February 01, 2010
Psychological Science: Sigmund Freud – A Personal and Scientific Coward?
by
Norman Costa
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.”
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.
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.
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.
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.
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?
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.
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.
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.
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
When depressed people who exercise join the ever-growing ranks of chronic disability patients, having succumbed to the risks of exercise, Vicki's flippant observation might be a good point. Meanwhile, the scientifically enlightened people here continue to ignore the epidemic scale of disability/disorder that's accompanied the widespread use of psychotropic drugs, especially among children.
Chris writes: "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."
I suppose technocratic apparatus applied to childbirth might account for soaring C-section rates, but I'll save that for another day, off-topic as it is.
Posted by: Louise Gordon | Feb 15, 2010 12:28:43 PM
Louise - I'm as big a critic of Big Science as anyone. I just don't see why you think a campaign to encourage psychology to be more empirically based would lead inevitably to a more medicated society.
Can't you see how silly it sounds to object to any kind of measurement or observation of human beings and then cite "studies of demonstrated successful treatment of mental-emotional problems"?
I think you are definitely conflating scientific with technocratic, as Chris points out. Science with a small "s" is a useful weapon for sales resistance, whatever the brand of snake oil.
Finally, as citizens, we don't have to put up with Big Pharma and the Defense Department driving the research agenda. But there's nothing to be gained by insisting that health practitioners abandon empiricism.
Posted by: Vicki Baker | Feb 15, 2010 12:47:47 PM
Or Fodor's new book about natural selection
Read, but with equanimity and critical thought--
Just saying!
Posted by: Dave Ranning | Feb 15, 2010 12:55:08 PM
Vicki,
I wasn't insisting that health practitioners abandon empiricism. To repeat, I object to what I see as Norman's vague contention that when psychology gets its measurements right, along the lines of Thorndike in education or IQ or employment testing, that psychology will become more scientific. I also said that I object to his apparent uncritical acceptance of DSM classifications of illness, which he countered with Welcome to science.
Big Pharma has indeed driven the mass drugging of school children, and so far, too many citizens are putting up with it, to the detriment of children's health.
Posted by: Louise Gordon | Feb 15, 2010 1:01:39 PM
Relaxation techniques, as therapy, go back to ancient times. The adoption of these therapies in modern times, in the U.S., have their roots in bio-feedback research. Bio-feedback therapy had its foundation, in large part, in behavior modification research. In turn, behavior modification therapy was grounded in the operant conditioning theories of Skinner.
Where non-adaptive behaviors were learned in the first place, they can be treated with unlearning, or new learning. How have we established this? Take a guess.
All science, not just psychological science, accept the principles of Percy Bridgeman (Harvard physicist and Nobel Laureate) regarding hypothetical constructs, operational definitions, and empiricism. I've referred to this in prior articles.
I've stated before, and I will repeat, that science does not tell of everything about nature and ourselves. But, what science can do, it can do very well. And, at the foundation of all science is systematic observation and the recording of data.
As to how science, and scientists, interact with the rest of the humanity, I refer you to the words of Jacob Bronowski from his book and PBS series, "The Ascent of Man." The scene shows Bronowski, shoes off and pants rolled up to his knees, standing a few yards from shore in a forest lake. It is the place where the Auschwitz crematorium ashes were flushed. The ashes included those of family, friends, and colleagues. He said that science and scientists can not, should not, must not conduct their work without considering the consequences to the rest of humanity. This is still a lesson that must be retaught and relearned.
Posted by: Norman Costa | Feb 15, 2010 1:17:30 PM
Louise,
Yes, I did say that when scientific psychologists get measurement right, in terms of the philosophy of science and in practice, scientific psychology will be much improved.
Now, how do you go from my point to concluding that civilization, mental health, and understanding what it means to be human will come to an abrupt end?
Posted by: Norman Costa | Feb 15, 2010 1:24:25 PM
Louise:
OK, here's">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1416251/?page=1">here's a study of the effects of exercise on depression
How does this study match your desired criteria for how psychology should operate, without a
"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." How is this study of depression not "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."
Why do you not doubt, in this instance "that ultimately such a stance, while called therapeutic, can lead to greater well-being for either the observed or the observer"?
Posted by: Vicki Baker | Feb 15, 2010 1:24:27 PM
Vicki's comment was not flippant. It was concise and to the point. Big difference!
Posted by: Norman Costa | Feb 15, 2010 1:25:47 PM
Louise,
Back in the mid-century, there was some speculation of a non-psychoanalytic kind as to why psychoanalysis should "work" -- why some of the ills it treated were measurably affected for the better. One wag pointed out that many problems would clear up of their own accord over the four to five years (and up...) required for a full-dress Freudian analysis. Dr. Phyllis Greenacre wrote of the value of the therapeutic relationship itself, that (I'm paraphrasing) it was impossible for two people to be alone in a room together for many hours a week over many years without a kind of intimacy occurring, and that this itself was a treatment of sorts. She did not mean anything sexual, obviously, but the intimacy of caring and being cared for. Except for the fact that many psychiatric ills worsen over time, and that, for certain analytic patients, no intimacy is possible (one reason why they like analysis, perhaps), these are good guesses, are they not?
The question is not whether physicians, clinical psychologists, pharmaceutical companies and tired parents conspire to treat badly behaved children as if they were medically ill. It is the degree to which psychology can or should resemble hard science. Is greater precision and accuracy in diagnostics a good thing? Is greater predictive accuracy re: outcomes a good thing when choices about treatment are to be made? You seem to be arguing that these are not good things, in themselves. Maybe you only mean that they make patients more abusable by those responsible for treatment who are failing Ethics 101 anyway. If so, you are close to arguing that anyone with taxonomania is a potential Dr. Mengele. This is a point that cannot compel.
Posted by: Elatia Harris | Feb 15, 2010 1:34:35 PM
Louise,
You stated: "Meanwhile, the scientifically enlightened people here continue to ignore the epidemic scale of disability/disorder [emphasis mine] that's accompanied the widespread use of psychotropic drugs, especially among children."
Do we know this to be true? How? To the extent that it is true, it is most likely based on data, collected in a systematic way, to demonstrate it.
I am not ignoring evils in this world. But even if I were, how would that invalidate my observations that the sun rises in the east and sets in the west? I am promoting better science, and you reply that your next door neighbor, who is a scientist, eats little children for breakfast. Let's keep some perspective here.
Posted by: Norman Costa | Feb 15, 2010 1:44:45 PM
Norman,
"Now, how do you go from my point to concluding that civilization, mental health, and understanding what it means to be human will come to an abrupt end?"
Where did I say that?
Posted by: Louise Gordon | Feb 15, 2010 2:38:23 PM
Vicki,
The link you provided does not connect to anything.
Posted by: Louise Gordon | Feb 15, 2010 2:39:18 PM
As someone who had had both years of Freudian Therapy, and spent years hiking in the backcountry, go with the exercise.
The therapy is cool, but an elite luxury.
I can't live without wilderness.
On a side note, it is obvious Chris would be a Fodor fan. I can see the obsession with Dawkins and Dennett now.
Posted by: Dave Ranning | Feb 15, 2010 2:58:36 PM
Norman,
You write:You stated: "Meanwhile, the scientifically enlightened people here continue to ignore the epidemic scale of disability/disorder [emphasis mine] that's accompanied the widespread use of psychotropic drugs, especially among children."
Do we know this to be true? How? To the extent that it is true, it is most likely based on data, collected in a systematic way, to demonstrate it.
I am not ignoring evils in this world. But even if I were, how would that invalidate my observations that the sun rises in the east and sets in the west? I am promoting better science, and you reply that your next door neighbor, who is a scientist, eats little children for breakfast. Let's keep some perspective here.
There is data. I've said that repeatedly, and people here ignore it. See the data on Robert Whitaker's web sites. He also has data on improved "outcomes," to speak in medicalese, of people in poor nations where pharmacological agents are not prevalent in the treatment of "disorders."
Norman, did you or did you not say that you thought the greater number of disorders listed in the DSM were attributable to "scientists'" improved ability to measure?
Do you or do you not believe that people, particularly children, are too often inaccurately diagnosed on the basis of that manual? Do you believe that every disorder in the DSM is genuine? For example, the relatively new classification of oppositional defiant disorder for children who fail to be docile enough in classrooms to please their teachers? And might such a child given that diagnosis then be drugged with a psychotropic drug that is damaging to his or her health? Because of improved scientific measurement that makes the DSM manual more accurate?
What I am saying is that the expansion of categories of illnesses and disorders listed in the DSM that you attribute to better scientific measuring capabilities is a bunch of baloney leading to social control and, later, brains and nervous systems going haywire.
Nothing to do with where the sun rises or sets. What is your opinion of the research Robert Whitaker has gathered that documents the ever-rising levels of disability, a rise that's concurrent with the widespread use of psychotropic drugs? Do you think he's wrong? Do you dispute his findings?
If you truly believe that the expansion of DSM categories of disorders and illnesses is based on improved science, then I think we simply have to agree to disagree and leave it at that. If this is the kind of greater measuring capability you're talking about, then I think you're not going to improve psychology at all.
Posted by: Louise Gordon | Feb 15, 2010 3:02:19 PM
Louise,
Remember the satire of SNL's skits on Republican VP candidate, Sarah Palin? In the first skit, Tina Fey, playing Sarah Palin, quipped the line, "...and I can see Russia from my house."
To this day, Sarah Palin complains about that quote and Fey's depiction of her. I have seen her, a couple of times, with a look of confused incredulity, a little pleading, and restrained anger while saying, "But I never said, "I can see Russia from my house.""
Posted by: Norman Costa | Feb 15, 2010 3:09:43 PM
Elatia,
Please see my comments to Norman re: what is and is not a disorder. Norman is of the opinion that the ever-expanding range of disorders in the DSM manual -- disorders that call for control, intervention and treatment, often with psychotropic drugs -- is the result of greater diagnostic accuracy. I disagree.
Posted by: Louise Gordon | Feb 15, 2010 3:10:32 PM
Here's the missing link:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1416251/
Posted by: Vicki Baker | Feb 15, 2010 3:15:50 PM
Norman,
I think there was a lot more to Benson's "discovery" and application of the Relaxation Response than animal models he studied in conjunction with students of B. F. Skinner. The same could be said for Jon Kabat-Zinn's pain reduction clinic at UMassWorcester, which also applies meditation for improvement in health.
Benson, et al. at HMS
Perhaps all the Skinner boxes and behaviorist ways of measurement were not in vain?
Watson, et al.
Posted by: Louise Gordon | Feb 15, 2010 3:19:41 PM
Norman,
You write: Remember the satire of SNL's skits on Republican VP candidate, Sarah Palin? In the first skit, Tina Fey, playing Sarah Palin, quipped the line, "...and I can see Russia from my house."
To this day, Sarah Palin complains about that quote and Fey's depiction of her. I have seen her, a couple of times, with a look of confused incredulity, a little pleading, and restrained anger while saying, "But I never said, "I can see Russia from my house.""
Are you now saying you don't think the ever greater number of disorders in the DSM is based on improved scientific measurement?
Posted by: Louise Gordon | Feb 15, 2010 3:55:18 PM
Vicki,
With the flurry of responses here, I have lost my last one to you on the exercise link.
Norman asked me if I knew of alternatives to drug treatment, and I cited the exercise studies on depression. I never said I thought they represented an ideal kind of therapeutic relationship. However, I would not object to such studies if the people in them volunteered to participate, unlike so many children, foster children and elders who are recruited by interventionists for drug treatment "for their own good."
Norman mentioned intervention and the interventionist exerting influence, or control, with the hope of having the object of such influence conform more closely to the interventionist's model of health.
To make a long story short, I don't think anyone can be controlled into health.
Posted by: Louise Gordon | Feb 15, 2010 4:00:36 PM
Louise,
If you say Whitaker has data to back his claims, then, lacking interest on my part to pursue that line of inquiry (I am pursuing other interests) I accept your assessment. I venture to guess that if the evidence was, "I heard from a lot of people, and this is what they told me," you might be hesitant to endorse him. You probably have some sense as to how good his data are. Data, data, data. Your confidence in the findings would suggest that if you were to explore the same information, you (or other competent people) would come to the same collection of data. That's one of the tests of systematic observation.
You are using science. You need science, even to debunk the purveyors of dishonest 'science.' Barbara Seaman is one of the greatest examples of using science to expose the abuses of scientists and their employers. It was a long, hard fight on her part to expose cover up, corruption, lying, falsifying research data, and political payoffs to expose the dangers of hormone replacement therapy (HRT.)
She would build her case on good data, and expose the buried and fraudulent data. The good data were able to withstand the scrutiny of analysis and scientific protocols.
How do we know she was right? She was exonerated by sound measurement practices and science in describing the epidemiological properties of various cancers. There was an immediate and unprecedented drop in related cancers. IMMEDIATE. Last I read, they continue to decline as more women stop or avoid HRT.
The DSM? Is it all wrong? Do we want to throw out the baby with the bath water? The DSM has several functions, the principle one being research. Whether No. 5 is the same, better, worse than No. 4, I don't know. That's for the public and the professional communities, working together, to determine.
But, let's take a look at your assertion that exercise alleviates depression. Let's assume I do not doubt your word, and accept what you say as true. As a scientist (I'm not a practitioner), I ask you, What kind of depression? Low grade chronic depression (dysthymia)? Reactive depression? Trauma related depression? Depression associated with various anxieties? Depression associated with grief? Depression associated with situational and transitional events? Depression with organic foundations? Bipolar depression? Major chronic depression? For many people in the last category, exercise doesn't work to relieve depression because they are unable to exercise.
Psychiatric, psychological, and nursing scientists want to understand your hypothetical constructs, your operational definitions, and how you conducted your data collection. What kind of exercise are you talking about? Does the same exercise work for everyone? For every type of depression? What about the problem of co-morbidity? Usually, we do not find depression all by itself.
How does the therapeutic outcome compare to nothing, talking therapy, medications of various kinds, placebo? Are there interactions that suggest that exercise plus anti anxiety drugs are better than either separately? Are the therapeutic benefits realized for all types of depression, or only some? Are the effects long lasting? What happens when exercise is halted? Does Yoga have the same effect as exercise?
Are these results consistent with other studies? Can the results be replicated? Are the benefits the same for different genders, ages, and socioeconomic status? Can exercise be used as a prophylactic? Health economists want to know the costs relative to other modalities.
One of the things I drill into my psychological research methods students is that it is, arguably, the hardest two semester course in the entire undergraduate curriculum. One of the reasons is that becoming a scientist requires an enormous precision in your thought process and in your writing. My students know to ask the myriad of questions I posed above. That's what scientists do.
It may seem a little hokey, but at the end of my classes I give my students a 'homemade' certificate of achievement that inducts them into the "Doubting Thomas" society and acknowledges them as scientists with all the rights and responsibilities entailed.
You, others, and my students have problems to solve in our society. My contribution is to make my students think like scientists, behave like scientists, and use the tools of science. The job of the non-scientist is to understand what scientist do, and bring the other perspectives in life and living that inform the process. Similarly, non-scientists need to inform their own views on what it means to be human (and many other important matters) from the contributions of science and scientists.
Posted by: Norman Costa | Feb 15, 2010 4:18:44 PM
Norman,
You have repeatedly countered the issues Louise has raised about the DSM-led mainstreaming of a host of weakly substantiated norms of mental health and disorders by the glib remark, "welcome to science!" and "All scientific knowledge is provisional, and no level of scientific achievement is, or ever will be, permanent or absolute." In your earlier articles and comments, I noticed that you have frequently invoked the following comparison with physics to support this reasoning:
This is an extraordinary sleight of hand, and surprising that a scientist should draw a parallel between the shifting DSM standards and the shift from Newton to Einstein. There is no real comparison here. Einstein turned classical mechanics into a special case following his general theory. The former still holds good and can be used, for instance, to describe, explain, formulate, measure, verify, and predict projectile motion with great accuracy and with identical results across all cultures. The mushrooming mental health norms and newfound disorders in kids in recent decades have no such foundations. In an earlier comment you wrote, "If you believe psychology is not a science ... then you ought to state clearly how psychology fails as a science." I have provided numerous arguments above and a link to which you have not given a response.
The psychoanalyst Marcus Bowman considers (based on the ~20 pages online, thanks Nick) psychoanalysis to be science—that is, he considers the careful investigation into each individual's unique case history and the particular interventions that work (or not) for each person to be science. (If anything this seems to me a stance against DSM norms.) As I see it, Bowman favors existential psychoanalysis and calls it science, arguing that the subjective investigation into each patient should not be expected to undergo independent "third-party" verification as in the older sciences. Whatever one thinks of this (and I'll have to read more of the book to decide), it is a far cry from Norman's approach of comparing psychoanalysis to the established idea of science, and advocating "measurement" to reduce the gap he sees. Compare his approach with what Bowman says,
I think it is important to defend the epistemological standards that underlie science, and use them to evaluate psychology as a science. Science commands great authority in our culture and we risk much by lowering our guard and letting non-science and pseudo-science crawl into the scientific tent. It's clear why folks might want their discipline to be deemed science: prestige, authority, power, funding, etc. But science has its epistemic standards. Nobody here denies that psychology, like disciplines such as political science, has furthered our understanding of human nature and flourishing. As for its success with many clinical therapies, I think most scientists would agree that "something works" is a necessary but not a sufficient criterion to be called science as we know it. Therefore, arguing that psychology is science is simultaneously an argument for radically changing our view of science. Bowman sees this clearly, but Norman wants to make psychology rise up to meet the established view of science through "measurement". The latter is quite misguided, and the reason I think so much debate has ensued here.
Posted by: Namit | Feb 15, 2010 4:42:09 PM
Louise,
Let's not overplay my use of the word 'control.' I was giving you examples as to how scientists conduct themselves at the different functions of science: description, explanation, prediction, and control.
If the word 'control' connotes excessive imposition as that associated with 'Big Brother', or the old Soviet system of psychiatric treatment and confinement of dissidents, I would be concerned. But that doesn't make psychological science not a science. You may not care for some of the implications and applications of control, but that doesn't make psychology not a science.
There are many beneficial applications of control. Earlier I used the example of human factors psychology. Alphonse Chapanis, in WWII, saved the lives of hundreds if not thousands, of pilots by discovering the cause of many crashes - the bad arrangement of dials, gauges, and indicators of various kinds on the instrument panel and in the cockpit. He analyzed (atomized) the elements of data, their meaning, information processing, problem solving, and decision making so as to minimize the burden of information processing, and subsequent error, for the pilot. Chapanis' solution (control:) Many dials and gauges were arranged to that 'normal' readings had all the dials going in the same direction. This meant the pilot's burden of information processing was eased so that he only had to detect exceptions. In turn, this facilitated the pilots decision-making. IT WAS PSYCHOLOGICAL CONTROL AT ITS BEST. This has carried over to driver dash board design for autos.
Posted by: Norman Costa | Feb 15, 2010 4:44:59 PM
Namit,
Thanks for the thoughtful comments. If you cut and paste a couple of ideas from your earlier comments, I'll do my best to reply. A lot a water has flowed under to posting bridge.
Measurement is one aspect of science, albeit a very important one. My position is not that psychology was not a science until I admonished my colleagues to get their measurement act together. It may seem a nit to non-scientists, but not being able to agree on a proper definition of measurement, and not realizing the definition used by some was not a definition at all, is an essential house keeping task that we have to get right.
Your quoting my words on Newton and Einstein is a place to explore some fundamental issues. Newton is, arguably, the greatest scientist in all of history. What he produced, in his equations, laws of motion, and descriptions of planetary movement changed everything about science and ushered in the modern era of physics.
It is probably safe to say that without Newton - and what followed him - that Einstein would not have created his theories and spawned the field of quantum mechanics.
However, there were assumptions, implicit and otherwise, in Newtonian physics that were shown to be completely wrong. Among these were the infinite extent of geometric space, and time; the independent realities of space and time, apart from matter; gravity being an attractive force acting at a distance. In addition, Einstein understood the equivalence of matter and energy, that time could be dilated, length was not immutable, and that the laws of physics were exactly the same for every observer, regardless of position and momentum relative to anything else.
Without Einstein, satellite telephones would not be possible. In Newtonian physics we would wind up with telephone calls being sent after you received them.
My understanding is that Newtonian physics is not so much a special case of Einsteinian physics, as a matter of not bothering to do the exact arithmetic when dealing with phenomena at the earth's surface and at 'normal' velocities.
My point still stands: Scientific knowledge is always the best of what we know at the present time, and will probably be superseded with new information. Scientific knowledge is always proximate and provisional.
There is no exact science, and no final certainty. Some things have probabilities that are so high that we regard them as near certainties.
In the case of the DSM, I will not comment on No. 5, because it is just out and there will be a lot of debate. However, the practice of voting on uses and interpretations of findings is not new. It is implicit in the peer review process. I am a review editor of scientific papers. I have a form to record my vote on publication that will be tabulated with other votes of other reviewers. Voting, or its equivalent, is involved in supporting research in science. Differences among scientists might be professional, personal, and political. Scientists who organize professional conferences will vote on the agenda and ground rules for acceptance of papers.
My comment on "Welcome to science," is not a glib, smart alec, disrespectful dismissal. The non-scientist might view voting on substance to be, well, not very scientific. The non-scientist might see, correctly, that measurement in the social sciences not exact, and criticize it as not being an exact science. The fact is that there are no exact sciences.
So I say again, as I do to my students throughout their course on research methods when they are dismayed at the limitations they discover about science, "Welcome to science. Now get over it and get to work doing science."
Posted by: Norman Costa | Feb 15, 2010 5:47:48 PM
Louise,
I was commenting, satiricly, on your question to me, "Where did I say that?"
Regarding the DSM, there are a lot of issues, good and bad, with the DSM. The first one was a piece of horse hockey, with vague generalizations in paragraph form. The major advance in the DSM is basing the descriptions on observable behavior, or behavioral events. Two of the best examples for non-psychologists are borderline personality disorder and bipolar disorder. You can find these on-line, as well as their European counterparts. This gets away from the diffuse and non-specific paragraphs of the first one.
As to finer gradations of described disorders, my example of depression, in my earlier reply, shows how it is necessary so we know what we are talking about. ADHD is a very good example. The work of Jules Bemporad MD in Scarsdale, NY has done much to add to the taxonomy. There is ADD-Inattentive type, and ADD-Hyperactive type. These subsets manifest different constellations of symptoms and need and respond to different kinds of treatments. I don't know if it has made it into the DSM
One big problem with the DSM is also it's greatest strength - the descriptions in term of observable behavior or behavioral events. As I understand it, the DSM (at least in part) does not include the results of diagnostic testing in the descriptions. This problem is manifest very clearly in the classifications of psychopathy, sociopathy, and Anti-social Personality Disorder (ASPD). I believe this was discussed in your Psychiatric Times link. Otherwise, you will find a brief discussion of the problem on Wikipedia if you look up psychopath.
Posted by: Norman Costa | Feb 15, 2010 6:33:26 PM
Norman,
Thanks for your response and your patience. Let me restate the objection I raised about your use of classical/ relativistic mechanics as an analogy for DSM. The point was that the motion described by classical mechanics (yes at low velocities and certain boundaries) still serves to objectively describe, explain, formulate, measure, verify, and predict the same results across all human cultures.
"Knowledge" in psychology is of a entirely different order (as Bowman concedes too) and your comparison is therefore misleading. Science, as we know it, prides itself on being universal—isn't that the unique value of science? We can't say this about most DSM norms, can we? I've noted that on metrics of precision, verification, reliability, explanation, objectivity, and universality (among others), psychology doesn't perform like the sciences. Here is an essay that lays out more reasons why psychology is not science. Would love to hear your take on these objections.
Posted by: Namit | Feb 15, 2010 7:04:09 PM
Hey campers, give this one look:
Crazy Like Us
Posted by: Dave Ranning | Feb 15, 2010 7:18:21 PM
Dave,
Great find!
Posted by: Louise Gordon | Feb 15, 2010 7:55:25 PM
Norman,
I thought I'd give you a chance to retract that brutal ad feminam attack, but doggone it, you didn't.
I'm signing off for a few days. I've come down with acute Internitis.
You betcha.
Posted by: Louise Gordon | Feb 15, 2010 7:59:12 PM
Namit,
I took a look at the Architecture of science and the A, B, and C points. It's nonsense. The author doesn't know what science is. He simply defines psychology out of science.
The APA's criticism of itself, though, is spot on, for the time it was done. I mentioned in a prior article that the secession of many psychologists from the APA and forming the Association for Psychological Science (APS) was in reaction to the bias against science by the APA, and among so many of its psychologists. Another example was the virtual secession of Division 14, Industrial and Organizational Psychology, with the formation of the Society for Industrial and Organizational Psychology (SIOP.) SIOP takes the role of the psychologist as scientist-practitioner very seriously.
One lesson from this is not to use the APA as the model of scientific psychology. APS and SIOP are much better models. There are many regional organizations that do a far better job at doing science. The Eastern Psychological Association (EPA) is an example.
The APA report, though a bit dated, made it clear that we were functioning well at the level of description. Beyond that, not so well. Remember, the basic function of all science is to describe the properties of things. Very good science can be done at the descriptive level. Astronomy has been largely an observational descriptive science. Physics is more an experimental descriptive science. Also, physics is more successful in explaining, predicting, and controlling. Charles Darwin did his underlying work leading to “The Origins of Species” and “The Descent of Man” on a purely descriptive level. He did not perform a single experiment. From his descriptive work he produced his theories.
Another example of great descriptive science is the primatologist Jane Goodall. Johannes Kepler worked for years with the descriptive data from other astronomers. He produced an incredible model of the solar system that described the motions of planets in elliptical orbits with previously unknown properties.
Richard Feynman said it best, in an interview, years ago. He said psychology has got the form of science down, but psychology is not producing any laws of nature. Psychology has made some very good contributions to science at the descriptive level. On the whole, however, I have to agree with him. Thus, my chiding of my colleagues to replace tautology with theory, agree on a good definition of measurement, stop appropriating the Uncertainty Principle from quantum physics when it doesn't apply, and confusing it with measurement error.
This article on Freud is an example of how science was working in the late 19th century. Charcot discovered that Hysteria was psychological, not organic. Freud, and Janet discovered, independently, the cause and the treatment of Hysteria. How? Through good descriptive research. Imagine how the mental health of women, and all people, might have benefited, if Freud had not abandoned his good scientific research in favor of a socially acceptable fairy tale.
Posted by: Norman Costa | Feb 15, 2010 8:21:43 PM
Namit,
I'll just drop the Newton-Einstein example, since it was used as an analogy.
Posted by: Norman Costa | Feb 15, 2010 8:23:40 PM
Louise,
Ad feminam attack?
You've spent the whole thread insinuating that Norman is on the side of psychiatric abuse of power, while only rarely deigning to actually respond to any of the points he has actually made.
You've even claimed that any sort of empirical, systematic observation of human behavior is inherently dehumanizing, while simultaneously citing scientific data when it suits your rhetorical purposes!
Can psychology be called a science? I don't know, and actually I don't care (sorry Norman) about that kind of academic turf war. Does science have something valuable to offer people struggling with mental illness? Yes. Do some of those offering valuable insights call themselves psychologists? Yes.
Crazy Like Us does sound like a good read. Again, nothing leads me to believe that a more scientific psychology would lead to more medication - probably the opposite.
Posted by: Vicki Baker | Feb 15, 2010 8:27:03 PM
Chicken soup for Louise, coming right up...
Posted by: Elatia Harris | Feb 15, 2010 8:29:52 PM
"Crazy Like Us"
Thanks Dave. Yep. This is really happening.
A long time ago, I was able to say that when it comes to mental illness, psychosis (schizophrenia, for example) seemed to be universal. The neuroses, however, seemed to be culturally bound. Of course, my statements are broad generalizations.
Years ago, anorexia and bulimia seemed to be U.S. or western disorders. They were not observed with any significance in many other cultures. Now we find previously culture bound disorders in parts of the world where they never existed before.
What is not clear yet, is how much is due to a cultural indoctrination by western views of mental illness, and how much is due to the internalizing of western culture itself. There are probably other factors. Understanding the phenomenon will take a lot of creative ideas for scientific investigation.
Posted by: Norman Costa | Feb 15, 2010 8:36:59 PM
Vicki,
You stated: "Can psychology be called a science? I don't know, and actually I don't care (sorry Norman) about that kind of academic turf war."
Ego te absolvo.
Posted by: Norman Costa | Feb 15, 2010 8:51:07 PM
Norm,
It is statements like this that persuade me that our views are not always as divergent as the terms of our conversation might suggest.
But I would like to offer that if different forms of mental health and illness are, in part, culturally contingent, then perhaps Feynman's criticisms about psychology yielding no laws of nature are misapplied?
Boyle's law, Ohm's law, the Second law of Thermodynamics, and all the others we could name apply universally, everywhere, and everywhen. They apply whether we believe in them or not, and they do not show any signs of variation over time and space. These are not statements we could make about the bulk of psychological knowledge. Where we are tempted to see a universal fact of psychology, we should look hard to see how much it overlaps with biological and medical sub-disciplines like pharmacology or neurology. (Though we might pause to ask if medical science has yielded any laws of nature?)
Now perhaps there are such things as laws of human nature in a psychological context. If they can be established to some meaningful standard, I won't resist. But why does psychology require them to establish its validity? There are no laws of history, but we don't deride historians for being insufficiently scientific (though we do deride them for being insufficiently rigorous in the methods available to them.) Ethnomusicology, political theory, media studies, economics and a whole host more will never yield any laws of nature (in a sense Feynmann would endorse), but they are fruitful pursuits all the same. Why is psychology so different?
Like Vicki, I'm not particularly interested in settling the abstract question of whether psychology is or is not a science. I am however interested in knowing what would follow from such a determination, which is the question that Nick and I raised several weeks ago, and that I still not have seen an answer to.
Posted by: Chris Schoen | Feb 15, 2010 9:39:59 PM
Chris,
It is my personal opinion that psychology is far from an established and agreed upon inventory of laws of nature. We are a young science (but a science nonetheless), with a history and one major professional organization (APA) that are far from being examples of good science. I have admonished and advocated for getting our scientific house in order. Details count.
There is nothing that says we MUST produce laws of nature. We used to make a distinction between experimental psychology, which focused on general principles for all people, and the psychology of individual differences. Today we do not maintain that distinction as firmly as we did 50 years ago.
Now I will go out on a limb and say that it is my personal opinion that there may be some candidates for universal principles. I will not defend them or argue them. That's for everyone else to do.
Candidate 1: B. F. Skinner's schedules of reinforcement, and their effects on learning and extinction of behaviors.
Candidate 2: Attitudes conform to our behavior, not the other way around. This is a variation on cognitive dissonance.
Canditate 3: D. P. Ausubel's Subsumption Theory of Meaningful Verbal Learning. Start with what the student knows, and go from there.
Posted by: Norman Costa | Feb 15, 2010 10:36:46 PM
Chris,
Norman did tell us earlier about what's at stake in having psychology classified as a science:
You asked "what would follow from such a determination"? My guess is: everything! :)
Adios until next Monday ...
Posted by: Namit | Feb 16, 2010 1:51:07 AM
Candidate 1: B. F. Skinner's schedules of reinforcement, and their effects on learning and extinction of behaviors.
I actually had Skinner as a Prof in a Future of Man class at UCSB.
We were all going to show up in Mickey Mouse hats the first day, but it didn't happen.
It was a very interesting class, as they rotated lectures. Buckminster Fuller was also a participant, along with Frank Herbert.
Posted by: Dave Ranning | Feb 16, 2010 11:02:42 AM
Dave,
Way cool! Did Skinner tell you about his pigeon-guided smart bombs from WWII?
Posted by: Norman Costa | Feb 16, 2010 11:26:07 AM
Vicki,
You write: "Ad feminam attack?
You've spent the whole thread insinuating that Norman is on the side of psychiatric abuse of power, while only rarely deigning to actually respond to any of the points he has actually made.
You've even claimed that any sort of empirical, systematic observation of human behavior is inherently dehumanizing, while simultaneously citing scientific data when it suits your rhetorical purposes!"
You seem to be confused. Perhaps if I had added several more you betchas to my ad feminam remark, you might have realized that I said it in jest.
I have not claimed that any systematic or empirical observation of human behavior is dehumanizing, nor, obviously, would I say that about epidemiology studies. I made those remarks in the context of Norman having cited intervention in school children's behavior, and I made them referring to a one-on-one therapeutic relationship -- the one in which Norman said that the interventionist tries to influence, or control, the subject of health ministrations so that he or she conforms to a greater degree to the interventionist's concept of health.
I also objected to Norman's uncritical acceptance of the DSM as a valid diagnostic tool. He is of the opinion that the expanded classifications of disorders has resulted from finer honed measurements. I disagree.
I have not responded to every single one of Norman's answers, yet in more than one instance, he responded to me with a Welcome to science, a remark that sidesteps the questions I asked. Further, till the very end of our exchanges, Norman ignored the evidence I've cited on the now epidemic proportions of mental disorders and disabilities documented by Robert Whitaker. This epidemic has increased along with greater psychotropic drug use and the expanded diagnostic categories listed in the DSM. I was encouraged to read Norman's final comments on this, with references to the damaging effects of hormone replacement therapy.
You write: "Again, nothing leads me to believe that a more scientific psychology would lead to more medication - probably the opposite."
As far as what Norman believes are greater or finer measurements accounting for the growing DSM list of illnesses, illnesses often treated with psychotropic drugs, this has not proven to be the case so far.
Posted by: Louise Gordon | Feb 16, 2010 1:04:00 PM
Psychology is more akin to Religion than Science.
Only religion threads ever grow past two screens on 3QD. QED.
Posted by: Carlos | Feb 16, 2010 2:10:54 PM
Carlos,
I thought the number and length of the comments were a tribute to my incisive writing and the saliency of the issues.
I have four books on my desk, as I write this:
D.P. Ausubel's "Ego Development and Psychopathology"
A.I. Kraut (ed) "Getting Action from Organizational Surverys" [I have a chapter in this book.]
Dunnett and Hough (eds) "Handbook of Industrial & Organizational Psychology"
J. Herman MD "Trauma and Recovery"
I have to tell you, Carlos, these are all research based, to the nth degree. There is no religion to be found.
I do have the book, "The Spiral Staircase," by Karen Armstrong on my desk. There is, also, Harold Bloom's and David Rosenberg's "The Book of J." Yep, there's a lot of religion in both of them, but no scientific psychology.
Posted by: Norman Costa | Feb 16, 2010 3:31:44 PM
Many journalists, it seems, are now clamoring to get their discipline classified as science. They have even proposed journalism's first scientific law: "sensationalism sells better than plain facts."
Other potential laws currently being evaluated include: "free market forces dilute journalistic ethics," and "Loyalty to readers is inversely proportional to loyalty to shareholders."
;-)
Posted by: Namit | Feb 17, 2010 12:15:03 AM
Hi, Namit,
Monday arrived quickly. ;) I can't stay too long since I'm still fighting that Internetitis flare-up with both soup (thank you, Elatia!) and Vosges curry-coconut chocolate bars, which I hope doesn't signify some kind of early onset eating disorder or rapid decline decadence disorder.
I found a book that might interest you and others dedicated to better scientific measuring capacity. I hope someone will continue the work begun by Kirk and Kutchins, applying their insights to the forthcoming DSM Number V:
NEJM
The Selling of DSM - The Rhetoric of Science in Psychiatry
I suspect that the potential science laws of journalism you're exploring apply universally and can be found in the selling of DSM, that bible of scientific benevolence.
Posted by: Louise Gordon | Feb 17, 2010 12:56:13 AM
">http://www.ahrp.org/cms/content/view/144/27/">
Conflicts of Interest
Posted by: Louise Gordon | Feb 17, 2010 2:42:02 AM
Namit,
Don't forget library science. It's first law, I believe, is the more digits you write down of a book's LoC classification, the less likely the book will be on the shelves.
Posted by: Chris Schoen | Feb 17, 2010 5:17:02 AM
Post a comment