Although some of his theories are still hotly debated, Sigmund Freud, (May 6, 1856 – September 23, 1939) is widely regarded as a trailblazer in the realm of psychiatry and psychology. The Austrian psychiatrist and neurologist, who was allegedly the first to offer a comprehensive explanation of how human behavior is determined by the conscious and unconscious forces, is regarded as the founder of psychoanalysis.
Along with the “talk therapy” that remains the staple of psychiatric treatment to this day, Freud popularized, among other notions, such concepts as the psychosexual stages of development; Oedipus complex; transference; dream symbolism; Ego, Id and Super-Ego; and the one that has become part of colloquial English more than any other psychiatric term – the Freudian slip.
Dr. Allan Schore is on the clinical faculty of the Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine, and at the UCLA Center for Culture, Brain, and Development. He is author of three seminal volumes, Affect Regulation and the Origin of the Self, Affect Dysregulation and Disorders of the Self and Affect Regulation and the Repair of the Self, as well as numerous articles and chapters.
Q: In a posthumously published work entitled Project for a Scientific Psychology, Freud tried to relate his psychological theory to neuroanatomy and physiology but abandoned the project altogether. Can you tell us why he chose not to develop this line of inquiry?
A: In the summer of 1895, Sigmund Freud became obsessed with the idea of writing an article in which he would directly link the operations of the brain and the functions of the mind. This goal seemed to be within reach, as Freud, in the previous two decades, had worked as a practicing neurologist. During this period, he had published over 100 scientific works. These contributions, during the seminal “golden age” of neurology, culminated in 1891 in his volume On Aphasia. His ideas about this condition and the brain systems involved in language are still cited in today’s neurological literature. From 1893 to 1895, Freud transitioned from the brain to mind in his work with Breuer. In the spring of 1895, he had completed the final chapter on psychotherapy for Studies on Hysteria. It was in this very time period that Freud thought it was in his capacities to integrate his extensive knowledge of brain anatomy and physiology with his current experiences in psychology and psychopathology in order “to furnish a psychology which shall be a natural science.” He referred to this ongoing work as “Psychology for Neurologists.”
Initially, Freud was confident and even elated that a solution was at hand. Breuer observed that Freud’s intellect during this time was “soaring at its highest.’’ By October, he finished the work in two notebooks totaling 100 pages. This short essay set forth, for the first time, many elemental constructs that would serve as the foundation, the bedrock of psychoanalytic theory. In this remarkable document, Freud introduced the concepts of primary and secondary processes; the principles of pleasure-unpleasure, constancy, and reality testing; the concepts of cathexis and identification; the theories of psychical regression and hallucination; the systems of perception, memory, unconscious and preconscious psychic activity; and the wish-fulfillment theory of dreams. It also contained the seeds of Freud’s developmental theory and a neurophysiological model of affect generation.
To construct a systematic model of the functioning of the human mind in terms of its underlying neurobiological mechanisms, Freud had to deduce the existence of certain brain mechanisms that were not yet discovered. For example, he described the essential function of “contact barriers,” yet Sherrington introduced the term “synapse” only two years after the “Project” was finished! And he referred to the critical activity of “secretory neurons” in the brainstem, yet the biogenic amines of the reticular core of the brain were not discovered until well into the 20th century.
Within one month after finishing the Project, Freud’s enthusiasm totally collapsed, and he repudiated the work, and never wanted to see it again. After Freud’s death, it was finally published in 1950 under a title devised by Strachey, “Project for a Scientific Psychology.” It is now thought that the ideas generated in this work, many of which were incorporated into the seventh chapter of The Interpretation of Dreams, represent the source pool from which he later developed the major concepts of his psychoanalytic model. And yet, according to Sulloway, Freud “never abandoned the assumption that psychoanalysis would someday come to terms with the neuro-physiological side of mental activity.”
Q: Along with Mark Solms, you’ve been credited with breathing new life into Freud’s theories with your research in the area of neuro-psychoanalysis. Can you tell us what neuro-psychoanalysis is and how are you bridging the gap between Freud’s subjective view of the mind and your objective analysis of the brain?
A: In a 1997 article in the Journal of the American Psychoanalytic Association, I suggested that the time was right for a rapprochement between psychoanalysis and neuroscience. This rapprochement has allowed for the emergence of modern neuro-psychoanalysis and has returned to the seminal questions introduced in the Project that lie at the core of psychoanalysis. Psychoanalysis has been called the science of unconscious processes. Neuro-psychoanalysis is thus the branch of neuroscience that deals with the relationship between the mind, especially the unconscious mind, and the nervous systems. Notice I say the “nervous systems” and not “the brain,” because the neuronal systems that rapidly process bodily-based information at levels beneath conscious awareness are located in both the central nervous system and the autonomic nervous system.
During the 1990’s, one hundred years after the Project and the centennial of the birth of psychoanalysis, neuro-psychoanalysis experienced an intense revitalization. In 1994, I published Affect Regulation and the Origin of the Self, exploring the neurobiological underpinnings of developmental and clinical psychoanalysis. In parallel, throughout this “decade of the brain,” the investigative tools of neuroscience were greatly expanded—advances in neuro-imaging technologies greatly enhanced the study of brain/mind/body functions. And developmental psychology and emotion research were now producing experimental data research that were directly relevant to psychoanalysis. In 1997, Solms applied a neuro-psychoanalytic perspective to the problem of consciousness. Contemporary neuro-psychoanalysis is thus currently focusing on the essential problems that were defined at the dawn of psychoanalysis, including affect, motivation, attention, and consciousness.
Furthermore, developmental neuro-psychoanalysis, the study of the early structural development of the human unconscious mind, is now inquiring into how object-relational experiences, embedded in the affective transactions of the mother-infant attachment relationship, are registered in the deep unconscious, and how they influence the development of the systems that dynamically process unconscious information for the rest of the lifespan. Knowledge of these developmental events offers us a chance to understand more deeply not just the contents of the dynamic unconscious, but its origin, structure, and dynamics. Other ongoing themes of my own work include the role of the right brain as the neurobiological substratum of Freud’s dynamic unconscious; the enduring effects of early relational trauma on the development of the right brain intrapsychic structure and the etiology of psycho-pathogenesis; the elaboration of psycho-neurobiological models of defensive projective identification and dissociation; the neuro-psychoanalysis of inter-subjective processes within the therapeutic alliance; and the mechanism of right brain-to-right brain affective transactions in transference-countertransference communications.
These trends indicate that current knowledge in neuro-psychoanalysis must impact not only theoretical but also clinical psychoanalysis. The rapid advances in neuro-psychoanalysis suggest that we now know enough about subjectivity and psychic structure that any theory can no longer only address psychological functions. Rather, it must be psycho-neurobiological, consonant with what neuroscience is now informing us about internal structure as it exists in nature. As in its beginnings, neuro-psychoanalysis, which currently serves as a critical two-way interdisciplinary link to the other sciences, can potentially enrich both neurology, the study of the brain, and psychoanalysis, the study of the unconscious subjective mind.
Q: Wouldn’t the very notion of bridging these two seemingly unrelated aspects commit you to a form of dualism?
A: Initially, some clinicians who had a less than positive idea about the role of science in psychoanalysis were afraid that biological reductionism would not do justice to a deeper understanding of the complexity of the subjective mind. But my neuro-psychoanalytic studies have specifically focused on the brain/mind/body circuits involved in subjective functions. These subjective bodily-based processes are necessary for survival, and occur at speeds that are too fast for conscious reflection. A purely phenomenological approach is thus inadequate to assess what has been termed moment-to-moment “process,” as opposed to verbal “content.”
Recent scientific models are now calling for a move from a reductionistic to a multilevel integrative analysis of any particular psychological phenomenon. Current theoretical models of development stress the need for studying this process simultaneously along several interrelated dimensions ranging from the biological through the social levels. This has led to the strong current trend towards interdisciplinary research. And neuroscientists now hold that only integration and not reduction can succeed in elucidating multidisciplinary problems.
According to the Shorter Oxford Dictionary, the term “dualism” has two meanings. First, it refers to a theory that mind and matter exist as separate entities. Over the last 10 years, the limitation of this conception has been demonstrated both experimentally and clinically. Indeed in order to overcome the long-standing Cartesian split between mind and body within psychiatry and psychology, it was necessary to offer an experimentally testable, clinically heuristic model that could bridge biology and psychology. This integrated bio-psychosocial model is generating more effective diagnostic and treatment models of trauma and psychosomatic disorders, disturbances of both mind and body.
The second meaning of dualism is a theory or system of thought which recognizes two independent principles. My work and others support the idea that “the brain” is actually a dual system of right and left hemispheres. A large body of research shows that right brain differs from the left in macrostructure, ultrastructure, physiology, neurochemistry, and behavior. These two cortical-subcortical systems process external and internal information in different ways. Each creates a coherent, utterly different and often incompatible version of the world, with competing priorities and values. I’ve offered a large body of data indicating what Freud called the conscious mind is located in the left, while the unconscious mind is in the right hemisphere. Neuroscience now demonstrates that the right hemisphere is dominant for subjective functions and self-integration.
Q: Mark Solms has stated that Freud’s view of the inner workings of the mind, with all its faults, is still “the most highly articulated methodological and theoretical approach that we have…from a subjective point of view…” Do you agree and why?
A: Absolutely. Over the last two decades, science has for the first time seriously explored an essential component of subjectivity, bodily-based emotional processes (hence, the current “emotional revolution”). But it has also rediscovered Freud’s unconscious. Neuroscience is now generating a large number of investigations into “implicit” non-conscious processes, including unconscious emotions. For over a century psychoanalysis has been documenting close up observations of this subjective realm. In a recent article in a conventional psychological journal, Perspectives in Psychological Science, the Yale psychologists Bargh and Morsella (2008) conclude, “Freud’s model of the unconscious as the primary guiding influence over everyday life, even today, is more specific and detailed than any to be found in contemporary cognitive or social psychology.”
Q: What, if any, neurophysiological states and processes subserve the unconscious states and processes, which are central to psychoanalytical theory?
A: Over the last two decades, I’ve cited a large body of experimental studies and clinical observations, which indicate that the right brain (“the right mind”) is the biological substrate of Freud’s unconscious. These studies shift Freud’s idea of the unconscious from the domain of repressed content to adaptive rapid non-conscious processes that occur beneath levels of awareness. They also describe a relational unconscious, whereby one unconscious communicates with another unconscious. The maturation of the early developing right brain occurs during the last trimester of pregnancy through the second year, and this maturation is dependent upon the nonverbal, implicit emotional attachment a child experiences with her mother.
Over the course of the lifespan, the right hemisphere, the “emotional” or “social brain” is dominant for the following adaptive capacities: attachment functions; primary process cognition; recognition/expression of facial expressions; regulation of central and autonomic arousal; processing/storage of implicit/procedural memory; processing novelty, threat, and unexpected stimuli; regulation of the human stress response and cortisol release; sustained attention and impulse control; reception, expression, and communication of positive and negative affects and pain; and the control of vital functions supporting survival enabling an organism to cope actively and passively with stress.
In addition, recent studies show that the right and not left brain is centrally involved in certain higher functions that are expressed in psychotherapy: inter-subjective processes, self-awareness, empathy, identification with others, self-related cognition, own body perception, autobiographical memories, humor, and implicit morality. Indeed, McGilchrist asserts that “The right hemisphere…has the most sophisticated and extensive, and quite possibly most lately evolved, representation in the prefrontal cortex, the most highly evolved part of the brain.”
Q: Have any theoretical psychologists produced better, or at least improved, working models, of some facets of Freud’s theory with which to explain the inner workings of the unconscious mind?
A: Over his lifetime Freud continually updated his clinical and theoretical models. After his death, there was a tendency by some to imprint his models into stone. Indeed, most educated readers and even scientists equate psychoanalysis with Freud’s work in the first quarter of the last century. And yet, certain essential problems were left unsolved by Freud, and relegated to the realm of meta-psychology. His incomplete model of early development, his inability to adequately conceptualize the complexities of affect, his overlooking of the central role of the body in mental life, and his repudiation of real-life trauma, were all subsequently addressed by psychoanalytic theorists and researchers in the second half of the last century.
Towards that end, Ferenczi and Anna Freud made early contributions to psychoanalytic conceptions of trauma. More complex theories of early development were offered by Spitz, Winnicott, Bowlby, and Erikson, and direct observational developmental studies were done by Mahler and Stern. This interest in early development is now being actively pursued in the research of Beebe, Tronick, and Fonagy. With respect to the clinical theory, the mechanism of unconscious communication was addressed by Klein, object relations theory was expanded by Fairbairn and Kernberg, the central role of empathy was articulated by Kohut, and the nature of the inter-subjective processes within the working alliance were elucidated by Sullivan and relational psychoanalysts such as Mitchell. There is currently a resurgence in Jung’s work, which is consonant with ongoing models that integrate mind and body. Interestingly, every early pioneer offered speculations about “internal psychic structure.” Modern neuro-psychoanalysis is acting as an important force for integrating the various subspecialties of the field. In my work, I have discussed the concepts of not only Freud but also Klein, Bowlby, Kohut, Winnicott and Mahler in terms of contemporary neuroscience.
Q: You’ve been described by one writer as the “American Bowlby” after John Bowlby, the British psychiatrist and psychoanalyst, noted for his interest in child development and for his pioneering work in attachment theory. Can you tell us how your work relates to his?
A: John Bowlby’s seminal work on attachment integrated psychoanalysis with behavioral biology. Bowlby presented his model in such a way that both a heuristic theoretical perspective and a testable experimental methodology could be created to observe, measure, and evaluate certain very specific mechanisms by which the early social environment interacts with the maturing organism in order to shape developmental processes. Bowlby argued that the collaborative knowledge bases of a spectrum of sciences would yield the most powerful models of both the nature of the fundamental processes that mediate the infant’s first attachment to another human being, and the essential psychobiological mechanisms by which these processes indelibly influence the development of the organism at later points of the life cycle. Over the last 40 years, attachment theory, an outgrowth of Freud’s psychoanalysis and Darwin’s biology, has expanded tremendously, and now offers the most comprehensive theory of early development available to science.
In three seminal volumes, Bowlby described how the attachment bond is mediated by bodily-based nonverbal, affective communication between infant and caregiver. He even speculated about the brain mechanisms involved in attachment, what he termed a biological control system that is centrally involved in instinctive behavior. And he hinted at the neurobiological operations of this control system—its functions must be associated with the organism’s “state of arousal” that results from the critical operations of the reticular formation, and with “the appraisal of organismic states and situations of the midbrain nuclei and limbic system.” He even offered a speculation about its anatomical location – the prefrontal lobes. Furthermore, this control system, he says, is “open in some degree to influence by the environment in which development occurs.”
In my 1994 book and in subsequent writings, I have identified the attachment control system specifically in the orbital (ventromedial) prefrontal cortex and its subcortical connections in the early maturing right hemisphere. My work thus returns to a bio-psychosocial perspective that ties together the biological and psychological realms. Integrating developmental psychological and neuroscience data, I have suggested that the emotional transactions embedded in rapid, non-conscious nonverbal attachment communications facilitate the experience-dependent maturation of the right hemisphere. My studies also identify Bowlby’s internal working models of attachment as strategies of affect regulation imprinted in right brain’s implicit procedural memory. More recently I’ve expanded Bowlby’s theorizing on the role of attachment disturbances in psycho-pathogenesis by offering models of the psycho-neurobiological mechanisms by which early relational trauma (abuse and neglect) alters the developmental trajectory of the right brain over the lifespan, and provides a predisposition for a number of psychiatric psychopathologies and personality disorders. And I’ve written about the central role of attachment dynamics in the psychotherapeutic patient-therapist relationship.
Q: You’ve drawn much insight from disparate fields such as biology, psychology, neuroscience, etc. How have these disciplines impinged on your work? Can you cite some specific examples?
A: My early training in clinical psychology and neuropsychology, my lifelong career as a psychoanalytic psychotherapist, my studies in various biological sciences, my interest in early development, and explorations of my own subjectivity, have all been sources of my theories. Over the course of my writings, I’ve focused on the central role of affect and affect regulation. This emphasis on non-conscious emotional processes in the development of the self has resulted in an interest in adaptive and maladaptive right brain/mind/body processes, and, in turn, on the integration of the psychological, biological, and psychiatric disciplines. Being on the editorial board and/or a reviewer of 35 scientific and clinical journals has allowed me to incorporate and impact the ongoing data from a variety of different disciplines. And it has acted as a vehicle to influence the direction of research, as well as to formulate more complex clinical models. Over the course of my career, I continue to offer theoretical models of normal and abnormal development. But I’m now also actively engaged in fMRI research on development, and evoked response studies of borderline personality disorder.
My interdisciplinary perspective has allowed me to not only expose scientists to complex clinical phenomena, but also to bring the rapid advances in various sciences to clinicians. This bio-psychosocial perspective attempts to bridge biological psychiatry and psychodynamic psychiatry, in, for example, applying current physiological and neuro-chemical data from stress research to clinical models of the treatment of relational trauma. In updated models of defenses, I’ve suggested a shift in emphasis away from repression to early forming dissociation, an accompaniment to all forms of relational trauma. Incorporating data on the role of the right brain (“right mind”) in implicit nonverbal communication, I’ve suggested that psychotherapy is not so much the talking cure as the affect communicating cure. My ideas on attachment have been incorporated into programs of early interventions directed towards optimizing ongoing brain development. And my integration of attachment theory into behavioral biology is expressed in my work on trauma in wild elephants.
Q: What are some of the biggest challenges facing your field of inquiry today?
A: In 2009, I was invited to present a plenary address to the American Psychological Association, “The paradigm shift: the right brain and the relational unconscious.” In the 1960s and 70s, psychology was dominated by a behavioral model. This transformed into a cognitive model in the 80s and 90s. At present, we are in an era where affect and psychobiological processes are taking center stage. My colleague in affective neuroscience, Jaak Panksepp, has argued, “The cognitive revolution, like radical neuro-behaviorism, intentionally sought to put emotions out of sight and out of mind. Now cognitive science must re-learn that ancient emotional systems have a power that is quite independent of neocortical cognitive processes.” Richard Ryan, the editor of the journal Motivation and Emotion, points out, “After three decades of the dominance of cognitive approaches, motivational and emotional processes have roared back into the limelight.”
The clash between conscious cognition and unconscious affect is playing out in contrasts and tensions between cognitive behavioral therapy and psychodynamic psychotherapy. A recent review article in the American Psychologist by Shedler (2009) demonstrates “Effect sizes for psychodynamic therapy are as large as those reported for other therapies that have been actively promoted as ’”empirically supported’” and ’evidence based.’” Indeed, research indicates the superiority of psychoanalytic treatment in maintaining therapeutic gains and improvements after treatment. Shedler concludes, “Blanket assertions that psychodynamic approaches lack scientific support are no longer defensible.”
The bias against the centrality of unconscious processes in human behavior is the same today as it was in Freud’s time. Similar to this bias is the devaluation of emotional processes and the right hemisphere. Over the last two decades, I’ve argued that the right and not left hemisphere is dominant in the human experience. Supporting this and countering the current overvaluation of the verbal, conscious, and analytical left brain, McGilchrist (2009) concludes, “The left hemisphere is detail oriented, prefers mechanisms to living things, and is biased to self-interest, The right has greater breadth, flexibility, and generosity. The left is the emissary of the right, which is its master. The emissary, however, is willful, believes itself superior, and sometimes betrays the master, bringing harm to the both.” This warning is especially important for our current cultural milieu, which overvalues conscious verbal and behavioral processes in research, mental health training programs, and education.
Neuro-psychoanalysis and the other sciences are currently making remarkable advances in our understanding of this right-lateralized “social,” “emotional” brain-mind-body system. We now need to devote our financial, political, and cultural resources towards pragmatically applying this essential knowledge in order to improve the human condition.
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