The Brain and the Inner World

An Introduction to the Neuroscience of Subjective Experience

Mark Solms, Oliver Turnbull

• Publisher: Routledge
• Year: 2018
• ISBN:
  9780429920233
• Edition: 1
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

This work is an eagerly awaited account of this momentous and ongoing revolution, elaborated for the general reader by two pioneers of the field. The book takes the nonspecialist reader on a guided tour through the exciting new discoveries, pointing out along the way how old psychodynamic concepts are being forged into a new scientific framework for understanding subjective experience – in health and disease.

Chapter 1

Introduction to Basic Concepts

This is very much a beginner’s guide to the brain. It makes virtually no assumptions about previous knowledge of neuroscience, and there is no intention to dazzle the reader with exotic facts and stunning photographs. The aim is rather simple: to familiarize nonspecialists with the basic facts of how the brain “produces” our subjective mental life (as far as we understand these facts today).

To this end, each chapter provides an overview of the neurobiology of a particular aspect of the mind. The focus is on aspects that would traditionally have been the preserve of psychoanalysts rather than neuroscientists. In the past century, there was an unfortunate division between the subject matter of neuropsychology and the lived reality of the mind. This once prompted the neurologist Oliver Sacks to write that “neuropsychology is admirable, but it excludes the psyche”!¹ Happily, that situation has now changed. The really interesting things about psychology, such as consciousness, emotions, and dreams—topics from which neuropsychologists “shrank in horror” (Zeki, 1993, p. 343) less than a decade ago—are finally coming into the ambit of neuroscience. Readers of this book will learn what is known today about the neurobiology of these mental functions—about the “inner world” of the mind.

An example of personality change following brain injury

The following celebrated case illustrates why the inner world of the mind should be of interest to brain scientists.

Figure 1.1 Phineas Gage’s lesion

In the 1840s, an unfortunate man by the name of Phineas Gage was laying railway tracks in the midwestern United States. He was pressing down a charge of dynamite into a rock formation, using a tamping rod, when the charge suddenly exploded. This caused the tamping rod to shoot through his head, from underneath his cheekbone into the frontal lobe of his brain and out through the top of his skull. Partly because the rod passed through so rapidly, probably cauterizing the tissue on its way, the damage to Gage’s brain was not very widespread (Figure 1.1); only a relatively small area of frontal tissue was affected (for a precise description see Damasio et al., 1994). Gage did not even lose consciousness, and he made a rapid physical recovery.

His physician, however, reported some interesting changes when he published the case in a local medical journal a few years after the incident. Dr. Harlow noted that, despite the good physical recovery and the relatively small extent of the brain injury, his patient was radically changed as a person; his personality was changed. Before the accident Gage had been the foreman of his team, a position of some responsibility; he was regarded as of reliable character and was highly valued by his employers. However, this is what Harlow said about Gage’s condition after the accident:

His physical health is good, and I am inclined to say that he has recovered… [but] the equilibrium or balance, so to speak, between his intellectual faculties and animal propensities, seems to have been destroyed. He is fitful, irreverent, indulging at times in the grossest profanity (which was not previously his custom), manifesting but little deference for his fellows, impatient of restraint or advice when it conflicts with his desires, at times pertinaciously obstinate, yet capricious and vacillating, devising many plans of future operation, which are no sooner arranged than they are abandoned. … In this regard his mind was radically changed, so decidedly that his friends and acquaintances said that he was “no longer Gage.” [Harlow, 1868, p. 327]

Disregarding the quaint language, the message of this nineteenth-century physician’s description still comes through clearly: as a result of his brain damage, Gage was “no longer Gage.” The inescapable conclusion is that Gage’s personality—his very identity—was somehow dependent upon the few cubic centimeters of brain tissue that were damaged in his accident. Today we know, from observing countless similar cases, that damage to that area of tissue almost always produces the very same type of personality change that it did in Gage’s case. There is some variability, depending above all on the individual’s personality before the injury, but these patients are typically fitful and irreverent, show little deference for others, are impatient of advice if it conflicts with their desires, and so forth. These are some of the cardinal features of what is now known as the “frontal-lobe personality.”²

In our clinical work as neuropsychologists we have met literally hundreds of Phineas Gages, all with damage to the same part of the brain. This is a fact of obvious importance for anyone with an interest in personality. It suggests that there is a predictable relationship between specific brain events and specific aspects of who we are. If any one of us were to suffer the same lesion in that specific area, we would be changed in much the same way that Gage was, and we, too, would no longer be our former selves. This is the basis of our view that anyone with a serious interest in the inner life of the mind should also be interested in the brain, and vice versa.

Two Approaches to the Science of the Mind

The mental life of real human beings is the traditional subject matter of psychoanalysis. We have said that it has recently become a legitimate subject matter for neuroscience too. In other words, we now have two disciplines (perhaps better described as two loose groups of disciplines) studying the same thing. But they approach this shared subject matter from completely different points of view.

The “subjective” approach to mental science (psychoanalysis) split off from the “objective” approach (the neurosciences) just over a hundred years ago. Freud’s Studies on Hysteria (1895d) or his The Interpretation of Dreams (1900a) provide useful milestones in this divergence. Since then, each approach has developed along its own path. The original reasons for the split were complex (see Kaplan-Solms & Solms, 2000; Solms & Saling, 1986; see also chapter 10). Mainly it was a matter of expedience. It was not possible to learn anything useful about the mind—the real mind, in Oliver Sacks’s sense—using the neuroscientific methods that were available at that time. Neuroscience could not (at that time) penetrate the mysteries of personality, motivation, emotion—the things that make us who we are—and it therefore seemed to Sigmund Freud that the most useful way to study, understand, and treat the disorders of the human subject was from a purely psychological perspective.

We do not wish to be excessively optimistic, but the reason that a book such as this one can be written today is because that situation has changed. We have powerful new methods and technologies in neuroscience that are yielding previously undreamed-of knowledge about the physiological underpinnings of the “inner world.” In short, neuroscience has caught up with—many would say overtaken—psychoanalysis as a science of the human subject, and today it is possible to learn some very important and valuable things about inner experience by studying the physical organ that was damaged in the case of Phineas Gage.

Reconciling the Two Approaches

It is essential for us to find some way of bridging this historical divide, and perhaps healing the rift, between these two different approaches to mental science. Neuroscientists—who are grappling with the complexities of human subjectivity for the first time—have much to learn from a century of psychoanalytic inquiry (see Kandel, 1998, 1999). Psychotherapists, for their part, have an opportunity to benefit from the enormous empirical advances in the neurosciences and, as a result, to make progress in their own disciplines, where scientific progress has become frustratingly slow. Psychoanalysis today is associated with bitter rivalry between opposing camps that apparently have no valid means of deciding between their conflicting standpoints on various theoretical matters. One solution might be to find links between the disputed theoretical concepts of psychoanalysis and those of the neurosciences.

This seems to be an appropriate way to proceed, but it is quite difficult to put into effect. There are a number of things that have to be done for us to be able to bridge the gulf that separates these two approaches. Each side has (for various reasons) regarded the other with suspicion and disdain for over a hundred years. Typically, neuroscientists have regarded psychoanalysis and related disciplines as “unscientific” (how can a science of subjectivity be objective?). Psychotherapists, for their part, have regarded the neurosciences (including biological psychiatry) as simplistic, to the extent of excluding the psyche. These attitudes have developed for good reasons, and they will not be overcome easily or quickly.

In addition, there are serious scientific problems to grapple with. How can we link these disciplines in a methodologically valid way? To take a concrete question, how do we set about identifying the neurological basis of something like, say, “repression”? How does one go about testing experimentally, from the neurobiological point of view, whether such a thing as repression even exists? Repression—if it exists—is a complicated, elusive, fleeting phenomenon. It is far from easy to capture such things in physiological terms.

If such problems are to be overcome effectively, a good deal of the effort required would have to be put in by members of both of the approaches working together. To do this, we would have to have interdisciplinary dialogues and research about topics of common interest. We would need to collaborate on clinical material and work together on the same cases, or on examples of the same disorders, to learn from each other’s approaches. But first of all, before we can realistically combine them, we need to learn about each other’s different perspectives.

This text goes under that “educational” heading. Our main aim in this book is to impart to readers raised on the language of psychoanalysis something about contemporary neuroscience, and in particular something about what contemporary neuroscience has to say about some topics of general interest. In doing so (and especially in the later chapters), we also hope to convey something of how neuroscience relates to what psychotherapists know and do, and how we might begin to make links between these two approaches to the mind.

What readers will not acquire from this book is a neuroscientific perspective on particular psychopathologies—such as neuropsychiatric perspectives on attention-deficit disorder, obsessive-compulsive disorder, tic disorders, panic attacks, and so on. These are very complicated topics in their own right and are beyond the scope of this general introduction to the field. We plan to write another book dealing with them in the not-too-distant future. One must become familiar with the field as a whole and know some elementary things about the brain in general and its basic mental functions before these more complex problems can be tackled. Fortunately, the neuroscience of these functions—consciousness, emotion, memory, and so on—involves some very interesting topics. But before we can delve into them, we first need to get some really basic facts out of the way.

Elementary Brain Anatomy and Physiology

We begin our task with an introduction to functional brain anatomy and physiology. Anatomy and physiology are not glamorous subjects—and a complete knowledge of them requires careful and intensive study. But they provide the very bedrock of the subject matter of this book. This section does not deal with them at the level of detail covered in a medical-school curriculum. We cover only those basic concepts that readers absolutely must be familiar with to easily understand the material discussed in the subsequent chapters. Readers who have a background in brain anatomy and physiology, perhaps from undergraduate medical or psychology courses, may wish to pass over the next few sections. Note, however, that a number of very important concepts are introduced in the section on “The Internal and External World” and again in that on “The Internal World.”

It is easy to overlook the fact that the brain is, after all, just an organ. It is an organ like the liver or the spleen or the stomach. Like these other organs of the body, it is made of cells. These cells are connected together to form a piece of tissue with a certain characteristic texture and shape, and so the brains of all of us look roughly the same. And yet, there is something almost miraculously special about this organ: it is the organ of the mind—indeed, of our very selves, as Gage’s case amply demonstrates.

Despite this unique property of the brain, its cells are not fundamentally different from the cells of other bodily organs. What is the prototypical nerve cell? It consists of three basic parts (Figure 1.2). The first, the cell body, contains essentially the same things found in cells in other organs—namely, the things that govern its basic metabo...

Table of contents

• Cover
• Half Title
• Title
• Copyright
• CONTENTS
• FOREWORD
• PREFACE
• CHAPTER 1 Introduction to Basic Concepts
• CHAPTER 2 Mind and Brain—How Do They Relate?
• CHAPTER 3 Consciousness and the Unconscious
• CHAPTER 4 Emotion and Motivation
• CHAPTER 5 Memory and Phantasy
• CHAPTER 6 Dreams and Hallucinations
• CHAPTER 7 Genetic and Environmental Influences on Mental Development
• CHAPTER 8 Words and Things: The Left and Right Cerebral Hemispheres
• CHAPTER 9 The Self and the Neurobiology of the “Talking Cure”
• CHAPTER 10 The Future and Neuro-Psychoanalysis
• REFERENCES
• INDEX