crescendo in the 19th century. What had earlier been regarded as a vice evolved as a perversion or psychological illness. Official reviews of homosexuality as both an illness and (for men) a crime led to discrimination, inhumane treatments and shame, guilt and fear for gay men and lesbians. Only recently has homosexuality been removed from all international diagnostic glossaries. AIMS To review how British psychiatry has regarded homosexuality over the past century. METHOD Review of key publications on homosexuality in British psychiatry. RESULTS The literature on homosexuality reflects evolving theories on sexuality over the past century. The assumptions in psychoanalysis and the behavioural sciences that sexuality could be altered led to unscientific theory and practice. CONCLUSIONS Mental health professionals in Britain should be aware of the mistakes of the past. Only in that way can we prevent future excesses and heal the gulf between gay and lesbian patients and their psychiatrists.
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This article surveys Freud's various versions of the seduction theory, from 1896 to 1933. It is concluded that the seduction theory had never been based on the patients' direct statements and conscious recall of seduction by the father in early childhood--unlike what Freud was to state much later (1933). This early seduction was mostly reconstructed by Freud from the patient's verbal material and behavior in treatment (including memories of sexual experiences from later childhood) which he interpreted as disguised and incomplete "reproductions" and reenactments of the original seduction trauma. Further, the external trauma was never meant to account by itself for the later neurotic symptoms. The "delayed action" of its unconscious memory, producing the repression of an event from the time of puberty, was a necessary part of the process. Thus internal psychic transformations and conflicts, anticipating Freud's later emphasis on fantasy and psychic reality, were already an intrinsic part of the seduction etiology of 1896. It is also noted that the father played no central role in the original theory as presented in 1896; it is only in the letters to Fliess that the father emerged as the prime seducer. The implications of this clarification of the seduction theory for the understanding of the changes and continuity in the development of Freud's theories are highlighted; their relevance to ongoing issues in psychoanalysis about the role of external trauma, fantasy, and reconstruction are briefly examined.
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Holmes J. Attachment, autonomy, intimacy: some clinical implications of attachment theory. THE BRITISH JOURNAL OF MEDICAL PSYCHOLOGY 1997; 70:231-48. [PMID: 9376330 DOI: 10.1111/j.2044-8341.1997.tb01902.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
This paper reviews the origins and current state of attachment theory, especially as relevant to the practice of psychotherapy. It is suggested that attachment experience becomes internalized as self-narrative around the age 3-5, and that these self-narratives form the basis of reflexive self-function and autobiographical competence in later life, as revealed by the Adult Attachment Interview. It proposes that the fundamental aims of psychotherapy can be characterized as the search for intimacy and autonomy, arising on the basis of parental attunement and containment of healthy protest, of which analogues are to be found in adult psychotherapy. A 'triangle of attachment' is introduced at whose apices are attachment, detachment and 'non-attachment' respectively. Attachment, which arises out of a secure base, provides the starting point for intimacy; the capacity for healthy protest and therefore detachment is the basis of autonomy; from non-attachment comes the capacity to reflect on oneself and so to disidentify with painful or traumatic experience.
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This paper is intended as a contribution to the understanding of errors in our field. The title refers to the index entries "incest" in several classic psychoanalytic texts. In a way that is analogous to the defenses utilized by survivors of incest, psychoanalysis has both known and not known, avowed and disavowed, the traumatic impact of actual incest. It is argued that psychoanalysis erred in (a) focusing too heavily on the implications of incest for the Oedipus complex instead of its implications for every stage of development, and (b) missing out on the full and detailed description of the clinical pictures of incest victims and of treatment issues, including transference and countertransference. The author presents an overview of the history prompted by Masson's original attack on Freud for abandoning the "seduction hypothesis." Topics covered are: Freud's early papers, the Freud-Ferenczi controversy (1932), and the state of psychoanalytic awareness in the 1960's of the importance of actual incest. Certain features of our field make it all too likely that new errors can be generated that may similarly take decades to recognize and undo. These include the politics of our discipline, and negative attitudes toward systematic gathering and assessment of evidence.
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The authors reviewed the studies on obsessive-compulsive disorders published from 1953 to 1978. They report on various theories of the etiology of the disorders and provide an overview of the studies based on these theories. The treatment modalities covered include behavioral modification, drug therapy psychotherapy, surgery, and experimental therapies. the authors conclude that, although the obsessive-compulsive disorders are widely present, there is a paucity of new data concerning their treatment. The evidence to date, however, suggests that psychotherapy is an essential ingredient in the treatment process. They recommended that further clinical studies be done to elucidate the etiology and treatment of these disorders.
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OBJECTIVE The purpose of this paper is the assessment of the healer's listening as an aspect of the history of caring and curing, with particular attention to its place in psychological healing. METHOD An extensive range of philosophical, religious, and medical sources from antiquity to the present were studied. RESULTS Over the centuries, listening has been a crucial aspect of the various endeavors undertaken by healers in the interest of acquiring information from, achieving understanding of, and bringing about healing effects for sufferers. Yet it has been vision rather than hearing that has been emphasized in knowing and understanding, and looking rather than listening that has been emphasized in healing endeavors. Only around the turn of the twentieth century did there emerge the focused study of care in listening, of listening beyond the words themselves, and of the significance of the interested listener as a soothing, empathic force. CONCLUSIONS The place of listening in depth and with empathy is a crucial element in healing. While the emphasis on looking remains significant in the gathering and appraisal of data, at times it threatens to overwhelm the need for an attentive and concerned listener. There appears to be a natural tension between the two modes that has, in modern times, been translated into a tension between the two modes that has, in modern times, been translated into a tension between a scientific mode of gaining information and a humanistic mode of knowing sufferers. A healer neglects either one at his or her peril--and at the peril of his or her patients.
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Granek L. Grief as pathology: The evolution of grief theory in psychology from Freud to the present. HISTORY OF PSYCHOLOGY 2010; 13:46-73. [PMID: 20499613 DOI: 10.1037/a0016991] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The emergence of grief as a topic worthy of psychological study is an early 20th century invention. Freud published his influential essay on mourning and melancholia in 1917. Since he proposed the concept of "grief work," contemporary psychologists have examined his theory empirically and have claimed that grief is a pathology that should be included within the psychological domain. How, and why, has grief theory evolved within the discipline of psychology in this way? In what ways do these changes in the understanding of grief coincide with other historical developments within the discipline? In this article, I trace the development of grief, originally conceived by Freud within a psychoanalytic and nonpathological framework, to the current conceptualization of grief within the disease model. I show how grief theory has evolved within the discipline of psychology to become (a) an object worthy of scientific study within the discipline, and subsequently, (b) a pathology to be privatized, specialized, and treated by mental health professionals.
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Abstract
John Bowlby bemoaned the separation between the biological and psychological approaches in psychiatry, and hoped that attachment theory, which brings together psychoanalysis and the science of ethology, would help bridge the rift between them. Recent findings in developmental psychology have delineated features of parent-infant interaction, especially responsiveness, attunement, and modulation of affect, which lead to either secure or insecure attachment. Similar principles can be applied to the relationship between psychotherapist and patient--the provision of a secure base, the emergence of a shared narrative ('autobiographical competence'), the processing of affect, coping with loss--these are common to most effective psychotherapies and provide the basis for a new interpersonal paradigm within psychotherapy. Attachment theory suggests they rest on a sound ethological and hence biological foundation.
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Hornstein GA. The return of the repressed: Psychology's problematic relations with psychoanalysis, 1909–1960. AMERICAN PSYCHOLOGIST 1992; 47:254-63. [PMID: 1567090 DOI: 10.1037/0003-066x.47.2.254] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
When psychoanalysis first arrived in the United States, most psychologists ignored it. By the 1920s, however, psychoanalysis had so captured the public imagination that it threatened to eclipse experimental psychology entirely. This article analyzes the complex nature of this threat and the myriad ways that psychologists responded to it. Because psychoanalysis entailed precisely the sort of radical subjectivity that psychologists had renounced as unscientific, core assumptions about the meaning of science were at stake. Psychologists' initial response was to retreat into positivism, thereby further limiting psychology's relevance and scope. By the 1950s, a new strategy had emerged: Psychoanalytic concepts would be put to experimental test, and those that qualified as "scientific" would be retained. This reinstated psychologists as arbiters of the mental world and restored "objective" criteria as the basis for making claims. A later tactic--co-opting psychoanalytic concepts into mainstream psychology--had the ironic effect of helping make psychology a more flexible and broad-based discipline.
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This essay reviews the history and evolution of the antipsychiatry movement. Radical antipsychiatry over several decades has changed from an antiestablishment campus-based movement to a patient-based consumerist movement. The antecedents of the movement are traced to a crisis in self-conception between biological and psychoanalytic psychiatry occurring during a decade characterized by other radical movements. It was promoted through the efforts of its four seminal thinkers: Michel Foucault in France, R. D. Laing in Great Britain, Thomas Szasz in the United States, and Franco Basaglia in Italy. They championed the concept that personal reality and freedom were independent of any definition of normalcy that organized psychiatry tried to impose. The original antipsychiatry movement made major contributions but also had significant weaknesses that ultimately undermined it. Today, antipsychiatry adherents have a broader base and no longer focus on dismantling organized psychiatry but look to promote radical consumerist reform.
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Bernardi R. The need for true controversies in psychoanalysis: the debates on Melanie Klein and Jacques Lacan in the Rio de la Plata. THE INTERNATIONAL JOURNAL OF PSYCHOANALYSIS 2002; 83:851-73. [PMID: 12204169 DOI: 10.1516/p2wf-57vj-25my-3rm4] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Controversies are part of the process of scientific knowing. In psychoanalysis, the diversity of theoretical, technical and epistemological positions makes the debate particularly necessary and by the same token difficult. In this paper, the author examines the function of controversies and the obstacles to their development, taking as examples the debates held in the Río de la Plata (Buenos Aires and Montevideo) during the nineteen seventies, when the dominant Kleinian ideas came into contact with Lacanian thought. The author examines different examples of argumentative discourses, using concepts taken from the theory of argumentation. The major difficulties encountered did not hinge on characteristics pertaining to psychoanalytic theories (i.e. the lack of commensurability between them), but on the defensive strategies aimed at keeping each theory's premises safe from the opposing party's arguments. A true debate implies the construction of a shared argumentative field that makes it possible to lay out the different positions and see some interaction between them and is guided by the search for the best argument. When this occurs, controversies promote the discipline's development, even when they fail to reach any consensus.
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Abstract
Analysis of the unconscious ego resistances is one of those clinical concepts more honored in the breach than in the observance. This same point has been made periodically over the past fifty years. It has not been sufficiently realized that a true psychoanalytic understanding of resistance analysis could only begin with Freud's second theory of anxiety. Freud himself never fully embraced this theory, and clinical contributions since then have varied in their ability to use the techniques inherent in the second theory of anxiety. Recent contributions to the literature have not eliminated the espousal of theories of resistance based on earlier views of anxiety. Reasons cited for this include: the ambiguities in Freud's writing, the direction of the early ego theorists, and proclivities toward deeper interpretations.
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