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And The Brain
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.
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).
(1893) 'Some Points for a Comparative Study of Organic and
Hysterical Motor Paralyses'. Standard Edition, 1: 160-172.
(1995) 'Is the Brain more Real than the Mind?'. Psychoanalytic
Psychotherapy, 9: 107-120.
© 2000 British Psychoanalytical Society & Institute of