Allen Frances MD Full Disclosure I am not a specialist on Freud Neuroscience Cognitive psychology Computer science The social sciences Art criticism Philosophy Intellectual history ID: 290412
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Slide1
How Well Does Freud’s Work Stand the Test of Time?
Allen Frances MD Slide2
Full Disclosure- I am not a specialist on:
Freud
Neuroscience
Cognitive psychology
Computer science
The social sciences
Art criticism
Philosophy
Intellectual history
I know almost nothing about everything and welcome contributions from the audience on all of these topics Slide3
Why Freud Counts
Complete model links brain and mind Science and humanities
Medicine with evolutionary biology
Normal and abnormal psychology
Individual and group psychology
Past, prehistory, and modern cultures Slide4
Freud’s Contributions Hold Up Well
Mind can be studied scientifically UCS determines much of what we do
Role of defense and psychic conflict
Bridge: Darwin to everyday life
Precursor of evolutionary psychology
Epigenesis
, not degeneracy or genetics
The
Kraepelin
of outpatient diagnosis
Father of all modern talk therapies Slide5
Freud as a Reluctant Social Reformer
All speak Freud without knowing it
Furthers modernism, individualism, fem emancipation, and sexual revolution
Embraced by intellectuals in their opposition to
Hapsberg
status quo regarding church, politics, bureaucracy, and morality
But unlike Adler, Reich, Fennel, From, and Marxists, Freud was pessimistic regarding changing human nature and societySlide6
Second Greatest Psychologist After Darwin
M and N Notebooks (1838-1840)
On the Origin of Species
(1859)
The Descent of Man and Selection in Relation to Sex
(1871)
The Expression of the Emotions in Man and Animals
(1872)
Biographical Sketch of an Infant
(1877)Slide7
Darwin’s Contributions to Psychology
Human psychology from animal and retains much of our inheritance Understanding baboons tells us more than reading Locke and the philosophers
Psychology can be an objective science amenable to observation and experiment
Materialist mind as a brain function: no
vitalism
or human
exceptionalism
Slide8
Darwin’s Contributions to Psychology (continued)
Natural and sexual selection lead to evolution of instincts, emotions, and intellectUCS-major rule influencing behavior
Instinct interacts with environment
The child is father to the man
Everything has or once had a purpose Slide9
Darwin’s Methods
Compare animal and human behaviors Survey human behavior around the world
Minute observation of child maturation
Reactions to facial expressions
Introspection and dream analysis Slide10
Darwin UCS vs. Freud UCS
Neither invented idea By 1700 UCS conceivable
By 1800 UCS topical
1870-1880 UCS fashionable
Darwin’s UCS is mostly adaptive, non-
conflictual
reflection of evolution
Freud adds dynamic unconscious-conflict between lusty instinctual wishes and repressive forces, some inborn
Hartmann adds conflict free sphere Slide11
Adaptive vs. Conflictual UCS Reflect:
Darwin entry point is normal function; Freud’s is the study of psychopathology
Darwin optimist; Freud pessimist
Darwin hates conflict; Freud relishes
Darwin establishment; Freud outsider
Darwin inborn moral sense to be good; Freud inborn punishing superego
Darwin cherished fruits of civilizing; Freud saw it as discontents Slide12
Freud Surfaced Many Intellectual Currents
Helmholz-brain; as electrical machine; see with out brains, not just our eyes
Meynert
, Jackson- hierarchy of brain structure and
fx
; inhibition and regress
The sexologists: Moll, Ellis, Kraft-Ebbing
Archeology-dig for deeper UCS layers
Anthropology-universals in UCS content Slide13
Freud’s Philosophical Influences
Plato-reality under world of appearance
Kant-limits of reason and perceptions
Schopenhauer,
Nietzche
, Herbart, Hartmann- UCS sexual and aggressive forces influence behavior Slide14
Freud: A Crypto Aristotlean Via Brentano
Deductive model building not experimental model testing
A beautiful speculative model must be true-
eg
humoral
, string, neurotransmitter
Becomes dogma-number of horses’ teeth
Freud an exquisite logician-errors come from false premises, not weak argument
Metapsychology
is not a science-closes off refutation and inclusion of new data
Appeal to authority impedes progress
Lack of
validators
promotes schisms Slide15
Literary Influences
Sophocles Bible
Shakespeare
Goethe
Dostoevski
Slide16
Strengths
Bridges gap between brain materialism and psychological romanticism
Breath-brain anatomist, clinician, psychologist, anthropologist, art critic
Intellectual ambition-linking symptoms, personality, dreams, myths, literature Slide17
Strengths (continued)
Smartest person in room-not always right, but never wrote or said a dull thing
No one idea entirely new-UCS in the air, two books in Vienna in 1890’s; sexology was hot new science
But brilliant in putting it all together in one integrated and plausible model
Literary gifts- reaches general audience and leaders of all academic disciplines Slide18
Freud’s Epistemological Weakness
Talmud: We don’t see things as they are, we see them as we are Kant/Comte: Beware observer bias-impossible to remove subjectivity
Relation of observer to the observed
Umpire 1: Call them as they are
Umpire 2: Call them as I see them
Umpire 3: They don’t exist till I call them Slide19
Basic Issues Haunt Psychoanalysis
Subjectivity and projection Circular reasoning-sought confirmations of theories that could not be disproved
Descriptive reified as explanatory
If you disagree, must be your neurosis Slide20
Freud’s Methodological Weaknesses
Small n study-20 hysterical patients
Contempt for statistics and experiment
Subjective: Darwin looked as babies, studied primitive men, Freud inferred secondhand from reconstruction
Focused mostly on
intrapsychic
life- downplays interpersonal causes Slide21
Freud’s Methodological Weaknesses (Continued)
Ignores great role of suggestion in theory confirmation and treatment cures
Moll- ‘Freud’s theory accounts for clinical
hx
; histories don’t prove the theories’
Inheritance of acquired characteristics Slide22
Freud’s Personal Weaknesses
Freud: “I inherited the defiance of our ancestors defending the Temple”
Breuer: “Freud is a man given to absolute and exclusive formulations”
Fleiss: “The reader of thoughts reads his own thoughts into other people”Slide23
Freud’s Personal Weaknesses (continued)
Liepmann
: “Ingenious artist of thoughts triumphs over the scientific investigator”
Bleuler
: “Prickly skin-for or against us”
Jung: “One repays a teacher badly if one remains only a pupil”
Freud: “The goody-goodies are no good and the naughty ones go away” Slide24
Borrowings-Not Always with Attribution
Breuer: UCS/talking cure/catharsis
Fliess
: infantile and bisexuality
Jung: UCS complexes/myth
Stekel
: death instinct
Adler: aggression/mastery/ego psych Slide25
Borrowings-Not Always with Attribution (Continued)
Groddeck
: the ID
Rank: signal anxiety/separation anxiety/termination/mother transference
Ferenczi
: transference/
countertransferen
Alexander: correction emotional experience
Reich: analyze character resistance first Slide26
Blind Spot: What Do Women Want?
No coherent psychology of femininity-Freud’s boy’s eye view of girls
Castration complex, penis envy, clitoris
vs
vagina, masochism, passivity
Conventional views of women as neurotic, irrational, undeveloped men Slide27
Blind Spot: What Do Women Want? (Continued)
Object of desire, not subject of empathy
Downplays role of mother/child bonding
Horney- much fuller female psychology Slide28
But Positives Too
His influence greatly liberated women Encouraged female analysts
Strongly influenced by women
Better father figure to female followersSlide29
Promising Career as Brain Anatomist
Neuron-cell body plus fibrils
Importance of contact barrier
Mediating vs. moderating synapses
Evolution: neurons similar across all species-crab, lamprey, mammal Slide30
Promising Career as Brain Anatomist (continued)
Development in pups, kittens, fetus, kids
Cells migrate and connections get more complicated, but early structures persist
Gold chloride stain-reported in brain
Types of neurons-Phi for perception, Psi for memory, Omega for Cs Slide31
But Freud Has a Career Dilemma
Ambition thwarted-how to be great when funding is lost and want to marry?Viennese dim view of clinical practice
Virchow- “the academic physician can do nothing; the practitioner knows nothing”
Solution-apply scientific, observational, theoretical, literary skills to achieve greatness for clinical not lab work Slide32
Promising Career as Clinical Neurologist
Agnosia- deficits with intact perception
Cerebral palsy
Aphasia
Cocaine as psychotropic drug Slide33
Early Steps Toward Psychoanalysis
Translates Charcot and Bernheim; practices and writes on hypnosis
Collaborates with Breuer and has specialty practice focused on hysteria
Attempt to transcend cathartic and suggestion models for psychotherapy
Free association to provide a study tool based on faith in psychic determinism Slide34
Causes of Hysteria
Early-misled by simple Koch causality
Into a series of blind alleys
Inborn degeneration
Current sexual frustration
Early sexual seductions
Stimulation by caretakers
Stimulation but only by father
Repression of inborn sexual instinct
Later-complementary epigenetic interaction of instinct with experienceSlide35
Why Stuck on Sex as Universal Cause
Excitement regarding Darwin sexual selection Sexology brings scientific legitimacy
Staging explains choice of neurosis
Libido is missing link mediating brain biology and mental functioning
Interaction nature/nurture
Conflict over instinctual wish fulfillment seems to explain everything Slide36
Steam Engine Metaphor
Brain as hydraulic power plant Sexual libido is power source
Symptoms due to discharge, build-up, or transfer of libidinal energies
Neurasthenia-too much masturbation
Anxiety-toxic
undischarged
stimulation
Neuroses-psychic conflict/repression Slide37
Symptoms Related to Libidinal Stages
Autoerotic stage-schizophrenia Narcissistic stage-delusional disorder
Oral stage-depression
Anal stage-obsessive/compulsive
Phallic stage-hysteria Slide38
Vicissitudes of Libidinal Stages
Regressions Fixations Repressions in neurosis
Expression in perversions
Also determine character Slide39
From Exciting Model to Procrustean Bed
Premature closure/incomplete facts Deductive theory of everything
Way too rigid-everything is sex instinct
Ignores other instincts-aggression, attachment, status, mastery, altruism
Ignores neural network dysfunctions
Ignores context/interpersonal issues
Freud’s
humoral
theory Slide40
Modern Cybernertic View
Brain as computer
Information processing, not energies
Symptoms the result of hardware and software malfunction Slide41
Dreams-Royal Road to the UCS
Kant and Schopenhauer-dreams as brief madness/madness a long dream
Freud-mind a creative dream machine
Insights from dreams explain not only symptoms but myth, art, literature, and psychopathology of everyday life Slide42
Dreams as a Research Tool
Allow scientific study UCS process
Reflect lawful connections of all mental functioning-nothing is random
Instincts less repressed revealing primary process and contents of UCS
Free association to interpret content and determine latent content Slide43
But UCS is Elusive
Associations may be secondary elaborations, not key to latent content
Dream may be no more that
Rorshach
No gold standard for interpretation
Wish fulfillment-random
pontine
firings?
Dreams tell us a lot, but not everything about human nature Slide44
Why Do We Dream?
Still a mystery We now know when dream, but not why
Role in memory/homeostasis Slide45
Topographical Model
Borrowed from Fechner, Jackson, Darwin CS tip of iceberg; most behavior UCS
Different rules govern different levels of psychic functioning
Freud adds method of study, instinct, regulation by censor, primary and secondary process
Stands up well to modern cognitive science and brain imaging Slide46
Structural Model-A Freud/H Hartman
Self-preservative and self-evaluating instincts in part inborn and largely UCS
General psychology that anticipates cognitive psychology
But ego psychologists are theorists, not experimenters, so doesn’t advance field
Useful description, not explanation Slide47
Libido t
heory a great burden on psychoanalysis
An ingenious but wrong 1890 neuroscience model that restricted its openness to including emerging brain and cognitive science
Freud
somewhat corrects imbalance with aggression and the “I” and the “It”
Followers extend further with attachment theory, ego psychology, role of interpersonal factors, conflict free Slide48
Theories of Everything Bound to Fail
Brain too complex for simple models Newton: “I can calculate the movement of stars but not the madness of men”
No Newton, Darwin, or Einstein of mind
Ambition spurs insights-but premature models can’t possibly answer all questions and don’t wear wellSlide49
Localization by Brain Imaging
ID- limbic system/brain stem I-dorsal prefrontal/
somatosensory
Over I-
ventromedial
frontal
Anxiety-
amygdala
Slide50
Brain Plasticity
Psychotherapy change brain fx-reduced
amygdalar
firing in panic pts
Cortical control-can’t
decondition
amygdalar
responses unless cortical connections intact
Mirror neurons explain empathy for other’s emotions-inferior front
gyrus
connected to
amygdala
via
insula
Slide51
Epigenesis
Rat maternal behavior influenced by childhood nurturing experiences-methylation
changes gene expression
Low MAOA 80% rate ASPD if abused as child; 20% not abused
As Freud predicted, it is interacting/modulated networks not isolated regions
Search for how connections work: NIMH RDOC Slide52
American Embrace/Rejection of Freud
Very rapid decline from cultural icon of hope/modernism/sexual revolution to quaint psychological charlatan
Tipping point in 1970’sSlide53
Why?
Psychoanalysis disappoints-Berthe
P:
“
Psa
like confession depends on person applying it-useful or double-edged sword”
Institutes freeze rather than adapt-other more practical therapies prevail
Too tied to specific medical
rx
, not to broader cultural and intellectual trends Slide54
Why? (continued)
Neuroscience tools lead to reductionism
Pharma
adverts-chemical imbalance
Novelty wears off-once brilliant insights seem like tired cocktail clichés Slide55
In US, Analytic Institutes Become Guilds
No interest in cognitive or brain science
Standardize theory and method
Closed and rigid religious cults
Indoctrination stifles incorporation of new science/new ideas/new therapies
Secret committee/loyal tests/”treason”Slide56
Freud as Mind Biologist Not Followed
Was the Project central or blind alley?Jones-Freud was a psychologist, cutting psychoanalysis off from neuroscience
Revisionist version emphasizes biology, and some biologists now embrace Freud
Freud was reformed lab-rat
would
have loved and incorporated neuroscience Slide57
Current Institutional Psychoanalysis
Not a research tool
Not a practical therapy
Not a modern model of the mind
Embalmed Freud to save him Slide58
Psychoanalysis Fares Better Outside US
When it is incorporated into cultural studies in other disciplines
Stays open to new ideas, finding, and techniques
Was previously less dominant Slide59
Conclusions
Freud was overvalued in his own time as a lone pioneer with final answers-but not lone and no final answers
Freud is undervalued now because his followers were too dogmatic to keep psychoanalysis lively and relevant Slide60
Enduring Legacy
Opens up science of UCS vs. Compte
cognitive and neuroscience behavioral economics, sociology
Treatment insights:
Optimism
Value of life narrative
Role of psychic conflict
Transference/repetition compulsion
Corrective emotional experience
Art and literary criticism Slide61
Among Most Influential Thinkers-Past 200 Years-Pretty Good Company
Einstein
Darwin
Marx
Freud Slide62
And to Be Fair
Made inspired guesses
Brain complexity still defeats powerful modern tools
Evolution, atomic theory, history are less complicated than human behavior Slide63
What Would Freud Think?
Valued psychoanalysis more for research than therapy-would back brief dynamic and cognitive therapies
No problem with medication treatment-for better and worse a pioneer
Not surprised psychoanalytic and medical professions don’t mix well
Would Freud’s biggest weaknesses (dogmatism, epistemology, experiment) be cured by long sleep? Would need a good analysisSlide64
Contrast: Freud vs. Einstein
Partly the subjectivity of subject matter Partly Freud’s autocratic personality
Partly relation of theory to professional guilds
Mostly issue of experimental validation Slide65
Like Joyce
Mytheopoesis of everyday life
Interior monologue
Gave people permission to be complicated and conflicted
Glory of individual Slide66
Tragic Paradox of Freud Legacy
His ideas deserve better follow-up
His dominance prevented the inclusion and adaptation to new data