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How Well Does Freud’s Work Stand the Test of Time? How Well Does Freud’s Work Stand the Test of Time?

How Well Does Freud’s Work Stand the Test of Time? - PowerPoint Presentation

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How Well Does Freud’s Work Stand the Test of Time? - PPT Presentation

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