H. Michael Meagher, MD

I’m sure we all recall that Freud began his professional life as a neurologist. He did neuroanatomical research, wrote three monographs on the infantile cerebral paralyses of children, and wrote a monograph On Aphasia. When he started a practice, he saw neurological and psychiatric patients, which is what a neurologist saw then. As he turned his attention to hysterical patients he tried to work out a neurological theory of hysteria, one grounded in the neurobiology of his day. This proved to be impossible given the state of biological knowledge at that time, so he turned his attention to a purely psychological approach to theory and practice and created psychoanalysis. However he continued to believe that neuroses would be explained in biological terms.

We must recollect that all of our provisional ideas in psychology will presumably one day be based on an organic substructure.

“On Narcissism” 1914

The deficiencies in our description would probably vanish if we were already in a position to replace the psychological terms with physiological or chemical ones…. We may expect (physics and chemistry) to give the most surprising information and we cannot guess what answers it will return in a few dozen years of questions we have put to it. They may be of a kind that will blow away the whole of our artificial structure of hypothesis.

“Beyond the Pleasure Principle” 1920

Neuroscience – cognitive neuroscience, developmental neuroscience, affective neuroscience, and social neuroscience – has made great strides in “The Decade of the Brain” and it seems that the time is here for psychoanalysts to join with neuroscientists in exploring the mind-brain. The International Neuro-Psychoanalysis Society has been founded. Eric Kandel has challenged us to bring our expertise in understanding the mind to the table for both examination and to enrich the biologists appreciation for the workings of the mind. Many institutes are including neuroscience in their coursework and more analysts are undertaking research. But many also have reservations. Some think that the neuroscientific findings will – or may – change our theory, but that it will have no effect on the practice of psychoanalysis. With this, there is a question about expending the effort to master a field that is not needed. However, it seems that neuroscience may already be influencing ptactice.

Mirror neurons are neurons which mirror similar neurons in another person (or primate) and which fire when the other person does something which we observe. If a monkey sees another monkey pick up a piece of food, the same neurons fire in the observing monkey as in the eating monkey. This seems to be a basis for empathy, imitation, and identification, and also is involved in language acquisition. In face to face therapy, analyst and analysand may be drawn into mirroring each other. Is free association possible in this circumstance? This may influence decisions about using the couch.

Neuroscience discredits infantile amnesia. Initially the infant and toddler only has procedural or implicit memory which in unconscious. Declarative memory takes longer to develop. Relationship patterns and moral learning are handled by procedural memory. Memory itself is always constructed. There may be more emphasis on understanding relationship patterns and associated fantasies and less on the recovery of repressed explicit memories.

Analysands vary in their cognitive capacities such as language abilities, long- and short-term memory, executive functioning, attention, and integration. Neuroscience has delineated more of the neural underpinnings of these skills. The analyst must know which are biologically based and which are the result of intrapsychic conflict in order to appropriately address the analysand’s problems.

More is known about the various affect systems that come into play in analysis. Often psychoactive medication is used – appropriately – to address depression or anxiety.

This may facilitate the analysis by making the analysand more capable of working in analysis, less demoralized and fearful of becoming more symptomatic if he gets into certain areas.

Trauma has its own special biology that the analyst should understand and respect. It is important to recognize that the release of glucocorticoids during trauma may prevent the hippocampus from encoding the memory of the events leading to no memory, not a repressed one,

Lastly, complexity, not linear dynamics, underlie biological systems. Because of this, outcome cannot be absolutely predicted. This allows us to understand discontinuities in child development and it requires a loosening of the epigenetic model of development. It does not mean that all bets are off however.

The neurosciences are here to stay as is psychoanalysis. If we can work together we both will benefit.

References

Guttmann G, and Scholz-Strasser I (Eds.) (1998) Freud and the Neurosciences: From Brain Research to the Unconscious.Vienna: Verlag der Oesterreichischen Akademie dre Wissenschaften.

Kandel ER. (1999) Biology and the future of psychoanalysis: a new intellectual framework for psychiatry revisited. Am. J. Psychiat. 156: 505-534.

Olds D. (2006)Interdisciplinary studies and our practice. J. Am. Psychoanal. Assoc. 54: 857-876.

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