Hope dies hard. Psychoanalysis has gone the way of alchemy, but an intrepid band of loyalists believes that it can make a comeback.
In itself this is a bad sign. If people are wishing for your comeback, that suggests that you have nowhere to go but up.
I will save the debate on the clinical effectiveness of psychoanalysis for another time. For today I want simply to consider the PR hit that Freud and psychoanalysis took in today’s New York Times book review.
Tasked with reviewing Jeffrey Lieberman’s book Shrinks, Natalie Angier, the Times science correspondent recalls her own experience of orthodox Freudian analysis:
One of the most miserable experiences of my young adulthood, in the mid-1980s, was the year I spent in formal Freudian psychoanalysis. How well I remember lying on that uncomfortable couch with its built-in simulacrum of a pillow, as I struggled desperately to just “let my mind go,” to free associate, to disinter childhood memories or impulses that might prove remotely useful to me or at least satisfy my psychiatrist, who often seemed to be picking distractedly at lint on her skirt. She was a brilliant woman, no doubt about it, yet I always left her office feeling like a failure, and the science writer in me couldn’t help wondering, Where is the clinical evidence that this excruciating and expensive ordeal really works?
Folks, this is the New York Times. Its science writer is calling psychoanalysis an “excruciating and expensive ordeal.” Excuse her pragmatism, but she is asking if there is any evidence that it works.
She finds an answer in Lieberman’s book:
… the evidence, quite simply, doesn’t exist. Whether for the treatment of relatively mild afflictions like my dysthymia, or for serious conditions like bipolar disorder, schizophrenia or depression, psychoanalysis never had much, if any proof of efficacy. Yet the Freudian conceit that repressed desires and conflicts were the source of mental illness, and that talking those urges out of hiding could lead to a cure, dominated American psychiatry for over half a century, Lieberman says, stranding the field in “an intellectual desert” from which it has only recently emerged. “Sigmund Shlomo Freud,” Lieberman writes, was “simultaneously psychiatry’s greatest hero and its most calamitous rogue.”
How did Freud deal with the fact that psychoanalysis could not provide evidence to suggest that it worked: First, he attacked anyone who questioned him. (My Lacanian friends have made this into an art form.) Second, he transformed psychoanalysis into a “petrified religion,” or what I more correctly called a pseudo-religion.
Angier writes:
Freud knew he lacked evidence for many of his “daring ideas about mental illness,” Lieberman says. Yet rather than conducting research to fill in the gaps, he instead began attacking anybody who questioned him. “He demanded complete loyalty to his theory, and insisted that his disciples follow his clinical techniques without deviation,” Lieberman argues, thereby “fossilizing a promising and dynamic scientific theory into a petrified religion.”
Don’t say I didn’t tell you.
We have pseudo-religions and pseudo-sciences, and now petrified religions, and perhaps we can add petrified science too?
ReplyDeleteIt makes me wonder what could the standards of "true religion", "true science", and I guess "living religion" and "living science"?
Richard Feynmann's "Cargocult science" observations can give us something of "pseudoscience"
https://en.wikipedia.org/wiki/Cargo_cult_science
http://www.lhup.edu/~DSIMANEK/cargocul.htm
But a first open question is whether psychology can ever be a "science" in Feynmann's sense, where belief can be avoided, and reproducible experiments can demonstrate correct understanding, vs placebos or mere effects of natural processes with time that would have occured with or without treatment.
I go to E.F. Schumacher's ideas of a chain of being:
https://en.wikipedia.org/wiki/A_Guide_for_the_Perplexed#Levels_of_being
And a quote: "Human beings are highly predictable as physico-chemical systems, less predictable as living bodies, much less so as conscious beings and hardly at all as self aware persons."
So if we see humans exist at 3 distinct ontological levels of being, we have to decide what level of being we are trying to "treat" and see different tools and different measures are necessary for each level.
And if we discover higher levels of being can not be "treated" by nonreligious language, what is a proper "scientist" to do?
Joseph Campbell supporting Jung and others offered one approach, seeing the human mind as a story teller, a myth maker, and some stories and myths are personal, and some are more collective, and that archetypes are like "instincts" behind those stories and myths, autonomous agents within and beneath our conscious thought, and not overly directable, but maybe more like a stream, you can use the energy of a stream to dig new channels by small directed changes in flow, but if you think you can just dam up all that energy to a directed purpose by the force of will, you'll fail.
So Jung would probably call psychology more as myth than science, and that means any techniques you find will look something more like religious rituals than scientific controlled experiments. How do you invoke what is hidden and subtle? How do you raise hidden patterns of behavior in a way that allow more conscious direction when its needed?
And whatever techniques you find, what measures do you have for success? And some patients might need a small nudge, while others are going to flounder in chaos for years no matter what you do or don't do, and that floundering itself is the needed process.
Perhaps it would be better if psychologists just attached themselves to a specific religion and then they wouldn't have to justify themselves as science, or any objective measures of success. They could say their purpose would be to help save the eternal souls of their congregation, and only God could measure their success, and they trusted the holy spirit to aid in their discernment of what could best help someone.
Well, on the good side, their clients could donate money tax free, while on the bad side, probably they couldn't justify $100/hour charge rates for their expertise.
"Freud knew he lacked evidence for many of his “daring ideas about mental illness,” Lieberman says. Yet rather than conducting research to fill in the gaps, he instead began attacking anybody who questioned him. “He demanded complete loyalty to his theory, and insisted that his disciples follow his clinical techniques without deviation,” Lieberman argues, thereby “fossilizing a promising and dynamic scientific theory into a petrified religion.”"
ReplyDeleteI didn't know he was a Progressive!