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February 01, 2010

Psychological Science: Sigmund Freud – A Personal and Scientific Coward?

Psychological Science: Sigmund Freud – A Personal and Scientific Coward?
by
Norman Costa

Sigmund-freud-trust-doctor


This article is, in part, a retelling of 'The Heroic Age of Hysteria,' a section from chapter 1, 'A Forgotten History,' in the 1997 book, “Trauma and Recovery: The aftermath of violence – from domestic abuse to political terror,” by Judith Herman, M.D. It was published by Basic Books, a member of the Perseus Books Group, New York. I highly recommend this book to all interested in the subject.

In part, this article relies on the work of Harold Bloom, principally, his 1998 book, “Shakespeare: The invention of the human,” and a few of his interviews related to Sigmund Freud. The book was published by Riverhead Books, a member of Penguin Putnam Inc., New York.


At the time Sigmund Freud (1856–1939) began his research into Hysteria, it was understood as a malady peculiar to women (according to 25 centuries of medical thinking) and accounted for any disease whose symptoms could not be found to have an organic cause. It was manifest in symptoms like partial paralysis, hallucinations, sensory losses, convulsions, and amnesias. Lumped into these symptoms was anything found (by men) to be mysterious or incomprehensible in women. The source of the problem, it was believed, resided in the uterus, and thus the medical term, Hysteria.

Sigmund Freud discovered the cause and the treatment of the disorder known as Hysteria. Also, the cause and treatment were discovered, independently, by Pierre Janet (1859–1947). The causes were violence, sexual assault, and incest beginning in childhood, sometimes at very early ages. The treatment involved a place of safety from abuse, the recalling of memories of the actual traumas, and the recounting and speaking of the events and the emotional content in great detail. Janet found the same. Freud referred to the aetiology of Hysteria as the 'seduction theory.'

“Each individual hysterical symptom immediately and permanently disappeared when we had succeeded in bringing clearly to light the memory of the event by which it was provoked and in arousing its accompanying affect, and when the patient had described that event in the greatest possible detail and put the affect into words. Recollection without affect almost invariably produces no result.” Sigmund Freud, 1895.

Within one year, Freud had repudiated, privately, his 'seduction theory' of Hysteria. By the first decade of the twentieth century, he formally renounced his historic and groundbreaking work: "I was at last obliged to recognize that these scenes of seduction had never taken place, and that they were only fantasies which my patients had made up." He said all his patients had lied to him. What is noteworthy is that he proffered this 'final word' on the subject with absolutely no data or findings to support his claim of universal mendacity in hysterics. In the words of Judith Herman:

“Out of the ruins of the traumatic theory of hysteria, Freud created psychoanalysis. The dominant psychological theory of the next century was founded in the denial of women's reality. Sexuality remained the central focus of inquiry. But the exploitative social context in which sexual relations actually occur became utterly invisible. Psychoanalysis became a study of the internal vicissitudes of fantasy and desire, dissociated from the reality of experience.”

…

“Protesting too much, he dissociated himself at once from the study of psychological trauma and from women. He went on to develop a theory of human development in which the inferiority and mendacity of women are fundamental points of doctrine.”



Question_mark
 

Three questions arise:

1. How did Freud, with his collaborator and mentor, Joseph Breuer (1842–1925), and independent rival, Pierre Janet, discover the traumatic basis of hysteria as well as its treatment? 

2. Why did Freud repudiate his findings on the traumatic basis for Hysteria?

3. In the face of his prior scientific investigation, how did Freud come to develop psychoanalysis, and his psycho-sexual theory of development that were based upon women's inferiority, their mendacity, and erotic fantasies and desires?

The answer to the third question is easy. He made it up. He concocted a fairy tale that suited him and his larger society. Freud became his own poster child for rationalization, denial, intellectualization, and depersonalization. He did this by bringing in a couple of heavy hitters to assist him – the creators of ancient western mythologies, and William Shakespeare. I will discuss more of this later. Now, let's turn to the first two questions.

Jean-martin_charcot

1. How did Freud and Janet discover, independently, the cause and treatment of Hysteria?

The title of Judith Herman's sub-chapter, “The Heroic Age of Hysteria,” sums up, nicely, two decades at the end of the 19th century, after 2,500 years of recorded medical knowledge. This 'Heroic Age' began with the great French neurologist Jean-Martin Charcot [1825–1893]. In 1870 he took over a long neglected hospital, the Salpetriere in Paris, that had become a dumping ground for the insane, the destitute, prostitutes, and criminals. Famously, it was known for it's population of rats. He developed it into a center for scientific investigation of medical neurology, and is considered the fountainhead of modern psychiatry. Today it is a world class medical teaching institute, where Jacques Chirac underwent by-pass surgery,and Princess Diana died.

Salpetriere

His interest in studying Hysteria was motivated by his own personal and scientific goals, as well as the scientific and political struggle to displace the Church as the arbiter of truth – at least in this world. Where the Church saw demonic possession, sickness of the soul, malingering, and sin, modern science was seeking to explain the phenomenon as a medical disease. The anti-clerical thinking, at that time, was that women needed to be claimed by science, otherwise, they would be reclaimed by the church. The modern conflict of Church authority versus scientific investigation was already underway. This was also the time of the Church's pronouncement on Papal Infallibility.

Charcot was an observer, data collector, describer, and taxonomist. The basic function of all science is to describe the properties of things. He chose to describe the disease of Hysteria. By using hypnosis, he was able to relieve some symptoms, as well as induce other symptoms. Thus, he concluded that the nature of Hysteria was fundamentally psychological and not neurological. This, alone, was a monumental discovery that changed the course of 2,500 years of medicine.

Charcot was a bit of a showman. His weekly lectures and demonstrations became famous in medicine and with the informed public, and were well attended. His technique of 'stage demonstration' has been parodied in countless movies. Among them is Mel Brooks' “Young Frankenstein,” with two scenes – one at the beginning, and one in the latter part of the film. It is probable that some of the hysterics in his demonstrations were too obliging in 'performing' the way he expected. However, his fundamental findings still stand. Although Charcot objectified women, and was little interested in their inner lives, his hospital became a safe place for women who experienced violence of all kinds. In retrospect, Charcot was unaware that he discovered the first element in the treatment of victims of trauma – having a place of safety.

Research freud charcot

Drawn to Charcot's hospital to participate in groundbreaking research were many young scientists and doctors. Among them were Sigmund Freud and Pierre Janet. Charcot had shown that the manifestation of Hysteria was psychological in nature. Now, the race was on to discover the underlying cause for Hysteria. As rivals, Freud and Janet were motivated to be the first to find and publish the discovery. This is always a great impetus for scientific research, now as it was then. The rivalry bore fruit. For a solid decade, doctors asked women to tell their stories and listened to what women had to say. In 2,500 years of medicine, this was unprecedented.

Contrary to Freud's expectations, or even his desires, the women were telling intimate stories of horrible abuse and sexual assault in their childhoods. He quickly realized that this personal history, including violence and incest, was fundamental to understanding their symptoms. He found that their Hysteria was relieved by recalling or recovering memories of abuse, and then verbalizing both the events and the attending feelings in great detail. Freud (also Janet) discovered the second element in the treatment of victims of trauma – talking out the story of one's trauma, recovering the details and the affect. Modern therapies modify this by having the victim tell their story to others who have experienced similar trauma.

Freud and Janet came to the same conclusion about the origin of Hysteria. Severe psychological trauma caused an extreme emotional response that resulted in an altered state of consciousness and produced the somatic symptoms. Janet called the altered state of consciousness 'dissociation,' while Freud and Breuer called it 'double consciousness.' Freud and Janet understood that the observed somatic symptoms were psychological representations of the actual experiences of sexual trauma.

Studies_in_hysteria

In May of 1895, Freud and his collaborator, Breuer, published their “Studies on Hysteria.” This was a collection of papers on theory, therapy, and case histories. Among the case histories was included the famous Anna O. She coined the phrase, “talking cure.” All the same, Breuer was not easy with the traumatic sexual origins of Hysteria. Shortly afterward, Freud was to confide in his friend, Wilhelm Fleiss, "Not long ago, Breuer made a big speech to the physician's society about me, putting himself forward as a convert to belief in sexual aetiology. When I thanked him privately for this, he spoiled my pleasure by saying, 'But all the same, I don't believe it.'" In mid-October, in a letter to Fliess, Freud affirms his 'seduction theory' that sexual shock and premature sexual pleasure underlie Hysteria. At the end of October, Freud was beginning to have doubts about his theory on the origins of Hysteria.

In April of 1896, Freud gave a lecture to the Society for Psychiatry and Neurology in Vienna. It was based upon “The Aetiology of Hysteria,” a report on 18 case studies, and published the following month. Judith Herman remarks, “A century later, this paper still rivals contemporary clinical descriptions of the effects of childhood sexual abuse. It is a brilliant, compassionate, eloquently argued, closely reasoned document. Its triumphant title and exultant tone suggest that Freud viewed his contribution as the crowning achievement in the field.”

His reception by the Society was unfriendly, if not hostile. With the publication of “The Aetiology of Hysteria,” Freud expected his place in science would be assured, and his professional livelihood would flourish. Instead, he was hurt and greatly disturbed by the deafening silence and indifference of his colleagues and his profession. In September of 1897, Freud writes to Fliess that he has abandoned his 'seduction theory.' He now pursues work on understanding fantasy.

2. Why did Freud repudiate sexual exploitation of women as the root cause of Hysteria?


Maresfie


There is a good deal of debate as to why Freud repudiated his 'seduction theory' as the origin of Hysteria. We can sum up the various reasons as follows:

Freud's career and livelihood were at stake in an atmosphere of hostility from his colleagues. Further, his patients did not stay with him, and his practice was collapsing. He wrote to Fliess, "I am as isolated as you could wish me to be: the word has been given out to abandon me, and a void is forming around me."

Given the pervasiveness of hysteria in the larger society, it would stretch the credulity of people who are not involved in the sexual exploitation of children. However, it would threaten the exposure of all those who perpetrated the horrors; And, it would bring to light those who were aware of sexual exploitation of children, but who did not act on behalf of the victims. Put differently, they all knew who they were.

Child-abuse

This was too big a pill for society to swallow. As late as the 1970s, some professional reference texts estimated the frequency of incest at one per million. The entire professional and medical culture transformed themselves, on the matter of sexual exploitation of women, into “The People of the Lie.” Had Freud been loyal to his research and his patients, he might have become the lone truth teller, bearing the hostility and reproach of society. Janet never backed down from his research or his patients, and suffered the consequences of being the lone truth teller. Charcot was also assailed on the matter. He never repudiated his research findings, but, he did regret ever getting into the study of Hysteria.

Feminism_image004

There was no political or cultural movement, save a nascent feminist movement, that was powerful enough to support his research findings and theory. By the beginning of the 20th century, the anti-clerical forces had won the day, and there was no continuing need to make the study of Hysteria a demonstration of science versus Church authority. The brief period of time when male doctors listened to women, and took them seriously, had come to an end. “The Heroic Age of Hysteria” lapsed into historical amnesia, and 2,500 years of dismissing women as inferior, lying, and hysterical by nature picked up where it left off before Charcot.

Fortunately, a growing feminist movement was taking shape in Europe and in the United States, but things wouldn't begin to produce results till the 1970s. The eventual recognition of sexual trauma, and the sexual exploitation of women in general, as the precursors to Hysteria, came about by the action of women themselves. It is not an overstatement to say that the feminist movement, particularly consciousness raising, forced the male bastions of power to listen to what women had to say, and to accept their understanding of reality as valid.

Freud_with_his_father_document.php

There was a strong possibility that Freud and his siblings had been sexually abused by their father. The formulation of the Oedipus complex was a tailor-made defense for his own coming to terms with what happened in his childhood. By his own admission, Freud was suffering from Hysteria. This was emerging in his own personal analysis. From 1895 to 1897, Freud was becoming more absorbed by 'insights' from his own personal analysis. These become the inspiration, if not an excuse, for further work, at the expense of leaving his research findings behind. He was conscious of manifesting deeply neurotic behavior. In October 1896, his father, Jacob Freud, dies. This comes at a crucial point in his life, and he struggles with his father's death for years to come.

In the next, and final, part of this article, I will deal with how he concocts a story line for psychoanalysis and psycho-sexual development, ignoring his own research, and relying on an intense and deep familiarity with Shakespeare and western mythology. Thank you for reading, do take the opportunity to comment, and please come back on March 1, 2010.

Posted by Norman Costa at 12:01 AM | Permalink

Comments

Thank you, Norman! It's been almost 20 years since Judith Herman published _Trauma and Recovery_, and that book has not been superseded, in my opinion.

While I have no special knowledge of Freud beyond having read his entire body of work, published correspondence included, and no authority for my point of view beyond reading and reflecting over decades, and being psychoanalyzed by a Freudian, I am not so sure you -- or Herman -- have described how Freud stepped back from his original insights into hysteria with a full appreciation of the complexities of his situation. Sure, an ambitious physician has to care if the medical establishment finds him risible, but throughout his life, Freud was more willing than almost anyone to go out on a limb.

But, this time, he crawled back to safety? That's only one interpretation. And that would be the interpretation I would choose only if there were no evidence Freud were not genuine -- however wrong -- in revising his thinking. If memory serves, Freud was unable to stomach the full implications of his original thinking. As he put it (I'm paraphrasing), either father-daughter incest was a common occurrence, even rampant, throughout Vienna, or girls afflicted with hysteria were having fantasies that it had occurred, fantasies that were making them ill. Yes, the truth was staring him in the face, as, ironically, he had summoned it to do. He had glimpsed it briefly and it did not compute -- it was indeed too much. I'm not so sure this is craven. It seems more like a situation from Sophocles or Shakespeare to me -- fully human and understandable, what most of us would do when asked to support the insupportable. That it would take generations of heroic women in medicine to face this situation for what it was is understandable too.

Also, Freud wrote about fantasy in a way that did anything but dismiss it, or relegate it to a feminine specialty. He distinguished wishful thinking -- having a fantasy and knowing it for fantasy -- from the kind of thinking that is a defining psychic reality, a functional truth with the weight and power of truth. I believe this is important in writing about what he means by fantasy. I do not dispute that Freud was wrong, in the way you cite and in many other ways, but a coward? That's a character with as great an isolation as a hero. To be a pioneer, moored in your own era, who cannot tolerate the implications of your own discoveries, is to be a participant in a culture-wide dilemma.

Posted by: Elatia Harris | Feb 1, 2010 10:29:46 AM

The Good Doctor traveled in lands that few had dared to admit, so, along with Elatia, I think coward may be the wrong word.
But points well taken, and thank you for the good work.

Posted by: Dave Ranning | Feb 1, 2010 11:55:24 AM


Elatia,

Thank you very much for your comments. As usual, you have something insightful and incisive to contribute.

You wrote, "I do not dispute that Freud was wrong, in the way you cite and in many other ways, but a coward? That's a character with as great an isolation as a hero. To be a pioneer, moored in your own era, who cannot tolerate the implications of your own discoveries, is to be a participant in a culture-wide dilemma."

Your last sentence focuses on the dilemma, here. That is why I put a question mark [?] at the end of the title.

I'll be doing a lot more thinking on this matter over the next four weeks. One important issue for me is the integrity of both scientific inquiry, and the scientist. As a scientist he still had to account for his data, even though he repudiated his "seduction theory." He could have abandoned this field of inquiry, lacking the will or theory to continue the research. There's no shame in that. Yet he stayed with this line of inquiry, and was obligated to explain his research data. From this point on, he is fair game to be criticized as a scientist for the way he used his data and his assumptions of mendacity in concocting a fairy tale to explain his data.

Was it that Freud could not tolerate the implications of his own discoveries, or, rather Freud could not tolerate the consequences to himself of his own discoveries?

Posted by: Norman Costa | Feb 1, 2010 12:06:25 PM

Norman and Dave,

How you define a fantasy has much to do with whether you think Freud himself replaced data with the kind of "fantasy" that allowed him to disregard data rather than reinterpret them.

A fantasy as Freud defines it has intense psychic reality with much or all of the power of the actual. It's akin to a very vivid memory, with the power of memory to sicken or make well. A fantasy of this kind is not a lie, a fairy tale or a made-up story. Freud has written extensively on this difference.

According to my reading, Freud did not on purpose falsify anything. He ceased believing that the young women he treated were recounting factual sexual abuse, and were instead speaking of a purely psychic reality which had made them just as ill as actual abuse would have done. Society, at the time, was readier to believe hysterical young women "remembered" things that -- looked at a certain way -- flattered the power/masculinity of the father, than it was ready to name accurately an epidemic of abuse by powerful figures who had impunity. Freud didn't invent this, but he participated in it, and that participation is horribly ironic more than craven.

In his later writings, one sees glimpses of how Freud saw himself -- as the towering figure who threw open the door but did not enter. His self-identification with Moses is particularly telling in this way. He wrote, also (in a letter), of himself and the early psychoanalytic circle as "conquistadors" -- not the most flattering image. And, over a century, the _terra_ of the conquest has indeed been seized back from him. I believe this is tremendously complex material that will not yield to an either/or reading, even one posited by heroic feminists.

We who let George W. Bush remain president for 8 years, who did not devote our energies and our fortunes to bringing him down, gladly accepting whatever fallout on ourselves as the high price of integrity and responsibility, should know all about the kind of doublethink Freud may have been involved in.

Posted by: Elatia Harris | Feb 1, 2010 12:52:05 PM


Elatia,

I'm getting ahead of myself, and into Part 2. So let me simply say that Freud's approach, post 'seduction theory', was to engage his audience with compelling metaphor, and thinking by analogy.

How does one get from his data to his metaphors and analogies. You can't. So you have to make it up. His audience accepted compelling metaphor and analogy as if they represented eternal truths.

Arguing by analogy doesn't prove anything in science.

Posted by: Norman Costa | Feb 1, 2010 2:39:23 PM

Norman, show me how arguing via analogy proves nothing in science.

Posted by: Elatia Harris | Feb 1, 2010 3:23:54 PM


Elatia,

Both metaphor and analogy are tools for explaining and exposition. They aid in communicating and understanding.

The classic examples of 'proof by analogy' are some of the proffered proofs for the existence of God. The 'God as Watchmaker' is the most notable one. The argument reduces to: Just as the watch implies the existence of a watchmaker, so does creation imply the existence of a creator.

In the case of Freud, his reading of Hamlet leads him to adopt the "Oedipal Complex" as a key component - metaphor, if you will - in his tripartite division of personality, and a stage in his theory of psycho-sexual development. There are no scientific data to support the adoption of this metaphor. However, he analogizes the input from his patients to the dilemmas and psychic struggles of Hamlet/Oedipus. The metaphor is so compelling, and the analogies so tidy, almost obvious, that one can behave as if life really works that way.

There is nothing wrong with using metaphor and analogy as inspiration for scientific research, or as expository tools to aid understanding. However, if you are claiming it is science, then you had better produce the research. Freud's explanation of his tripartite model of personality, and his psycho-sexual stages of development have all been discredited over the decades by proper research.

Regarding some of your earlier comments, I do not know that Freud, consciously, knowingly, and with forethought, fabricated that which he knew to be untrue. I agree with you that the matter is complex.

But, Freud understood that his work was science, and that he was presenting his work as a scientist. If you say that what you are doing is science, and that you are a scientist, then you have to behave like a scientist. Disregarding your data, creating compelling metaphors, and analogizing patient behavior to the metaphor do not meet the definition of science - Understanding nature and ourselves through systematic observation and the recording of data. Science always rises or falls with its data. That's the starting point. When Freud repudiated the 'seduction hypothesis' and developed his psycho-sexual theories, he established the metaphor as the standard, and then analogized the data (input from his patients) to his theory. This is not scientific proof.

Posted by: Norman Costa | Feb 1, 2010 4:14:37 PM

This is a difficult topic and in discussing it we need to be clear what seduction theory put forward, and what evidence was used to support it. Seduction theory was never a simple comment on whether women who claim to have been sexually abused are telling the truth. Seduction theory (in its original 1896 form*) proposed that sexual abuse is at the heart of all cases of "hysteria" (psychosomatic neurosis.) These two ideas get conflated by critics like Jeffrey Masson and Judith Herman, who imply that Freud effectively tried to cover up incest as a social problem because he could not endure violent resistance in the medical community. But rejection of seduction theory is not equivalent to saying that incest is not pervasive, or not reprehensible.

Masson and Herman put a great store on Freud's scientific data showing that incest was the primary cause of hysteria. No clinical evidence for Seduction Theory has ever been published. Whatever it was, it could not have been forensic. Doubtless a great number of Freud's patients did suffer sexual abuse. Of all the ways to screw up a child, incest remains the time-honored champion. But we don't have any compelling factual data to correlate patients' reports of childhood "seduction," which only emerged after a long and arduous (and nascent) analytic process, to any independent corroboration of the event. Some Freud scholars characterize Freud's therapeutic technique at this time as coercive. I can't comment on that, but it's important that we don't know how the "memories" which constituted Freud's data set were engendered, and how much they relied on his own interpretation. (We know of a few cases in which patients actually contradicted Freud's account of such memories.) Whether the majority of Freud's hysteria patients up until 1896 had been sexually abused, the evidence we have is deeply inconclusive, and it's ironic that Herman and Masson must take the word of the very person they are trying to discredit.

Perhaps Freud would have been a "coward" at any rate if he not realized that seduction theory was not tenable. But it is just myth-making to say that he repudiated a theory he knew to be true because he couldn't handle the scorn, or because it was an ill fit with his misogynistic nature.

*Alice Miller, for example, expands Seduction Theory to include non-sexual "seduction" in a way Freud, with his fixation on sexual repression, could probably not have foreseen.

Posted by: Chris Schoen | Feb 1, 2010 4:47:29 PM

Perhaps more to the point, the fact that "female hysteria" is a made-up disease rather obviates the question of whether Freud and Janet found a "scientific" explanation for it.

The neurotic symptoms Freud described ranged from what we now call somatization disorder, to HPD, to generalized anxiety, and are suffered by both men and women. As pervasive as sexual abuse of children undoubtedly is, it is vanishingly unlikely that it underlies such a wide variety of neurotic behavior.

Posted by: Chris Schoen | Feb 1, 2010 5:44:56 PM

Or to be a bit more balanced, we might note that Freud was among the first to realize that the operations of the mind run deeper than mere reason. "Hysteria" was indeed a constellation of modern disorders which Freud -- lacking the benefit of the last century of psychological research -- could only define as a single disorder with varied symptoms. Nineteenth Century Viennese women lived in a psychological straight jacket compared to their male contemporaries (and, needless to say, modern women -- thank goodness) in which sexual abuse could not be discussed in any context. As such, his early patients tended to be female sexual abuse victims. Again, lacking our modern (indeed, very recent) understanding of the ease with which false memories can be constructed through suggestion, he set out to look for child sexual abuse as "the" cause of the disorder he was seeking to understand. Needless to say, he found it, and only later smelled a rat.

I think the best sugar packet summary of Freud's work is that, like Darwin, he was wrong on almost all of his specifics, but correct in his basic ideas.

Posted by: Space Toast | Feb 1, 2010 8:33:06 PM

Norman, Chris, Space Toast --

Am I bright enough tonight to answer all of you? Well, a girl can only try.

Norman, the deep structures of personality were not provable in Freud's day and are not provable now. You cannot show me that the id, the ego and the super-ego are outmoded now, any more than you could have shown me they existed 100 years ago. I can remember when Prince Charles was accused of having the largest private collection of toilet seats in London. He couldn't prove he didn't have it. To my reading, that's where we are now with the id, the ego, and the super-ego. All we can say is, it's not how we tend to think about things these days, and the rightness of the theory will remain shrouded in mystery -- as will its wrongness.

Also, I believe Freud pointed to Hamlet and Oedipus as dramatic treatments of universal truths about the human situation. As illuminating both backwards and forwards. More about the early psychoanalytic circle's view of this stuff can be found in _Hamlet and Oedipus_, by Ernest Jones, a British psychoanalyst who was a member of the early circle. If Shakespeare -- and Sophocles -- discovered truths of human nature for which "Hamlet" and "Oedipus" became shorthand, that is different from Freud's basing his theories on literature. Rather, he is basing them on the basis of literature -- observation. Hamlet and Oedipus are truthful characters because they speak to the most harrowing reaches of human experience. A multitude abides in each of them -- Freud was partaking of this.

Now, that may not be terribly scientific of him. But it's different than analogizing to literature.

Chris, the same symptoms of PTSD can ensue from trauma of many kinds. So that a survivor of war trauma may present symptoms very much like one of childhood sexual abuse. I think it's important to consider the whole context from which Freudian theories arose: a society filled with sexual repression and with sexual crimes against women. In 1978, the Psychoanalytic Society of Bombay had 36 members, according to an NYRB article published that year. Those treating physicians reported many young female patients who would have been highly recognizable to Freud's early circle. There is the matter of cultural relativism to consider, with Bombay of the 1970s comparing closely to Vienna of the 1890s. Perhaps the last word should belong to Berthe von Pappenheim, the "Frauelein Anna O." of the famous case study, who wrote extensively of her "talking cure." She should get a hearing, no? For, who is she covering up for? A neo-Freudian from way, way back, I will content myself with remarking how horribly uncomfortable, and illogical, Freudian concepts still render everyone.

Space Toast, you make a very good point. Psychoanalytic theory moved the locus of the greatest distress from era to era. By the 1960s, ontological insecurity and metaphysical anxiety had become the problems to reckon with -- it was that kind of a time. What are our problems now? We are looking for causes and treatments the flatter the current thinking, they will say, in the future. What could that thinking be? That it is substantially hidden from the sharpest among us is not a sign we have no integrity, only that we cannot see the larger context to judge of our truthfulness within it.

Posted by: Elatia Harris | Feb 1, 2010 10:25:50 PM

Elatia: While I have no special knowledge of Freud beyond having read his entire body of work, published correspondence included, and no authority for my point of view beyond reading and reflecting over decades, and being psychoanalyzed by a Freudian..

The best understatement on 3 QD.... ever!

Posted by: Ruchira | Feb 1, 2010 10:31:07 PM

Ruchira,

Hahahahaaha! I know how it sounds. But acceptable academic cred for airing my point of view does NOT consist in those qualifications. I would need a terminal degree in psychology, when I have merely a B.A. in art history. Or I would need to be an M.D. who went on to become a Freudian analyst -- med school + residency + 4 years training analysis, at least. Or, something egregious that showed I must know whereof I speak. If we have any dyed-in-the-wool Freudians here, with impressive sheepskins, I wish they'd come out to play. I merely read, pay, think, and dream.

Norman -- who I know has done his homework -- excepted, however, it does always strike me funny how few people who are ready to derogate from Freud have read him, or begin to understand him. Yes, he was wrong about so much. But so many of his detractors are simply unfit to take the measure of the man.

Posted by: Elatia Harris | Feb 1, 2010 10:57:01 PM


Elatia,

Thank you again for your thoughtful comments.

Science is an approach to understanding nature and ourselves through systematic observation and the recording of data. I emphasize the phrase an approach because science is not the only approach to understanding nature and ourselves.

Other approaches might be intuition, transcendent experiences, meditation, art, religion, and literature. I've always advised people going into clinical programs to read the great literature. A close friend suggested to me that if you want to understand human nature and relationships, read French and Russian novels.

This thread is giving me a peek into how I have to approach writing Part 2 of this article. I have my work cut out for me.

Posted by: Norman Costa | Feb 1, 2010 11:11:59 PM

Chris, the same symptoms of PTSD can ensue from trauma of many kinds. So that a survivor of war trauma may present symptoms very much like one of childhood sexual abuse.

Yes, I phrased that badly.

I didn't mean to suggest that certain neurotic symptoms, in the abstract, could not be attributable to sexual abuse. I meant that it would be absurd to suppose that all neurotics had been sexually abused.

I do think that if we use the word "seduction" metaphorically, as Alice Miller has, to include non-sexual boundary transgressions, then seduction theory starts to make a lot more sense. But whatever his motives (and I agree with you, Elatia, they seem to derive from an unwillingness to face the full horror of it), Freud was right to abandon a theory that reduced all neurosis to a sexual cause.

Posted by: Chris Schoen | Feb 1, 2010 11:50:20 PM


Chris,

Hysteria was not a made up disease. It was collection of symptoms for which there was no organic cause. These serious symptoms included partial paralysis, hallucinations, sensory losses, convulsions, and amnesias. Today we know them as various disorders that resulted from trauma. Collectively, we call these disorders PTSD.

Evidence for the reality of Hysteria, PTSD in today's terms, has been validated to near certainty. Within the past few weeks a new diagnostic technique was announced, involving the reading of electrical activity in the brain. It is cheap, fast, and highly accurate.

Part of the scientific evidence for Hysteria, was the amazing response to treatment - talking through the events and the affect in detail, in the context of a safe place. when you treat someone and symptoms improve or completely disappear, that's a pretty good sign that something was there in the first place.

You state: "As pervasive as sexual abuse of children undoubtedly is, it is vanishingly unlikely that it underlies such a wide variety of neurotic behavior."

Sexual abuse of children DOES UNDERLIE A WIDE VARIETY OF NEUROTIC BEHAVIOR. You can find a long list of symptoms for PTSD at the following URL: http://www.helpguide.org/mental/post_traumatic_stress_disorder_symptoms_treatment.htm

You state: "I meant that it would be absurd to suppose that all neurotics had been sexually abused."

Of course this would be absurd, if somebody said it. I don't recall Freud or anyone saying that. What Freud discovered was that Hysteria had it origins in trauma of varied kinds (violence, sexual assault, and incest.)

However others interpreted or expanded the concept of 'seduction theory,' Freud was highly circumscribed and consistent in his use and understanding of the term. It meant psychological trauma from violence, sexual assault, and incest.

Posted by: Norman Costa | Feb 2, 2010 12:26:06 AM


Space Toast,

You state: "Again, lacking our modern (indeed, very recent) understanding of the ease with which false memories can be constructed through suggestion, he set out to look for child sexual abuse as "the" cause of the disorder he was seeking to understand. Needless to say, he found it, and only later smelled a rat."

None of this is correct.

The Loftus research showed that some memories can be suggested to some people under some conditions. There is no evidence that suggested memories are long lasting and could produce symptoms of PTSD. She did not show that the recovery of repressed memories in the context of therapy was necessarily a product of suggestion. The one major contribution of Loftus to clinical practice, in helping victims recover repressed memories, was NOT to use hypnosis to aid the recovery. "...[T]he EASE with which false memories can be constructed through suggestion," in the context of psychotherapy for PTSD, is a total FICTION.

I don't know where you got your information, but Freud did not set out to look for sexual abuse as the cause of Hysteria. It took him by surprise, and he was uneasy and hesitant, at first. Eventually, he realized he was on to something important. This idea is totally false. In Freud's own words,

"When I began to analyze the second patient ... the expectation of a sexual neurosis being the basis of hysteria was fairly remote from my mind. I had come fresh from the school of Charcot, and I regarded the linking of hysteria with the topic of sexuality as a sort of insult–just as the women patients themselves do."

The fact is, Freud, in the elucidation of his theories of psychoanalysis and psycho-sexual development, and his tripartite division of personality, was wrong on just about everything. The truth is that he got some details correct, but the centerpieces of his theories have long been discredited after decades of research.

Posted by: Norman Costa | Feb 2, 2010 12:57:54 AM

Norman,

This conversation has the benefit of directing me to the words of the man himself, who I haven't read of some time, for which I thank you.

You wrote:

However others interpreted or expanded the concept of 'seduction theory,' Freud was highly circumscribed and consistent in his use and understanding of the term. It meant psychological trauma from violence, sexual assault, and incest.

Freud makes no mention in Aetiology of a generalized "violence" as one of the traumas contributing to hysteria. (It would be odd to call it "seduction theory" if it were). The relevant influences are exclusively sexual. He writes:

Sexual experiences in childhood consisting in stimulation of the genitals, coitus-like acts, and so on, must therefore be recognized, in the last analysis, as the traumas which lead to a hysterical reaction."

He further wrote that "in all of [his] cases" of hysteria he had "come to learn of sexual experiences of this kind," and later:

Our view then is that infantile sexual experiences are the fundamental precondition for hysteria.

And again 25 years later, describing this period in his Autobiographical Sketch:

I was thus led into regarding the neuroses as being without exception disturbances of the sexual function.

No mention of trauma from a generalized, non-sexual "violence."

Today we know [Hysteria] as various disorders that resulted from trauma. Collectively, we call these disorders PTSD.

I don't find the equation of Hysteria with PTSD convincing, for three reasons. First, as I understand it, PTSD can result from a traumatic experience at any stage in life, whereas Hysteria was considered to result from incidents in childhood exclusively. Second, there are sins of omission, like neglect, that give rise to "hysterical" symptoms without rising to the level of a precipitous traumatic event. Third, the (DSM) symptoms of PTSD (re-experiencing, hypervigilance, aversion) don't match up very well at all with the reported symptoms of Hysteria, which were much more like our modern concepts of neurosis and somaticization disorder.

However since you are a professional psychologist and I am just a dilletante, I'll give you the benefit of the doubt on this. Let me ask you, then, given the characterization (in Freud's own words) of Seduction Theory as attributing Hysteria exclusively to sexual traumas, does the analogy of Hysteria to PTSD make Seduction Theory more or less tenable in your view?

Finally, I have never denied that "Sexual abuse of children DOES UNDERLIE A WIDE VARIETY OF NEUROTIC BEHAVIOR." I regard it as one of the worst transgressions a person (usually a parent) can commit against a child. But this is not the same as saying that all neurosis has a sexual transgression at the root of it, which was Freud's clear position in 1896, before he changed his mind.

Posted by: Chris Schoen | Feb 2, 2010 1:50:03 AM

Or to be a bit more balanced, we might note that Freud was among the first to realize that the operations of the mind run deeper than mere reason.

This is what he added to the mix, in a serious way, often wrong, but exposed a new path.

Like Elatia, I have had quite a bit of therapy with a Freudian, but don't consider myself extremely literate on the subject.
He is politically interesting, but that is another subject, along with his influence on advertising.

Posted by: Dave Ranning | Feb 2, 2010 1:59:35 AM

"the deep structures of personality were not provable in Freud's day and are not provable now. You cannot show me that the id, the ego and the super-ego are outmoded now, any more than you could have shown me they existed 100 years ago...that's where we are now with the id, the ego, and the super-ego. All we can say is, it's not how we tend to think about things these days, and the rightness of the theory will remain shrouded in mystery -- as will its wrongness."

I'm only posting to point out that this is the same sort of fallacious reasoning that purveyors of other non-scientific theories use to peddle their lies and distortions. On a blog such as this, where THREE POSTS DOWN there is a youtube video that is probably mocking homeopathy, this statement deserves nothing but scorn.

Posted by: Fill | Feb 2, 2010 2:00:48 AM

Tsk, Tsk.

Posted by: Carlos | Feb 2, 2010 6:16:19 AM

Carlos, thanks for getting us out of italics hell, which always makes polite comments look so pointed, and rude comments look so crazed.

Fill, it's possible to have an explanation for what you see that is deeply theoretical, to posit the existence of things that cannot be located -- yet, or perhaps ever -- and to do this on the basis of behavior you can and do see. Like at CERN, for instance. When such theories are not in use any more, they are not thereby proven conclusively wrong. Off-topic, but homeopathy succeeds or crashes based on results obtained by homeopaths, not scientific proof, of which they have none. If enough people became well -- cured of killer diseases -- through homeopathy, that might have a mainstreaming effect on those ideas, and many people would see the world through that lens because the results would have gotten their attention. Maybe there's an analogy here...

Chris, it's good to read Freud -- good for Underverse -- and I'm glad you're doing it (again) instead of water-skiing on Lake Wikipedia. He was among other things a brilliant writer with a matchless ability to articulate difficult thoughts. He was awarded the Goethe Prize for writing, although reading him with pleasure and understanding in German has always been a bridge too far for me.

People who want to disagree with Freud should trouble to read him -- they'll find plenty of grist for their mill. From the very beginning of his career as a writer, with the publication of _The Interpretation of Dreams_ in 1896, Freud expected to be disagreed with. He recommended then that those who disagreed with him re-read his books. "Or, just read them," he added. Then as now, the material is so horrid to some that they need not get on top of it to disagree. So that, like Nietzsche, he is reviled by spot-readers and non-readers. The thing about Freud is not whether he was right; the thing is that he entered the labyrinth in a way few thinkers had ever done, or ever will do.

Posted by: Elatia Harris | Feb 2, 2010 10:24:51 AM

Carlos,

You'll have to tell me how you did that. I thought a close italics tag at the top would do the trick, but it didn't.

When is Typepad going to add a markup tool bar? It would make things so much easier.

Elatia,

I never navigate Lake Wikpedia in anything faster than an canoe.

It's worth remembering what a positivist Freud was, even if future generations of Freudians were/are not. Freud was not Lacan, after all. He would have agreed with Norman that that science involves "understanding nature and ourselves through systematic observation and the recording of data." But not, perhaps, with Norman's remark that "data is the starting place." Data is useless without organizing concepts, and Freud knew an emerging science needed to start there (from his Autobiographical Sketch):

In the natural sciences, of which psychology is one, such clear-cut general concepts [as his critics were requesting of him] are superfluous and indeed impossible. Zoology and botany did not start from correct and adequate definitions of an animal and a plant; to this day [1924] biology has been unable to give any certain meaning to the concept of life. Physics itself, indeed, would never have made any advance if it had had to wait until its concepts of matter, force, and gravitation, and so on, had reached the desirable degree of clarity and precision. The basic ideas [in any science] are always indeterminate at first... It is only by means of a progressive analysis of the material of observation that they can be made clear and can find a significant and consistent meaning. (my emphasis)

His success in this was incomplete, of course. But as you have been asserting here, his failure has not been as great as many of his detractors have claimed, and much of the "discrediting" that has transpired has been by people who were never interested in taking his ideas very seriously, in part no doubt because they demanded an uncomfortable introspection (that even Freud bridled at) and a challenge to our self-image as rational creatures.

Tripartite identity is still a major part of psychodynamic theory, in which not only is it possible today to be a licensed practitioner, but to have your services reimbursed by all the major health insurers. If it had been truly "discredited" as Norman argues, we would expect to find it as rare (and delegitimized) as phrenology, or bloodletting.

Posted by: Chris Schoen | Feb 2, 2010 12:13:02 PM

Chris, I have lost so much time to snorkeling in Lake Wikipedia that I discovered it was quicker to go to my bookshelf and look for pages where my orange highlighter once ruled. The trouble being that 9/10s of everything I've ever read is in storage, deep storage.

Posted by: Elatia Harris | Feb 2, 2010 12:30:05 PM

The i tag has to really want to change.

Posted by: Carlos | Feb 2, 2010 2:35:16 PM

Chris,

You judge the validity of healing methods, scientific or otherwise, on the basis of insurance reimbursement?

Sometimes 3QD is so weird.

Posted by: Louise Gordon | Feb 2, 2010 2:40:21 PM

Louise,

Sorry, that isn't what I meant to imply. I was responding to Norman's statement about Freudian concepts being "discredited." Insurer reimbursement is one measurement (that magic word) of what is normative. A "discredited" therapy would presumably not be sanctioned by state licensing boards, and thus not subject to coverage. But I can find such services offered by a licensed practitioner in almost any city in the country.

That's not to say that whatever the states will license is what they *should* license (though in this case, yes, they should continue to sanction psychotherapy grounded in psychodynamic theory.) If trans-occipital lobotomy were still accepted practice I would feel quite free to judge its validity on other grounds. But we would not want to call it "discredited," in that case. We'd just call it morally wrong.

If Norman wants to make the case that psychodynamic therapy (based in part on Freudian principles like the tripartite identity, the unconscious, the reality principle, primary/secondary process, etc.) is harmful to patients (or just plain ineffective) he's free to do so (hopefully with some supporting data). But the fact that one faction in the psychological community (however powerful) rejects certain Freudian influences does not mean that they don't still play a sanctioned role in our society.

Posted by: Chris Schoen | Feb 2, 2010 3:14:19 PM

"Given the pervasiveness of hysteria in the larger society, it would stretch the credulity of people who are not involved in the sexual exploitation of children. However, it would threaten the exposure of all those who perpetrated the horrors; And, it would bring to light those who were aware of sexual exploitation of children, but who did not act on behalf of the victims. Put differently, they all knew who they were."

There was another group who might have stayed away from Freud had he persisted in his original theory, and that was victims of traumatic childhood sexual abuse. If Freud had become strongly identified with that theory, then the people who were not ready to acknowledge the fact that they had been the victims of such abuse would have been most reluctant to schedule a visit with him. The method of treatment he described would therefore have been of little use to anyone. By declaring memories of incest to be fantastic symptoms of hysteria, rather than truthful records of the events that caused his patients troubles, Freud may have given his patients permission to tell their stories. While the interpretation Freud imposed on those stories and manipulated his patients into accepting might have to be classified as a lie, that does not mean that his decision did not ultimately expose more truth than it concealed.

Of course this isn't the sort of argument an ethics panel would be likely to find convincing if it were judging Doctor Freud. But them we are not an ethics panel, and Freud is no longer available for that sort of judgement. We ought rather to think like historians, and try to weigh all of the consequences of Freud's actions.

Posted by: Acilius | Feb 2, 2010 5:11:13 PM


Chris,

Thanks for your comments.

Violence should be understood as sexual violence, rape in particular. Today, we understand that violence of all kinds can lead to psychological trauma and the characteristics of Hysteria symptoms, now understood as PTSD. Also, we know that witnessing violence, sexual assault, and incest can produce psychological trauma. Those who aid people in a trauma crisis can also develop PTSD.

I am acquainted with a gentleman who was a first responder, a fireman, in the 9-11 disaster. He stayed for a long period of time working on the recovery of remains. As a result of this experience he has PTSD. He is not able to work at his old job, and is recovering from alcoholism.

As to the equivalence of Hysteria and PTSD, Judith Herman's book is the bible on the subject. The title says it all: "Trauma and Recovery: The aftermath of violence - from domestic abuse to political terror."

Freud's seeming reference to 'all of neurosis' as a consequence of child sexual abuse, is actually a reference to all of neurosis observed in hysterics whom he studied.

Posted by: Norman Costa | Feb 2, 2010 8:32:10 PM

This is a very well researched and superbly written philosophical article.
I say philosophical, because it elevates to the condition of a ‘disease’, a mere collection of symptoms --- many of them suggestion-induced.
However, while doing so, it fails to meet the essentials requirements to have hysteria considered an illness.
To qualify as an illness, the following requirements are to be met:
1. The presence of a causative agent
2. The presence of a consistent clinical picture representing the response of the body to the agent
3. Laboratory tests that confirm the diagnosis
Hysteria, as all can easily see, fails in all of the above respects.
Meanwhile, DSM-ETC, with its symptom list, does little or nothing to clarify the confusion, while factions at war among its members battle between themselves to gain the upper hand in the control of the nomenclature.
But that’s another matter altogether.
In the 1960s, the late Sam Guze and his associates at Washington University suggested a medical model to define hysteria and solve the conundrum.
Based on this model, they used the label of Briquet’s syndrome naming it after the physician that first described it.
Unfortunately, the idea did not go anywhere.
Last December I wrote an extensive review of the subject matter under the title: Histeria, su Historia, las brujas de Salem, el holograma del incons¬ciente: El Exorcista revisitado…

It can be read at the following websites: www.psikis.cl and www.monografías.com.

As to Freud’s foibles, I admire him despite his enormous flaws.

Maybe this is so, because I too was analyzed by an admired Freudian analyst.

Who knows?

In closing I’d like to add that it’s only a tribute to Mr. Costa’s lucid prose and well reasoned arguments that such a cast of enlightened intellectuals responded so enthusiastically to his provocative ideas.
I await expectantly the next installation with these parting words.
Well done!

Posted by: Felix E F Larocca MD | Feb 2, 2010 8:33:23 PM

Dr. Larocca, long time no see! Thanks for coming back...

Posted by: Elatia Harris | Feb 2, 2010 8:51:27 PM


Chris,

You stated that Freud would not agree with me that data are the starting place for science. Then you state: "Data is useless without organizing concepts, and Freud knew an emerging science needed to start there."

To support your assertion you offer a quote from Freud. Actually, you are misreading the quote. Freud is agreeing with me - or I with him. Read the last sentence, again, and substitute the word 'data' for the phrase 'material of observation.' Then it reads like this:

"It is only by means of a progressive analysis of the [DATA] that they can be made clear and can find a significant and consistent meaning."

His comments prior to this sentence are in line with what I have stated.

The hierarchy of functions in science is 1. Description (data), 2. Explanation (your 'organizing concepts'), 3. Prediction, 4. Control.

The basic function of all science is to describe the properties of things. That means: data rules, and that's where you start.

Much discredited theory and practice are still actively pursued and covered by insurance. Essentially these have been grandfathered into the system as a result of inertia and a strong, but dwindling following. It is only a few years ago, at least in NY State, that it became a requirement that mental health delivery and services have to be evidence based. This model is being implemented everywhere. It will be some time before we see how this pans out for practice and reimbursement.

Posted by: Norman Costa | Feb 2, 2010 9:05:45 PM


Chris,

I was very careful in saying precisely what was discredited:

"The fact is, Freud, in the ELUCIDATION OF HIS THEORIES of psychoanalysis and psycho-sexual development, and his tripartite division of personality, was wrong on just about everything. The truth is that he got some details correct, but the centerpieces of his theories have long been discredited after decades of research."

It was Freud's explanation of how it all works that has been discredited. Id, Ego, Superego are concepts still in use today, but they are understood and used very differently. We now have a whole field of Ego Psychology that would be unrecognizable to Freud.

Freud's explanation of psycho-sexual stages of development is completely debunked. Sometimes the expression "Oedipal" is used, but with a very different sense - not anything like that envisioned by Freud.

Freud tended to reify the unconscious. The term 'unconscious' is a very convenient shorthand that most people understand. However, modern theories think more in terms of levels of consciousness, or different levels of access to consciousness, as well as altered states of consciousness.

There are many more examples. Most therapists, these days, employ an eclectic approach to their practice. Someone doing psychoanalysis might not be seen as the way Freud might do it.

Posted by: Norman Costa | Feb 2, 2010 9:29:13 PM

Elatia, Thanks to you!

I'm glad to be back

Posted by: Felix E F Larocca MD | Feb 2, 2010 9:29:35 PM


Dr. Larocca,

Thank you for your observations and your kind remarks. I will be looking at your paper.

Posted by: Norman Costa | Feb 2, 2010 9:49:00 PM


Acilius,

Very good observations. Thanks.

Posted by: Norman Costa | Feb 2, 2010 9:50:48 PM

Norman,

You write: The hierarchy of functions in science is 1. Description (data), 2. Explanation (your 'organizing concepts'), 3. Prediction, 4. Control.

In the psychology you've been describing as moving towards science (if and when it gets its measuring capacity right), what would be predicted and controlled? What is the purpose of prediction and control in psychology?

Posted by: Louise Gordon | Feb 2, 2010 11:42:26 PM

Norman,

My point is that your/Judith Herman's equation of Hysteria with PTSD would render Seduction Theory unworkable. And yet the position you offer here, with support from Herman, is that Freud's Seduction Theory was a valid theory, based on good science. You can't have it both ways.

As you mention with your example of the first responder, PTSD is a disorder that can result from any severe trauma, not just sexual ones. War, for example, or any number of violent crimes. If we equate Hysteria with PTSD, then Freud's Seduction Theory cannot be correct, since ST posits only sexual causes for the range of symptoms you are arguing are shared by PTSD and Hysteria.

Therefore, either PTSD and Hysteria are not the same, or the Seduction Theory is incorrect.

However, even if PTSD and Hysteria are not the same, that doesn't mean that the Seduction Theory is true. Many of the types of symptoms that Freud classified as "hysteric" are known to arise from non-sexual causes. (For example conversion disorder). So Seduction Theory would seem to be untenable even if we decouple it from PTSD, which is the point I was arguing earlier with my mention of "absurdity."

Your argument that Freud restricted Seduction Theory to apply only to Hysteria is not supported by his own writings. In his "Draft K" document to Fliess (1896) he lists a number of "Neuroses of Defense" that are each precipitated exclusively by sexual events (according to his thinking at the time). These include "obsessional neurosis" (OCD) "paranoia" (paranoid schizophrenia), phobias, and megalomania. In the "Draft B" document (1893) he writes that "every neurasthenia is sexual." (Granted, neurasthenia seems to overlap significantly with what was called hysteria). He also strongly indicates in this document that he believes that depression and anxiety disorders are sexual in origin.

I don't think anybody could read the correspondence with Fliess from that time, and not believe that Freud intended Seduction Theory to apply to neurosis broadly. His statements about it are simply too unambiguous, and too numerous, to leave any room for doubt.

I will respond separately to the matters of Freud's influence and relative failures to conduct his work scientifically, as we've discussed in parallel threads. (These seem better to relate to your upcoming Part II, at any rate.) But whatever Herman's virtues in helping us to better understand trauma, generally, I don't think her expositions on Seduction Theory bear up very well against the documentary evidence. This is not a matter of whether Freud's 18 patients all suffered sexual abuse or not. They may have. (Though the evidence is slim, here). It is about the theory he developed based on these patients, which attempted to place a sexual transgression at the heart of every instance of clinical hysteria. There can be no doubt of this based on his published writings alone. That is not good science, it is bad science, and we are all better off that he went on to elaborate his ideas in a more complex and sophisticated fashion.

Posted by: Chris Schoen | Feb 3, 2010 12:00:18 AM

It was Freud's explanation of how it all works that has been discredited. Id, Ego, Superego are concepts still in use today, but they are understood and used very differently. We now have a whole field of Ego Psychology that would be unrecognizable to Freud.

Fair enough. But it suggests a bit of a double standard. If you would be willing to make the same kind of statement about Darwin or Copernicus, whose explanations of their primary metaphors have likewise been discredited (blending inheritance, circular orbits, stationary sun) then I have no further quarrel on this topic.

Posted by: Chris Schoen | Feb 3, 2010 12:20:39 AM

Canoeing in Lake Google, I just stumbled upon Abraham Maslow's Psychology of Science, which I find relevant to the topics at hand. Drifting away from Freud here, but also away from positivist, determinist views of science, which seem especially ill suited to psychology.

Posted by: Louise Gordon | Feb 3, 2010 1:17:39 AM

People do this: <i>italic<i>, so one has to do this: </i></i>.

Posted by: Sagredo | Feb 3, 2010 5:27:41 AM


Louise,

Thanks for your very good question.

You asked: "In the psychology you've been describing as moving towards science (if and when it gets its measuring capacity right), what would be predicted and controlled? What is the purpose of prediction and control in psychology?

In a science like meteorology it's obvious what is being predicted and why - the weather. The science has been getting better at it, over time, but there's still a lot of errorin the predictions. As far as control is concerned, short of seeding clouds for rain, there isn't much immediate control that can be exercised.

The social sciences (of which psychology is included) has done a reasonably good job at prediction in a number of areas. Preemployment testing and job performance, for example. But even this is limited in scope. The SATs are highly predictive of GPA at the end of freshman year in college. But the predictive success is short lived. The predictive success declines to very little by the time a student is in senior year.

The purpose of using SATs, in conjunction with other input for prediction of academic performance, is the same as using preemployment testing for hiring: Efficiency.

Last year, in the Journal of Early Adolescence, it was reported that depression in early adolescence could be predicted by antisocial behavior in elementary school girls. For boys and girls in elementary school, increased anxiety was predictive of early adolescent depression. Obviously, if one could predict such disorder, it opens the way for intervention.

This brings us to the matter of control. Psychology is not as successful in controlling elements in its sphere of study, as are other sciences like metallurgy, pharmacology, and physics. There is a scene in the early part of the movie, "2001, A Space Odyssey" where it was decided not to inform the public about evidence of intelligent life beyond the earth. The bureaucrat gave the reason as needing time to CONDITION the population. This is a clear reference to B. F. Skinner's behavioral science we know as operant conditioning. Needless to say, it didn't work out for Skinner's behaviorism.

Therapy can be thought of as control - influencing the behavior of an individual people to conform to behavior that represents better mental health. As the risk of sounding glibly simple, we now know that is it possible to 'rewire' the brain through various kinds of interventions. In the case of PTSD, the new technique of diagnosing PTSD by reading electrical signals in the brain will likely show a change in brain activity as a result of treatment.

Psychological warfare is an attempt to control elements on the battle field that favor a victory. My personal view is that its effectiveness is debatable.

Salespeople, politicians, and psychopaths are more effective in manipulating, read 'controlling,' people's behavior that any of us psychologists.

Posted by: Norman Costa | Feb 3, 2010 3:42:06 PM

Norman, Thank you for answering my question I don't have time to explore the issue of intervention now. Suffice it to say that I don't think control or being intervened upon would lead to salutary results. I hope to continue this discussion another time.

I did find a film that I hope you enjoy:


Freud & Bernays

Posted by: Louise Gordon | Feb 3, 2010 7:40:54 PM


Louise,

Thanks,

I watched the entire series. I missed the program when it originally aired.

I recommend it to anyone interested in Freud and psychoanalysis. It amounts to a history of the influence of Freudian psychoanalysis in the United States - its rise, its grand moments, and its fall from grace.

Posted by: Norman Costa | Feb 4, 2010 3:24:05 AM

Louise,

I'm not sure it's fair to lay Bernays at Freud's door any more than it would be fair to blame Gregor Mendel for Monsanto.

I didn't have a chance to watch this film before it was pulled from Google, but I hope it doesn't give the impression that Freud was interested in thought control and mass manipulation. In the Freudian, or neo-Freudian, tradition, the intent is just the opposite; making unconscious thoughts and attitudes conscious makes it that much more difficult for them to be exploited by others.

I agree with you that "control" is an unfortunate word in the context of social sciences. I'd go further and say it doesn't have much place in the physical sciences either. "Control" is an artifact of magical thinking, from the days of alchemy and folk science. To really control nature, one would have to be outside of nature, which of course we are not, as we are all-too-slowly learning.

Therapy is a broad word with many meanings, but I can think of very few psychological therapies that, in Norman's words, "influence the behavior" a patient to "conform" to mental health norms. Even cognitive-behaviorist therapy (CBT), which is the least insightful of all psychological therapies, treats the patient as an agent, with interests that may conflict with her psychologist or with society at large.

Having said that, there have been horrible periods in the last 100 years where so-called therapies have been employed not to improve patients lives, but to make them less of a nuisance to others--e.g. prefrontal lobotomies, which were performed on tens of thousands of Americans.

At any rate, you are right to be suspicious of psychological practices that seek to "modify behavior" without regard to the wholeness or autonomy of the patient. But these are much more likely to be legacies of the Behaviorist school of Watson-Thorndike-Skinner than of psychoanalysis or psychodynamic theory.

Carlos and Sagredo, thank you.

Posted by: Chris Schoen | Feb 6, 2010 1:37:30 PM

Chris,

That excellent documentary is still available. Go to Google Video and search for "the century of the self". It has four parts, about an hour each. The first one is here. Everyone should watch it.

Posted by: Namit | Feb 6, 2010 1:58:59 PM

Chris,

You write: "Having said that, there have been horrible periods in the last 100 years where so-called therapies have been employed not to improve patients lives, but to make them less of a nuisance to others--e.g. prefrontal lobotomies, which were performed on tens of thousands of Americans."

If you read Robert Whitaker's Mad in America, you'll see that the introduction of psychotropic drugs in the fifties led to conditions nearly as debilitating to patients as surgical lobotomy. Whitaker also has a new book coming out in April, together with a blog:


Anatomy of an Epidemic

You write: "At any rate, you are right to be suspicious of psychological practices that seek to "modify behavior" without regard to the wholeness or autonomy of the patient. But these are much more likely to be legacies of the Behaviorist school of Watson-Thorndike-Skinner than of psychoanalysis or psychodynamic theory."

That may be true (unless you happened to be Emma undergoing nasal surgery in pre-legacy times). However, I would agree with you that historical figures should not be judged by today's standards.

Some people seek healing from the shaman in the forest, some people explore what they believe is their subconscious and go through rituals like transference with their analyst. I don't object to anyone doing whatever they want to to effect what they believe are salutary benefits in their lives. I object to calling any of this science, from free associating on the analyst's couch to popping a Prozac or other chemical wonder. For some reason, people believe that "behavioral" difficulties can be resolved through tweaking brain chemistry -- or, as Norman said -- rewiring the brain. I realize that Norman is not hoping to duplicate what Cameron and the CIA tried in Canada, completely obliterating "patients'" memories through electroshock and other so-called treatments. But fiddling with the brain in the absence of evidence of something like Alzheimer's or degeneration caused by other neurological diseases is, IMHO, a very bad idea.

But once it's called science, with shrinks masquerading as scientists, just about anything goes, which is revealed in the history of mad doctoring. Only shrinks can nullify someone's constitutional rights by claiming they are a danger to themselves or others and therefore must be locked up or given treatment against their will. While people are outraged that suspected terrorists can be given indeterminate sentences without being charged with a crime, psychiatry has set the precedent for such barbarism.

I don't know when the preposterous concept of masturbatory insanity went out of fashion, but it was only in 1973 or '74 that homosexuality was expunged as a disorder in the DSM manual. And that happened not through measuring techniques, the subject of the first article in this series, but because practitioners in the realm of shrinkdom voted it out. This is the height of absurdity.

Posted by: Louise Gordon | Feb 7, 2010 11:42:33 AM

Louise,

I agree with you to a point, but your argument comes very close to a critique of normativity itself. If we can call some people criminals, why can we not also call some people insane, or ill? Both categories are prone to abuse, but that doesn't mean we need reject them altogether. Whatever was going on in the residential clinics shut down by Reagan in the 80s, it was arguably better than rank homelessness.

I wish you'd show your cards a little more on this topic. It would be helpful to know more about some of your foundational ideas of mind and human nature. They seem not to be religious, rationalist, Darwinian, Freudian, neo-Freudian, Behaviorist, or Cognitivist. What's left--Existentialist?

Posted by: Chris Schoen | Feb 7, 2010 4:13:00 PM

Chris,

Nothing like challenges to the normative to liven things up. You can call people anything you like, but when psychiatrists do this with labels called diagnoses, then deprive people of their freedom or give them drugs and other treatment that lead to chronic disability, I think that it's time to challenge the normative.

For years shrinks have pushed their pills by telling people that without them, they'd be like a diabetic without insulin. Look at the evidence Robert Whitaker has uncovered and tell me if you think normative psychiatric treatment of behavior deemed "illness" is effective. From Robert Whitaker's site:

"In 1955, there were 355,000 adults in state and county mental hospitals with a psychiatric diagnosis. During the next three decades (the era of the first generation psychiatric drugs), the number of disabled mentally ill rose to 1.25 million. Prozac arrived on the market in 1988, and during the next 20 years, the number of disabled mentally ill grew to more than four million adults (in 2007.) Finally, the prescribing of psychiatric medications to children and adolescents took off during this period (1987 to 2007), and as this medical practice took hold, the number of youth in America receiving a government disability check because of a mental illness leapt from 16,200 in 1987 to 561,569 in 2007 (a 35-fold increase.)"

A 35-fold increase in disability is a bit high, don't you think?

Also, I was not saying that people who've been turned into chronic institutionalized mental patients should be thrown out in the street. If they've become unable to care for themselves, I believe society has an obligation to provide for them. But if clinics shut down by Reagan in the 80s were anything like Willowbrook, an institution that was charged with care of children with "mental deficits," I think I'd prefer "rank homelessness" to living in such a setting:


Willowbrook

I don't have time right now to expound upon my foundational ideas of mind and human nature, but I do appreciate your inquiry. I guess you could say that I'm Christian heretic, pagan (virtuous, of course), William Blakeian . . . oh, I don't know how else to classify my foundations.

Posted by: Louise Gordon | Feb 7, 2010 5:57:24 PM

Louise,

I'm just glad you're not a secret Scientologist.

I'm not defending status quo norms; I'm just saying that some norms are needed in any society, so let's not throw out the baby with the bathwater. I agree with you that pharmacology is out of control, and I by no means subscribe to the all-too-convenient theory of "bad wiring" necessitating all these new treatments. I'd probably agree with Whitaker on most counts. I'll have a look at his site.

But anyone who has done any sustained thinking about mental health can see how frequently it is wanting in this culture. Neurosis is real. There are many ways to heal it, including art, ritual, meditation, and just plain good luck. But within psychology, there is a tradition--that emerged from Freud's work and thought--that doeesn't aim (speaking broadly) to paper over the conflicts that keep people from being more whole, whether by pills or other palliative means.

I just don't think psychodynamic theory deserves to be lumped in with the exploitative aspects of psychology you are concerned with.

But I hope we get to talk more about Blakean / pagan / mystical philosophies of mind on this thread, or some other.

Posted by: Chris Schoen | Feb 8, 2010 12:25:11 AM

Chris,

I'm just glad you're not a secret Scientologist.

That has to be one of the world's best insults. Golly, I didn't know this conversation might prove to be rougher than when Winfield Abbe expounds on the cancer generals. ;)

I wasn't lumping psychodynamic theory together with predatory and exploitative use of pharma. I said I didn't see how psychiatry and psychoanalysis qualified as science. Nor do I see how improved measuring sticks will make psychology more scientific.

If you like psychodynamic theory, fine. Other people like meditation, Reiki healing or trips to Lourdes. That doesn't mean such methods are based in science.

I have to be excused now to go work on my Relaxation Response. Look forward to Blake another time, maybe over at underverse.

Posted by: Louise Gordon | Feb 8, 2010 9:11:33 AM

Louise,

That doesn't mean such methods are based in science.

You and Norman are coming at this from different angles, but you both seem willing to apply the crucible of "science" on much more simple terms than I am prepared to.

Norman's scheme, nothing-but-the-facts, recalls the doomed positivistic program of eliminating metaphysics from the sciences altogether. It might make our lives easier--perhaps even better--if this were possible; but it's not. Every scientific theory has a story beneath it, not always explicit in the mind of the theorist.

"Physics envy" happens because the Newtonian story is the one we can all best agree on. It seems the least muddled because the metaphysics is almost universally taken for granted. The irony is that the whole thing is just a convincing approximation that works on mid-sized phenomenal objects. At the quantum level, matter seems to have none of the properties Newton ascribed to it.

I support, on these grounds, your resistance to describing human nature on a mechanistic basis. But at the same time, our discussion of human nature, as a culture, is a long and distinguished one. It would be odd if we didn't put our ideas about it into practice.

We already put our metaphysical ideas about human nature into practice when it comes to jurisprudence and the social contract. The fact that this practice isn't "based in science" in a narrow white-coats-and-beakers sense, doesn't mean that anything goes, and that we should have no social structure at all. Social structure is a place where facts, value and ideas intertwine. If there were no empirical aspect to how we live, we might still be subjects to some holy Empire.

I think I could mount a pretty good defense of psychodynamic theory, though at a minimum it would be subject to further refinement, and it might well be all just bollocks. In either case its level of articulation, and its extensive integration with clinical practice and observation make it a different kind of animal than miracles at Lourdes.

I don't know enough about Reiki to make a comparison. I have my doubts about some of the principles reiki is based on. But if reiki were well elaborated by a series of thoughtful and dedicated practitioners with some curiosity about how theory and practice inter-relate, then it counts as a science in the broad sense I would like to use the word, an elaborated body of knowledge approached with intellectual honesty.

My concern is that in giving the ground of "science" to a definition like Norman's, you are leaving nothing for the rest of human experience but a matter of taste, and that's hard to build a culture out of.

Posted by: Chris Schoen | Feb 8, 2010 12:57:42 PM

Chris,

I think your concept of science is broader than mine.

You write: "I think I could mount a pretty good defense of psychodynamic theory, though at a minimum it would be subject to further refinement, and it might well be all just bollocks."

Take heart, you don't have to because neuroscientists are doing that for you, and in the following video, someone explains how:


psychoanalysis

">http://actv.haifa.ac.il/programs/Item.aspx?it=962&lang=en-US">
Neuroscience Meets Freud


Neuro

Now all participants in this conversation may realize they were partly right -- or wrong.

Posted by: Louise Gordon | Feb 8, 2010 4:55:10 PM

Ooops!

This should take you to the video with Mark Solms, who may or may not be a modern culture builder:

http://actv.haifa.ac.il/programs/Item.aspx?it=962&lang=en-US

Posted by: Louise Gordon | Feb 8, 2010 5:22:59 PM

Chris,

My concern is that in giving the ground of "science" to a definition like Norman's, you are leaving nothing for the rest of human experience but a matter of taste, and that's hard to build a culture out of.

Is this really the choice we face? I would say we already have meaningful categories for the many kinds of human knowledge, such as the (natural) sciences, social sciences, and the humanities. I think we can all agree that these represent different approaches to understanding nature, including ourselves. I stand with those who insist that psychology is a social science and reject attempts by positivist psychologists to "upgrade" it to the "prestige" of science (recall the term I invented for such a condition: "phynis envy" :). Further, no amount of measurement can make psychology a science any more than it can make economics a science.

This does not make psychodynamics a matter of taste, at least not entirely, not any more than economics, philology, or archaeology are a matter of taste. We can build societies with pragmatic norms based on such knowledge, while acknowledging that these norms are not based on science. There are legitimate issues of precision, verification, reliability, explanation, and universality (among others) that the social sciences do not deliver on as well as the sciences. If we expanded the definition of science to include any "elaborated body of knowledge approached with intellectual honesty", then we'd also need to call history a branch of science. What would we gain by that?

Posted by: Namit | Feb 9, 2010 12:19:04 AM

Namit, and Louise,

Other languages--German, for example, if I'm not mistaken-- use the word science (Wissenschaft) in this broader way, to indicate systematic knowledge. And of course in the original Latin, it means no more than that. Why shouldn't history be a "science," in this sense?

As long as science means "physics, chemistry and some of biology," there will always be a tug of war, like the one here, with some complaining that a discipline like psychology is just a pretender to the throne.

As Norman has written several times, there is significant pressure to make disciplines like psychology more "evidence based." It's de rigeur in most popular science books today to give "Humanities" a crooked squint, before writing them off as a bunch of ivory tower nonsense. And look at the way schools are funded, or unfunded. If it's not a hard science, it's suspect. (Louise has already drawn the appropriate parallels to the desire of Capital for metrics and efficiency.)

So, yes, I think the word could come in for some rehabilitation.

Posted by: Chris Schoen | Feb 9, 2010 12:45:08 AM


At the risk of repeating myself:

Science is an approach to understanding nature and ourselves through systematic observation and the recording of data.

I emphasize the phrase an approach because science is not the only approach to understanding nature and ourselves.

Other approaches might be intuition, transcendent experiences, meditation, art, religion, history, and literature.

I've always advised people going into clinical programs to read the great literature. A close friend suggested to me that if you want to understand human nature and relationships, read French and Russian novels.

Posted by: Norman Costa | Feb 9, 2010 1:14:22 AM

Norman,

I fully agree. I'd only suggest replacing "nature and ourselves" with "nature, including ourselves".

As you say, science is an approach. Psychology is also an approach. My point is that psychology is not science, however hard we insist, and no amount of "measurement" is going to make it so.

Chris,

If we rehabilitated to "science" its erstwhile meaning, a new word would emerge to take its place and guide funding decisions. :-) A better bet might be to stand up for, and make respectable again, the areas of understanding that science cannot approach, each with its own throne (I know you do). If/when that happens, funding would become more balanced. Without that, we're all finito pronto.

Posted by: Namit | Feb 9, 2010 2:37:44 AM

I fully agree. I'd only suggest replacing "nature and ourselves" with "nature, including ourselves".

As you say, science is an approach. Psychology is also an approach. My point is that psychology is not science, however hard we insist, and no amount of "measurement" is going to make it so.

I think Norman's implicit question has been: if nature includes ourselves, and the regularity of nature is what science attempts to describe, then why shouldn't there be a psychological science? Have any of us given him an answer to that?

I think a partial response is that science (back to our more orthodox, narrow definition) has never been equipped to study mind or intentionality, neither of which can be directly observed or quantified (which is why "psychometrics" is such a misnomer.)

And yet, how can we not describe our interiority with the same degree of elaboration with which we describe the "exterior" world? Any firewall between inside and outside wold seem to alienate us more and more from the world as we continue to enhance our articulation of it. It's a real problem.

I think it has a lot to do with our embrace, following Renaissance thinkers like Newton and Leibniz, of a myth of scientific objectivity, but that's all too much to go into here. The problem itself makes me sympathetic to Norman's attempt to view psychology as a science, though I think it's ultimately misguided.

Posted by: Chris Schoen | Feb 9, 2010 6:01:32 AM

Chris,

That is really the question, isn't it? On what grounds can we claim that there can be no psychological science?

I think there are two ways to mount such a case. One is theoretical, the other based on results.

The theoretical argument might go like this. The practice of science begins with delineating an observer from the observed. It relies on a subject-object schema of analysis. The success of a science depends on how well matched this schema is to the aspect of nature we investigate. Gravitation and thermodynamics are more amenable to the observer-observed / subject-object schema of analysis.** But this is not the case for other aspects of nature like human society and the mind, where we are embedded far more deeply into what we try to study, making it largely impossible to delineate the observer from the observed.

The argument based on results might go like this. Science—confronting the embedded, holistic nature of our relation to the world—continues to run out of descriptive and predictive steam when studying the human mind, morality, psychology, aesthetics, and our social world. It has had very limited success in these areas. Of course, someone here might say that we haven't given it enough time and the jury is still out. But as I see it, fields like artificial human intelligence are moribund for very good reasons that mesh in nicely with the theoretical argument above.


** Which is not to say that we can entirely eliminate metaphysics from it.

Posted by: Namit | Feb 9, 2010 12:42:11 PM

I've been away for a month, but I'm afraid I have something very off-topic (and somewhat personal) to complain about. Costa's previous article, "Psychological Science: Measurement, Uncertainty, and Determinism – Part 2", was a strange, jarringly-written, unfocused attack on a group of people he called "scientific psychologists". I (with Chris and others) asked him to name these people. Despite an email to me promising that he would he did not respond. That article thus stands as a colossal waste of everyone's time, for it is an attack on no-one.

Now, we have a similarly unfocused, strangely ad hominem essay about Freud. 3QD, you can do way better than this.

Posted by: Nick Smyth | Feb 9, 2010 1:24:17 PM


Nick Smyth,

Yes, I said I was going to respond, as you indicated. With all good intentions, I was not able to devote the time necessary to bring up my research. I have many other obligations, among them a need to earn a living.

Your disappointment still stands, and I am sorry I did not reply as promised.

However, I took a cursory look through the Google search offered by another commenter (maybe it was Carlos. I'm not sure.) In those search results were plenty of examples of what I was talking about. Most of them I had not seen before, and reinforces my point that the indiscriminate appropriation of Heisenberg's Uncertainty Principle in psychology and psychiatry is very much alive and well. Some of it is downright hilarious.

So I refer you to those comments and check out those search results. They will not disappoint.

Posted by: Norman Costa | Feb 9, 2010 5:50:28 PM


Nick Smyth,

You stated: "Now, we have a ... strangely ad hominem essay about Freud. 3QD, you can do way better than this."

I was very careful to end my title with a question mark'?.' I did not invent this criticism of Freud. It has been around for quite a while. My summation of the several issues as to why he abandoned the traumatic aetiology of hysteria come from a number of sources. There is an additional idea, contributed by Elatia Harris, that may have some merit. She suggested that his findings and earlier explanation may have been, simply, beyond his own credulity and ability to ingest, psychologically and emotionally.

Note: I deliberately stayed away from Masson's criticism of Freud and most of psychiatry. Though he has a number of worthwhile ideas, in general, I regard him as 'way over the top.'

As I mentioned, part of this first essay is a retelling of Judith Herman's sub-chapter, 'The Heroic Age of Hysteria,' in her groundbreaking, and highly researched, book, "Trauma and Recovery." Here is a quote that is relevant to your concern:

"Freud's subsequent retreat from the study of psychological trauma has come to be viewed as a matter of scandal. His recantation has been vilified as an act of personal cowardice. Yet to engage in this kind of ad hominem attack seems like a curious relic of Freud's own era, in which advances in knowledge were understood as Promethean acts of solitary male genius. No matter how cogent his arguments or how valid his observations, Freud's discovery could not gain acceptance in the absence of a political and social context that would support the investigation of hysteria, wherever it might lead. Such a context had never existed in Vienna and was fast disappearing in France. Freud's rival Janet, who never abandoned his traumatic theory of hysteria and who never retreated from his hysterical patients, lived to see his works forgotten and his ideas neglected.

"Over time, Freud's repudiation of the traumatic theory of hysteria did take on a peculiarly dogmatic quality. The man who had pursued the investigation the furthest and grasped its implications the most completely retreated in later life into the most rigid denial. In the process, he disavowed his female patients. Though he continued to focus on his patients' sexual lives, he no longer acknowledged the exploitative nature of women's real experiences. With a stubborn persistence that drove him into ever greater convolutions of theory, he insisted that women imagined and longed for the abusive sexual encounters of which they complained."

I will give my personal responses to the questions, suggested by the title of this essay, in Part 2 on Monday, March 1, 2010. I am sure you and others will have views of your own at that time. That ought to be a very good exchange of ideas.

Posted by: Norman Costa | Feb 9, 2010 6:18:52 PM


In several essays in my "Psychological Science Series," it has been my view that psychology is a science, according to the definition, offered above, which is recognized by all of the major sciences, their organizations, and their practitioners.

1. Psychology, it has been my view, is not as successful as some other sciences in producing laws of nature within our sphere of inquiry.

2. Part of the differences in success is due to the fact that the social sciences deal with much larger errors of measurement than the more successful sciences (for example, physics, metallurgy, and biology.) Econometrics has a much higher level of measurement error than chemistry. Psychology is somewhere in between.

3. I have made the point, in prior essays, that scientific psychology has problems in some very fundamental matters in the philosophy of science. Included are the failure to recognize tautologies that have passed for theory, a lack of a clear understanding of the concept of measurement, and the inappropriate incorporation of Heisenberg'a Uncertainty Principle.

It seems to me that some criticism, among our comments, of psychology as a science is simply a matter of defining it as not a science, or at least not accessible to science. As far as science is concerned, if we behave as scientists should, then we are doing science in our respective fields. There is no basis of discussion between these two views, if one side simply defines away the science.

If someone asked me, "Does scientific psychology understand the Mind?" my answer would be, "I don't know unless we can agree on a definition of Mind." Trying to agree to a definition of Mind would probably take an infinite number of comments, while never achieving an agreement. Again, if Mind is defined as not accessible to science, then there is no discussion possible. I mentioned in an earlier essay that a book on "Catholic Psychology" defined memory as a function of the soul, and therefore, not accessible to scientific investigation. Why argue? Memory has been a subject of psychology since it's inception as a science.

It's important to understand how science goes about it's work, especially in areas where non-scientists cannot fathom an accessibility to science. Take Mind, for example.

1. To the scientific psychologist, Mind is a concept, an abstraction, a thought, an idea. We refer to it as an hypothetical construct.

2. We attempt to investigate Mind by breaking it down into component hypothetical constructs: memory, learning, perception, emotions, cognition, abnormalities, etc.

3. After this we develop operational definitions to represent the hypothetical constructs. In other words, what operations could the participant perform, that would allow the scientist to infer properties of the construct? Let's take memory, for example. The participant might be required to reproduce 9 random digits, spoken by a researcher. Thus, we have an operational definition of some limited aspect of memory. Other operational definitions might involve the study of brain activities of various kinds. From a scientific approach, we develop our operational definitions from the perspective that Mind is what the brain does.

4. The scientist records these data, and uses them to describe an aspect of memory, possibly develop an explanation (a theory of memory), maybe use the understanding of memory to predict (diagnose) brain damage, and develop improved ways to enhance (control) human learning. I've talked about a new diagnostic technique for PTSD by the reading of certain electrical activities in the brain.

Another view which comes forward in some of the comments, above, is that the idea of predicting, or controlling in psychological science is anathema to some people. As unacceptable as these ideas are to some people (and I say this without judgment of any kind), the fact is that this is how science and scientists view their work.

Finally, some views focus on the fact that science can't tell us everything about nature and ourselves. (I have no disagreement with the view that 'ourselves' is included in nature.) Most scientists would agree. However, some scientists, like Richard Dawkins, comes pretty close to saying that science, eventually, will reveal all. I do not subscribe to this. Science can be very good at what it does. But science is also limited in what it can examine in nature and ourselves. There are other sources of understanding that we find so valuable in trying to achieve a rapprochement with the human condition. You already know what these are.

Posted by: Norman Costa | Feb 9, 2010 7:18:51 PM

Norman,

I think you do a good job of laying out how scientific psychologists approach the mind.

2. We attempt to investigate Mind by breaking it down into component hypothetical constructs: memory, learning, perception, emotions, cognition, abnormalities, etc.

The problem begins right here. This is what the AI folks attempted for years with a discreet computational theory of the mind, which eventually became a degenerative research program. This "breaking it down" approach has worked for aspects of nature that we now consider the domain of the natural sciences, but it has had very limited success when applied to aspects of nature that we consider the domain of the social sciences or the humanities. Why is this so? Well, if we reflect on our everyday lives, does it make sense that our experience of the world lends itself to being broken down (without much loss of fidelity) into atomic, context-free sets of facts and rules, objects and predicates, memory and perception units, emotional and cognitive modules, normal and abnormal properties, etc.? Many have responded with a categorical NO (including some who do empirical phenomenology, which I want to read more about).

3. After this we develop operational definitions to represent the hypothetical constructs.

The problem continues. Many have argued, for instance, that what we call common sense is "a combination of skills, practices, discriminations, etc., which are not intentional states, and so, a fortiori, do not have any representational content to be explicated in terms of elements and rules." Further, think of how we are when absorbed in work, say, using familiar pieces of equipment: "we are drawn in by affordances and respond directly to them, so that the distinction between us and our equipment—between inner and outer—vanishes." How do you represent and quantify such fluid mental states, so integral to being human?

You'll disagree but my own view is that smart money now regards reductionist approaches, like the one you present, as fundamentally flawed for the study of mind and society (I grant that some "low hanging fruit" is available, as with AI). I think the primary deficit here is not in measurement, but in understanding what it means to be human.

Posted by: Namit | Feb 10, 2010 2:31:59 AM

Norman,

Thanks for returning to some of the loose ends from your earlier series.

I clicked through the first 20 hits on Carlos' link, and didn't find that any contained a proposition by a professional psychologist that a psychological measurement effect can be based on Heisenberg's work in particle physics. (Granted, some journal articles were behind paywalls and it wasn't entirely clear what they were putting forth.) I did find that Heisenberg's uncertainty principle was sometimes used as analogy (not, in most cases, by a psychologist) to demonstrate that observing a subject can disrupt that subject's "natural" activity. But this is commonplace, and I don't see how this would make a laughingstock of anyone. You yourself mentioned that you use this analogy with your students.

This doesn't mean that no one has made such an argument, but we still lack the data to support your assertion that this is a problem in the psychological community, when you write:

We need to stop inserting a reference to the 'Uncertainty Principle,' in the introductions to our technical papers, as if it were a demonstrated proof of our claims that the act of measuring something changes that which is measured in psychological research. The burden is on the teachers of psychological research methods, text book authors, and review editors of technical publications. It must be acknowledged that the 'Uncertainty Principle' belongs ONLY to quantum physics. Similarly, we have to dispel any notion that probabilities associated with errors of measurement in psychology have any connection to quantum uncertainty.

If there is a pervasive issue with psychologists treating the "uncertainty principle" as a demonstrated law in such a way as to weaken the credibility of the discipline as a whole, I humbly and respectfully ask, with Nick, for some substantiation of it. (Ditto for the idea that psychometrics is bogged down in Plato's theory of ideal forms.) So far we still just have your word for it.

On the larger question of whether psychology can or should be considered a science in the traditional sense, my disagreement is in parallel with Namit's. The problem with the approach you outline here:

1. To the scientific psychologist, Mind is a concept, an abstraction, a thought, an idea. We refer to it as an hypothetical construct.

2. We attempt to investigate Mind by breaking it down into component hypothetical constructs: memory, learning, perception, emotions, cognition, abnormalities, etc.

is that it is can't permit itself to be informed about what we already know about human nature from history, philosophy, literature, and cultural studies. I recognise that you've said more than once that we can learn important things from these areas, but our subject here is the question of what "psychology" proper is, or should be, and your offered definition seems to sever it from important areas of inquiry that have long and well served us.

For example, I consider it an established fact of human nature (of the relationship between mind and enculturation) that we are inclined to project inner attributes that are unacceptable to us--thoughts, feelings, motives--outward onto others. Recognition of this inclination is invaluable to our understanding of ourselves, especially now, when humans live in such close quarters, and with such destructive powers. Without asking you to commit to agreeing with me on the importance and ubiquity of psychological projection, I think you will still concede that it is a component of the human psychological make up.

Your methodology, as I understand it, would exclude the phenomenon of projection from our understanding of human psychology, since it does not offer itself to the kind of measurement that science requires. I would suggest this as a serious drawback to holding psychology to a scientific standard, and what is more I see no justification for it. Several generations of theorists and researchers, from S. Freud, to Anna Freud, to Jung, to Von Franz have meaningfully articulated how projection works in practice. Are we to cast this articulation aside just because it must be discussed in intensional, instead of extensional terms like physics?

Treatments for PTSD are a wonderful thing, but they pale in comparison to being able to prevent the trauma of war, persecution, rape, child abuse, and torture in the first place. I'm not sure what the point is of a science that won't allow itself (or others) to engage the major themes of human nature. On these grounds I agree whole-heartedly with Namit's statement that psychology's "primary deficit is not in measurement, but in understanding what it means to be human."


Posted by: Chris Schoen | Feb 10, 2010 4:27:33 PM


Namit,

Thanks for you comments.

Yes, I will disagree with you, but that is what makes the discussion interesting. I don't like it when people say things with which you can't argue. For example, “People should do good and avoid evil.”

I think it's time to settle on a definition of psychology. Psychology is the science of mental life and behavior in animals and humans. Up through the 1960s, the definition emphasized 'mental life.' From then on, mostly through the influence of the Skinnerian view and research, 'behavior' was substituted for 'mental life.' Lately, psychology has tried to mend it's either-or approach to defining our work and combined the two.

I have a problem with the term reductionism as used in this and other 3QD discussions. There isn't a definition that I can glean from the discussions that give me an understanding of what the writers intend. The only thing I sense, is that it is used as a label of opprobrium, and glibly, I might add. In short: Reductionism, BAD! Not reductionism, GOOD. As I understand the term, and at the risk of oversimplification, the behaviorism of Skinner was about as close as one can get to a reductionist science. Behavior is seen as sets of strings of associations and generalizations. Thank Goddess we got over that. Freud's theories can be seen as reductionist, but not as a science. It was reductionism put in terms of literary metaphors and analogies.

As to my example of how science might work by asserting an hypothetical constructs, and parsing it into sub-constructs, this is not reductionism. In fact, it is elaboration. What I have demonstrated is not a technique peculiar to science. It is a property of all human beings in all endeavors throughout all of our lives. It is the human's ability to categorize, sort, discriminate, arrange, subsume, order, etc., the phenomena we encounter, and the thoughts we generate.

Operational definitions are creative inventions of scientists that are used to study phenomena that can not be observed directly, or phenomena that are manifested in different ways under different circumstances. Mind, depression, extroversion, executive potential, and language skill are not monolithic entities that need no parsing. Want to understand what it means to be human, IN PART, watch the way scientists do their research.

The basic function of all science is to describe the properties of things. One approach to describing properties is to isolate the effects of specific variables, and how different variable might interact in understanding different phenomena. Would this level of science be of no value, absolutely, to an understanding of what it means to be human? Why should the philosopher or educator be denied these fruits of scientific inquiry? Because somebody drops the 'R' word (reductionism) on top of it? I think not.

There is basic science and there is applied science. Are you outlawing basic science that delves into component variables? A component may not explain the total functioning of the person, but this is part of what a scientific enterprise does.

As for putting it all together to say something about the human condition and what it means to be human, that's what you guys are for. Philosophers, historians, social observers, writers of literature and poetry, educators, theologians, and political analysts need more than an armchair to inform themselves. I am sure you wouldn't deny them the contributions that psychological science would offer – circumscribed as it may be.

You are holding scientific psychology to a standard that does not apply. You might as well say that cell pathology doesn't tell us about what it means to be human; Or, fault chemists for not being able to predict volcanic activity Or, denounce materials science (for example, metallurgy) as not really a science because it doesn't tell us how to understand the design of a whole space shuttle; Or, criticize the linguists who study the grammar and syntax of Dolphin language, because the linguists do not explain what it means to be an aquatic mammal.

When you do arrive at an understanding of what it means to be human, or find someone else that has discovered it, there will be a mob beating a path to your door. Each one will be eager to tell you that you and each of the others at your door have got it wrong.

Posted by: Norman Costa | Feb 11, 2010 2:20:49 PM

Norman,

There's more than a little about your emphasis on measurement that makes me think you are trying to "parse" what you call mental health and disorder as if you were doing cost-benefit analysis with human qualities, thoughts and emotions.

First, there are the professionals who create the DSM manual delineating what are and are not disorders. Then the psychologists measure according to this standard?

There is a measurer and a measuree, an observer and an observed, a professional who wants to influence or control someone else to become more closely aligned with what the measurer-observer considers health. I find this stance to be fundamentally dehumanizing to the observed, as in I-It relationships as opposed to the I-Thou relationships Martin Buber explored in both education and psychology. I do not believe that ultimately such a stance, while called therapeutic, can lead to greater well-being for either the observed or the observer.

In the example of the school students' behavior, you said that certain behavior was predictive of other behavior later on and thus might enable psychologists or counselors to intervene to prevent later trouble. But you did not mention that public school classrooms, with their regimentation and other dehumanizing behaviorist approaches to learning (reward-punishment models) are themselves breeding grounds of dysfunctionality. Instead, you focused on the individual students whose behavior was deemed a problem when in fact their school environment may be the problem. (See Phil Zimbardo's sites.)

How many children are caught in the truancy-to-prison pipeline? How many are medicated at very young ages with Ritalin as an aid to classroom management? How many young people are shuffled off to a psychologist, who, working with a consultant-psychiatrist, the doctor with the Rx pad, will prescribe psychotropic drugs for the sake of so-called health or adjustment, i.e., behavior control? And with the massive drugging of young people has come a 35-fold increase in chronic disability within 20 years, as Robert Whitaker cites on his Anatomy of an Epidemic web site.

Also missing from this discussion -- and what it means to be human -- are concepts of wellness and well-being. Abraham Maslow began to conceptualize models of wellness or health through his human needs hierarchies, but most of psychiatry and psychology still seem focused on maladies listed in the DSM and symptom abatement, not well-being.

Will there ever be a science of well-being? Or just patching up broken-down people in broken-down systems?

Chris mentioned war and PTSD, and asked about preventing war. In the last comments section on your earlier article, I mentioned the Killology site that explains how the military discovered how reluctant the majority of combatants are to fire their weapons in war. So they created training systems to reach greater shoot-to-kill capacity on the battlefield, thereby overriding what is apparently a natural aversion to killing other humans. And now PTSD has greatly increased, together with what the military might consider better body counts.

Science or not, psychology may help people overcome PTSD, but what is it doing to lead humanity out of the conceptual blind alleys that drive so much dysfunction or disorder?

Posted by: Louise Gordon | Feb 11, 2010 7:42:33 PM

Louise, have you ever had a loved one go through a potentially disabling mental health crisis? I'm asking because I have, and I found it very helpful to have the kind of information you seem to be belittling - peer-reviewed studies of effectiveness of various treatments, anything that summarized the current scientific thinking about the nature of the illness, etc.
Yeah, I guess what we were doing was trying to "parse" mental disorder by figuring out how we could best use our resources of time and money to help our hurting loved one.

I'd also be interested in how you would address the very real social problems you bring up, without doing any measuring or "parsing".

Norman: Are you familiar with the Gottman Institute? (http://www.gottman.com/about/)
Would they meet your criteria for science-based psychology?

Posted by: Vicki Baker | Feb 11, 2010 9:12:30 PM

Vicki,

I prefer to leave me and my loved ones out of this, thank you. I have provided a greater range of information than the DSM manual as a gauge of illness or wellness, or employment tests as a measure of "efficiency." If you read Robert Whitaker's site, I think you'll find some very interesting studies that contraindicate the prevailing trends toward psychotropic drugs that play a large role in creating chronic disability.

What am I doing to address social problems I raised without measuring and parsing? Seeking and living by alternatives, the best I can.

Posted by: Louise Gordon | Feb 11, 2010 9:37:29 PM

Norman,

You define psychology as "the science of mental life and behavior in animals and humans". I don't agree as this assumes what I am disputing. :) I see psychology as "a discipline that provides insights into the mental life and behavior in animals and humans." Btw, I'm sympathetic to your complaint that reductionism is often hurled as a dismissive label. But this of course does not mean it never represents a legitimate critique; I had tried to explain what I meant before using the term.

Now, I don't have a problem per se with anyone studying any phenomenon and making "hypothetical constructs, and parsing it into sub-constructs". As you say, people do this all the time. Philosophers and historians do it, and they have given us real insights into the human material. Physicists certainly do it, as do psychologists and linguists. But doing so is not enough to qualify this activity as science, as you admit. We don't consider historians to be scientists. Who then decides whether a discipline like psychology where "parsing into sub-constructs" happens is science?

Well, the decision is certainly not up to the psychologists alone. It requires subjecting the discipline's key theories, methods, and results to scrutiny by a wider scientific community and achieving their consensus. Psychology, as you know, has no such consensus. You say it should, I and others have argued it shouldn't. Here is an essay that lays out more reasons why psychology is not science.

Further, as I wrote, on issues like precision, verification, reliability, explanation, and universality (among others), psychology doesn't perform like the sciences. Take universality: Do psychological insights into "executive potential" also hold true for a Papua New Guinea tribe? Further, an astute observer of humanity, say a historian or a novelist, may have a similar explanation of class conflict as a social psychologist. Is the historian a proto-scientist, or is the psychologist a historian armed with more data points and statistics? How do we decide?

You then write:

You are holding scientific psychology to a standard that does not apply. You might as well say that cell pathology doesn't tell us about what it means to be human; Or, fault chemists for not being able to predict volcanic activity Or, denounce materials science (for example, metallurgy) as not really a science because it doesn't tell us how to understand the design of a whole space shuttle; Or, criticize the linguists who study the grammar and syntax of Dolphin language, because the linguists do not explain what it means to be an aquatic mammal.

Norman, I'm only holding scientific psychology to the standard you claim for it: "psychology is the science of mental life and behavior in animals and humans." Cell pathology makes claims about cell pathology, not about what it means to be human; it offers falsifiable and verifiable theories, such as what changes occur in cells when the malaria parasite strikes. Nor do chemists, material scientists, or linguists make those claims you cite about the "whole" of which they may be a part. Psychology does. But psychology's success with certain (non-controversial) clinical therapies does not make it "a science of mental life and behavior", if psychology, as Chris notes too, has no way of accounting for a great deal of what goes on in our mental life and behavior (the components thereof—assuming it makes sense to speak of components—representational and not, their interrelationships, etc.).

A crude model based on a set of variables and assumptions is certainly possible to construct, but it will then provide crude results. I spent years in the 90s trying to create computer models of complex systems, and it became clear to me that while some predictions were possible, there were limits to how accurate the model could be made due to the intractability of the system itself. For all but a few predictions, it was a GIGO model: garbage in, garbage out. It wasn't science just because it wore the garb of science and enabled some explanations and predictions. The mind and human society are a gazillion times more complex than what we had worked with. Why do you think psychology can offer much more than irredeemably crude models of mental life?

Posted by: Namit | Feb 12, 2010 4:16:06 AM

I think the primary deficit here is not in measurement, but in understanding what it means to be human.

That about sums it up. And Dawkins, Dennett, and Pinker would agree.

Posted by: Dave Ranning | Feb 12, 2010 9:34:00 AM

Dave,

But what does the Pope think about it?

Posted by: Louise Gordon | Feb 12, 2010 12:43:59 PM

Alternatives to prison schools:

http://rickposner.com/

http://www.huffingtonpost.com/jonathan-kim/rethink-interview-cevin-s_b_439460.html


Alternatives to prisons and warmaking:

http://www.cehd.umn.edu/ssw/rjp/

http://www.corr.state.mn.us/rj/Default.htm


Alternatives to torture:

http://physiciansforhumanrights.org/library/documents/letters/letter-phr-to-apa14aug08.pdf

Posted by: Louise Gordon | Feb 12, 2010 12:45:56 PM

I dunno, it seems to me like asking one's colleagues to refrain from false quantification and making shit up when they don't like the evidence is a Good Thing. If trying to make psychology more scientific means that psychologists will have to say "I don't know" or "We aren't sure" more often, that's also probably a Good Thing. I see Norman's project as a threat to bogus expert authority, not a promoter of it.

Namit, I have to think more about what you've written.

Posted by: Vicki Baker | Feb 12, 2010 1:33:19 PM

The Pope?
Seems preoccupied with something else

Of course, we could ask the current one about his time in the Hitler Youth.

Posted by: Dave Ranning | Feb 12, 2010 2:18:21 PM

Vicki,

I'm sympathetic, but you are conflating two different things, I think.

I don't see in Namit's or Nick's critique any desire to prevent a scientific analysis of various methods and treatments, nor would I advocate against this. The same ability we want to offer a person suffering from diabetes or cancer to find an effective treatment applies to a person suffering from depression or psychosis (to the extent such people seek treatment; they often don't, and this arouses Louise's legitimate concerns about agency.) This is an apt context for scientific study and Norman is correct to argue in favor of it (though I would join Louise in favoring an approach that privileged prevention of trauma and neurosis, as much as possible, over treatment).

But our English word "psychology" means more than just diagnosing and treating mental and emotional ailments. It also means enquiring into the nature of mental and emotional wellness. (You can't have one without the other). As Namit argued, this means establishing theoretical constructs that are far better suited to hermeneutic, than scientific analysis.

Norman's definition, from Webster's, elides the second and third entries found there, neither of which has been deprecated just yet:

2 a : the mental or behavioral characteristics of an individual or group b : the study of mind and behavior in relation to a particular field of knowledge or activity
3 : a theory or system of psychology

More to the point, unless we are going to be tautological about it, we have to ask what "science" means in this context. (If we are to be consistent, and consult Webster's we will have several options to choose from). By convention psychology is often, though not universally, considered a social science, which does not have the connotations of empiricism and measurement that we have been discussing. Such a definition does not help us answer the question we have been batting back and forth from the start: is psychology a science in the sense of cell biology, or in the sense of (for example) political science? Is hermeneutics a permitted methodology, or must we cleave only to the scientific method?

What I have not yet seen from any participants in this thread is an argument for why psychology must do more than contain a legitimate scientific component (as we find in medicine, for example), to the full extent of restricting itself to that component. If Norman had merely argued for the former, he might have found much more concord in this thread. Instead, as Nick has argued from the start, Norman offered a much more outsized argument, with much broader and wider ramifications. Having done so, I think he still has to bear the burden of finding a new place to locate definitions (2) and (3) in Websters. If these are no longer to be considered psychology, what shall we call them?

Posted by: Chris Schoen | Feb 12, 2010 3:10:06 PM

Seems preoccupied with something else
Completely off-topic, but: What the f*ck?

Posted by: billy | Feb 12, 2010 3:27:13 PM


I'm not trying to find concord. I'm trying to enlighten all you huddled masses out there.

Anyway, I just got back from a trip and find that you folks won't give me any peace. Let's see how I feel after something to eat.

Posted by: Norman Costa | Feb 12, 2010 8:37:13 PM

Completely off-topic, but: What the f*ck?
It's obviously Louise's fault. She asked about the Pope, and as this is a discussion that has some relation to mental health, the link to these psychopaths seemed appropriate.

Posted by: Dave Ranning | Feb 13, 2010 1:51:57 AM

Anyway, I just got back from a trip and find that you folks won't give me any peace

You know how we huddled masses are--very unruly. ;)

Posted by: Chris Schoen | Feb 13, 2010 12:54:21 PM


Friends and admirers,

I'm going to continue this discussion in my next post with Part 2.

In the mean time, I recommend the two stories on the neuro-cognitive science of spiritual experience, on the main 3QD page.

Also, the research of Andrew Newberg M.D. is germain:

http://www.andrewnewberg.com/default.asp

http://www.andrewnewberg.com/qna.asp

Posted by: Norman Costa | Feb 14, 2010 12:47:59 AM

New DSM, Number 5.


MindHacks


Washington Post


LA Times


Psych Times

Deliberations were secret, but now you can make your very own scientific suggestions!


dsm5.org

Posted by: Louise Gordon | Feb 14, 2010 4:39:52 PM


Louise,

The Psychiatric Times article is very, very good.

Occasionally my students will react with disappointment when they see how much controversy and conflict exist among scientists. My answer is always the same, "Welcome to science."

Posted by: Norman Costa | Feb 14, 2010 5:29:29 PM

Norman,

I take it you presume the conflicts enumerated in the Psychiatric Times article are based in science versus mere opinion? That scientists gathered evidence to substantiate, say, their claims of prepsychosis that the author of the article disputes? That there is scientific evidence to back up the claim that gambling should be in or out as a mental disorder? Or obesity? That scientific evidence can be weighed to dispute inflated false positives or negatives that the author mentions?

I'd say it's welcome to secret committees, guesses, opinions and favorite diagnoses, not science, and pathologizing nearly the entire population. What's next, prepsychosis in utero based on ultrasound?

Posted by: Louise Gordon | Feb 14, 2010 6:25:34 PM

Hey Chris, Louise, you should really check this book out if you can:

http://tinyurl.com/yck97b9

It's an honest and unflinching look at Freud's mistakes, but it's also a devastating critique of those who use the concept of "science" to denigrate and exclude psychoanalysis (and psychotherapy in general). Most interestingly, it applies equal pressure to the continental-hermeneutic tradition (i.e. Lacan) which commits the converse error: arguing that science is not as important as we think it is and that psychoanalysis is some sort of independent, extra-scientific discipline.

Posted by: Nick Smyth | Feb 14, 2010 7:05:15 PM


Louise,

The basic function of science is to describe the properties of things.

When you get to the functions of explaining, predicting, and controlling, it can be a free for all.

You should have seen what the first edition of the DSM looked like - vague generalizations, and diffuse descriptions.

We've come a long way. Welcome to science.

Posted by: Norman Costa | Feb 14, 2010 7:22:01 PM


Nick Smyth,

Now this discussion could REALLY get interesting.

Posted by: Norman Costa | Feb 14, 2010 7:27:07 PM

Norman,

And on the basis of a free for all, school psychologists and psychiatrists recommend giving powerful drug cocktails to children and adults, when they're not even sure why they're prescribing them? Maybe you've come a long way, but the ever-expanding "patient" population you purport to be serving has not.

Posted by: Louise Gordon | Feb 14, 2010 7:34:32 PM

Louise, Nick, Norman and others --

Ruchira recently put me onto a fantastic new book, _The Immortal Life of Henrietta Lacks_, by Rebecca Skloot, which may have some applications here. It is among other things a snapshot of mid-century medical arts as they were applied to a highly vulnerable population -- black people within driving distance of Johns Hopkins, where they were treated as charity patients. What is fascinating and horrifying is that this was not second-best care for poor black people, but elite care given away, with especially low regard to the concept of informed consent. As they used to say in Clinton Era Washington, "mistakes were made." And the mistakes were more of a moral than a scientific nature.

The point of reading about the medical arts at the mid-century is hardly to gasp with distaste at what butchers the practitioners were then, what moral cowards with ready excuses, but to think more precisely about our own era, where there are sure to be abuses as grotesque as any of 60 years earlier.

To take a historical perspective on science is to see a battle between progressive and regressive forces, with the lines not so neatly drawn, either. Those lines are not so neatly drawn even within the nature of any one scientist. This is because science exists inside culture, and must reflect it. Who will be treated, and why, and how well, are decisions that we do not, at present, let science make -- we let bureaucrats make them. In the future they may see that as an obscenity, or -- who knows? -- the scope of bureaucrats to dominate decision-making in the medical arts may one day rival the dead hand of the Papal Inquisition on scientific inquiry at the time of Galileo. And if, in another half century, we are living in a technocracy pure and simple, that will not exactly put a period on our problems with moral philosophy.

I have enjoyed reading this thread, my agreement with anyone's POV not being the essential thing. I think Norman's article raises questions, rather than delivers answers -- not a bad thing to do. The observations he ends with about Janet and Charcot regretting their involvement with hysteria, the symptoms of which would not be properly understood for three-quarters of a century more, reminded me of Roger Bacon's late life weariness with what it had cost him to take on the Church, disappointment made more horrible by his deep wish, his mission, to further the Church's aims, not to beat them back. The way that mainstream science seems to pile on anyone who wants to differ with it to make it better (Hello, Robert Trivers), is closer to the spirit of the Inquisition than most scientists would probably wish to believe.

Good link, Nick! Louise, it is really awful -- medication is a double-edged sword. You may think we're headed for a dystopia like THX-1138, where "medication avoidance" is police business. Others may have observed that lives have been saved by therapy and medication based on precision and accuracy in diagnosing. That there should be a spectrum of points of view about this is not only not deplorable, but natural. I can tell you that from the perspective of having read _The Immortal Life of Henrietta Lacks_, the notion of informed consent is taken more seriously by scientists now than by scientists then.

Posted by: Elatia Harris | Feb 14, 2010 8:16:47 PM


Elatia,

Thank you for some sorely needed perspective.

Posted by: Norman Costa | Feb 14, 2010 8:27:54 PM

Some additional "perspective":

Published by the American Friends Service Committee:


Robert Whitaker Interview

"Whitaker: In 1998, you could still find experiments where they would take people stumbling into emergency rooms, first episode. So let's say you got a kid, and he's in dire trouble, and they would do an experiment on him, rather than do something to knock down his emotional turmoil. Instead, they would give him amphetamines or Ritalin, to see if it would make him worse. Imagine that!
Then, the final thing is, when you look at the "informed consent" on this, sometimes they would tell the patients they were giving them medications. But you would never, ever see in the "informed consent" that they were giving them an agent expected to make them worse. So this research is being done in an arena of lies, is the only way to put it. It's a value system that doesn't represent this group of people as human beings...."

"Whitaker: Ten years ago, the drug companies said they needed to expand their market for psychiatric drugs, and who did they go after? The children, because that's an untapped market. And they've been very successful in that. If you chart psychotropic drug use in children, it's exploded. And what do we have today? We have a "crisis" in crazy kids, in psychiatric illness among children.
In other words, 10 years later, use of the drugs hasn't led to less problems among the kids, but every sign that psychiatric problems are exploding among the children. That only makes sense if you understand that the drugs indeed cause abnormalities in neurotransmitter function, and when you do that with drugs you get serious psychological and emotional problems. So we clearly are, with this widespread use of the drugs, creating an ever-expanding population of kids who are psychiatrically disturbed -- but it's coming from the treatment."

Posted by: Louise Gordon | Feb 14, 2010 8:45:32 PM


Louise,

I wouldn't be so naive as to dismiss your observations that there are unscrupulous people in psychological and psychiatric professions. But, you've been characterizing entire areas of scientific investigation, and professions in terms of their worst abuses.

I don't know whether the new DSM-5 will be better or not. However, most people do not understand the primary purpose of the DSM - Research.

If new therapy modalities for Borderline Personality Disorder are to be studied and developed, then there better be a consistent template for diagnosing BPD. If a pharmacological formula is being evaluated for the manic phase of bipolar disorder, it would be a good idea to agree on a definition of the disorder for the purpose of selecting participants.

If alternative methods are beneficial, then someone should demonstrate support for such claims.

Also, there is a lot more to the field of psychology than personality and mental health. There is a lot more to understand, through the methods of science. I've tried to make it clear that psychological science is limited in its scope and application. There is a lot is does not understand, and a lot that will not yield to scientific inquiry.

When scientists are doing science, and non-scientists (who haven't a clue as to what it is) say with certainty that scientists are not doing science, I think the critics have gone a bridge to far. When non-scientists declare, by fiat, that psychological science cannot tell us anything about Mind, and never bother to state what Mind is -such that it is outside the scope of science, and why - the critics have replaced their non-understandings of psychology and science with vague, diffuse, non-specific, and generalized notions, then the stage for less understanding has been set.

Engineering/Human Factors psychologists break down information processing, problem-solving, and decision-making tasks of pilots and crew to enable them to meet their performance objectives, safety, and avoid errors. Yet, critics consider this as atomization, not science, a waste of time in trying to tap into unfathomable Mind, as probably handled unethically, anyway, and tells us nothing about what it means to be human.

As I have stated earlier, if you want to know what it means to be human, well, that what you guys are for. Obviously, there is nothing in psychological science that can inform your imaginings and opinions and conjectures on what it means to be human, but don't let our modest contributions of data and facts get in your way. And when you figure out how you and everyone else will know that your idea of science is yielding INSIGHTS, put in into words so the rest of us can recognize the event of arriving at that Ah Ha momnent when it happens.

Posted by: Norman Costa | Feb 14, 2010 9:31:50 PM


Here's an example of a scientific study that doesn't tell us anything about what it means to be human. Or does it? Or how to help veterans cope after combat? Or nip PTSD in the bud? Of course this study is not science anyway. Probably most of the researchers involved are hostile, unethical, and should be sedated themselves. As we have read throughout this discussion, they will do more harm than good.

US | February 14, 2010
Study Suggests More Veterans May Be Helped by Talking About Killing

By JAMES DAO

Killing is the one thing many combat veterans avoid discussing when they return home, whether out of shame, guilt or a deep fear of being misunderstood.

http://www.nytimes.com/2010/02/14/us/14killing.html?emc=eta1

Copyright 2010 The New York Times Company | Privacy Policy

Oh! I know. This is irrelevant because it doesn't compare to preventing war in the first place. How could I not have appreciated such a perspective.

Posted by: Norman Costa | Feb 14, 2010 9:46:29 PM

The point of reading about the medical arts at the mid-century is hardly to gasp with distaste at what butchers the practitioners were then, what moral cowards with ready excuses, but to think more precisely about our own era, where there are sure to be abuses as grotesque as any of 60 years earlier.

Oh, Elatia.

Posted by: Carlos | Feb 14, 2010 10:10:41 PM

Norman,

You write: "But, you've been characterizing entire areas of scientific investigation, and professions in terms of their worst abuses."

With the exception of the torture-aid psychologists cited by Physicians for Human Rights, no, I haven’t been talking about the worst abuses, but what is mainstream, standard practice. However, even in that case, one wonders why the APA took its time in condemning participation of its members in such crimes.

When chronic disability among young people has increased 35-fold in 20 years, I'm not talking about a few bad apples. There has also been an enormous increase in chronic mental disorder in the adult population in this country over the last 50 years. I'm talking about large segments of the population being turned into chronically disabled people through MAINSTREAM treatments prescribed by psychiatrists or primary care physicians, often in coordination with psychologists who rely on MDs as consultants to their practice.

I also take exception to your seemingly uncritical acceptance of the DSM as a valid indicator of health or mental disorder. If people are VOTING illnesses in and out of this manual, I don't see how that qualifies the decision making that goes into it as science. You also said that you thought the greater increase in disorders listed was due to greater ability to gauge or measure disorder. I see it as an expansion of what should be a limited purview within medicine, especially neurology, to something that is attempting to pathologize nearly all of human existence.

What is deplorable is your refusal to acknowledge the massive damage being done to people in the name of mental health by everyone from school counselors and psychologists to mainstream members of the psychiatric profession. I am not talking about a few unscrupulous people. I'm talking about ridiculously flawed "treatments" that are damaging and a manual that's used as a diagnostic and billing tool that is laughable. You talk about PTSD and BPD, but what about spelling and math disorder? What kind of prescription might be given to children to treat that kind of "illness"?

I don't think anyone on this thread said that psychology could tell us NOTHING about mind. I said in an earlier thread that I appreciated the insights of people in psychiatry such as Robert Jay Lifton. I also appreciate the insights of people like Abraham Maslow, Ellen Langer, Phil Zimbardo and Peter Gray, a psychologist at Boston College.

But I don't see how psychology qualifies as a science, nor have you adequately explained to anyone how greater measuring accuracy and/or capacity would suddenly turn it into a science. In fact, thinking back on your first article in this series, weren't you the one who said psychology won't fully qualify as legitimate science until it gets its measuring capacity and measurement standards in order?

Concerning alternative methods of treatment, there are many. On Robert Whitaker's Anatomy of an Epidemic site, he lists some studies of demonstrated successful treatment of mental-emotional problems, such as exercise for depression. Herb Benson's "Relaxation Response" institute at Mass General also has success in treating all kinds of physical-mental-emotional problems.

Posted by: Louise Gordon | Feb 15, 2010 12:59:42 AM

some studies of demonstrated successful treatment of mental-emotional problems, such as exercise for depression

Sounds like science to me. Treating people like objects and measuring their responses to exercise. Next thing you know we'll all be doing mandatory calisthenics outdoors, like in Red China. The horror!

Posted by: Vicki Baker | Feb 15, 2010 10:00:39 AM

Vicki, good point. There is nothing non-scientific about exercise physiology. Many but not all people with a continuous, mild depression are better off treating it with a 2-mile walk every day than with an SSRI -- there is much scientifically gathered data to show this. We are always in danger of forgetting that the best medicine is no medicine at all, but that too is folk wisdom that science is capable of demonstrating.

Just one of the troubles with gathering data from people with psychiatric illnesses, including depression that chronically bruises well being without being life-threatening, is that the organ affected is the organ that makes the decisions about how the treatment is going -- or at least about how to answer questions about the efficacy of the treatment. So, if I say I am depressed, no matter what I do, and that the interventions that others have reported as helpful -- mild aerobics, Prozac, talk therapy -- are making no difference to me, I must be believed, because few physicians would commit the solecism of telling me I actually feel pretty good. It would be a lot niftier, scientifically, if I had TB or high cholesterol, so that the doctor could indeed tell me how I was.

The art of observation, once the mainstay of a medical education, is falling off, because few physicians can take time for it even if they know how to do it. And, of course, diagnostic tools are dazzling, compared to what the highly trained naked eye can see. But when the physician of Alice James -- sister of William and Henry, and a lifelong hypochondriac -- diagnosed her liver cancer, he did so on the basis of "an earthy tone" in her complexion. There was nothing non-scientific about that, and neurologists, psychiatrists and clinical psychologists are still more reliant on observation than many. Still, none of them could tell me how I experience myself, that owing to diagnostics and treatment and their own observation of me, I am really feeling either just fine, or feeling so ill my legal rights must for a while be taken from me.

What could be interesting to me, the patient whose complaints are not yielding to most interventions -- at least, not that I can tell! -- is to know that I had followed medical advice (drugs, exercise, talk therapy) for only half the time needed for a small minority of patients to benefit from it, that I might well belong to that minority. So I would be in the position of thinking, hm-m, should I do more of what doesn't work for me? Or should I see if I am in that minority for whom these very things work, eventually? Whatever I think, I am dealing with scientifically gathered data for decisions, but much of that data is based on reports from people, like me, who have reported their experience of themselves.

Would I like this all to be more scientific? Yes indeed. But self-hood is not yet a matter for hard science.

Posted by: Elatia Harris | Feb 15, 2010 11:42:24 AM

Good observation, Elatia.

There is considerable pressure in our culture, which has no small entanglement with capitalism and profit, to confuse "scientific" with "technocratic." Often when people express a visceral mistrust of a scientific perspective, what they are really objecting to is the replacement of human interaction with apparatus. The irony is that this substitution is probably a big part of what is making us so sick in the first place.

Posted by: Chris Schoen | Feb 15, 2010 11:59:44 AM

The way that mainstream science seems to pile on anyone who wants to differ with it to make it better (Hello, Robert Trivers), is closer to the spirit of the Inquisition than most scientists would probably wish to believe.

Or Fodor's new book about natural selection, which I think I will have to read, Nick, before I hit up the Bowman book, but it looks really interesting.

Posted by: Chris Schoen | Feb 15, 2010 12:04:06 PM

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