The PANY Bulletin

Psychoanalytic Association of New York
Volume 39, Number 2 Summer 2001

Neuro-Psychoanalytic Research
by Lawrence Kunstadt, Ph. D.

Psychoanalysis is very good at generating hypotheses but not too good at testing them experimentally. Psychoanalysis is especially not very good at testing its tenets against competing hypotheses. This is because the methodology of psychoanalysis does not allow controlled conditions or quantitatively varying stimuli and each analysis is unique, not repeatable and not public.

In an attempt to formulate research strategies that can address psychoanalytic tenets and attempt to integrate neurobiology and psychoanalysis, a group of about two dozen neurobiologists and psychoanalysts met at the New York Psychoanalytic Institute on May 1st and 2nd to discuss both theoretical issues and actual research programs. The meeting was sponsored by The Psychoanalytic Research Fund and the Arnold Pfeffer Center for Neuro-Psychoanalysis at The New York Psychoanalytic Institute.

The theoretical discussion was a free-flowing, open-ended disputation about what is feasible, what makes sense, what such research can accomplish and what research strategies are valid. In addition, there was discussion about the social issues: antagonism between the two fields, the misunderstanding of each other's concepts, the lack of an integrated culture, the vast difference in methodologies and so on.

Jaak Panksepp started out by saying that psychoanalysis cannot progress until it takes Darwin seriously. He said that based on his experience one aspect of the human mind is that it spontaneously generates hypotheses about why things occur. Freud was great at generating hypotheses but analysis has not responded to neurobiology's criticism that these hypotheses should be tested. One thing psychoanalysis must develop is new methods of research, especially methods that can cut through complexity and that can realize general principles from psychoanalysis' study of individuals. One possibility for integration, he suggested, is that all mammals share certain mind/brain principles which can serve as a common understanding for both fields.

Panksepp further suggested that neuro-psychoanalytic researchers should tag on to neurosurgical teams and look for affective and other mental changes during therapeutic stimulation of the brain, something that is not generally being done. Using this technique, it is not even desirable to first generate hypotheses: just see what happens without necessarily having to explain it.

Mark Solms responded by asking what constitutes psychoanalytic research as opposed to other types of psychological research.

Mortimer Ostow said one of the major problems is that psychoanalysts and neurobiologists do not even have a common vocabulary. How can we validate psychoanalytic concepts neurobiologically? The two approaches that have worked are those of Mark Solms and Jaak Panksepp. A way to reconcile the two fields is to pay more attention to theory, such as taxonomies of affect rather than 'affect' as a byproduct of the brain or by relating drive theory to instinct theory. We have to develop both a vocabulary and a theory that both fields can accept.

Solms pointed out that the International Neuro-Psychoanalysis Society has already set out to create a dictionary or some sort of compendium of vocabulary that can be used by both neuroscientists and psychoanalysts.

Peter Neubauer said we should choose between creating new research and finding existing research that can be elaborated by having someone from the other field join the team. We need to spend time with each other (neuroscientists and analysts) in order to not just define concepts but to really understand what each field means by the concept. This, he reminded us, takes time and open dialogue.

As an analyst, he asked, what is the rock bottom idea underlying his beliefs? It is that if you bring something into consciousness, it really makes a difference. This simple principle can be elaborated greatly. Can it be brought into the sphere of neurobiologists' interest and studied by both?

Another participant asked whether we are talking about normal or diseased brains. Solms responded that there are two approaches: the therapeutic, which aims at helping the patient medically, and the scientific, which tags along to discover principles about the phenomena under study. There is no schism between studying normal and diseased brains.

Peter Neubauer said we should distinguish between different levels of abstractions and hypotheses; some are closer and some are further from clinical observations. Those based on direct clinical observation lend themselves better to the interplay with neuroscience.

Solms raised the question, what is the purpose of neuro-psychoanalytic research? To test psychoanalytic hypotheses in order to understand analytic theory better as analysts? To prove psychoanalytic hypotheses in order to gain credibility in the non-analytic community? To offer neuroscience a set of guiding theories? To bring the complexity of the mind to neuroscience?

Panksepp responded that the complexity of the human mind makes it a poor candidate for study by neuroscience. Any science can only bite off a small bit of a phenomenon at a time. Cognitive neuroscience has not been able to deal with the complexity of the human mind. He reminded us of Fodor's book, The Mind Doesn't Work That Way, which is a response to Pinker's book, How the Mind Works. In his book Fodor acknowledges that his modularity theory does not work and that cognitive science has not progressed much over the past four decades.

Solms says he agrees with Panksepp that neuroscience can help psychoanalysis shed dead wood in its own theories. However, he went on, neuroscience needs to loosen up and acknowledge and take account of the real messiness of mental life. Psychoanalysis has traditionally attempted to grapple with this and this is one of its strength. Solms' method is to take something narrow and concrete, a brain lesion, and look at the patient's mind the way a psychoanalyst would, using ordinary psychoanalytic methods which capture to a greater extent than any science the richness of what is going on in the patient's mind. This method shows that the neuroscientific explanations are wrong and forces neuroscience to take account of his results.

Oliver Turnbull pointed out that while Solms' method has found neuroscientific theories to be lacking, his work is still perceived as psychoanalytic and is not accepted by neuroscientists. His own (Turnbull's) work is devoted to using methods already accepted by neuroscientists to study psychoanalytic phenomena.

Panksepp said cognitive neuroscientists desperately need psychoanalysts because within cognitive neuroscience, with a few exceptions, there is virtually no agreement about anything. Cognitive psychology has failed on primary principles: the brain is not a computer. This is why evolutionary psychology is so important, but this field falters because it ignores neuroscience.

Howard Schlossman said that we (analysts and neuroscientists) haven't talked to each other for years, and there is a historical chasm that must be overcome. For years psychoanalysis looked disfavorably upon outsiders while natural scientists criticized analysis for being untestable and unscientific. Years ago there were attempts by analysts to "scientificize" analysis by taping sessions but this ran into the problem that it distorted the transference. The problem is attitudinal. Perhaps rather than broadening our research we should choose a narrow research problem the study of which will convince neuroscientists that analysis is legitimate.

Another participant said that the killer idea will not work. We need to jump into research and over decades we will be able to integrate the work and make it mean something.

Peter Neubauer pointed out that we should define the limitations of analysis and ask neuroscientists for help at the borders of analysis. Why can't analysis cure addictions? Why can't it cure alcoholism?

Marianne Leuzinger-Bohleber said we must account for different traditions. For instance, in Switzerland there is a forty-year tradition of cognitive science and now analysts are turning to robots. Perhaps a comparative approach will lead to problems all fields can address with mutual recognition. In Germany, neuroscientists and psychoanalysts are talking with philosophers about topics of mutual interest.

A participant said there are ethical issues about using "volunteers" as subjects or telling people what experiments they should perform. We should go back to the early debate between Wundt and Charcot. Wundt thought the best experimental subject was the medical student, Charcot the sick patient. We should go around to analytic institutes and ask analysts, who presumably have been analyzed and are relatively free of neurotic transferences, to be experimental subjects. These analysts should also be able to help us understand the phenomena we are studying, even if they are the subjects.

Panksepp noted that most subjects for experimental psychology are freshmen whose main motivation is to get out of the experimental situation. Subjects for analytic research should be interested in the research.

Ed Nersessian said it should not be difficult to research certain hypotheses i.e. one emotion can block another emotion, or that when a memory is distorted the distortion itself is meaningful, or that alterations in dreams that are remembered serve to maintain a lower level of anxiety than would otherwise be expected. He said he does not know why it should be difficult to research these hypotheses. Panksepp said the way to decide whether or not these are difficult experiments is to do them, or at least to plan them. Some debate followed on how much to simplify notions in order to test them.

Todd Sacktor compared psychoanalysis to evolutionary theory, which is also not experimental but which has become incredibly successful. The theory itself was accepted for decades before its genetic basis was understood. But ultimately it captured all of biology only after Mendel's theory was incorporated half a century later, and it became totally accepted a century after Darwin when the molecular basis of genes became understood. So, he concluded, don't worry so much about these theoretical issues.

A philosophical and historical discussion then ensued about the relation between neuroscience and psychoanalysis. A description would take several pages. The discussion went on for hours. Yours truly made some comments that are too pessimistic to put into print.

The following day several researchers from Europe and the US came to present their research strategies. Mortimer Ostow, representing the Psychoanalytic Research Fund, opened the meeting with a wide- ranging presentation of what meaningful research strategies could accomplish. His own work, beginning decades ago, has focused on the use of psychotropic medications in psychoanalytic patients. Among other original ideas he has proposed is the idea that dreams can be used to monitor the efficacy of these medications.

Mark Solms discussed his work, which involves psychoanalytically oriented treatment of patients with focal brain damage resulting primarily from strokes. He has demonstrated how such treatment can also be used as a research paradigm. He has found that brain damage to different areas results in specific effects to not just cognitive function but to mental structures as conceived psychoanalytically.

Ziad Nahas of the University of South Carolina Medical School described his work using transcranial magnetic stimulation to transiently stimulate parts of the brain. In this new technique an electromagnetic coil is placed against the subject's scalp. The coil sends a magnetic pulse through the skull that depolarizes cortical neurons. Nahas's work involves localizing and describing brain mechanisms of unconscious motivation. Using this technique you can selectively stimulate or inhibit small parts of the brain.

Robert Scharf of the New York Psychoanalytic Institute, who has been leading a study group on neuroimaging techniques, proposed a study to measure the brain correlates of psychoanalytic therapy in panic states.

David Pincus of Cleveland described the use of a very thin microelectrode in deep brain stimulation. His technique involves the penetration of limbic areas involved for therapeutic purposes. While intervening therapeutically, this deep placement allows him to study the correlates of affective states. For instance, while a neurosurgeon stimulates the subthalamic nucleus in a Parkinsonian patient, he can also look for the affective changes caused by stimulation of this nucleus.

Oliver Turnbull of the University of Wales described his work on affective changes after brain lesions.

Marianne Leuzinger-Bohleber of the Psychoanalytic Institute in Frankfurt described her functional MRI study of dreaming during sleep.

Following is a list of participants. The above column was based on audiotapes. I apologize to those whose voices I could not identify and the people whose comments were omitted.

Committee of International Neuro-Psychoanalysis Society: Mark Solms (London, Co-Chair), Gyuri Fodor (Vienna, Co-Treasurer), Jaak Panksepp (Bowling Green, OH, Co-Chair), Irene Matthis (Stockholm, Regional Co-Ordinator), Oliver Turnbull (Bangor, UK, Secretary).

Invited guests:
Marianne Leuzinger-Bohleber (Frankfurt), Richard Brockman (NY), Judith Feher-Guwerich (Boston), Brian Johnston (Boston), Marcia Kaplan (Cincinnati), Lawrence Kunstadt (NY), Edward Nersessian (NY), Peter Neubauer (NY), David Olds (NY), Mortimer Ostow (NY), Howard Schlossman (NY), Todd Sacktor (NY), Robert Scharf (NY), Roger Tabakin (London), Paul Verhage (Ghent), Yoram Yovell (Jerusalem).