The Feeling Brain

Selected Papers on Neuropsychoanalysis

Mark Solms

• Publisher: Routledge
• Year: 2018
• ISBN:
  9780429920752
• Edition: 1
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

This book focuses on the matter of neuropsychoanalysis. It shows how the neuropsychoanalytic approach makes it possible to begin to locate within the tissues of the brain some of the metapsychological abstractions that Sigmund Freud derived from his work with purely psychiatric disorders.

PART I

WHAT IS A NEUROPSYCHOANALYTIC PERSPECTIVE?

CHAPTER ONE

What is neuropsychoanalysis?

Mark Solms & Oliver H. Turnbull

The first formal use of the term “neuro-psychoanalysis” occurred in 1999, when it was introduced as the title of the journal by that name. Plainly, however, the relationship between psychoanalysis and neuroscience is much older than the term. In the dozen years since the word “neuropsychoanalysis” was first used, it has been employed in a number of different ways, for different purposes, by different people.¹ This chapter serves to briefly survey some of this complexity and, in the process, to sketch out the intended scope of the field. In doing so, we will also address some of the criticisms that the field has encountered in the decade or so since its foundation.

There are two major limitations to this account. The first is that we can speak only for ourselves and thus describe what we think “neuropsychoanalysis” is—and ought to be. Nevertheless, we may claim a certain privilege in that respect, by virtue of one of us (MS) having invented the term. Second, we aim to speak only of the absolute basics of the discipline, to address only the foundational issues.

We will address the question “what is neuropsychoanalysis?” under four headings: (1) the historical foundations of neuropsychoanalysis, (2) its philosophical foundations, (3) its scientific foundations, and lastly (4) we will discuss what neuropsychoanalysis is not.

The historical foundations of neuropsychoanalysis

When we speak of the historical foundations of neuropsychoanalysis, we must of course begin with Freud. In doing so we are also addressing the question as to whether or not neuropsychoanalysis is really a legitimate part of psychoanalysis. The alternative view is that it is somehow a foreign body in our midst, or a deviation, or perhaps even something fundamentally anti-psychoanalytic.

In relation to this question, Freud’s attitude to the issue is of paramount importance. If neuropsychoanalysis is legitimately part of what Freud conceived psychoanalysis to be, it places the interdiscipline of neuropsychoanalysis in a strong position with respect to this “parent” discipline. It was Freud, after all, who invented psychoanalysis. Happily, therefore, Freud’s view on the matter was very clear, and also consistent throughout his life. Freud was, of course, a neuroscientist and a neurologist for the first two decades of his professional life (Solms, 2002; Solms & Saling, 1986; Sulloway, 1979). Throughout his later psychoanalytic work he had a specific scientific programme in mind, largely continuous with his earlier neuroscientific work, albeit shaped by the limitations of the scientific methods and techniques available to him at that time (for more on this topic see Solms & Saling, 1986; Solms, 1998a; Turnbull, 2001).

Freud’s programme was to map the structure and functions of the human mind, and naturally he recognized that these were intimately related to the structure and functions of the human brain. However, as regards the mapping of these relationships, he consistently argued that the brain sciences of his time did not have the tools, in both conceptual and technical terms, necessary for exploring these relationships. He therefore shifted to a purely psychological method—a shift that he reluctantly saw as a necessary expedience. Just a few quotations illustrate this position:

We must recollect that our provisional ideas in psychology will presumably some day be based on an organic substructure. … We are taking this probability into account in replacing the special chemical substances by special psychical forces. [Freud, 1914c, pp. 78–79]

The deficiencies in our description would probably vanish if we were already in a position to replace the psychological terms by physiological or chemical ones. [Freud, 1920g, p. 60]

Biology is truly a land of unlimited possibilities. We may expect it to give us the most surprising information and we cannot guess what answers it will return in a few dozen years to the questions we have put to it. [Freud, 1920g, p. 60]

There are many such statements throughout Freud’s work. All reveal, first, that he viewed the separation of psychoanalysis from neuroscience as a pragmatic decision. Second, he was always at pains to clarify that progress in neuroscience would have the inevitable result that at some time in the future the neurosciences will advance sufficiently to make the gap bridgeable. As one of the quotes above suggests, his rough estimate was that this might happen in a “few dozen years”. That was in 1920.

What were the methodological limitations that Freud encountered at that time? The main neuroscientific tool then available was the clinico-anatomical method, based on the clinical investigation of patients who had suffered focal brain lesions (Finger, 1994)—that is to say, studying how different functions of the mind were altered by damage to different parts of the brain. It was effectively the only method available for studying mind–brain relationships (though Freud’s later years did briefly overlap with early developments in neurochemistry; see Finger, 1994).² However, Freud regarded the clinico-anatomical method as unsuitable for his purposes, despite having used it himself in his pre-analytic work. Best known is his 1891 book on the aphasias, which demonstrates how sophisticated was his mastery of that method, and of its limitations (for a modern appreciation of Freud’s early neuropsychological investigations, see Shallice, 1988, pp. 245–247).

In that book, and in the papers that he published soon after (Solms, 2001b), Freud rejected the clinico-anatomical method, as he made the transition into psychoanalysis. He did so for several reasons. First, he recognized that the mind is a dynamic entity. It was Freud’s emphatic view, even as a neurologist (Freud, 1891), that the mind was not made up of static modules or boxes connected up by arrows. Instead, Freud saw the mind as comprising dynamic, fluid processes. Second, Freud observed that the mind consisted in far more than consciousness; there was, beneath consciousness, a vast sub-structure, the workings of which had to be explored and understood before we would ever be able to make sense of the volitional brain.

The aim of psychoanalysis then became to develop a method and ultimately to derive from that method a theory (and a therapy), that would enable science to explore and understand the dynamic nature and unconscious structure of the mind. It is widely known that Freud then proceeded to use this purely clinical method, free from neuroscientific constraints, from 1895 or thereabouts, until 1939. This pioneering work left us a vast legacy, including a series of theoretical models of the basic organization of the mind, which we now refer to as “metapsychology”.

Some psychoanalysts, misreading Freud, argue that the theoretical work of psychoanalysis must continue to remain aloof from neuroscience forever. We must avoid using neuroscientific methods, no matter how far these advance, and cling to our exclusively clinical, psychological approach. These are authors who question “whether the study of [neuroscience] contributes in any way to the understanding or development of psychoanalysis as theory or practice … whether neuroscience is of value to psychoanalysis per se” (Blass & Carmeli, 2007, p. 34; for a further opinion, see Karlsson, 2010, pp. 40–64). The proponents of this view appear (fortunately, in our opinion) to form a diminishing minority (British Psychoanalytical Society, 2008), but we must acknowledge that there are still some colleagues who believe that psychoanalysis has nothing to learn from neuroscience in principle. (Oddly, however, they do seem to think that neuroscience has something to learn from psychoanalysis!)

Independently of this theoretical—or ideological—question, there remains the technical question as to whether neuroscience has developed sufficiently as a discipline to allow it to make an adequate contribution to psychoanalytic theory: whether the methodological limitations (and related limitations of neuropsychological knowledge that Freud referred to) still remain. Stepping back, it is clear that there have been huge technical and methodological advances in the neurosciences over the last several decades. To offer but the briefest historical summary:

Electroencephalography (EEG) was introduced in the 1930s (Berger, 1929), though it was not fully exploited until after the war. This represented the beginning of a capability, initially rather crude, to measure and observe dynamic aspects of brain activity under changing functional conditions. The later development of event-related potentials (ERPs) in the 1960s (Sutton, Braren, Zubin & John, 1965; Sutton, Tueting, Zubin & John, 1967; Walter, Cooper, Aldridge, McCallum, & Winter, 1964; for a recent review see Luck, 2005) offered substantial advances over the basic EEG technique, by virtue of experimental control and averaging procedures. The recent development of magnetoencephalography (MEG) represents a further substantial advance, allowing us to study the neural dynamics associated with mental events at the millisecond level, with increasing anatomical precision.

In another domain, after the Second World War, there were tremendous developments in neuropsychology, using the lesion method in a new way which adapted its inherent limitations to the dynamic nature of the mind. Alexander Luria, in particular, developed a method known as “dynamic localisation” (Luria, 1966, 1973; see Kaplan-Solms & Solms, 2000, pp. 39–34; see also Solms & Turnbull, 2002, pp. 64–66). This method permitted the investigator to identify constellations of brain structures that interact to form functional systems, where each structure contributes an elementary component function to the complex psychological whole. On this basis, modern neuropsychology has a well-developed understanding of most of the basic mental functions. This applies especially to cognitive functions.

Further enormous technical advances followed the advent of computerized tomography in the 1970s, which made it possible to identify the precise location of a brain lesion while the patient was still alive. This was followed by magnetic resonance imaging (MRI). And from the 1990s onward, functional neuroimaging (functional magnetic resonance imaging, fMRI; positron emission tomography, PET; and single photon emission computed tomography, SPECT) made it possible to directly observe neurodynamic processes under changing psychological conditions.

It is now also possible to deliver temporary, short-acting “lesions” to neurologically intact research participants—either through sodium amytal injection (which was first introduced in the 1940s) or through magnetic pulses delivered to the outside of the skull via transcranial magnetic stimulation (TMS; which had been readily available since the 1990s). Innumerable other technologies also exist, ranging from stimulation of the cortical surface in neurosurgical operations (Penfield & Boldrey, 1937; Penfield & Rasmussen, 1950), through deep-brain stimulation (Mayberg et al., 2005), through psychopharmacological probes (Ostow, 1962, 1980), to mention only the most obvious examples.

Even this brief summary demonstrates that we do now have neuroscientific methods that enable us to study the dynamic nature of the mind and to identify the neural organization of its unconscious substructure. Each of these methods has its limitations, as all methods do, and there are undoubtedly many future advances to come—but the landscape of scientific enquiry in this domain has, certainly, radically changed since Freud’s lifetime. For this reason, it seems entirely appropriate to reconsider whether we might now attempt to map the neurological basis of what we have learnt in psychoanalysis about the structure and functions of the mind, using neuroscientific methods available to us today. Freud would, in our opinion, have considered this a welcome and wholly legitimate development of the work that he pioneered. There has been something of an explosion in the number of books addressing this issue (e.g., Bazan, 2007; Bernstein, 2011; Corrigall & Wilkinson, 2003; Cozolino, 2002; Doidge, 2008; Fotopoulou, Pfaff, & Conway, 2012; Kaplan-Solms & Solms, 2000; Mancia, 2006; Northoff, 2011; Peled, 2008; Shevrin, Bond, Brakel, Hertel, & Williams, 1996; Solms & Turnbull, 2002).

The philosophical foundations of neuropsychoanalysis

If we are to correlate our psychoanalytic models of the mind with what we know about the structure and functions of the brain, we are immediately confronted with the philosophical problem of how mind and brain relate—with the “mind–body problem”. This opens huge philosophical questions. Are we reducing the mind to the brain, are we explaining away the mind, or are we merely correlating mind and brain? And if we are merely correlating them, what is the causal basis of this apparently compulsory correlation? Is the relationship hierarchical, whereby psychoanalysis studies mere epiphenomena of the brain? Or is the mind an emergent property of the brain? (Chalmers, 1995a, 1995b, 1996; Churchland, 1986; Searle, 1980; for a basic review of these issues, see Solms, 1997a, or Solms & Turnbull, 2002, pp. 45–66).

It is, of course, terribly important in this field to be clear about one’s conceptualization of the relationship between the mind and brain. We favour a conceptualization (shared by Freud) that we think neuropsychoanalysis as a whole may be based upon. This approach is typically labelled “dual-aspect monism” (see Solms, 1997a; Solms & Turnbull, 2002, pp. 56–58).

Freud says, very clearly in many places, that the actual nature of the mind is unconscious (for review see Solms, 1997a). He uses the phrase “the mind in itself” referring directly to the philosophy of Kant. For Kant, our subjective being, the thing we perceive when we look inwards, is not the mind in itself: the mind in itself cannot be perceived directly. We can only know the mind via our phenomenal consciousness, which provides an indirect and incomplete representation of the mental apparatus and it workings. The actual ontological nature of the mind is something epistemologically unknowable: it necessarily lies behind (and generates) conscious perception. We can, of course, infer its nature from our conscious observations and thereby “push back” the bounds of consciousness, which is what the psychoanalytic method seeks to do. Ultimately, however, we can never directly know the mind itself. We must therefore have recourse to abstractions, derived from inferences, and built into figurative models: metapsychology.

Similar epistemological limitations hold for the theoretical abstractions of other branches of psychology—to the extent that they too attempt to describe the inner workings of (any aspect of) the mind. Even highly developed theories such as, for example, dual-route reading models (Coltheart, Curtis, Atkins, & Haller, 1993), models of multiple memory systems (Schacter, 1996; Schacter, Norman, & Koutstaal, 1998), models of divergent visual systems engaged in perception and action (Milner & Goodale, 1993), and so on. All of psychology is ultimately just model-building of one sort or another. It is only the scale of Freud’s metapsychology that distinguishes it, in this respect, from the more narrowly focused models of cognitive psychology and neuroscience. It is also (partly) for this reason that the metapsychology lacks some of the specificity of modern cognitive models. But that has no bearing on their ultimate epistemological limitations.

Freud argued not only that the mind is epistemologically unknowable, but also that it is ontologically no different from the rest of nature. Kant’s view was that everything in the world as we know it, including the contents of our external awareness, is only an indirect representation of reality. What all scientists do is probe beyond this perceptual data to try to get a better picture of what Freud called the “the real state of affairs” (1940a [1938], p. 196). This approach, we note, is common to all the natural sciences—often with the use of artificial perceptual a...