Just as the old psychoanalyst seemed destined for history's trash heap, neuroscientists are resurrecting his most defining insights.
Freud’s theory, which he formulated in the 1890s and revised repeatedly, was both comprehensive and radical. Its bottom line is that we do not know ourselves. In his formulation, the mind constantly generates powerful wishes that are repressed — shut down by our own internal censors before we even become aware of them. Much of what we do and think is shaped by these unconscious impulses, unbeknownst to us.
By the end of the 20th century, the two disciplines, psychoanalysis and neuroscience, did not even seem to be talking about the same thing. Psychoanalysis was hostile to the idea of testing hypotheses through experiments. Neuroscience claimed to explain the brain but ignored its finest product: the dazzling, intimate sensations of human consciousness.
That is both a shame and an amazing intellectual opportunity, says the South African neuropsychologist and psychoanalyst Mark Solms, co-chair of the International Neuropsychoanalysis Society. Solms is convinced that reconnecting psychoanalysis and neuroscience is absolutely essential — the only way we will ever truly understand the brain.
The point is not to prove that Freud was right, but to apply the techniques of modern biology to explore some of his most enduring ideas. Neurobiology has the ability to test these ideas with powerful tools and experimental rigor. Together, the two fields might finally answer the most elusive question of them all: How is it that dreams, fantasies, memories and feelings — the subjective self — emerge from a hunk of flesh?
To be fair, neurobiologists had good reasons to be wary of studying inner life. Interpreting data about internal experiences is fraught with potential errors. People are notoriously inaccurate at identifying their own sensations and emotions, and words are vague. When someone says he feels good, does it mean the same as someone else who also feels good? Before the spread of neuroimaging techniques in the late 1990s, there were few objective markers of mental events. (Even today, neuroscientists’ ability to connect people’s specific thoughts and feelings to their brain signals is crude.)
At about the same time, during the 1990s, neuroscientist Jaak Panksepp was exploring the feelings of animals. Panksepp saw that human emotions and emotional problems could be explored by studying other mammals — how their brains generated emotions akin to the anger, sadness and joy that humans describe, what neurons and neural circuits were involved.
More than a decade later, the study of emotions is a major field in brain science. Even the study of consciousness, long considered impossibly speculative, now attracts mainstream researchers. But as biologists wander into these realms, they need guidance — hypotheses to test and refine, well-thought-out concepts and questions that point the way toward useful experiments.
They could do worse than look to Freud for inspiration, suggests Eric Kandel of Columbia University, a Nobel Prize-winning expert on learning and memory and one of the most respected voices in neuroscience. “Flawed as it may be, Freud’s is still a coherent and intellectually satisfying view of the mind,” says Kandel. “You can’t have a meaningful science of the brain without having a meaningful science of the mind.”
In a study that is now legend, cognitive scientist Benjamin Libet asked people to press a button whenever they felt like it while he monitored the electrical activity in their brains. He could see that movement-controlling brain regions become active about a quarter of a second before subjects said they’d consciously decided to push the button. Some unconscious part of the brain decided well before the conscious mind did.
Another Freudian premise that reappears in current science is that our minds are inherently conflicted, the terrain of a struggle between instinctual impulses and inhibitory mechanisms. Instead of the Freudian terms idand ego, biologists use neuroanatomical descriptions:
Emory medical school neurologist and depression researcher Helen Mayberg explains that her work on depression strives to describe the same overarching concepts that Freud invoked, including links between brain circuits and disordered moods. “Analysis has a much richer tapestry of both words and concepts” than neurobiology, says Mayberg. “The things Freud wrote about are things that every awake person on the planet thinks about.”
Depression is a perfect example. The prevailing theory in biomedical research is mechanistic: Depression is just another biochemical problem, essentially no different from diabetes or gout. That approach leads to the creation of dozens of medicines that tamper with serotonin and other brain chemicals — drugs that, for more than half of patients, don’t work. “Pharma has dumped a gazillion dollars down the drain and never [has] come up with a new concept,” says Panksepp.
Like most psychiatrists, he and Solms say the place to begin is with the existential reality of depression — the soul-crushing hopelessness and despair. Their fundamental question: Why does depression feel so bad?
“Oliver Sacks has this saying: Neuropsychology is admirable, but it excludes the psyche,” Solms says.
Solms supervises the progress of his group of New York psychoanalysts on monthly trips from South Africa. In New York, he listens to developments in the group’s roster of psychoanalytic cases. In Cape Town, he is a professor of neuropsychology, making rounds in the University of Cape Town’s teaching hospital, and chairing the university’s neuropsychology department.
As Solms says: “There can’t be a mind for neuroscience and a mind for psychoanalysis. There’s only one human mind.”
More recently, scientists at King’s College London and the University of Melbourne have found, using brain scans, that psychological stress may be to blame for unexplained physical symptoms, including paralysis and seizures Freud may have been right about repressed memories causing hysteria.
The scientists used functional magnetic resonance imaging, or fMRI, to trace changes in blood flow to particular areas of the brain while participants were probed about their past, yielding both anatomical and functional views of their brains.
Patients showed differences in brain activity when they recalled traumatic memories compared with healthy volunteers in a study published in last month’s edition of JAMA Psychiatry. Besides supporting Freud’s theory and helping to explain one of the most common complaints seen by neurologists, the research may lead to new treatment approaches for patients whose symptoms were often written off by doctors in the past.
PS: For those are open enough to consider how two such diverse streams might come to flow together, we recommend a look at one of Freud's last papers, and our favorite Notes on the Mystic Writing Pad. Based on his comments on a popular childrens' writing toy.
For me it is quite possible as good as anything we have for understanding how the hippocampus and the cortex work together. We look forward to any readers sharing their ideas of this short and famous paper.