Finding the Body in the Mind

Embodied Memories, Trauma, and Depression

Marianne Leuzinger-Bohleber

• Publisher: Routledge
• Year: 2018
• Print ISBN: 9781782202097
• eBook ISBN: 9780429913785
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

Since the 1990s many different scientific disciplines have intensified their interest in the so called 'mind-body-problem': psychoanalysis, philosophy, academic psychology, cognitive science and modern neuroscience. The conceptualization of how the mind works has changed completely, and this has profound implications for clinical psychoanalytical practice as well as for theorizing in contemporary psychoanalysis. The question of how unconscious fantasies and conflicts, as well as traumatic experiences, can be understood and worked through is, and has been, one of the central topics of psychoanalysis. Interdisciplinary studies from the fields of embodied cognitive science, epigenetics, and cognitive neuroscience offer challenging explanations of the functions in the analysts mind which might allow him to create spontaneous associations through which he unconsciously 'understands' the traumatic, embodied experiences of the patient.

Chapter One
Psychoanalysis as a “science of the unconscious” and its dialogue with the neurosciences and embodied cognitive science: some historical and epistemological remarks

As you know, we have never prided ourselves on the completeness and finality of our knowledge and capacity. We are just as ready now as we were earlier to admit the imperfections of our understanding, to learn new things and to alter our methods in any way that can improve them. (Freud, 1914g, p. 159)

Introduction

What kind of a science is psychoanalysis really? What did Freud mean when he defined psychoanalysis as a special “science of the unconscious”? As a young man Freud was very interested, as is known, in philosophy and in the humanities before he turned with a remarkably strong emotional reaction to the natural sciences. He worked at that time on research in medicine and neurology in the laboratory of Ernst Brücke’s Institute of Physiology, where he became acquainted with a strict positivistic understanding of science, that attracted him throughout his whole life. As we know, however, Freud later turned away from the neurology of his time since he recognised the boundaries of the methodological possibilities concerning research of the psyche in this discipline. With The Interpretation of Dreams, the founding work of psychoanalysis, he defined this as “pure psychology” (Grubrich-Simitis, 2009). He further understood himself, however, to be a physician who observed very precisely as a natural scientist. His wish of a precise, “empirical” examination of hypotheses and theories protected Freud, as Joel Whitebook (2010) notes, from his own predilection to wild speculation. Thus, Freud as a “philosophical physician” could establish a new “science of the unconscious”.

Concerning the history of the International Psychoanalytical Association (IPA), this understanding of psychoanalysis has been a key to its success. It is well known that Freud, even in 1909, considered integrating psychoanalysis into the medical organisation, “medical psychology and psychotherapy”, of August Forel, or even into the “Orden” (Order, a professional organisation) for ethics and culture. Fortunately, he decided during New Year’s Eve of 1910 to found his own, independent organisation, the IPA (see Falzeder, 2010). As a result of this decision, the independence of psychoanalysis as a scientific discipline with its own research methodology and institution was protected. Afterwards, Freud always emphasised that psychoanalysis did not deserve to be “swallowed by the medical faculty, but could instead as ‘the psychology of the unconscious’ (Tiefenpsychologie), the discipline of the unconscious, become indispensible to all sciences that have to do with the emergence of human culture and its great institutions as art, religion and social systems.” (Freud, 1926e, p. 247).

In the century of its history, the specificity of psychoanalytic science became more and more precise. Psychoanalysis developed a differentiated, independent method of research for the examination of its specific object of research, of unconscious conflicts and fantasies.

It has additionally, as all other current disciplines, its own criteria of quality and truth that it has to represent with transparency and self-confidence in scientific dialogue, in order, as with any science, to be criticised from outside. As will be discussed in this chapter, this conceptualisation of psychoanalysis as a scientific discipline has to be critically reflected in a fruitful dialogue with other contemporary scientific disciplines, particularly in the dialogue with contemporary neurosciences and embodied cognitive science.

In this introductory chapter I would like to present my view for discussion, that it is important for psychoanalysis in our current media-influenced “knowledge–society” to authentically present to the public in new forms that it has its own elaborated, empirical-clinical research and treatment methods, that connects it in countless studies with various forms of extra-clinical research, for example, empirical-quantitative, experimental but also interdisciplinary, socially critical research. I am starting with some remarks on psychoanalysis in the contemporary “knowledge–society” compared with some episodes during its 100 years of history, and then illustrate the specifics as well as the richness of contemporary psychoanalytical research (focusing on the situation in Germany, mostly referring to concrete research examples of ongoing projects at the Sigmund-Freud-Institute in Frankfurt and without being able to give a complete overview).

Psychoanalysis—a special scientific discipline in the politicised, commercialised, and media-influenced world of science, part of the “knowledge–society”

Western societies have used a large part of their resources in the last 300 years for the acquisition, expansion, and examination of their knowledge. The “industrial society” has changed to a “knowledge–society” in the last century. If psychoanalysis wants to remain in this world of science then it must realise the extreme changes in this field and to attempt to understand its influence on the reality of psychoanalytic research.

• a) The first component of the change in science has to do with differentiation. As Hermann von Helmholtz ascertained one hundred years ago, each single researcher is increasingly forced to dedicate himself to more and more specific methods with more and more narrow questions. For this reason the age of the universal geniuses belongs to the past: modern scientists are, for the most part, highly specialised experts with a limited knowledge about adjacent disciplines (Helmholtz, 1986, quoted by Weingart, 2002, 703). They are dependent upon networking on an international, intergenerational, and interdisciplinary level. In connection with this process of differentiation, also the criteria of “science” and “scientific truth” in the respective disciplines have changed and this is becoming also more specific, not only in the natural sciences but also in the humanities. The concept of a unified science, of “science”, relying on the experimental design, on the double-blind experiment in classical physics has proven to be a myth: we live in the times of the “plurality of science” (see also Hampe, 2003; Leuzinger-Bohleber & Bürgin, 2003).
• b) A second characteristic of these changes has to do with the relationship of science and society: modern scientific disciplines—and thus also psychoanalysis—are in permanent, accelerated, and globalised competition at different levels with one another. Thus, the practical relevance of its research results is permanently evaluated by society’s foundations and political interest groups, that, for example, increasingly gain influence over the financing of research projects. In this sense, science loses more and more of its self-determination. Science becomes politicised—politics more scientific.
• c) A third characteristic is connected with this. Because politics and society expect quicker results from science concerning recommendations for the solution of societal problems, less and less peace and quiet is left for basic research, from which relatively certain knowledge for practical application was derived. This leads to a paradox situation: on the one hand ever fewer “normal citizens” and politicians have confidence in their own judgment on complex issues without consulting scientists, but on the other hand it has become common knowledge that even scientific experts do not have “objective” truths, that so-called “scientific knowledge” is to be regarded critically. Moreover, it also carries new risks, as the catastrophes of Chernobyl, the BSE crisis, and now the financial crisis have suddenly shown. This leads to a new source of insecurity and diffuse fears. Which scientific expert is given the most confidence is dependent on his media-transmitted credibility, which now becomes a relevant factor in society that is competed for in politics and in public.
• d) A fourth factor is the role of the media. Scientific knowledge is usually taken note of, when it—correspondingly simple and dramatic but credible—finds its way into the media.

“It is paradox—the more independent science and the media are, the tighter their coupling. And as the media gain importance, science is losing the monopoly of judging scientific knowledge. The abstract criterion of truth is no longer sufficient in the public debate because the media add the criterion of public acceptance. This does not mean that scientific verification is being replaced, but it is being supplemented by other measures. … The loss of distance [between science and the media] will not lead to the end of communication of truths. Trust and confidence remain both constitutive and rare values in communication, and the more society depends on reliable knowledge, the more these are required. The main characterization of today’s society is the competition for trust. Once achieved, this is invaluable and science should be keen to preserve it. Therefore, it is only the efforts needed to produce trust and confidence that have become greater. (Weingart, 2002, p. 706, my emphasis)

Remarks to the one hundred year old history of research of psychoanalysis

What influence did and do the above mentioned changes have on psychoanalysis specifically? It is my opinion that psychoanalysis, as a science that relies on the intimacy of the psychoanalytic situation, is quite severely hit by the paradox and dilemma of these changes. As a science of the unconscious, it seems to me to be especially dependent upon if and how it is successful in gaining and keeping the confidence of the world of science, of the public, of politicians and funders, but also of potential patients, candidates in training, and the health system. In the last century the dominating zeitgeist has changed several times, as Bohleber (2010a) has discussed in respect to German psychoanalysis. This has, although seldom discussed, had its effect on the understanding of research of psychoanalysis and on its concrete research projects, its questions, designs, and goals. In this framework just a few remarks may be allowed.

Freud’s life-long hope that, due to the development of the modern natural sciences, the time would come in which the insights of psychoanalysis that have been won with pure psychological, clinical-empirical methods of observation, could be also “objectively” examined with the “hard” methods of natural science, seems to often become reality today through the dialogue with the modern neurosciences (see also the introduction to this volume). Forty years ago, however, it is known that Jürgen Habermas (1968) called this Freudian longing the “scientific misunderstanding” (Szientistisches Selbstmissverständnis) of psychoanalysis. He characterised psychoanalysis as following an emancipatory interest in insight, in contrast to behaviour therapy, that has a technical interest. This distinction met with a positive response from a whole generation, and psychoanalysis, of course, due to other factors, was at its zenith as it has never been before or since. Psychoanalysis experienced, on the whole, as a critical hermeneutic method of individual and social contradictions, of unconscious sources of psychic and psychosomatic suffering, an exclusive social acceptance in these years that at times verged on idealisation. Although there were always attacks and controversies, psychoanalysis as a method of treatment and as a critical theory of culture did not have to worry about its existence during this period.

The social acceptance of that time also formed the understanding of the science and research of psychoanalysis in those decades. Briefly summarised, in the 1970s and 1980s, beside the genuine clinical psychoanalytic research, this concerned above all hermeneutic–oriented and social psychological approaches, analysis of culture, and an interdisciplinary exchange with philosophy and sociology, and the sciences of literature, humanities, and pedagogy, as well as film and art. Empirical and especially quantitative research in psychoanalysis, and the dialogue with the natural sciences, were considered by many to be naïve and not fitting for psychoanalysis, even to the point of being harmful. This problematic way of communication had long-lasting consequences: To mention just one example, Siri Hustvedt (2010), writes laconically in her new bestseller The Shaking Woman:

Although American psychiatry was once heavily influenced by psychoanalysis, the two disciplines have grown further and further apart, especially since the 1970s. Many psychiatrists have little or no knowledge of psychoanalysis, which has become increasingly marginalized in the culture. Large numbers of American psychiatrists now leave most of the talk to social workers and stick to writing prescriptions. Pharmacology dominates. Nevertheless, there are still many psychoanalysts practicing around the world, and it’s a discipline I’ve been fascinated by since I was sixteen and first read Freud. (Hustvedt, 2010, p. 17)

As Thomas Kuhn describes in his analysis of the history of science, different paradigms often exist side by side within a scientific discipline. However, one of them usually dominates—the one that fits best to the zeitgeist. It seems to me that the above mentioned understanding of psychoanalysis as a critical hermeneutics of the 1970s and 1980s is still currently represented in French psychoanalysis and partly in the Latin-American IPA societies (see e.g., Ahumada & Doria-Medina, 2010; Bernardi, 2003; De Mijolla, 2003; Duarte Guimaraes Filho, 2009, Green, 2003; Perron, 2003, 2006; Vinocur de Fischbein, 2009; Widlöcher, 2003), while in the Anglo-Saxon and German-speaking psychoanalysis, the discussion, or perhaps even the adjustment to an empirical–quantitative research paradigm, has been pushed to the fore (see, among others, Fonagy, 2009b). In these countries the zeitgeist has changed: in times of “evidence–based medicine” and of medical guidelines the impression can at times arise, that also for psychoanalysis there exists only one form of research, namely empirical–quantitative psychoanalytic research, in the sense of the classical natural sciences, of “science”. This is—by closer inspection—a strange reoccurrence of an out-dated and problematical idea of a “unified science” (Einheitswissenschaft) (see e.g., Hampe, 2003), an unconscious simplification of the complexities of research in the above-mentioned knowledge–society, which, as is my impression, also involves certain dangers for psychoanalysis.

I would like to briefly illustrate this point by means of a diagram of clinical and extra-clinical research in psychoanalysis, which I have developed in another paper. In order not to argue mainly on an abstract level, I refer in my plea for the creative use of a broad spectrum of current psychoanalytic research strategies, to current research projects of the Sigmund-Freud-Institute in which we attempt to encounter the actual zeitgeist and without renouncing the autonomy and specifity of psychoanalysis as a scientific discipline.

Clinical and extra-clinical research in psychoanalysis

Today, we can differentiate between two different groups of psychoanalytic research, the clinical and extra-clinical. By clinical research we mean the genuine research in the psychoanalytic situation itself. Ulrich Moser describes it as on-line research, while the extra-clinical research (the off-line research) takes place after the psychoanalytic sessions and embraces a variety of different research strategies as will be described below.

But first, clinical research: It takes place in the intimacy of the psychoanalytic situation, and can be described as a circular process of discovery in which—together with the patient—idiosyncratic observations of unconscious fantasies and conflicts are successively visualised, symbolised, and finally put into words at different levels of abstraction, an understanding that moulds our processes of perception in subsequent clinical situations, even though we enter into each new session with the basic, genuine psychoanalytic attitude, that has been described as “not knowing”. The circular processes of discovery take place first above all unconsciously and in the realm of implicit private theories. Only a small part hereof is accessible to conscious reflection by the psychoanalyst (see EPF Working Party of Bohleber, Canestri, Denis, and Fonagy, Project Group for Clinical Observation of the IPA, Altman de Litvan, 2014).

The insights that are won in this clinical research are presented inside and outside the psychoanalytic community for critical discussion. In agreement with many current psychoanalysts, clinical research is for me the central core of psychoanalytic research in general. It is connected with a characteristic psychoanalytic idea of experience and linked to epistemic values (Erkenntniswerte) (compare Hampe 2004, 2009; Toulmin, 1977). Clinical, psychoanalytic research deals with the understanding of the unconscious construction of meaning, of personal and biographical uniqueness, as in the exact analysis of the complex weavings of various determinants in the micro-world of the patient (Moser, 2009), and for that reason can be characterised, as mentioned, as critica...

Table of contents

• Cover
• Half Title
• Title
• Copyright
• CONTENTS
• ACKNOWLEDGEMENTS
• ABOUT THE AUTHOR
• SERIES EDITOR’S FOREWORD
• FOREWORD
• INTRODUCTION
• CHAPTER ONE Psychoanalysis as a “science of the unconscious” and its dialogue with the neurosciences and embodied cognitive science: some historical and epistemological remarks
• CHAPTER TWO Finding the body in the mind: embodiment and approaching the non-represented—a case study and some theory
• CHAPTER THREE The relevance of the embodiment concept for psychoanalysis
• CHAPTER FOUR “I still don’t know who I really am …” Depression and trauma: a transgenerational psychoanalytical perspective
• CHAPTER FIVE Inspiration of the clinical psychoanalytical practice by the dialogue with the neurosciences and embodied cognitive science: some examples
• CHAPTER SIX How to investigate transformations in psychoanalysis? Contrasting clinical and extra-clinical findings on changes of dreams in psychoanalysis with a severely traumatised, chronically depressed analysand
• CHAPTER SEVEN “Finding the body in the mind …” and some consequences for early prevention: the concept “outreaching psychoanalysis” and some realisations
• NOTES
• REFERENCES
• INDEX