BPAS - Mark Solms: Psychoanalysis and the Brain

Psychoanalysis emerged 100 years ago as a treatment for the neuroses. Neuroses were defined as 'functional' disorders of the nervous system, in which no perceptible abnormality could be found in the brain. The prevailing view (held by Freud's teacher, Charcot, for example) was that the physical causes of neurotic illness would yield eventually to advances in scientific technology.
Freud, however, based psychoanalysis on the observation that neurotic symptoms violated the established laws of functional anatomy; neurotic symptoms simply did not make sense from the physical viewpoint. By contrast, when one took seriously the personal viewpoint of the patient, and reconstructed the emotional history of the illness, then the symptoms did make sense. For example, although the abnormal sensation on one side of an hysterical patient's face did not conform to somatosensory neuroanatomy (and therefore could not be attributed to imperceptible anatomical changes), it did make sense subjectively: the symptoms first appeared when the patient was slapped in the face under humiliating circumstances, for reasons about which she still felt intense guilt and shame. In short, Freud observed that the essential nature of neurotic symptoms needed to be described in subjective (psychological) terms,- using concepts like remembering and feeling rather than objective (anatomical) ones.
Of course Freud recognised that all subjective events must somehow exist also in a physiological form. It should be possible in principle to identify processes in the brain which correspond (for example) to emotionally charged memories of the type described above. However, things like personal memories and the feelings attached to them are only perceptible as such from the viewpoint of subjective awareness. They cannot be perceived objectively; they cease to exist as memories and feelings when they are approached from an external (material) point of view. A memory of being slapped in the face literally disappears when it is studied through the anatomist's microscope. One can never find a subjective experience inside the tissues of the brain.
On this basis,- although psychoanalysts have always acknowledged that subjective experiences cab be represented as physiological processes,- they have focused instead on the experiences themselves, which exist only subjectively. Successive generations of psychoanalysts have sought to understand the internal construction of subjectivity, using methods that provide the closest possible access to it. This has given rise to a rich literature describing the essential processes not only of hysteria and the other classical neuroses, but also (subsequently) of normal mental functioning on the one hand and of more serious forms of mental illness on the other.
Today neuroscientists are able to access mental functions by way of their physical correlates far more readily than was possible 100 years ago. Most important from a practical standpoint has been the development of new, chemical forms of treatment. It is not surprising that these treatments are more effective in respect of gross functional parameters (with relatively simple physiological correlates) than with the more complex, individualised parameters that weave the fabric of a specific personality.
These developments frequently are construed as being incompatible with or damaging to psychoanalysis. However, if we are now at the threshold of an era in which the understanding that we have gained of mental suffering from the perspective of its inner workings can be correlated systematically with a detailed understanding of its external, physiological correlates, then psychoanalysis has as much to gain as anyone else. But correlation is not reduction. The subject matter of psychoanalysis continues to exist as such, alongside its physical correlates. Accordingly, psychoanalysts must continue to study and treat subjective experience in the form that it actually exists, using methods that are best suited to observation and interaction with it. This remains their unique contribution to the advancement of knowledge and the reduction of human suffering. It is also their contribution to neuroscience.

The Author
Mark Solms is a psychoanalyst and an Honorary Lecturer in Neurosurgery at the St. Bartholomew's and Royal London School of Medicine. His publications include A moment of Transition: Two Neuroscientific Articles by Sigmund Freud (Karnac 1990) and The Neuropsychology of Dreams: A Clinico-Anatomical Study. (Lawrence Erlbaum Associates, 1997).

Further Reading
Freud, S. (1893) 'Some Points for a Comparative Study of Organic and Hysterical Motor Paralyses'. Standard Edition, 1: 160-172.

Solms,M. (1995) 'Is the Brain more Real than the Mind?'. Psychoanalytic Psychotherapy, 9: 107-120.