Feeling the Words

Neuropsychoanalytic Understanding of Memory and the Unconscious

Mauro Mancia

• Publisher: Routledge
• Year: 2014
• eBook ISBN: 9781317724247
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

How are the implicit memory and the unrepressed unconscious related?

Feeling the Words incorporates a thorough review of essential psychoanalytic concepts, a clear critical history of analytical ideas and an assessment of the contribution neuroscience has to offer.

Mauro Mancia uses numerous detailed clinical examples to demonstrate how insights from neuroscience and infant development research can change how the analyst responds to his or her patient. Major topics such as the transference, the Oedipus complex, the interpretation of dreams and the nature of mental pain are reviewed and refined in the light of these recent developments. The book is divided into three parts, covering:

• Memory and the unconscious
• The dream: between neuroscience and psychoanalysis
• Further reflections on narcissism and other clinical topics

Feeling the Words offers an original perspective on the connection between memory and the unconscious. It will be welcomed by all psychoanalysts interested in investigating new ways of working with patients.

Part One

Memory and the unconscious

This part deals with the two dimensions of memory: implicit and explicit. We look at the neuroscientific literature on this function, focusing on the time the amygdala and hippocampus take to mature. The amygdala is responsible for the emotions and for the implicit memory circuit, while the hippocampus selects and codifies information for the explicit memory. The fact that the amygdala matures sooner than the hippocampus explains why implicit memory is available before explicit memory.

This dual memory system leads to the idea that the unconscious too may be organized as a double function: unrepressed, regarding implicit memory, the storehouse of affective and emotional experiences dating from very early in life – possibly even the last weeks of gestation too – and repressed, connected to explicit memory, which matures once the child has reached the age of 2.

The unrepressed early unconscious can come to light in the transference and in dreams. It reveals itself in the transference through the “musical dimension” based on the child’s earliest affective and emotional experiences, conveyed through the mother’s tone of voice and the prosody – the stresses and tempo – of her language. The dream achieves the symbolization of presymbolic, preverbal experiences, so they become verbalizable and “thinkable”. The dream also provides a means of figuratively filling the gap of non-representation, serving as a means of reconstructing the person’s unconscious affective and emotional life story.

This part also looks closely at the part played by the unrepressed early unconscious in artistic output – poetry, music, art – according to Jakobson’s principle for grasping the analogies between the languages of the transference and of poetry and music.

1

Memory between neuroscience and psychoanalysis

Memory has fascinated psychoanalysts ever since Freud. It is essential for an individual’s identity and for the organization of the person’s conscious and unconscious.¹ Since the late 1990s interdisciplinary studies of the memory have aroused much interest, and the ground is increasingly shared by psychoanalysts and neuroscientists. In 2000 an issue of Psiche in Italy bore witness to this: dedicated to “Memory and memories”, it offered articles by F. Scalzone, A. Palmisano, C. Semenza and others, plus one of mine, all on this one topic. Other important papers have appeared on the subject (Fonagy, 1999; Pally, 1999; Davis, 2001), which was also dealt with at a neuropsychoanalysis conference in 2001 in New York, where M. Solms, C. Semenza and H. Shevrin presented reports. These contributions suggest that memory is a complex function of the brain structures and mind, of interest to many fields of research, from neuropsychology and molecular biology, to experimental psychology and psychoanalysis.

Memory comes in various shapes: there is motor memory, essential for everyday movements and exercises learned; sensory memory, where the experiences of the five senses are stored; cognitive memory, for learning in general; even musical memory, which seems complicated as it involves the motor and positional memory as well as the visual and auditory mechanisms; genetic memory helps in adaptation to the environment, and historical memory can be shared by a whole nation.

All these memories come in short- and long-term versions. In this chapter I shall look particularly at the anatomo-functional correlates of the long-term memory, and its importance in analysis. Short-term memory, sometimes called operative memory, stores information only for a few minutes; long-term memory is where things are filed away for a whole lifetime. The two types of memory are, however, related. According to Atkinson and Shiffrin (1971), information stored in long-term memory has first to pass through short-term – operative – memory where it is screened and selected before being moved forward for long-term storage. This is a sort of cascade. However, in other “parallel” models information is sent directly to long-term memory, without necessarily going through the operative system (Vallard, 1983).

Long-term memory comprises explicit, or declarative, memory, and implicit, non-declarative memory (Squire, 1994; Schacter, 1996). Recollections from explicit memory can be consciously brought to the surface and expressed in words. This memory can be selective, episodic – meaning only certain specific events in the person’s life are stored there – or it may be semantic, regarding facts, knowledge and the ability to make sense of very old recollections. Explicit memory therefore enables a person to “reconstruct” their own life story.

Implicit memory, on the other hand, stores experiences that are not conscious and cannot be described verbally. Here various forms of learning are filed, such as priming (meaning a person’s ability to identify an object visually or auditively as a result of having already been exposed to it, possibly not consciously but only subliminally) procedural memory, which keeps track of motor and cognitive skills such as the movements needed for certain sports, or to play musical instruments, and the memory of numerous everyday things we do automatically without even being conscious of how; emotional and affective memory, where the brain stores its recollections of emotions arousing from affective experiences of the child’s earliest relations with the environment, and particularly with the mother. This type of implicit memory may also operate in the late stages of pregnancy, when the fetus lives in close rapport with the mother, feeling her heartbeat and breathing rhythms, and particularly her voice. These build up a model of constancy, rhythm and musicality around which the infant will organize his or her first representations at birth (Mancia, 1981, 1989; Imbasciati, 1998; Cheour et al., 2002). This implicit memory may also store sensory experiences from the outside world that the newborn perceives and memorizes (De Casper and Fifer, 1980).

Psycholinguists consider the mother’s voice, memorized by the fetus, very important; the memory is reactivated during breast-feeding, as indicated by the changes in heart rate and the infant’s rate of suckling when it hears its mother’s voice, rather than others (Mehler et al., 1978; Michnick Golinkoff and Hirsh-Pasek, 1999).

At birth and in the first two years or so, while the child’s systems of symbolization and language are developing, the affective experiences in the child’s primary relation with the mother are extremely significant, and are quite likely put away in the memory. While many of these will be positive, and essential for the child’s mental and physical growth, some may be traumatic – the parents may be neglectful and inadequate; they may have mental illnesses; frustrations, violence and abuse from the family and environment can all cause harm to the child and will form the core of the child’s implicit memory. To the extent that these emotion- and affect-laden experiences, with the fantasies and defenses they set up, are memorized in this preverbal and presymbolic stage of life, they will form part of an early unconscious nucleus of the child’s personality, coloring his or her affects, behavior and personality right into adulthood. This nucleus will create an implicit way of establishing relations with others (Stern et al., 1998).

This is not the unconscious related to repression (Freud, 1915a, 1915b) as in early childhood the structures needed for the complex process of repression (the hippocampus, temporal and orbito-frontal cortex) are not yet mature (Perner and Ruffman, 1995; Siegel, 1999). These are more like memories “filed” in the temporo-parieto-occipital posterior cortical areas, particularly in the right hemisphere, from the child’s preverbal and presymbolic stages; they are therefore beyond the reach of consciousness and never surface to the level of verbal expression. This implies that experiences, fantasies and defenses stored in the implicit memory are fundamental to the psychoanalytical theory of the mind, and in particular to the theory of dreams.

In the sections below I take an interdisciplinary look at memory, discussing the latest neuropsychological and molecular biology findings and relating them to memory’s part in psychoanalytical theory and clinical practice. Finally, I shall focus on the potential for interaction and integration between neuroscientific findings and psychoanalysis as they relate to this mental function.

Neuroscience and memory

The contribution of neuropsychology

Clinical experience in the past hundred years has offered numerous examples of short- and long-term memory disorders. Much of today’s information on memory was obtained in human beings with brain lesions. Short-term, operative, memory involves neurons in the prefrontal cortex (Fuster, 1997) and the inferior temporal cortex (Miller et al., 1993). This system comprises the hippocampus, which selects information, and the amygdala, which has an indirect part through the emotions; this is where information is “processed” for permanent storage, as long-term memories, in various parts of the associative cortex.

Alzheimer’s disease is a classic illustration of a memory disorder, resulting from loss of the ability to store new information and persistent retrieval of experience dating from before the onset of the disease. These patients also have an abnormality of semantic memory, which draws on recollections of past events to give meaning to new experiences. Bioimaging investigations in these patients have shown a reduction in the function of hippocampal neurons bilaterally, of the cingulate cortex and the fronto-basal areas. Therefore structures of the medial temporal lobe (MTL) – particularly the hippocampus – and frontal areas are necessary for the selection of information and its storage in long-term memory.

Another cause of amnesia in humans is Korsakoff’s syndrome, where patients can recall events from before the onset of the dysmnesia, but are no longer able to select, process and transfer recent events to long-term memory. Here again, bioimaging shows alterations to the hippocampus and dorsal medial nucleus of the thalamus, through which information reaches the prefrontal cortex.

A useful confirmation of these clinical observations is provided by patient HM, who had undergone bilateral removal of the hippocampus and temporal lobe cortex for therapeutic purposes. His subsequent memory disorder meant he could no longer memorize new experiences, but had no problems with older recollections.

Alexander Luria (1973) tells the fascinating account of Lieutenant Zasetskij, who had suffered a lesion to the parieto-occipital region of the left hemisphere, in the areas of the angular and supramarginal gyri (Brodmann’s 39 and 40). Zasetskij lived in a state of “mental aphasia” which made it hard for him to read because he immediately forgot the first letter of a word, then if he finally grasped a string of words he forgot the one he had just read. He could never get the meaning of a whole sentence (semantic amnesia).

These clinical examples show that the brain structures needed for the long-term memory are in the MTL, which comprises the rhinal, perirhinal and parahippocampal cortex, and the hippocampus. The amygdala is needed for the emotional component of the process. Information is “archived” in various parts of the associative cortex, depending on the nature of the sensory experiences involved. All the cortical associative areas can potentially store information.

This was the background to early experiments in rats which showed that memory persisted even after extensive cortical lesions (Lashley, 1950; Pribram, 1969). This is why memory is considered a holistic phenomenon as it concerns the whole of the neocortical associative mantle in both hemispheres. The more specific process of selection, modification and processing of information for storage in the memory requires the MTL, particularly the hippocampus. The amygdala participates by controlling the emotions (Mishkin, 1978).

Recent electrophysiological and neuropsychological investigations confirm that the hippocampus and MTL are essential for memory. Operative memory essentially needs the prefrontal cortex, where specific neurons organize “memory fields”. These illustrate how the process of memorization is divided up into compartments, as each neuron is selectively activated for specific information – such as a face, or a peculiarly shaped object – and is functionally connected to other associative areas, particularly the posterior parietal cortex (Goldman-Rakic et al., 2000).

The cognitive neurosciences have focused closely on the distinction between explicit, declarative memory and implicit, non-declarative memory (Schacter, 1995; see also Siegel, 1999). Explicit memory needs an intact MTL (rhinal and parahippocampal cortex), hippocampus and diencephalic nuclei of the median line. The amygdala, though indispensable for remembering emotions, does not seem essential to declarative memory (Squire and Knowlton, 2000). Implicit memory, in contrast, does not depend on the MTL and diencephalic structures (Squire et al., 1993) which are vital to declarative memory.

Implicit memory was in fact “discovered” in patients with amnesia due to lesions to these structures, through priming (Warrington and Weiskrantz, 1974) and others in relation to procedural memory (Schacter, 1996). Implicit memory seems to involve the posterior associative cortical areas and, for motor activity – procedural memory – other parts like the basal nuclei and cerebellum (Markowitsch, 2000).

The MTL is explicit memory’s mainstay, as information is stored in the rhinal cortex (comprising the inter-rhinal and perirhinal parts), which is believed to be responsible for recognizing objects from their shape and remembering them. The hippocampus helps locate the object in space and the amygdala instigates the emotional responses to that object (Murray, 2000).

Patients with lesions to the right occipital lobe have an intact explicit memory but their implicit memory for words is damaged. This confirms these two memories probably use separate “processing” systems and the system in the right occipital cortex governs the visual implicit memory for words (Gabrieli et al., 1995).

Bilateral lesions to the hippocampus make it impossible to code information and recuperate new information, besides that acquired before the onset of amnesia (Cipolotti et al., 2001). These authors describe a patient with hippocampal lesions who could not recall autobiographic episodes from any time in his life. It is episodic explicit memory that is particularly damaged, while semantic memory’s role is less clear, as if these two forms of explicit memory involved the hippocampus differently. In the light of this case, Nadel and Moscovitch (2001) suggested that all the structures of the MTL were required for retention and recovery of autobiographic memory.

The question of how explicit and implicit memories are organized and how we retrive their information is still very much open, as shown by Stickgold et al. (2000). Subjects with bilateral lesions to the MTL and hippocampus were asked to learn a simple computer game requiring spatial organization, in order to test their memory. People with no lesions had no problem, after a few test runs, in remembering the game. The hippocampal lesion patients, on the other hand, could not remember the rules at all, but they reported having dreamt of them, at sleep onset.

This finding is interesting because it shows that something learnt can still be remembered outside the hippocampus through circuits that file information directly in the neocortex. In Stickgold’s patients, declarative memory had been eliminated by the hippocampal lesions, but an “unconscious”, non-declarative memory remained which surfaced in a dream in early sleep – a sort of implicit memory. The authors do not guess at what specific cortical areas might be involved.

Sperry (1974) reported that commissurotomized patients worked with their left hand obeying visual commands received from the right hemisphere, but not consciously, and without verbalizing the fact. On the basis of this finding and subsequent observations in primates (Schacter and Curran, 2000) we are led to suggest that information that does not reach the level of consciousness may be stored through the posterior cortical areas (parietotemporo-occipital), particularly in the right hemisphere.

The contribution of molecular b...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• Foreword
• Acknowledgements
• Introduction: beyond Freud: the twilight of Oedipus and the neurosciences’ contribution to psychoanalysis
• Part One: Memory and the unconscious
• Part Two: The dream: between neuroscience and psychoanalysis
• Part Three: Further reflections on narcissism and other clinical topics
• Notes
• References
• Index