My good friend recently sent me information regarding a study which took place from 1954 through 1964. In this study 51 monks agreed to undergo a psychoanalysis. The result - 2/3rd's left the monastery!
How did the pope respond to this study? Of course - He banned psychoanalysis! This banning of psychoanalysis is an institutional limit to human freedom; it's an oppressive act which is in the service of power, rather than in the service of truth. Galileo suffered such a fate at the hands of the Catholic church, and it took the church nearly 400 years to admit that they were wrong (ahh...the infallible pope was wrong!).
What do I mean by "truth" here? Well, ask yourself a question: what "truth" is there in the act of a monk leaving the "monkhood" as a result of psychoanalysis? Psychoanalysis, in this case, reveals a truth which otherwise would not have been revealed: psychoanalysis revealed that the monks wanted to live another sort of life. The truth was revealed to the monks; not on behalf of religious faith; not on behalf of "unwavering faith" (unwavering faith is simply clinging to a proposition that one refuses to question - why should this be valued at all?); but on behalf of an agreement to simply speak THE TRUTH - the truth of the psyche without any restrictions of freedom...the question being: What comes to mind?
Why was the pope wrong (ahh, the infallible pope was wrong again!) in banning psychoanalysis? Psychoanalysis (what the hell - any form of dynamic psychotherapy) could've been used as a method for determining whether one truly wanted to live a life in the monastery; there could've been huge potential here! Who knows...maybe psychoanalytical/psychological mindedness (which could've grown at the institutional level over time) could've prevented much harm which the church dished out in their later years; of course, I'm speaking of the rampant child abuse as well as the attempted cover-ups which the Church dwelt with for quite a while (mid 90's through the early 2000's).
What would Freud have called the Church's decision to ban psychoanalysis? Simple - repression. But as we know, every repression has its inverse: the return of the repressed. How has this repression, this banning of psychoanalysis, returned?
http://unreasonablefaith.com:80/2009/05/06/why-psychoanalysis-and-priests-dont-mix/
Wednesday, June 3, 2009
Friday, February 20, 2009
Freud Bashing
I recently had a conversation with an old friend from high school. He told me that he was interested in marriage and family therapy, and I told him that I was interested in clinical psychology, neuropsychology and especially psychoanalysis. From there we got into a discussion on Freud and I explained to him the concepts of transference, repression, oedipal conflict, and the unconscious. He agreed with the sensibility of these psychoanalytic concepts and understood them almost intuitively, but as he departed he said "but you don't really believe in that Freud stuff; do you?"
What can we make of this disavowed after-thought, and where does it originate? Is it the way Freud looked when the photographers took his picture: that depressed/mean/weary look he always had (its hard to find photographs of Freud smiling) while puffing on one of the 30 cigars that he smoked per day; always talking about sex; claiming that he understands how the human mind really works.
One of the reasons that we all-too-often reject Freud without first giving him a proper reading (who the hell out there has actually read this man's books!) is the fact that we still aren't comfortable talking about sex. Psychoanalysis gives THE most comprehensive account of human sexuality. Every other account of human sexuality goes something like this: Sex is very important for one's well-being. This, unfortunately, is how far we've come in understanding sexuality since Freud. Freud, on the other hand, discovered that sexuality is often at the very root of psychopathology; even apparent paralyses of the hands, feet and limbs can have a sexual origin (see hysteria, conversion hysteria, or conversion disorder).
Sex is a very important part of one's well being...
This phrase is nothing but a politically correct, popularized and watered-down psychology. It doesn't offer us anything new in terms of knowledge or theory. Thank God for Freud in helping us to understand "something" of human sexuality; otherwise, we would know next to nothing.
What can we make of this disavowed after-thought, and where does it originate? Is it the way Freud looked when the photographers took his picture: that depressed/mean/weary look he always had (its hard to find photographs of Freud smiling) while puffing on one of the 30 cigars that he smoked per day; always talking about sex; claiming that he understands how the human mind really works.
One of the reasons that we all-too-often reject Freud without first giving him a proper reading (who the hell out there has actually read this man's books!) is the fact that we still aren't comfortable talking about sex. Psychoanalysis gives THE most comprehensive account of human sexuality. Every other account of human sexuality goes something like this: Sex is very important for one's well-being. This, unfortunately, is how far we've come in understanding sexuality since Freud. Freud, on the other hand, discovered that sexuality is often at the very root of psychopathology; even apparent paralyses of the hands, feet and limbs can have a sexual origin (see hysteria, conversion hysteria, or conversion disorder).
Sex is a very important part of one's well being...
This phrase is nothing but a politically correct, popularized and watered-down psychology. It doesn't offer us anything new in terms of knowledge or theory. Thank God for Freud in helping us to understand "something" of human sexuality; otherwise, we would know next to nothing.
Friday, December 12, 2008
Discussing Ramachandran's lecture: Anosognosia: The interface between neurology, psychiatry and psychoanalysis
Here is an excerpt from an essay I recently finished entitled "Heraclitus Through Lacanian Theory: The Logos and the Unconscious"
This excerpt discusses Ramachandran's excellent lecture entitled: Anosognosia: The interface between neurology, psychiatry and psychoanalysis.
Ramachandran is one of the world's foremost authorities on neuroscience, and the fact that he devoted an entire lecture on the link between Freud and neuroscience is very exciting.
For a link to this great lecture - http://www.veoh.com/videos/v15598629Wqrq8dHY
Here is my excerpt
Vilayanur Ramachandran is a neurologist who treats patients with some very rare neurological ailments, such as Anosognosia, Capgras delusion, and phantom limb pain. Anosognosia simply means that a neurological patient is vehemently denying the fact that they have an illness. It’s a condition which appears after an individual has had a stroke affecting the right parietal lobe. Because the individual’s right cerebral hemisphere is damaged, they are paralyzed on the left side of the body (all these minor details will be very useful to us further in the essay).
It’s important to note that although patients with Anosognosia have no cognitive deficit and are fully cognizant and intelligible, they nevertheless deny the plain and simple fact that they are paralyzed! These patients can see their hand just fine, and although it is not moving they continually insist that it is moving. Ramachandran desired to see what would happen if he questioned these patients like a lawyer questioning a lying witness: Ramachandran wanted to prove to these patients that they were paralyzed by using hard empirical evidence. For example, Ramachandran asked a patient to touch his nose (Ramachandran’s nose) with his left hand (the patient’s left hand, which is paralyzed). Ramachandran then asked the patient why he wasn’t touching his nose, and the patient replied, “Doctor, I was in the air force, and I am not used to taking orders!” (Ramachandran, 2004). Another patient, when asked why she wasn’t touching Ramachandran’s nose, replied, “No! I’m tired of all these medical students prodding me all day!” (Ramachandran, 2004).
Both of these patients are obviously conjuring up an excuse which allows them to avoid the unfortunate reality of their paralysis. In psychoanalysis we call this excuse a “rationalization.” Rationalization is one of the many Freudian defense mechanisms. Defense mechanisms “defend” or protect the ego from truths which would cause the person too much distress, “A mental attribute or mechanism or dynamism, which serves to protect the person against danger arising from his impulses or affects” (Psychiatric Dictionary, p. 174). It is terrifying for one to confront the fact that one will not be able to move one’s arm anymore, and all of this distress would do the ego no good. The ego is constantly seeking to maintain a proper homeostatic state (i.e. the pleasure principle), but powerful and distressing emotions disturb this homeostasis. Therefore, the patient’s ego will defend itself against this distressing truth in order to maintain its own well-being and balance.
Ramachandran discovered that patients with anosognosia not only use rationalization; they use nearly all of the Freudian defense mechanisms! For example, Ramachandran asked a patient how high he could lift a table with his right arm (the non-paralyzed arm), and the patient replied that he could lift it 3 inches, but when asked how high he could lift the table with his left arm (his paralyzed arm), the patient replied that he could lift it 6 inches. Here we see the defense mechanism called “reaction formation,” which can be understood as an unconscious overcompensation or overriding of the truth, “It’s as if there’s a little man in there (the mind) who really knows what’s going on” (Ramachandran, 2004).
Patients with anosognosia sometimes claim that their paralyzed arm doesn’t belong to them, but that it is actually their mothers arm, or that it belongs to somebody else; this wild and odd claim is called “confabulation.” Furthermore, patients often display a kind of “sadistic humor” while performing all of these defensive measures; using humor itself as a defense mechanism (see Freud’s Jokes and Their Relation to the Unconscious). Ramachandran states that these patients are not aware of what they are doing because defense mechanisms function at the unconscious level, just as Freud and Lacan hypothesized. Here we see the Heraclitean ontological gap between logos (the causal psychological/neurological mechanisms) and human knowledge (the patient’s beliefs about what is happening). It’s abundantly clear that these patients have no insight regarding their condition (see fragment 25), and their personal views on the matter are quite far from the truth (see fragment 6). This realm is not one of subjectivity, or what Heraclitus calls “private understanding.” At this level, the level of the patient’s conscious self understanding, the ego is simply too deceptive and irrational to be taken seriously. Instead, the doctor must understand what is occurring at the unconscious level, which Heraclitus calls the logos.
The Caloric Reflex Test is a medical intervention often used on patients suffering from anosognosia. It’s a test which involves squirting very cold water into the patient’s inner ear, thereby causing a shift in the patient’s level of awareness. Patients then become aware of the nature of their illness: they are aware of their paralysis; they know how long they’ve been paralyzed; and they admit that they cannot move their paralyzed arm. But as soon as the Caloric Reflex Test’s effects wear off, the patient again becomes unaware, and in denial of their illness. Luckily for the patient, anosognosia is only temporary; it lasts from a few days to a few weeks. However, as a result of the stroke the patient has permanent brain damage, and will likely remain paralyzed. Anosognosia, or the denial of illness, is simply how the ego responds to such a traumatic event. Interestingly enough, as the patient recovers from anosognosia they have the tendency to repress the fact that they were denying their illness: “they deny their previous denials” (Ramachandran, 2004). This example showcases the defense mechanism called repression (see p. 6, paragraph 1). This neurological evidence strongly supports the division of unconscious and conscious, which was first developed by Freud, and later taken up by Lacan.
Heraclitus’ ontology, even in the realm of neurology, has been shown to be accurate and of merit in better understanding the “gaps” inherent to human reality.Ramachandran emphasizes that patients who suffer from anosognosia are not so different from everybody else. We all use Freudian defense mechanisms by virtue of the fact that we have a left cerebral hemisphere. Ramachandran deduced this fact by observing that patients with anosognosia all had damage to the right cerebral hemisphere; anosognosia is rarely seen in patients with damage to the left cerebral hemisphere, “For this reason it is necessary to follow what is common” (Cohen, p. 25). When the right cerebral hemisphere is damaged the patient’s defenses seem to become grossly exaggerated, while the patient’s ability to confront empirical reality (the fact that they are paralyzed) is greatly lessened. Therefore, the right cerebral hemisphere is devoted to acknowledging inconsistencies while adapting to various, often unpleasant, truths. The left cerebral hemisphere, on the other hand, is constantly building a coherent sense of self; no matter how contradictory it may seem to outside observers. It is dedicated to distorting and “filtering out” various (often unpleasant) truths, and it performs these processes via the Freudian defense mechanisms (see p. 6, paragraph 1).
The two cerebral hemispheres are therefore opposed to one another, but out of this opposition arises a homeostatic balance, a continuity, “What is opposed brings together; the finest harmony (harmonia) is composed of things at variance, and everything comes to be in accordance with strife” (Cohen, p. 29). Once this balance is disturbed (via stroke) we get a glimpse into the various oppositions which lie beneath this illusion of continuity which we simply call “I.”
References
Ramachandran, V.S. (2004). Anosognosia: The interface between neurology, psychiatry and psychoanalysis. 5th Neuro-Psychoanalysis Congress: Splitting, Denial and Narcissism.
Cohen, S. M, Curd, P., Reeve, C.D.C. (2005). Cohen, S. M / Curd, P. / Reeve, C.D.C. (Ed.). Readings in Ancient Greek Philosophy: From Thales to Aristotle. (pp. 268, 272, 235, 236, 144, 145,). (3rd Ed.). Indianapolis, IN: Hackett Publishing Company.
Wednesday, November 12, 2008
Up and Comming Projects!
I have not posted any blogs as of late because I have been terribly busy with my college course-work, but I have been developing some essays that I will soon post. These essays will concern how modern neuroscience corroborates with Freud's psychoanalytic theories. The main question that I will continue asking is: Is modern neuroscience beginning to prove Freud's theories, or is it dismantling Freud; showing his theories to be ancient, and showing Freud himself to be a old dinosaur?
I will be seeking answers from world renowned neuroscientists, neuropsychologists, and psychoanalysts. The following are some of the lectures that I will be critically examining. It must be kept in mind that these lectures are not theory driven, but are based off the findings of modern-day neuroscience, which allows us to see how the brain, and the mind, actually function.
Mark Solms: Freud Today
Mark Solms: What is Repression?
V. Ramachandran: Anosognosia: The interface between neurology, psychiatry and psychoanalysis
I encourage all readers to watch and/or listen to these lectures, which can be found here
http://www.neuro-psa.org.uk/npsa/index.php?module=pagemaster&PAGE_user_op=view_page&PAGE_id=62 or search for them on www.veoh.com
My essays will be on these lectures, which, I believe, are some the most imporant lectures in the contemporary world of psychology, psychoanalysis, and neuroscience.
I will be seeking answers from world renowned neuroscientists, neuropsychologists, and psychoanalysts. The following are some of the lectures that I will be critically examining. It must be kept in mind that these lectures are not theory driven, but are based off the findings of modern-day neuroscience, which allows us to see how the brain, and the mind, actually function.
Mark Solms: Freud Today
Mark Solms: What is Repression?
V. Ramachandran: Anosognosia: The interface between neurology, psychiatry and psychoanalysis
I encourage all readers to watch and/or listen to these lectures, which can be found here
http://www.neuro-psa.org.uk/npsa/index.php?module=pagemaster&PAGE_user_op=view_page&PAGE_id=62 or search for them on www.veoh.com
My essays will be on these lectures, which, I believe, are some the most imporant lectures in the contemporary world of psychology, psychoanalysis, and neuroscience.
Friday, October 10, 2008
Freud and Sexuality
Chris: So how do you feel about the “strong sexuality” within the writings of Freud? Do you believe it?
Adam: Well, in order to answer this question I must first determine what is “sexual” about sexuality itself. The answer is simple: pleasure. We associate sex with the utmost pleasure. An orgasm is seen as a pleasure overload, and is almost universally thought of as the most pleasurable experience one can have. But, as well all know, there are many pleasure producing activities in life other than having sex. These pleasure producing activities involve all of our senses.
What do watching a well-filmed movie, observing a masterful work of art (such as Van Gogh), and viewing pornography have in common? Simple – These activities are pleasure for the eyes; we can have a metaphorical “hard-on” while caught-up in any of these activities, and this can often be seen in common sayings: “Man, he’s really getting off on that art,” or “The visuals were amazing” – akin to – “The sex was amazing.”
We moan while eating a tender piece of meat at a fancy restaurant, and that same moan can be heard during the sexual act. The water can feel orgasmic as we enter a warm Jacuzzi. The smell of certain fragrances can sexually arouse men or women, leading them in a pursuit of pleasure which goes beyond the nose itself (led by the nose). And music can be heaven for the ears (as sex is often thought of as a heaven-like unity – “It’s like I’m in heaven” etc). Her voice can sound like that of an angel, or her voice may sound sexy and seductive, in which case you become aroused by a partial object: that of sound. And remember, it could a very “un-sexy” old woman on the other side of the phone line, or perhaps, an old man…
I hope these examples have convinced you that sexuality extends beyond the sexual act itself, and is contained in all of our senses, as well as many of our daily activities. Looking at a woman’s boots, hearing a women’s voice, smelling a women’s scent, feeling a women’s touch, and tasting a women’s lips all involve our entire sensory apparatus. However, none of these examples involve “the whole women” as such, or even the act of copulation. Instead, they involve a part of our bodies (our sense organs - the eye, the ear, etc), a “partial object” relating to the women (boots, voice, scent, etc), and the sexual pleasure that is produced when these two parties interact. But one must remember that what makes these aforementioned examples “sexual” is not their alluding to the act of copulation itself, but the sensual (i.e. sexual) pleasure they produce. This sensual pleasure can be produced without reference to the act of copulation; therefore, everything which produces pleasure has a sexual (i.e. sensual) aspect or meaning.
It may be beneficial to think of pleasure as a continuum, or rather, a thermometer. All of our pleasures register a certain degree on the thermometer, and the things which cause us to experience more pleasure register a higher degree on the thermometer than our lower pleasures. When the thermometer reaches its peak we call this orgasm; but not so fast.... How are we to explain those who do not enjoy or take pleasure in sex? How about those who choose not to have it? Sex may be traumatic for such people: rape victims, nuns, people who associate it with evil, etc. What pleasures give these individuals the utmost ecstasy? What, for them, replaces the orgasm on the topmost bulb of the thermometer? It could be anything relating to the senses, or even, to the imagination (which is just the nebulous amalgamation of the senses in the form of memory): art, music, food (it often is for those who are morbidly obese), movies, even religion (see Freud’s The Future of an Illusion).
Freud gave up sex rather early, and what did he replace it with: psychoanalysis, writing, seeing patients, etc. Sublimation is the process of exchanging sex for other pleasures. Indeed, when we sublimate we seem to release this sexual energy through a seemingly non-sexual act. In The Four Fundamental Concepts of Psycho-analysis, Lacan offers a great example of sublimation: “For the moment, I am not fucking, I am talking to you. Well! I can have exactly the same satisfaction as if I were fucking. That’s what it means. Indeed, it raises the question of whether in fact I am not fucking at this moment” (p. 165-166).
The last point I want to emphasize is that we are sexual beings from day one in the sense that we first obtain pleasure through sucking: sucking on the breast, sucking on nipples, pacifiers, etc. When we are old enough we crawl around and put things in our mouths, chew on objects, etc. All these actions are mediated by pleasure and gratification; not necessarily nourishment. The aforementioned pacifier is a perfect example of the fact that sucking, for infants and toddlers, is gratifying and soothing, but not necessarily nourishing.
When Freud speaks of the organism “expelling” its libidinal energies and returning to that tensionless state, he is referring to behavior such as infants falling asleep while sucking on pacifiers (although they often continue the sucking motions while asleep). Nature has created a system in which what is pleasurable is oftentimes nourishing as well, as is the case with an infant sucking at the breast, but we must also ask ourselves: what exactly does a grown man get out of sucking a pair of breasts during the sexual act?
Have I answered your question?
Chris: Yes Indeed! It actually makes perfect sense now.
Adam: Well, in order to answer this question I must first determine what is “sexual” about sexuality itself. The answer is simple: pleasure. We associate sex with the utmost pleasure. An orgasm is seen as a pleasure overload, and is almost universally thought of as the most pleasurable experience one can have. But, as well all know, there are many pleasure producing activities in life other than having sex. These pleasure producing activities involve all of our senses.
What do watching a well-filmed movie, observing a masterful work of art (such as Van Gogh), and viewing pornography have in common? Simple – These activities are pleasure for the eyes; we can have a metaphorical “hard-on” while caught-up in any of these activities, and this can often be seen in common sayings: “Man, he’s really getting off on that art,” or “The visuals were amazing” – akin to – “The sex was amazing.”
We moan while eating a tender piece of meat at a fancy restaurant, and that same moan can be heard during the sexual act. The water can feel orgasmic as we enter a warm Jacuzzi. The smell of certain fragrances can sexually arouse men or women, leading them in a pursuit of pleasure which goes beyond the nose itself (led by the nose). And music can be heaven for the ears (as sex is often thought of as a heaven-like unity – “It’s like I’m in heaven” etc). Her voice can sound like that of an angel, or her voice may sound sexy and seductive, in which case you become aroused by a partial object: that of sound. And remember, it could a very “un-sexy” old woman on the other side of the phone line, or perhaps, an old man…
I hope these examples have convinced you that sexuality extends beyond the sexual act itself, and is contained in all of our senses, as well as many of our daily activities. Looking at a woman’s boots, hearing a women’s voice, smelling a women’s scent, feeling a women’s touch, and tasting a women’s lips all involve our entire sensory apparatus. However, none of these examples involve “the whole women” as such, or even the act of copulation. Instead, they involve a part of our bodies (our sense organs - the eye, the ear, etc), a “partial object” relating to the women (boots, voice, scent, etc), and the sexual pleasure that is produced when these two parties interact. But one must remember that what makes these aforementioned examples “sexual” is not their alluding to the act of copulation itself, but the sensual (i.e. sexual) pleasure they produce. This sensual pleasure can be produced without reference to the act of copulation; therefore, everything which produces pleasure has a sexual (i.e. sensual) aspect or meaning.
It may be beneficial to think of pleasure as a continuum, or rather, a thermometer. All of our pleasures register a certain degree on the thermometer, and the things which cause us to experience more pleasure register a higher degree on the thermometer than our lower pleasures. When the thermometer reaches its peak we call this orgasm; but not so fast.... How are we to explain those who do not enjoy or take pleasure in sex? How about those who choose not to have it? Sex may be traumatic for such people: rape victims, nuns, people who associate it with evil, etc. What pleasures give these individuals the utmost ecstasy? What, for them, replaces the orgasm on the topmost bulb of the thermometer? It could be anything relating to the senses, or even, to the imagination (which is just the nebulous amalgamation of the senses in the form of memory): art, music, food (it often is for those who are morbidly obese), movies, even religion (see Freud’s The Future of an Illusion).
Freud gave up sex rather early, and what did he replace it with: psychoanalysis, writing, seeing patients, etc. Sublimation is the process of exchanging sex for other pleasures. Indeed, when we sublimate we seem to release this sexual energy through a seemingly non-sexual act. In The Four Fundamental Concepts of Psycho-analysis, Lacan offers a great example of sublimation: “For the moment, I am not fucking, I am talking to you. Well! I can have exactly the same satisfaction as if I were fucking. That’s what it means. Indeed, it raises the question of whether in fact I am not fucking at this moment” (p. 165-166).
The last point I want to emphasize is that we are sexual beings from day one in the sense that we first obtain pleasure through sucking: sucking on the breast, sucking on nipples, pacifiers, etc. When we are old enough we crawl around and put things in our mouths, chew on objects, etc. All these actions are mediated by pleasure and gratification; not necessarily nourishment. The aforementioned pacifier is a perfect example of the fact that sucking, for infants and toddlers, is gratifying and soothing, but not necessarily nourishing.
When Freud speaks of the organism “expelling” its libidinal energies and returning to that tensionless state, he is referring to behavior such as infants falling asleep while sucking on pacifiers (although they often continue the sucking motions while asleep). Nature has created a system in which what is pleasurable is oftentimes nourishing as well, as is the case with an infant sucking at the breast, but we must also ask ourselves: what exactly does a grown man get out of sucking a pair of breasts during the sexual act?
Have I answered your question?
Chris: Yes Indeed! It actually makes perfect sense now.
Thursday, October 2, 2008
Psychoanalytic Therapy Wins Backing
BY BENEDICT CAREY
Intensive psychoanalytic therapy, the “talking cure” rooted in the ideas of Freud, has all but disappeared in the age of drug treatments and managed care.But now researchers are reporting that the therapy can be effective against some chronic mental problems, including anxiety and borderline personality disorder.In a review of 23 studies of such treatment involving 1,053 patients, the researchers concluded that the therapy, given as often as three times a week, in many cases for more than a year, relieved symptoms of those problems significantly more than did some shorter-term therapies.The authors, writing in Wednesday’s issue of The Journal of the American Medical Association, strongly urged scientists to undertake more testing of psychodynamic therapy, as it is known, before it is lost altogether as a historical curiosity.
The review is the first such evaluation of psychoanalysis to appear in a major medical journal, and the studies on which the new paper was based are not widely known among doctors.The field has resisted scientific scrutiny for years, arguing that the process of treatment is highly individualized and so does not easily lend itself to such study. It is based on Freud’s idea that symptoms are rooted in underlying, often longstanding psychological conflicts that can be discovered in part through close examination of the patient-therapist relationship.
Experts cautioned that the evidence cited in the new research was still too meager to claim clear superiority for psychoanalytic therapy over different treatments, like cognitive behavior therapy, a shorter-term approach. The studies that the authors reviewed are simply not strong enough, these experts said.“But this review certainly does seem to contradict the notion that cognitive or other short-term therapies are better than any others,” said Bruce E. Wampold, chairman of the department of counseling psychology at the University of Wisconsin. “When it’s done well, psychodynamic therapy appears to be just as effective as any other for some patients, and this strikes me as a turning point” for such intensive therapy.
The researchers, Falk Leichsenring of the University of Giessen and Sven Rabung of the University Medical Center Hamburg-Eppendorf, both in Germany, reviewed only those studies in which the therapy had been frequent — more than once a week in many cases — and had lasted at least a year or, alternatively, had been 50 sessions long. Further, the studies had to have followed patients closely, using strict definitions of improvement.The investigators examined studies that tracked patients with a variety of mental problems, among them severe depression, anorexia nervosa and borderline personality disorder, which is characterized by a fear of abandonment and dark squalls of despair and neediness.Psychodynamic therapy, Dr. Leichsenring wrote in an e-mail message, “showed significant, large and stable treatment effects which even significantly increased between the end of treatment and follow-up assessment.”
The review found no correlation between patients’ improvement and the length of treatment. But improve they did, and psychiatrists said it was clear that patients with severe, chronic emotional problems benefited from the steady, frequent, close attention that psychoanalysts provide.“If you define borderline personality broadly as an inability to regulate emotions, it characterizes a lot of people who show up in clinics, whether their given diagnosis is depression, pediatric bipolar or substance abuse,” said Dr. Andrew J. Gerber, a psychiatrist at Columbia. For some of those patients, Dr. Gerber said, “this paper suggests that you’ve got to get into longer-term therapy to make improvements last.”
Some psychoanalysts were more surprised by where the paper appeared than by its results: most review papers in major medical journals have hundreds of studies to draw on, or certainly far more than 23. The new review is encouraging, they said, but also a reminder of how much more study needs to be done.Dr. Barbara L. Milrod, a professor of psychiatry at Weill Cornell Medical College, who like Dr. Gerber is a clinical practitioner of psychodynamic therapy, said further research was crucial as a matter of survival for a valuable treatment.“Let’s be real,” Dr. Milrod said. “Major medical centers have been shutting down psychodynamic training programs because there isn’t an adequate evidence base.”
My Views on this Article
I'm not surprised by the positive findings which this meta-analytic study has produced; other meta-analytic studies on psychoanalysis (or long term psychodynamic psychotherapy) have shown similar results (see Wallerstein, 1986 - Menninger Foundation's "Psychotherapy Research Project").
If a patient's psychopathology can be traced back to early childhood/oedipal conflicts, and there is more than one clear-cut "symptom" (which there usually is, even in individuals not seeking psychotherapeutic help) then the doctor/therapist better have a good foundation in the theories and practice of psychoanalysis.
It is also no surprise to me that long-term treatments are more effective than those that are short-term: if psychopathology is rooted in early childhood conflicts, and it continues in all its vicissitudes, becoming conditioned and reinforced through years and years of life experience, then you better believe its going to take some time to see clear improvements!
Psychoanalysis is the process of the patient uncovering and re-interpreting his/her past. The ol' saying, "we must understand the past in order to move-on effectively into the future," can be applied to psychoanalysis.
This process of uncovering and reinterpretation takes time! But nowadays we want everything so damn fast: all of our pleasures and wants must be fulfilled as soon as possible - the crowd yells...
This is why short-term therapies have become so prevalent nowadays; not because of their "efficacity," but because of our ideology! The patients are always told to adjust to what is "reasonable," and rational; in other words - to do what their therapist tells them! This is not the way to go.
Tell them to change their thoughts and actions so that they'll be more in accordance with societal norms, give em some medications, and smack em on the butt right out of the office! This, I'm afraid to tell you, is the nature of many short-term psychotherapies...
This is not the way to go, and things are beginning to change. Freud is returning.
Intensive psychoanalytic therapy, the “talking cure” rooted in the ideas of Freud, has all but disappeared in the age of drug treatments and managed care.But now researchers are reporting that the therapy can be effective against some chronic mental problems, including anxiety and borderline personality disorder.In a review of 23 studies of such treatment involving 1,053 patients, the researchers concluded that the therapy, given as often as three times a week, in many cases for more than a year, relieved symptoms of those problems significantly more than did some shorter-term therapies.The authors, writing in Wednesday’s issue of The Journal of the American Medical Association, strongly urged scientists to undertake more testing of psychodynamic therapy, as it is known, before it is lost altogether as a historical curiosity.
The review is the first such evaluation of psychoanalysis to appear in a major medical journal, and the studies on which the new paper was based are not widely known among doctors.The field has resisted scientific scrutiny for years, arguing that the process of treatment is highly individualized and so does not easily lend itself to such study. It is based on Freud’s idea that symptoms are rooted in underlying, often longstanding psychological conflicts that can be discovered in part through close examination of the patient-therapist relationship.
Experts cautioned that the evidence cited in the new research was still too meager to claim clear superiority for psychoanalytic therapy over different treatments, like cognitive behavior therapy, a shorter-term approach. The studies that the authors reviewed are simply not strong enough, these experts said.“But this review certainly does seem to contradict the notion that cognitive or other short-term therapies are better than any others,” said Bruce E. Wampold, chairman of the department of counseling psychology at the University of Wisconsin. “When it’s done well, psychodynamic therapy appears to be just as effective as any other for some patients, and this strikes me as a turning point” for such intensive therapy.
The researchers, Falk Leichsenring of the University of Giessen and Sven Rabung of the University Medical Center Hamburg-Eppendorf, both in Germany, reviewed only those studies in which the therapy had been frequent — more than once a week in many cases — and had lasted at least a year or, alternatively, had been 50 sessions long. Further, the studies had to have followed patients closely, using strict definitions of improvement.The investigators examined studies that tracked patients with a variety of mental problems, among them severe depression, anorexia nervosa and borderline personality disorder, which is characterized by a fear of abandonment and dark squalls of despair and neediness.Psychodynamic therapy, Dr. Leichsenring wrote in an e-mail message, “showed significant, large and stable treatment effects which even significantly increased between the end of treatment and follow-up assessment.”
The review found no correlation between patients’ improvement and the length of treatment. But improve they did, and psychiatrists said it was clear that patients with severe, chronic emotional problems benefited from the steady, frequent, close attention that psychoanalysts provide.“If you define borderline personality broadly as an inability to regulate emotions, it characterizes a lot of people who show up in clinics, whether their given diagnosis is depression, pediatric bipolar or substance abuse,” said Dr. Andrew J. Gerber, a psychiatrist at Columbia. For some of those patients, Dr. Gerber said, “this paper suggests that you’ve got to get into longer-term therapy to make improvements last.”
Some psychoanalysts were more surprised by where the paper appeared than by its results: most review papers in major medical journals have hundreds of studies to draw on, or certainly far more than 23. The new review is encouraging, they said, but also a reminder of how much more study needs to be done.Dr. Barbara L. Milrod, a professor of psychiatry at Weill Cornell Medical College, who like Dr. Gerber is a clinical practitioner of psychodynamic therapy, said further research was crucial as a matter of survival for a valuable treatment.“Let’s be real,” Dr. Milrod said. “Major medical centers have been shutting down psychodynamic training programs because there isn’t an adequate evidence base.”
My Views on this Article
I'm not surprised by the positive findings which this meta-analytic study has produced; other meta-analytic studies on psychoanalysis (or long term psychodynamic psychotherapy) have shown similar results (see Wallerstein, 1986 - Menninger Foundation's "Psychotherapy Research Project").
If a patient's psychopathology can be traced back to early childhood/oedipal conflicts, and there is more than one clear-cut "symptom" (which there usually is, even in individuals not seeking psychotherapeutic help) then the doctor/therapist better have a good foundation in the theories and practice of psychoanalysis.
It is also no surprise to me that long-term treatments are more effective than those that are short-term: if psychopathology is rooted in early childhood conflicts, and it continues in all its vicissitudes, becoming conditioned and reinforced through years and years of life experience, then you better believe its going to take some time to see clear improvements!
Psychoanalysis is the process of the patient uncovering and re-interpreting his/her past. The ol' saying, "we must understand the past in order to move-on effectively into the future," can be applied to psychoanalysis.
This process of uncovering and reinterpretation takes time! But nowadays we want everything so damn fast: all of our pleasures and wants must be fulfilled as soon as possible - the crowd yells...
This is why short-term therapies have become so prevalent nowadays; not because of their "efficacity," but because of our ideology! The patients are always told to adjust to what is "reasonable," and rational; in other words - to do what their therapist tells them! This is not the way to go.
Tell them to change their thoughts and actions so that they'll be more in accordance with societal norms, give em some medications, and smack em on the butt right out of the office! This, I'm afraid to tell you, is the nature of many short-term psychotherapies...
This is not the way to go, and things are beginning to change. Freud is returning.
Monday, September 22, 2008
The Truth of the Subject is the Truth of the Unconscious: Hysteria
The Truth of the Subject is the Truth of the Unconscious: Hysteria
For my first official blog I will simplify a quote from Dr. Eugenie Georgaca’s 1st excellent presentation on Lacan.
(Which you can find here - http://www.youtube.com/watch?v=Iy5lyRZSkPg)
Lacan can often appear overly difficult and enigmatic, but if one understands Lacan then one also understands Freud; Freud’s theory is very much elucidated by Lacan’s unique conceptualizations and writing. For now, however, we will focus on Freud in order to give credence to Lacan’s claim about the unconscious.
I will begin by discussing Dr. Georgaca’s first claim: the truth of the subject is the truth of the unconscious (subject, i.e. – the patient). This may sound enigmatic and a bit “out there” at first sight, but I will demonstrate how reasonable this claim actually is.
Let us apply this claim about the unconscious to a form of psychopathology: hysteria (aka conversion disorder). For those of you who are not familiar with hysteria, please see Freud and Breuer’s Studies on Hysteria (or search for hysteria or conversion disorder on Google). Hysteria is a type of psychological disorder in which a person will show a peculiar physical symptom which persists without having a physical, organic basis. Hysterical symptoms commonly include paralysis of the hands, temporary blindness, deafness/ringing in one’s ear, a horse voice/inability to speak, etc… So what causes hysterical symptoms?
Repression is the root-cause of all hysterical symptoms. When we (our “ego”) experience an event, memory, or idea as traumatic/distressing, this event is often “pushed out” (i.e., repressed) of our conscious awareness and enters an area of the mind known as “the unconscious.” All repressed memories are wholly unconscious, but they do not remain stagnant: they push for recognition and exert their force in the form of these, seemingly nonsensical, hysterical symptoms. Hysterical symptoms are what we refer to in psychoanalysis as “The return of the repressed.” Since the trauma cannot present itself directly (in the form of language, emotion, context, and meaning) due to its distressing and/or incomprehensible nature, it finds indirect pathways through which it can find an “energetic release” and/or “substitute satisfaction.”
For a great presentation on repression please see Mark Solm’s recent neuropsychoanalytic presentation entitled “What is Repression” - www.veoh.com/videos/v6319112tnjW7EJH (veoh accounts are free, and well worth it!)
In Studies on Hysteria Freud states, “Hysterics suffer mainly from reminisces” (p. 7). Basically, a particular event/memory continues to haunt these individuals, not in the direct form of memories and/or flashbacks, but in the indirect form of physical symptoms which symbolically represent the disagreeable/traumatic occurrence. For example, if one’s hand is hysterically paralyzed, then it may be due to touching something that one shouldn’t have touched perhaps; if one cannot see (hysterical blindness), then is there something one wishes to avoid seeing?
There are many other examples of hysterical symptoms such as these in the medical/psychological literature, but the point I want to make is that the origin of these symptoms is unconscious. The patient has no conscious awareness as to why he/she possesses the odd hysterical symptom, and in this sense there is no self-conscious knowledge that the patient possesses as to the true nature of his/her symptom. This proves Dr. Georgaca’s initial claim (which was both Freud and Lacan’s original claim): the truth of the subject is the truth of the unconscious.
Hysteria is not the only type of psychopathology with an underlying unconscious basis: obsessional neurosis, compromise formations, and various repetition-compulsions often include unconscious psychodynamic mechanisms.
So, how is hysteria treated? To answer this question let us return to this essay’s initial thesis: the truth of the subject is the truth of the unconscious. A hysterical symptom is the result of a repressed memory, idea, or wish. As such, the truth of a hysterical symptom’s nature lies in the unconscious, which can be thought of as the symptom’s “control room” from which it operates. This “truth” must be brought to light; the doctor must help the patient bring what is unconscious into consciousness; to bring the operator out of the underground control room and to the surface, to see the light of day.
This is achieved by the work of psychoanalysis, hypnosis, and/or psychodynamic psychotherapy. Here Freud’s original formula, to the best of my knowledge, still stands: the patient must be brought to remember the origin of the symptom (through psychoanalysis and/or hypnosis), to put it into words as much as he/she can (the process of symbolization, context, and meaning), to remember it as vividly as he/she can, and to experience the emotion which accompanies it (the event, memory, wish, etc).
Thus making the unconscious conscious, and, as stated by Freud, “Where Id was, ego shall be.” This general formula is how the hysteric can be helped to eliminate the hysterical symptom.
Note: For a recent neurological explanation of hysteria, please see V.S Ramachandran’s lecture series “The Emerging Mind: Part 5 - Neuroscience, the new philosophy”
For my first official blog I will simplify a quote from Dr. Eugenie Georgaca’s 1st excellent presentation on Lacan.
(Which you can find here - http://www.youtube.com/watch?v=Iy5lyRZSkPg)
Lacan can often appear overly difficult and enigmatic, but if one understands Lacan then one also understands Freud; Freud’s theory is very much elucidated by Lacan’s unique conceptualizations and writing. For now, however, we will focus on Freud in order to give credence to Lacan’s claim about the unconscious.
I will begin by discussing Dr. Georgaca’s first claim: the truth of the subject is the truth of the unconscious (subject, i.e. – the patient). This may sound enigmatic and a bit “out there” at first sight, but I will demonstrate how reasonable this claim actually is.
Let us apply this claim about the unconscious to a form of psychopathology: hysteria (aka conversion disorder). For those of you who are not familiar with hysteria, please see Freud and Breuer’s Studies on Hysteria (or search for hysteria or conversion disorder on Google). Hysteria is a type of psychological disorder in which a person will show a peculiar physical symptom which persists without having a physical, organic basis. Hysterical symptoms commonly include paralysis of the hands, temporary blindness, deafness/ringing in one’s ear, a horse voice/inability to speak, etc… So what causes hysterical symptoms?
Repression is the root-cause of all hysterical symptoms. When we (our “ego”) experience an event, memory, or idea as traumatic/distressing, this event is often “pushed out” (i.e., repressed) of our conscious awareness and enters an area of the mind known as “the unconscious.” All repressed memories are wholly unconscious, but they do not remain stagnant: they push for recognition and exert their force in the form of these, seemingly nonsensical, hysterical symptoms. Hysterical symptoms are what we refer to in psychoanalysis as “The return of the repressed.” Since the trauma cannot present itself directly (in the form of language, emotion, context, and meaning) due to its distressing and/or incomprehensible nature, it finds indirect pathways through which it can find an “energetic release” and/or “substitute satisfaction.”
For a great presentation on repression please see Mark Solm’s recent neuropsychoanalytic presentation entitled “What is Repression” - www.veoh.com/videos/v6319112tnjW7EJH (veoh accounts are free, and well worth it!)
In Studies on Hysteria Freud states, “Hysterics suffer mainly from reminisces” (p. 7). Basically, a particular event/memory continues to haunt these individuals, not in the direct form of memories and/or flashbacks, but in the indirect form of physical symptoms which symbolically represent the disagreeable/traumatic occurrence. For example, if one’s hand is hysterically paralyzed, then it may be due to touching something that one shouldn’t have touched perhaps; if one cannot see (hysterical blindness), then is there something one wishes to avoid seeing?
There are many other examples of hysterical symptoms such as these in the medical/psychological literature, but the point I want to make is that the origin of these symptoms is unconscious. The patient has no conscious awareness as to why he/she possesses the odd hysterical symptom, and in this sense there is no self-conscious knowledge that the patient possesses as to the true nature of his/her symptom. This proves Dr. Georgaca’s initial claim (which was both Freud and Lacan’s original claim): the truth of the subject is the truth of the unconscious.
Hysteria is not the only type of psychopathology with an underlying unconscious basis: obsessional neurosis, compromise formations, and various repetition-compulsions often include unconscious psychodynamic mechanisms.
So, how is hysteria treated? To answer this question let us return to this essay’s initial thesis: the truth of the subject is the truth of the unconscious. A hysterical symptom is the result of a repressed memory, idea, or wish. As such, the truth of a hysterical symptom’s nature lies in the unconscious, which can be thought of as the symptom’s “control room” from which it operates. This “truth” must be brought to light; the doctor must help the patient bring what is unconscious into consciousness; to bring the operator out of the underground control room and to the surface, to see the light of day.
This is achieved by the work of psychoanalysis, hypnosis, and/or psychodynamic psychotherapy. Here Freud’s original formula, to the best of my knowledge, still stands: the patient must be brought to remember the origin of the symptom (through psychoanalysis and/or hypnosis), to put it into words as much as he/she can (the process of symbolization, context, and meaning), to remember it as vividly as he/she can, and to experience the emotion which accompanies it (the event, memory, wish, etc).
Thus making the unconscious conscious, and, as stated by Freud, “Where Id was, ego shall be.” This general formula is how the hysteric can be helped to eliminate the hysterical symptom.
Note: For a recent neurological explanation of hysteria, please see V.S Ramachandran’s lecture series “The Emerging Mind: Part 5 - Neuroscience, the new philosophy”
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