The Brain, the Mind and the Self

A psychoanalytic road map

Arnold Goldberg

• Publisher: Routledge
• Year: 2015
• Print ISBN: 9781138788336
• eBook ISBN: 9781317657965
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

Psychoanalysis enjoyed an enormous popularity at one time, but has recently fallen out of favor as new psychiatric medications have dominated the treatment of mental illness and a new interest in the brain and neuroscience begins to dominate the theory as to the cause and cure of mental illness.

How do we distinguish between the brain, the mind and the self? In his new book, Arnold Goldberg approaches this question from a psychoanalytic perspective, and examines how recent research findings can shed light on it. He repositions psychoanalysis as an interpretive science that is a different activity to most other sciences that are considered empirical.

Giving clear coverage of the various psychoanalytic models of the mind and the self, Goldberg examines how these theories fare against neuroscientific evidence, and what implications these have for psychoanalytic clinical practice. The Brain, the Mind and the Self: A psychoanalytic road map sets up evidence-based, robust psychoanalytic theory and practice that will give psychoanalysts, social workers and practicing psychologists a valuable insight into the future of psychoanalysis.

Arnold Goldberg, M.D. was born and raised in Chicago and trained at the University of Illinois, Michael Reese Hospital and the Institute for Psychoanalysis in Chicago. He is recently retired from the Cynthia Oudejans Harris MD chair, and Professor of Psychiatry at Rush Medical Center.

Part I
Distinguishing the brain, the mind and the self

Chapter 1
The brain, the mind and the self

Three conundrums in psychiatry and psychoanalysis

The visitor to the field of mental health is first directed to the discipline of psychology and then to the separate area of psychopathology and is soon confronted with what seems to be a battleground of language. If he or she enters the realm of psychiatry, the issues are clear: it is all about the brain and neuroscience. If a turn to psychoanalysis is taken, then things get a bit foggy: psychoanalysis is all about the mind, with some concern with the self, both of which are reasonable concepts. However, a multitude of choices are offered as to theories and techniques dealing with them, peppered with a number of names of supposedly famous persons. The visitor is not allowed a chance to deliberate, since there is an accompanying pressure to commit before deliberation with the warning that one cannot freely comprehend the issues without a full commitment. Also, the visitor cannot for long be a visitor without an allegiance that ultimately transforms one into a believer.

It should come as no surprise. The believers in the brain feel psychodynamics and psychoanalysis are quaint relics that are mainly passé, save for a few disorders that are yet to be managed. The believers in psychoanalysis are a bit more cordial to neuroscience, but feel it cannot ever do the work of analysis. That cordiality does not, however, dominate the field – some believers in psychoanalysis are totally dismissive of the brain, along with all other schools of theory and technique. It is truly a battleground. As such, it is directed and devoted to a single winner with but a few hopeful efforts at reconciliation. Rather, the road to belief is one of the removal of discords. It bears repeating: the brain generates the mind, and all problems are ultimately to be found in and treated in that organ in the skull. The mind is everything that has meaning, and a concentration on the brain is but a diversion. The self is the agent or the person that is involved in and with the world and cannot or should not be reduced to an organ or divorced from the world. That is one solution.

The dictionary defines conundrum as a puzzle or a hard question, and one needs to recognize that such puzzles are often dismissed rather than solved. One effort that is directed toward a solution is that of treating the brain, the mind and the self as three different but related areas of inquiry with no need to reduce them all to a single study, yet with the added recognition that they study what may be or seems to be the same or similar problems. Mistakes occur when we choose to misapply or misdirect our efforts, such as trying to locate the self in the brain or examining the meaning of the ventral striatum. Each area of study is restricted by its own special language and its own rules. Not surprisingly, a number of writers and philosophers have both helped and hindered our efforts at clarification of the conundrum.

It is always a bit risky to begin a work that is meant to be read by non-philosophers with the name of Martin Heidegger, one who is often automatically felt to be rather opaque, even to bona fide philosophers. When first suggested some years ago (Goldberg, 2004), the name was linked to that of Heinz Kohut as an odd couple with the premise that understanding was the common ground between these two thinkers (more about that in Chapter 7). Heidegger felt that understanding is the essence of “being in the world” (Goldberg, 2004, p. 205), whereas Kohut felt that we achieve understanding by way of an empathic connection to someone else. Heidegger insisted that the subject does not stand apart and look at the world – indeed, one is always in the world. Kohut felt that the individual person or the self is never alone and apart from others, and that one must consider others to be a necessary part of the self; for this he coined the word “selfobject.”

We now introduce a third person into our effort to initiate a definition and clarification of the three concepts that seem to bedevil the three fields of psychiatry, psychology and psychoanalysis. The concepts are the brain, the mind and the self. The third member of our research efforts is Rupert Sheldrake (Sheldrake, 2012), who posits a field theory of mind, which makes the claim that minds extend beyond the brain, and thus our experiences of the world are not merely a replica of our perceptions but rather extend out far beyond and are influenced by our expectations of the world plus intentions and memories (Sheldrake, p. 223). Another triad.

Neuroscience teaches us that a variety of stimuli impinge upon our brain, and the various connections within the brain thereupon deliver a readout or printout, which is considered to be the mind. Piaget tells us that until age 10, children do not consider the mind to be confined to the head, but rather that it extends into the world beyond us. However, Crick offers us a truism that he calls an Astonishing Hypothesis: “You… are… no more than the behavior of a vast assembly of nerve cells and their associated molecules” (Crick, 1994, p. 3). Over time many of us seem to accept this hypothesis and so devote our time and energy to reducing the mind to its biological substrate with the accompanying hope that ultimately all mental illness will be managed and treated by a proper study of the brain.

The very idea of a mind extending beyond the brain is usually handled by invoking our imagination, and we all can imagine what things might be like in another time or place, or even by entertaining a number of scenarios that might take place. However, we can readily attribute those exercises to the brain. I first began to appreciate this new idea with the very interesting and peculiar phenomenon of “the stare.” Almost everyone has, at one time or another, felt that someone whom they could not see was staring at them. People do “feel” that they are being watched when they are really being watched, and this has even been experimentally confirmed, including with animals and surveillance cameras (Sheldrake, 2012, pp. 225–226). This “attention at a distance” seems to confirm that minds are not confined to the inside of the brain. We seem to be receiving impressions beyond our ordinary senses. One may extend this idea to problems of telepathy and mind reading by psychic powers, but those points may well divest us from the major issue of recognizing that the mind extends beyond the brain, and the Crick hypothesis is wrong.

The mind must be differentiated from the brain without in any way denying that the brain is the substrate of the mind; i.e., the brain does indeed generate the mind just as single letters combine to make up words, and molecules make up complex proteins. We must next differentiate the self from these other two entities. Heinz Kohut felt the self to be constituted by the individual along with his or her selfobjects, which he subdivided into mirroring, idealizing and twinship selfobjects. These “other” persons allow us to extend beyond our skins and to become parts of a larger community. Indeed, we are sustained by our selfobjects.

For some, the problem surrounding the concepts of brain, mind and self is handled with utmost efficiency by a simple denial of the existence of anything other than the brain. The mind may be allowed a presence by having it be identical to the brain. The self is just willed out of existence. Although most philosophers pay lip service to Wittgenstein’s caution that our language determines our thinking, the deniers seem to be able to talk about the person who is doing that thinking without acknowledging his or her actuality. To insist that concepts such as beauty or even hate exist is often handled by likening such talk to the search for the soul. The self or the person either cannot be found (as we shall see soon in a quote by Hume) or is a vague concept that need never rise to the level of something tangible like an honest-to-goodness area of the brain. Rest easy, for we will never find the self in the brain inasmuch as we must recognize that language is the ability to use words rather than to assign words to things. One finds wisdom in the Bible or joy in a novel without ever being able to exactly point to that discovery. The search for the self will not result in a location.

There is an old adage in science: “the absence of evidence is not the evidence of absence.” Unfortunately, the following quotations reveal that the evidence sought is never to be found.

One effort to give up on learning what a self is can be found in a book by Nicholas Fearn, which begins with two quotes:

For my part, when I enter most intimately into what I call myself, I always stumble on some particular perception or other of heat or cold, light or shade, love or hatred, pain or pleasure. I can never catch myself at any time without perception, and can never observe anything but the perception.

David Hume (quoted in Fearn, 2005, p. 3)

One cannot but wonder exactly who is the “I” who enters and stumbles and cannot catch or observe. Ah, it must be the brain. But wait, now this:

You enter the brain, through the eye, march up the optic nerve, round and round the cortex, looking behind every mirror, and then, before you know it, you emerge into daylight on the spike of a motor neuron impulse, scratching your head and wondering where the self is.

Daniel Dennett (quoted in Fearn, 2005, p. 3)

Well the self is clearly not in the brain since Dennett tried and failed to find it there. One might wonder exactly who Dennett is, because he and Hume seem to do a great deal of traveling around without a self. Perhaps he and Hume have other means of transportation or are sneaking in a self without paying the cost of admission. They are outstanding examples of trying to not mean what they mean. They travel alone in a self-contradictory vehicle and will never find what they feel that they are looking for.

Thus we must move beyond that fragile organ within our skull to issues that involve a world that has meaning to us and that we are a part of. There is, of course, a natural resistance by our fellow scientists who claim that our mind and our self are no more than the brain. But surely they can be generated by our brain and still be more than our brain. We engage the world by our understanding, which, for Heidegger, is realized in interpretation and for Kohut is achieved by empathy. Here is where psychoanalysis becomes the primary vehicle to allow us to explain how we live in the world rather than merely look out at the world.

Although it may appear to be lacking in precision, we can imagine a number of scenarios that can aid in the differentiation and definition of brain, mind and self. Imagine a picnic on a beach in which a little boy wanders away from his family. He is not concerned with keeping an eye on them or they with watching him. He wanders far and is soon lost. He believes that they (the mother and/or father) will come for him. A motion picture called Home Alone was a popular version of this particular imaginary story. The mother has lost her child from her mind and suddenly remembers and recovers him with anxiety and even terror. The child may or may not assume that he is yet in his mother’s mind. Although each brain is generating these thoughts and fears, they are temporarily irrelevant to the story. The mother both has her child now in her mind and is also able to be empathic with his fears. How and when he disappeared from her mind and then reappeared is a matter of speculation, but she is now able to feel and see “what it must be like” for him as well as what it is like for her.

A similar clinical situation occurred for Dr. S., who was treating a depressed male patient who regularly professed suicidal thoughts and plans. Dr. S. found that he simply could not get this patient out of his mind, and wanted to call the patient if only to be reassured that the man was alive. A supervisor told Dr. S. that the patient needed to feel that he was being thought about, because he felt empty and lost if he contemplated a state wherein nobody seemed to care about him. The supervisor felt that Dr. S. was a necessary structural component for the patient; i.e., a selfobject. The supervisor understood the nature of this therapeutic connection and interpreted it to Dr. S. The patient was found to be severely suicidal after visiting one of his many physicians and receiving a variety of potential possible maladies. Dr. S. told the patient that he wanted to accompany him to his next doctor’s visit in order to determine the onset of those suicidal thoughts, but also to assuage the doctor’s own anxiety. He had clearly over-identified with the patient as he could not properly regulate his empathic involvement, which, however, became manageable with the aid of his supervisor’s interpretation.

To recapitulate: as the little boy walked along the beach away from his family, he felt that he was a part of the world and connected to them. Children under 10 do not believe that the world resides inside their heads but rather that it really is as it appears and that we are all connected to one another. The mother, at least momentarily, lost her child from her mind until somehow she is made (perhaps by someone asking about him) to reconnect with him. The child’s idealization of the mother may allow him the security of being found or, if this is somewhat pathological, the child’s failure of idealization may stimulate his own anxiety at being forgotten. No matter how one constructs this fictional scenario, it is clear that the minds of these two protagonists extend far and wide over the beach. We shall not at this point debate the possibility of the child and mother knowing that they are forgotten or remembered. Much the same applies to Dr. S. and his patient.

We surely use the brain, mind and self in different ways to talk about different ideas. These are semantically distinct discourses and need to be distinguished as such. They need not nor should not be reduced to each other. The patient of Dr. S. was depressed and so his brain had an unusual chemical and electrical activity. He also involved a number of physicians in his life and became a part of their minds much as they occupied his own mind. We can explain both the story of the little boy and his mother as well as that of Dr. S. and his patient with psychoanalytic discussions involving the self.

Arva Nöe says, “we are out of our heads. We are in the world and of it. We are patterns of active engagement with fluid boundaries and changing components. We are distributed” (2009, p. 183). Therefore, from the earlier claim made by Crick that we are “no more than the behavior of a vast assembly of nerve cells and their associated molecules” to our being “patterns of active engagement with fluid boundaries” to our being constituted by our nuclear self plus our selfobjects, we may conclude that any effort to reduce us to one idea or thing will likely prove to be futile. Rather, we must recognize that we employ different languages to talk about brain, mind and self, and each language is true and sufficient within itself. One outstanding philosopher who is devoted to reducing all mental activity to the brain, demonstrating the value of seeing the brain as a computer, does confront the problem of meaning by saying,

Meaning isn’t going to be a simple property that maps easily onto brains and we’re not going to find “deeper” facts anywhere that just settle the question of what a sentence, or a thought, or a belief really means. The best we can do – and it is quite enough – is to find and anchor (apparently) best interpretations of all the… data we have.

(Dennett, 2013b, p. 197)

One can only wonder why this renowned philosopher does not recognize that he has moved into a well-studied field – i.e., the science of interpretation – and in so doing entered the study of meaning, which is not a lesser activity than the study of computer activity but is surely a different one.

A recent study suggested that brain scans could become useful for the study of mental disorder, just as ECGs were employed for cardiac pathology and so would eliminate or diminish the participation of the subject in this diagnostic venture. The person need not contribute to the investigation by stating how he or she felt. One could also limit the investigation to the other arena of mind and self and so insist that there is no need for a brain scan. And, of course, the psychoanalyst may primarily investigate the unconscious determinates of the mind in a similar single-minded effort. Factors such as time, money and interest regularly drive the direction of inquiry and force a narrow but often effective approach. Yet we must wonder if a study of mental disorder can or should eliminate the individual. The ease of using an ECG to evaluate the heart does divorce the person from the organ, but need not take the position that the heart is identical to the person. We are more than our brains, and this acknowledgment does not diminish their role and function nor does it open the door to the premise that we are only our brains. The brain generates the mind, which is the seat of meaning, and its agent is the self. The study of mental illness must involve all three with no effort to reduce them to a single issue.

Dreams and dreaming serve as examples of the difference between an empirical study of a fixed phenomenon and an interpretation of a meaning. The ordinary dream book often attempts to make a one-to-one decoding, such as a black cat stands for, or a sword indicates, etc. Yet the analysis of dreams can be decoded or interpreted only by the free associations of the patient. Thus, there can be only personal or individual meanings to any single percept such as a black cat. And these individual meanings depend upon the particular life history of the person. To the degree that we all share experiences, we may conclude that we may well share meanings, but again that requires personal concurrence and cannot ever be automatically assumed. If one had grown up with a black kitten who was a constant childhood companion, then surely a dream of a black cat has a meaning for that person that distinguishes it from anything that approaches a universal meaning.

The inevitable question that arises in the effort to solve the conundrum of this triad is whether the elements can be studied individually. Of course we know that such studies are pursued, but we may be unwittingly making a mistake of premature categorization. One fascinating example of this is the study of mirror neurons, which has been eagerly embraced by those investigators who describe the need for and occurrence of “mirroring” behavior. In an investigation of animals watching other animals carry out a particular action, changes in the motor part of the brain mirrored those in the brains of the animals they were watching. Thus the brain activity mirrors that of the animal being watched. However, special neurons are not required for this and Victor Gallese, one of the discoverers of mirror neurons, refers to this imitation or action as “resonance behavior” (Gallese, 2008). Resonance is not confined to the brain but to the entire pattern of movements of the body. As Sheldrake notes, “watching other people engaged in sexual activity stimulates erotic arousal by a kind of resonance. The entire pornography industry depends on it” (Sheldrake, 2012, p. 204).

Materialism, dualism and self-organizing systems

The mind-brain problem has been a struggle for a variety of scientists and philosophers, ranging from Paul Churchland who claims that mental states are but “folk psychology” that will be ultimately replaced by explanations of nerve acti...

Table of contents

• Cover Page
• Half Title Page
• Title Page
• Copyright Page
• Frontmatter
• Contents
• Introduction
• Part I Distinguishing the brain, the mind and the self
• Part II The newer models of the mind and the self
• Part III Clinical examples of the special role of psychoanalysis
• Bibliography
• Index