Mind and – Or Versus – Brain – and “neuropsychoanalysis”

This book was a gift from my wife: In the Mind Fields by Casey Schwartz. I’ve written before how the concept of the self bugs me. I keep pondering: what, really, is this feeling that I’m me? David Hume identified why this is so hard – it’s using the self to look for itself.

The book is subtitled Exploring the New Science of Neuropsychoanalysis. But it wasn’t persuasive that there even is such a thing.

It’s a tale of two disciplines. Psychoanalysis, the whole Freudian thing, tries to demystify the workings of the mind. Neuroscience tries to understand the workings of the brain. It’s interested in figuring out how the brain creates the mind. But, once you have one, the thoughts it produces are no concern of neuroscience. That’s psychology, the province of psychoanalysis. And, in turn, psychoanalysis isn’t much interested in the nuts and bolts of brain function that neuroscience explores.

Indeed, as the book says, psychoanalysts are so fixated on the mind that they tend to forget it’s produced by the brain. They’re often actually somewhat hostile to neuroscience, seeing it as aridly divorced from the reality of human experience, as lived through the psychology they are concerned with. While neuroscientists tend to look down on psychoanalysis as unscientific, non-rigorous, subjective psychobabble.

Neuropsychoanalysis (as the name implies) seeks to bridge this chasm, by bringing the findings of neuroscience into the practice of psychoanalysis. However, while its leading prophet, Mark Solms, does use the word, the book left me unclear how, if at all, this marriage actually works in practice.

Eventually, the author comes around to focusing intensively on one case: Harry, and his psychoanalyst, David Silvers. A normal, athletic man, Harry had a stroke in his thirties that partly crippled him and left him aphasic – i.e., largely speechless. (He fully understood language, but couldn’t put thoughts into words.) Unable to continue his tutoring business, Harry’s life became a cycle of medical appointments.

Now, this was quintessentially a neuroscience case. Harry’s problem was not psychological; his brain was physically damaged. Of course, he did have some psychological difficulty adjusting to his loss and new circumstances but that was certainly not mental illness. At one point, though, Silvers labels him “depressed.” That diagnosis seemed superciliously offhand. Depression is a particular pathology, apparently caused by brain chemistry effects. Harry was not “depressed,” he was responding to a rotten break, as any normal person would. If anything, he seemed pretty cheerful under the circumstances.

So what was Harry doing in psychoanalysis altogether? It works by talking through issues with the analyst. But the supreme irony here is that Harry’s problem was his inability to talk! He did manage to communicate, somewhat, sort of. But Silvers acknowledged that his sessions with Harry did not resemble his usual interactions with patients.

The book flap states that Harry “nevertheless benefits from Silvers’s analytic technique.” This assertion is key to the whole book. Yet I could not see how Harry benefited, therapeutically. He and Silvers did establish a human bond, which Harry seemed to value. But Silvers’s psychoanalysis did nothing to improve his situation. In fact, Harry was actually in worse shape at the end.

Nor could I see how Silvers’s efforts could be labeled “neuropsychoanalysis.” He had no neuroscience training, and nowhere did he appear to be using neuroscientific insights to help Harry. This evokes the old saw, “if your only tool is a hammer, every problem looks like a nail.” Silvers’s psychoanalytic toolkit was simply mismatched to Harry’s case.

Freud, who figures prominently throughout this book, had a lot to say about the self and its behavior – some of it wrong, though he himself would have acknowledged the tentativeness of his theories – but he had no clue what makes a self. Someday neuroscience may crack this very hard problem.

Then maybe I can finally know who and what I am.