Daylight
It was Freud’s 150th the other day. Prospect looks in on the birthday boy.
[Janet] Malcolm was not one of psychoanalysis’s detractors. Far from discrediting it, her aim had been to distinguish charlatanism from genuine practice. But American psychoanalysis had by that time reached its baroque period, and was ripe for pillorying. A decade later, the Berkeley English professor Frederick Crews delivered the coup-de-grâce in the New York Review of Books with an essay which still stands as one of the most unflinching executions to have been performed on Freudian practice, theory and scientific pretensions.
I still have fond memories of the fuss that essay kicked up. That and the Sokal hoax made the mid-nineties a pleasant time to be alive.
But as a feature of public health in this country, psychoanalysis in its pure form is almost non-existent. It is hard to argue that such an uneconomic method, which makes such conditional claims for what it can achieve, should play much of a part in the big problems facing the NHS in treating mental illness. So we are left with a vague impression that, while the practice is impractical, the theory still contains a blueprint of how the mind works. Perhaps Freud was similar to Darwin (whom he admired), providing a model which would later be refined by scientific developments. In fact, the better analogy may be with Marx (whom he did not admire) – hugely influential in the 20th century, but with little evidence for his “scientific” theories.
But of course that one little word ‘influential’ opens up a huge yawning gap through which people can (and do) drive great honking 18-wheelers of rhetorical verisimilitude. Or to put it slightly less metaphorically, fans of Freud (like fans of other eloquent and persuasive but evidence-impoverished theorists) like to use the word ‘influential’ in a tricky way, to smuggle claims of, how shall I put it, of having gotten something right for their chosen theorists past people who are willing to confuse ‘influential’ with ‘right’. But influential is different from right. Tim LaHaye is exceedingly influential, but he’s not right. This of course is the point Linklater is making with the Marx analogy.
What we know for certain is that most of the brain is not conscious; but this does not mean that the subconscious pathways of cognitive science amount to the same dynamic region of conflicting desires that Freud postulated. It simply tells us the obvious, that the brain conducts most of its operations without our being aware of them. The non-conscious mind may even have turned out to be less of a mystery than the conscious one. It is consciousness that cognitive scientists find hardest to locate rather than what lies beneath it.
But consciousness, as cognitive behaviour therapy has found, is a lot easier and more productive to work with. Thoughts influence (there’s that word again) mood, and thoughts and mood can be changed – and there’s not even any call to develop a fixation on the therapist. It’s less spooky and disconcerting and exciting than psychoanalysis, and much more helpful. Oh well. Many happy returns, Herr Professor Doktor.
So if the “non-conscious mind” (assuming that this is not a contradiction in terms” is less mysterious, but Freud was wrong about what went on there, what is the right view of it? And if we can cure people without digging into it, by cognitive therapies, does that mean that the unconscious has no causative role in mental illness? If so, what does cause mental illnesses? Just “chemical imbalances”? Or something more?
We may be well rid of “Dr. Fraud’s” waste-of-time theories, but does that mean we really know anything more than he did in our brand new, shiny twenty-first century? (And something similar, perhaps, could be said of Marx, but that’s another story.)
JonJ,
There’s plenty of non-conscious mind, with plenty of causative role, although not as some dark and mysterious entity distinct from the conscious mind. We all have assumptions about the way the world works and what we’re like as individuals. In some cases these are so well established that we never think about them, so they take the status of given, objective fact rather than personal opinion. Sometimes these assumptions are irrationally negative and can produce thoughts, emotions and actions associated with phobias, depression, etc.
As these are often not beliefs that the patient has previously been conscious of, their causal role in shaping the way one interprets one’s experiences can persist without them being aware of it.
Part of CBT involves getting the patient to make explicit these underlying assumptions, so that they can be directly challenged. An examination of conscious thoughts and deliberate behaviour can help in determining the non-conscious mindset that contributes to producing them. Then a patient (with or, in the end, without therapist) can consciously head off automatic thoughts and impulses at the pass and think about alternative ways of interpreting a situation and responding to it. With time, this deliberate examination and critiquing of automatic conscious thoughts contributes to a re-shaping of the mindset that lies beneath.
We know plenty more than Dr Freud, because we’ve got tons of research behind us – specifically looking at causal links. Cognitive theory is much more functional and less philosophical than psychoanalytic theory, so it can seem a little impersonal. The Prospect piece complains that it doesn’t provide a narrative to explain the meaning of human experience. But why should it have to? CBT helps people make their lives better, it gives them a happier human experience. It certainly doesn’t help in all cases, but it’s still not bad going.