Tag: psychoanalysis

Psychoanalysis 2.0

Posted on by Herbert Harris

by Herbert Harris

I began my psychiatric training in 1990, the year that marked the start of a program called the “Decade of the Brain.” This was a well-funded, high-profile initiative to promote neuroscience research, and it succeeded spectacularly. New imaging techniques, molecular insights, and psychopharmacological discoveries transformed psychiatry into a vibrant biomedical science. The program brought thousands of careers, including my own, into the neurosciences.

Despite its progress, the Decade of the Brain also widened an existing rift. This was the large gap between the psychoanalytic tradition and the biological sciences. The divide wasn’t new. Freud started with neurology but shifted to psychoanalysis when the brain sciences of his time couldn’t fully explain the complexities of the mind. For the first half of the 20th century, psychoanalysis was the main way to understand mental illness. Then, in the 1950s, new psychiatric drugs appeared: chlorpromazine for psychosis, lithium for mood disorders, and antidepressants for depression. For the first time, it seemed possible to treat mental illness by directly targeting the brain, rather than long-term therapy or institutional care.

By the time I was a resident, these diverging traditions had opened into a chasm. On one side was biological psychiatry, focused on neurotransmitters, neuroimaging, and cognitive-behavioral treatments, with outcomes that could be measured and tested. On the other side were psychoanalysis and its branches: attachment theory, object relations, and the investigation of unconscious conflicts through language, narrative, and symbolism. They had become separate languages, spoken within distinct professional communities, each wary of the other. There were occasional efforts at rapprochement, but little sustainable progress. By the end of the Decade of the Brain, reconciliation seemed almost impossible. I was fortunate to be in a training program that had a research track, allowing me to work in a lab, but I also had mentors who were distinguished analysts. It was like being in two different residencies.

Both have proven valuable over the years, but I never expected them to converge. However, today, circumstances appear to be shifting. A merging of neurobiology, computational neuroscience, and neuroimaging has created a new paradigm: active inference. For the first time, we can start to identify strong links between analytic models of the mind and biological models of the brain. Read more »

Can Love Last? A (mostly) encouraging story about the fate of romance over time

Posted on by Gary Borjesson

by Gary Borjesson

Note: Since it is February, and since the world can surely use more love, I offer this as a little Valentine’s gift, dedicated to romantic love. Its inspiration is Stephen Mitchell’s book, Can Love Last? This is not a book review but an invitation to reflect on romantic love, with Mitchell as our guide.

The urn with the lovers that inspired John Keats’ famous poem, Ode on a Grecian Urn, which beautifully captures the split between wanting and having.

In my early twenties I fell in love with a woman who couldn’t color inside the lines. Brilliant, sensitive, and adventurous, but unreliable, addicted, and self-destructive. Around that time I was also in love with an amazing woman who was healthier and more reliable, if also (like me) less dangerously exciting. I felt conflicted: Should I embrace a more romantic and adventurous life, or choose something safer and more sustainable? My gut told me that choosing adventure in this case would end in heartbreak and bad habits. My heart was split between wanting safety and wanting danger. My head didn’t know what to think.

Many of us face a similar bind, whether to choose safety or adventure. Whether to plan ahead or live more spontaneously and passionately. Whether to hit the open road or put down roots. In his fascinating and wise book, Can Love Last? the fate of romance over time, psychoanalyst Stephen Mitchell addresses this bind, and offers a way through. The way begins by recognizing that romantic love is actually constituted through the tension between “the ordinary and transcendent, safety and adventure, the familiar and the novel, that runs through human experience.”

So, how do we make true love? In Mitchell’s grand vision, it’s not about siding with passion or security, it’s about about bringing them into the living conversation that is romantic love. In the final chapter of Can Love Last Mitchell sums up his argument

deeper more authentic commitments in love entail not a devotion to stasis but a dedication to process in the face of uncertainty. Genuine passion, in contrast to its degraded forms, is not split off from a longing for security and predictability, but is in a continual dialectical relationship with that longing.

Mitchell’s way of putting it would have appealed to my 22-year-old self, who would soon be going off to grad school in philosophy. Back then, however, I didn’t have the maturity or self-awareness to put this wisdom into practice—even if I could have appreciated the theory. Nevertheless, for those who want to make love that lasts, Mitchell’s book offers insight and inspiration. Many practical suggestions can also be gleaned. Read more »

Wednesday, December 11, 2024

Of True and False Selves: Donald Winnicott’s View

Posted on by Gary Borjesson

by Gary Borjesson

The power and peril of seeing, and being seen, has been with us from the beginning. Almost the first thing Adam and Eve do is seek to hide from being seen by God. (Good luck with that!) Much later, Hegel showed how, in contrast, the desire to be seen—the desire for recognition—is a motive force of human history. Later still, we are learning how critical being seen is to a child’s development.

The negative effects of not being seen are a core theme of Alice Miller’s Drama of the Gifted Child. This book made a deep impression when I first read it years ago, long before I became a psychotherapist. At the risk of triggering those (including myself) with an allergy to therapeutic speak—I felt seen. I wasn’t alone. Since its publication in 1979, the book has sold well over a million copies worldwide.

Miller explores how some children use their “gift” of sensitivity to adapt to inadequate parenting. In particular, she describes how a “false self” develops from the “true self.” This distinction comes from the British pediatrician and psychoanalyst D.W. Winnicott, who observed and thought deeply the relation of parents and children. (Many people besides biological parents can play the role of caregiver; I will use the words “parent” and “mother” to preserve the archetypal resonances.) I expect many readers will recognize aspects of their experience in Winnicott’s influential account of how we can come to feel lost to our true selves.

We all make use of a ‘false’ self. As Winnicott notes, “Each person has a polite or socialized self, and also a personal private self that is not available except for intimacy.” (Home Is Where We Start From: Essays by a Psychoanalyst, Norton & Co, 1990. All quotes are from this book.) Someone gives you a heartfelt gift that you don’t like. But you say you like it because you see there is nothing to be gained by saying how you really feel. The social world depends on having this polite self capable of getting along by masking our true thoughts and feelings. Read more »

Monday, August 7, 2023

Undead Freud

Posted on by Christopher Horner

by Chris Horner

if often he was wrong and, at times, absurd,
to us he is no more a person
now but a whole climate of opinion
under whom we conduct our different lives

—W. H. Auden ‘In memory of Sigmund Freud’

Undead

Freud and psychoanalysis seem to be in a state resembling Schrodinger’s famous cat: alive and dead at the same time. Dead and discredited and yet alive and influential. Perhaps the better analogy here is not to the ambiguous feline but to another figure: that of the undead. For while Freud the man expired in 1939 and has been killed again and again before and after that date, still he returns, like something repressed that just won’t lie down and vanish.

In an interesting essay in the New Republic in 1995, Jonathan Lear commented on the extraordinary fervour with which Freud and psychoanalysis seemed to be killed, again and again [1]. It prompts the thought: why? Lear proposes three cultural currents that motivate Freud bashing: the development of drugs, alongside increasing knowledge and interest in how the brain works, the way cheap pharmacology seems preferable to expensive psychoanalysis, and finally a backlash against some of the grander claims about Freud and his techniques that were much touted in the earlier part of the last century. Certainly Freud got things wrong and sometimes went about his analysis in a way that seems quite mistaken. But is that it? Read more »