Psychoanalysis, Neuroscience and Adolescent Development

Non-Linear Perspectives on the Regulation of the Self

Harold K. Bendicsen

• Publisher: Routledge
• Year: 2019
• Print ISBN: 9780367134945
• eBook ISBN: 9780429648939
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

Psychoanalysis, Neuroscience and Adolescent Development: Non-Linear Perspectives on the Regulation of the Self explores how psychoanalysis can combine its theoretical perspectives with more recent discoveries about neurological and non-linear developmental processes that unfold during the period of puberty to young adulthood, to help inform understanding of contemporary adolescent behaviours and mental health issues.

With the powerful impact of neuroscience research findings, opportunities emerge to create a new paradigm to attempt to organize specific psychoanalytic theories. Neurobiological regulation offers such an opportunity. By combining elements of domains of compatible knowledge into a flexible explanatory synergy, the potential for an intellectually satisfying theoretical framework can be created. In this work, Harold Bendicsen formulates a multi-disciplinary theoretical approach involving current research and drawing on neuroscience to consider the behaviour regulation processes of the mind/brain and the capacities and potential it brings to understanding the development of adolescents and young adults.

Psychoanalysis, Neuroscience and Adolescent Development advances Bendicsen's study of adolescence and the transition to young adulthood, begun in The Transformational Self. It will be of great interest to psychoanalysts and psychoanalytic psychotherapists, as well as psychologists, clinical social workers, psychiatrists and counsellors.

1

The succession of psychoanalytic theories from drive theory to neuropsychoanalysis¹

The ever shifting state of our theorizing

The 125-year history of the psychoanalytic movement is littered with the record of schisms, a testament to its inability to accommodate emerging theoretical positions. It is so much a part of psychoanalytic history that it has become a distinguishing feature of its core nature. In this fertile area of potential cross-fertilization of ideas, the journey is not infrequently through or around unfriendly, even hostile, camps of differing opinion. What accounts for this theoretical balkanization? Is it because of the powerful personal investments in our ideational creations that understands contrary opinions as a diminishment of our narcissistic creativity (Kohut, 1966), which is too painful to tolerate? Surely, in the exchange of ideas, this state of affairs is seen in virtually all walks of life. But why should this be so endemic in psychoanalysis?

Goldberg (2013), in discussing the diversity and pluralism of psychoanalytic theorizing, has framed the issue in unambiguous terminology.

One paper stands out in my mind as especially incomprehensible because of a variety of symbols and words that seems almost to resemble a secret code. A colleague explained to me the particular theory that these symbols represented, and essentially the theory made good sense, once an effective translation could be accomplished. No doubt the author of this particular paper felt that he or she was writing to like-minded members of his or her group and so gave little mind to those of us who might fall outside of such membership. When Freud wrote about the “narcissism of minor differences,” he indicated that groups were bound close together and so were able to keep other groups at bay by these allegiances, which were fueled by aggressive impulses (Freud, 1910, p. 199). A good deal of anger and irritation is often felt in reading of clinical cases or non-clinical papers which pursue a vocabulary of terms which are idiosyncratic and may seem to exclude a subset of aliens. Thus Freud’s explanation seems quite correct.

(Goldberg, 2013, p. 1)

The tendency to form exclusive secret theoretical clubs runs the risk of further polarizing and fragmenting the greater psychoanalytic community, not to mention the academic community. “Our diverse schools of psychoanalysis are more devoted to defending borders than to an open exchange of information” (p. 12). Optimistically, envisioning the possibility of an evolving collaborative process, Goldberg concludes, “Once we appreciate the value of other analytic efforts, we may be able to establish and utilize a common vocabulary as well as a common vision of effectiveness” (p. 12).

Goldberg’s sentiments are echoed by Barratt (2013) who uses the term “theoretical bedlam” to characterize the intense psychoanalytic theoretical fragmentation.

Indeed, the history of the psychoanalytic movement through the 20th century provides an appalling spectacle of in-groups and tightly knit clubs fighting with each other, of internecine rivalries, backbiting, and name-calling that is only thinly veiled in professional courtesy, of rampant authoritarianism, of politically motivated expulsions and the formation of counter-organizations, and thus of proliferative organizational splitting.

(In O’Loughlin, 2016, p. 5)

Over twenty years ago, P. Tyson et al. had already taken the argument further in reflecting on expansionist tendencies:

The point here is simply that each contending theoretical perspective in psychoanalysis, however narrowly defined its original base of inquiry and intervention within the domain of psychoanalytic application, is soon broadened to become a proclaimed superior metapsychology and intervention system for all those whose mental and emotional distress bring them within the psychoanalytic professional orbit.

(Tyson, Tyson and Wallerstein, 1990, p. x)

Cooper (2008), reflecting on the entrenched “plurality of authoritarian orthodoxies” (p. 250), wrote, “Among many psychoanalysts an innovative idea is more likely to be regarded as an assault rather than an interesting opportunity” (p. 241). In addition,

Our aesthetics is important in determining how we think analytically. Some of us are more interested in storytelling – a hermeneutic view; some of us are more interested in archaeology – reconstructing the past; some of us are more interested in architecture – providing a structure to human life. Our aesthetic preferences – our ‘taste’ and sensibilities – are very difficult to change, even in the face of “facts”.

(p. 250)

Hinshelwood (2013) echoes these positions. “Psychoanalytic schools narcissistically guard the group’s knowledge and set it against others with a hostility approaching siege mentality. This leads to further retreat into our separate groups, each marked by its conceptual convictions” (p. 8). So the more our theories proliferate, the more isolationist our theoretical camps, with their different thought styles, seem to become. It is hoped that regulation theory, with its emphasis on a set of multidisciplinary, interlocking theories, can offer an opportunity to build flexible bridges among these fixed conceptual positions.

As adherents of particular theories lay claim to possessing the truth, how do we know what truth is in psychoanalysis? Hanly (1990, in Cooper 2008) suggests that two ways of assessing truth are possible and described correspondence and coherence theories of truth.

Correspondence assumes that an assertion is true if it accurately describes something that is actually “out there.” Coherence assumes that a statement is as close as we can get to truth if it fits within a general scheme of how one sees the world.

(p. 245)

I will advance my regulatory hypothesis using a coherence position argument in this monologue.

As a heuristic device, allow me to compare and contrast the “hard” v the “soft” sciences. If psychoanalytic theorizing is fragmented, it seems to be less the case in scientific fields, the so-called “hard sciences,” such as physics, chemistry and biology. In those endeavors theory building (i.e., theory that is settled and accepted) rests on the accumulation and deepening of data in a progressive, collaborative way. Investigations proceed by building on the concepts and findings of previous theory and research. A sharper boundary exists between the explanatory systems and empirical phenomena. A physical theory, for example, need only account for physical phenomena without obligation to account for competing theories. Sensitivity to the history of previous discoveries is keen (Palombo, 1991). However, such a sharp division is not always the case as we see in the discovery of quantum mechanics where theoretical disagreements and arguments consumed enormous personal energy on the part of the adherents (Cassidy, 1992, pp. 226–246).

In so-called “soft sciences,” such as anthropology, sociology, personality psychology, research is carried on in limited domains without much attention paid to competing theories. Consequently, personality psychology is largely a non-cumulative affair (Palombo, 1991 in Bendicsen, 2013). In the absence of a grand unifying theory, a Weltanschauung (Freud, 1933, p. 158), to borrow a term characterizing Freud’s intellectual quest, competing personality theories abound with their hypotheses assuming the certitude of religious dogma. Assuming Palombo’s dichotomy is essentially correct, does the psychoanalytic enterprise not thrive on collaborative theory building because its foundation in biology is too tentative and, consequently, it inherently fits better into the category of the “soft sciences?” I am reminded (in personal communications with J. Colby Martin on September 8, 2013 and William Gieseke on October 7, 2013) that it is a fallacy of reductionism to believe that the study of the nature of human experience, the domain of psychoanalysis, can be made more “real” by attaching it to the biological sciences. As has been often observed, many detractors of psychoanalysis consider psychoanalysis to have more in common with religion than science. Jung, perhaps Freud’s most significant detractor, on his 1909 visit to the United States in an apparently off-hand comment, took such a position. Disputing Freud’s claim that psychoanalysis should be considered among the sciences, Jung said, “Psychoanalysis is not a science but a religion” (Gay, 1988, p. 239).

Drive theory and beyond

Drive theory developed out of Freud’s frustrated attempt to fashion a new psychology based on the evolving understanding of the organization of the nervous system, the exciting discovery of the neuron and the designation of this brain cell by the name of “neuron,” all by 1891 (Freud, 1895). By 1897 the Neuron Doctrine with four tenets had been formulated: 1) the neuron is the fundamental structure and functional unit of the nervous system; 2) neurons are discreet cells which are not continuous with other cells; 3) the neuron is composed of three parts – the dendrites, axon and cell body; 4) information flows along the neuron in one direction (from the dendrites to the axon via the cell body) (Costandi, 2006, p. 18).

A confluence of formative experiences in the 1880s, when Freud was in his 30s, fostered a creative synergy which led Freud to move away from laboratory research in neurophysiology to the office practice of neurology. Freud’s study of hypnosis with Jean Martin Charcot in Paris in 1885–1886 at the Salpetriere led Freud to abandon the German method of Continental neurology in which the anatomical and physiological parts of the clinico-anatomical equation were stressed. “Clinical material served the secondary purpose of demonstrating and confirming existing anatomical and physiological theory” (Kaplan-Solms and Solms, 2002, p. 11). After Broca’s and Wernicke’s seminal discoveries in the aphasias during the 1860s and 1870s the race was on to discover and identify localization of other mental functions, normal and abnormal. Broca pinpointed the function of expressive language in the left hemisphere at the junction of the parietal and temporal lobes and Wernicke located the function of receptive language in the left hemisphere in the temporal lobe.

In the French school of Continental neurology, the emphasis fell upon the clinical side of the equation. The aim was to develop correlations between external manifestations and signs and the interior of the disease process. This was the origin of the concept of clinical syndromes. Freud became expert on the clinico-anatomical method but grew to feel its limitations and that the future of neurology lay in expanding the potential of the clinical part of the equation.

With Freud’s return from Paris his interest began to shift from the localization of functions in the anatomical study of the aphasias to the non-localization of functions in the clinical psychological study of the neuroses (using hypnosis), especially hysteria and neurasthenia. Over the next decade Freud, still a neurologist, expanded his work on the aphasias (Freud, 1891) to include the neuroses (Freud and Breuer, 1895). While the German and French schools of neurology generally complemented each other well in the study of the aphasias, a divide appeared in the study of the neuroses. The French school was less interested in explaining the clinical pictures on the basis of existing theory. Rather its emphasis lay in identifying, classifying and describing them; so French neurology was first and foremost a nosology in the broadest sense of classifying diseases (Kaplan-Solms and Solms, 2002, p. 12). Freud made two groundbreaking observations linking the aphasias and the neuroses with the non-localization of functions. First, “psychological faculties break down according to the logic of their own functional laws, not according to the laws of cerebral anatomy.” And second, “psychological functions are never destroyed, by localized brain lesions … Rather, they are distorted and changed in dynamic ways that reflect a mutual interdependence with other faculties” (p. 17). Here we see the seeds of a formative metapsychology, the underpinning to later psychoanalytic thinking.

In addition to the discovery of neurons and Freud’s shift to French neurology, a third factor that contributed to the formation of drive theory were the close collaborations with Wilhelm Fliess, a Berlin physician, during the years from 1887 to about 1900 and a parallel collaboration with Josef Breuer, a fatherly mentor, physician and co-author of Studies on Hysteria (1895d), which lasted from 1887 to about 1898. (See Palombo, Bendicsen and Koch, pp. 6–7 for details and perspectives on these significant partnerships.) Freud drew on each working friendship to produce conceptual yields which formed the underpinnings to drive theory. From the work with Fliess, Freud clarified his thinking on the ideas of “reality testing, the formal distinction between primary and secondary processes, and the wish fulfillment of dreams” (Preface to the “Project for a Scientific Psychology” in the Standard Edition, Vol. I, p. 284 and Palombo, Bendicsen and Koch, p. 5). From the work with Breuer, Freud developed the ideas of free association, resistance, repression, symptom formation, conversion, transference, countertransference, symbolic content and unconscious conflict (Berzoff, Flanagan and Hertz, 2008, p. 27). These concepts formed Freud’s well-known metapsychological framework: the economic hypothesis (1895), the topographical hypothesis (1895), the dynamic hypothesis (1895) and the genetic (or psychosexual) hypothesis (1905). These four hypotheses became the foundation of drive theory. The term drive, for example, the libidinal drive, refers to the psychological manifestation of a biological instinct. Drive theory became the wellspring for all the variations of psychoanalytic theory to follow. From this point forward all subsequent psychologies that lay claim to being psychoanalytic have at their base, to one degree or another, an abiding belief in the dynamic unconscious, developmental model thinking and transference and countertransference. (See either the Palombo, Bendicsen and Koch, pp. 1–45, or the Berzoff, Flanagan and Hertz, 2008, pp. 17–47 sources for a further elaboration of drive theory.)

While Freud’s collaboration with Breuer (Studies on Hysteria, 1895) produced an immediate and intense interest in the subject of psychoanalysis, the more removed collaboration with Fliess (Project for a Scientific Psychology, 1895) had to wait until 1954 and the English translation for the discipline of dynamic neuropsychology to become reinvigorated. It is known that Freud wrote a large section of his Project for a Scientific Psychology (1895) and sent it unfinished to Fliess for review. Essentially, Freud could not align his main problem, that of psychological repression, with the primitive neuron theory of his day (Sulloway, 1979, pp. 123–130). Freud then asked Fliess to destroy it, which Fliess fortunately did not.

To sum up this section,

Freud carried over from neurology into psychology a basic method – namely the clinical-descriptive method of Charcot (or the method of syndrome analysis, as it later came to be known) – and a basic conceptualization of (functional, author’s insertion) mind-brain relationships – namely the anti-localization or dynamic conceptualization – which gives pride of place to psychological methods of analyzing psychological syndromes regardless of whether or not they have an organic etiology.

(Kaplan-Solms and Solms, 2002, p. 25)

In much briefer fashion I now turn to an enumeration of the record of post drive theory varieties of psychoanalytic theorizing.

Psychoanalytic theoretical insularity may be said to have begun with Freud’s bitter experience with the t...

Table of contents

• Cover
• Half Title
• Title
• Copyright
• Dedication
• CONTENTS
• Preface
• Acknowledgements
• Introduction
• 1 The succession of psychoanalytic theories from drive theory to neuropsychoanalysis
• 2 Regulation theoryToward a new paradigm
• 3 Case example
• 4 Alternative developmental model thinking
• 5 Case formulation from a regulation theory perspective
• 6 Desideratafurther thoughts on case formulations
• 7 Treatment efficacy
• 8 Some thoughts on the adolescent passage, emerging adults and millennials
• 9 Synopsis
• Appendix I: Critical thinking mental health decision-making flow chart
• Appendix II: Theories of alcoholism
• References
• Index