The history of psychoanalysis is a history of controversial discussions that have provided a means of resolving problems or clarifying positions regarding theory, technique, and institutional power. Rather than creating yet another journal with a theoretical bias for like-minded theorists and clinicians to develop their ideas, this journal will take on controversial topics and create a forum for discussions between colleagues who specifically do not think alike. The intention here is to create a village square for discussion and debate about controversial issues.
As the first topic to discuss, we have chosen the age-old question, Is psychoanalysis a science or an art? If it is a science, what kind of a science is it? If it is an art, what kind of art is it? And if it's not a science or an art, what else could it be? I open this issue of the International Journal of Controversial Discussions with a set of musings to orient the reader to some of the matters involved in such questions. The rest of this issue will be dedicated to distinguished psychoanalysts presenting their ideas in concise articles followed by other analysts responding to those articles.
Sigmund Freud was born in 1856, three years before the publication of Darwin's The Origin of Species. Darwin's scientific breakthrough invigorated the sciences and influenced popular thinking about religion and politics. Freud grew up in this scientific movement that reshaped the views of self and society—specifically, in a shift away from a Judeo-Christian religious worldview to a scientific worldview. Freud followed these developments closely in high school and then at university.
From April through October 1895, Freud penned an essay titled Project for a Scientific Psychology that began with the words “The intention is to furnish a psychology that shall be a natural science.” He went on: “that is, to represent psychical processes as quantitatively determinate states of specifiable material particles, thus making those processes
perspicuous and free from contradiction” (Freud, 1895/1966, SE 1, p. 295). Freud, the neurologist who had stained and studied neurons and explored hysteria through hypnosis with Jean-Martin Charcot, was trying to make sense of it all with his exceptional powers of observation and his synthetic theory-making mind.
As James Strachey (1966) wrote in his introduction to the English translation of Freud's Project, “All emphasis in the picture here is upon the environment's impact upon the organism and the organism's reaction to it… The ‘instincts’ are only shadowy entities, with scarcely even a name” (p. 291). The technique of psychoanalysis is for the most part absent, and free association, interpretation of unconscious material, and transference “are barely hinted at” (p. 291). Freud ultimately threw out this neurological framework, because, as Strachey wrote, “He found that his neuronal machinery had no means of accounting for what, in The Ego and the Id, he described as being ‘in the last resort our one beacon-light in the darkness of depth-psychology’—namely, ‘the property of being conscious or not’” (p. 293). Strachey ended his introduction by saying, “The Project must remain a torso, disavowed by its creator” (p. 293). While Freud dismissed this early work, and we can understand why, I see the Project as Freud's Golem, a “being,” in a sense, who set the stage for all that was yet to come and was then dismissed.
By 1913 everything had changed. The foundation of psychoanalysis had been established. And then, following the completion of Totem and Taboo, Freud wrote a small essay titled The Claims of Psycho-Analysis to Scientific Interest (1913/1955a). He did not ask if psychoanalysis was a science but instead demonstrated that other fields, including scientific fields, could be interested in psychoanalysis. In that essay he addressed the following topics:
The Philological Interest of Psycho-Analysis
The Philosophical Interest of Psycho-Analysis
The Biological Interest of Psycho-Analysis
The Interest of Psycho-Analysis from a Developmental Point of View
The Interest of Psycho-Analysis from the Point of View of the History of Civilization
The Interest of Psycho-Analysis from the Point of View of the Science of Aesthetics
The Sociological Interest of Psycho-Analysis
The Educational Interest of Psycho-Analysis
As psychoanalysis gained interested readers and critics, people wondered, Is this “science of the mind” real? Is it even a science? And in some ways, and perhaps more important, who should be allowed to practice it? Neurologists? Psychiatrists? Medical doctors? Psychologists? Philosophers? Lawyers? Art historians? School teachers? Artists?
And then it happened: Theodor Reik, a psychoanalyst and close associate of Freud, was charged by Austrian authorities with “quackery”—the practice of medicine without a license. Theodor Reik was a lay analyst. He held a PhD in psychology, not a medical degree. While Sigmund Freud was himself a physician, many of his colleagues were not medically trained. They were never excluded by him and were, in fact, highly valued for the different perspectives they brought to psychoanalysis. Freud argued vigorously on their behalf and against the officials in Austria who challenged the legitimacy of lay analysis.
When Reik was charged with quackery, an official involved with the legal case called upon Freud to write an opinion on the subject. Freud wrote his opinion in The Question of Lay Analysis (1926/1959). Ultimately the charges against Reik were dropped, but Freud did not believe his little book had anything to do with the legal basis for dropping the case.
At that time there were many highly respected lay analysts in Europe, such as Hanns Sachs, Otto Rank, Theodor Reik, Ernst Kris, Melanie Klein, Oskar Pfister, August Aichhorn, Lou Andreas-Salomé, Beate Rank, Siegfried Bernfeld, Geza Róheim, Susan Issacs, Victor Tausk, Robert Waelder, Ella Freeman Sharpe, Marie Bonaparte, and Anna Freud. But lay analysis was still held suspect by the legal authorities in Austria. In the United States, it was legal but seen as unacceptable by most medical analysts, who equated lay analysis with “wild analysis” and quackery.
Freud recognized psychoanalysis as a special kind of conversation that
any properly trained analyst, whether medically trained or not, can establish with a patient. While acknowledging the contributions of medical analysts, he also wrote, “In his medical school a doctor receives a training which is more or less the opposite of what he would need as a preparation for psychoanalysis” (Freud, 1926/1959, SE 20, p. 228). Freud described a proper analytic training as including in-depth course-work in psychology, biology, the science of sex, medical disturbances belonging to the field of psychiatry, the history of civilization, mythology, the psychology of religion, and literature (p. 228).
Although there were a few European analysts opposed to lay analysis, most of them supported it. In the United States, however, the overwhelming majority of analysts were opposed to it. The US colleagues cited the problems of wild analysts, quacks, and charlatans in their country and sought to restrict the practice of psychoanalysis to medically trained analysts. In the International Journal of Psychoanalysis, Freud addressed their position by saying, “Our American colleagues' resolution against lay analysts was prompted essentially by practical motives; yet it seems to me unpractical, for it cannot alter any one of the factors which govern the situation. It is in some sort equivalent to an attempt at repression” (Freud, 1927, p. 398).
Thus, behind the question of Is psychoanalysis a science or an art? lurked the question, Who is qualified, and permitted, to practice psycho-analysis? But independent of the lay analysis question, medically trained psychoanalysts were concerned for their own reasons. They were marginalized by other medical specialties and felt called upon to defend their profession as medical and scientific. In the 20th and 21st centuries much of the modern world found, and continues to find, “science” as the most respectable context within which to frame any discipline as “real.” But, of course, there is plenty in the world that is real and yet also not science or discoverable by science.
Is dance a science? Are teaching or journalism sciences? How about history or literature or counseling? Speculation, intuition, and clinical judgment are essential in the work of the psychoanalyst, and they can certainly be employed in the scientific process. But are they sciences in and of themselves? Is it possible that parts of psychoanalysis are science, or employ scientific methods, and other parts are not?
In 1952, even before the English publication of the Project, the California Institute of Technology sponsored the Hixon Lectures on the Scientific Status of Psychoanalysis (Pumpian-Mindlin, 1952), with lectures given by Ernest R. Hilgard, PhD, Lawrence S. Kubie, MD, and Eugene Pumpian-Mindlin, MD. Hilgard addressed “Experimental Approaches to Psychoanalysis” (p. 2-45), including experimental tests of the validity of psychodynamics and aspects of psychoanalytic theory and techniques. Kubie discussed “Problems and Techniques of Validation in Psychoanalysis” (p. 46-124), starting with a broad review of psychoanalytic observations and a call for help from the exact sciences to make concepts more precise. He also proposed the establishment of a research institute in psychoanalytic psychology with an interdisciplinary team of researchers. Pumpian-Mindlin spoke on “The Position of Psychoanalysis in Relation to the Social and Biological Sciences” and brought into high relief how psychoanalysis straddles biological phenomena and our participation in society. He stated, “Psychoanalysis cannot give the final exact answers that science demands, at this time, but the great question is whether science can afford to exclude such important aspects of human activity as psychoanalysis attempts to investigate” (p. 125-158).
While it might be debatable whether psychoanalysis is a science or not, what is not debatable is whether it is possible to conduct scientific research on psychoanalytic concepts. One need only think of the research on maternal deprivation or projective tests. Once a psychoanalytic concept is operationalized, it is possible to construct a scientific study to examine it. This is the way it is in other social sciences as well. But what about psychoanalysis as a treatment? Is that a science? There, too, researchers have conducted numerous outcome studies in psychoanalysis. One of the common forms of psychotherapy research employs the transcription of analytic sessions. But how does one recognize, in a typed transcript, those words that seemingly leap from the dialogue and become points of analytic orientation. How does one transcribe intuition, or empathy, or being emotionally present? Despite these problems, psychotherapy researchers have a reputation for creativity and compelling conclusions. (For a good overview of this literature, see An Open Door Review of Outcome Studies in Psychoanalysis [2002], edited by Peter Fonagy.) But the question remains, Is the practice of psychoanalysis itself a science?
Why do we care if psychoanalysis is a science? Do we diminish what is not scientific and grant reality to what is? Are we chasing after the public's need to recognize psychoanalysis as real and distinguish it from palm reading? Is it a way to elevate the status of psychoanalysis above the offshoot psychologies of Adler, Jung, Reich, Perls, Berne, and others like them? And if so, what of Klein, Kohut, and the relationalists? Who is legitimate or real? What is real? And how can psychoanalysis be real if it isn't science? If it is a science, what kind of a science is it? A hard science? A natural science? A social science? A historical science?
In the 1920s and early '30s there was an effort to anchor psychoanalytic theory in the physical sciences. This led Siegfried Bernfeld, with his background in botany and mathematics, to collaborate with Sergei Feitelberg in a series of physiological studies proposing to measure libido. In 1930 they published Energie und Trieb (Energy and Drive). Bernfeld's daughter, Ruth Goldberg, was a subject in her father's libidometry experiments and recalled, “I would sit still and they would have some apparatus to touch the skin to see when I started feeling it…to measure the energy, I suppose, that was needed till the subject would feel it…one of those sensory experiments where some needle came toward the skin and you said when you could feel it” (Goldberg interview, Los Angeles, August 10, ). But Bernfeld was not alone in the concrete interpretation of libido as a form of energy. It was seen as a form of real energy by many psychoanalysts and, of course, Wilhelm Reich had his own version, which he called “orgone energy.”
George Gero, MD , the Hungarian analyst, said that when Bernfeld told Freud about his project to measure libido, Freud was unimpressed and said, “Well, my friend Bernfeld, I believe I will die with unmeasured libido” (Gero phone interview, April 28, ). My understanding is that this effort to measure libido ultimately led Bernfeld and Feitelberg to a dead end, after which, I presume, the concept of libido was allowed to return to its place as what I would call an “energetic metaphor” for the location, direction, and intensity of desire. Ruth Goldberg recalled, “He didn't pursue it, because it was fruitless. It was just not an approach that gave results.” That said, Nathan Adler, a close student of Bernfeld's in San Francisco, laughed at himself when he recalled his own efforts, no doubt under Bernfeld's influence, to measure libido by measuring the strength of the urinary stream (Adler interview, San Francisco, c. November 15, ).
Ultimately, Bernfeld would say psychoanalysis is a Spurenwissenschaft, a science of traces, referring to the facts of observation in psychoanalysis—that is, the traces of the resistance and transference (Etchegoyen, 1995, pp. 10-12).
Many analysts will be quick to point out the “empirical” nature of their clinical work but may hold back from calling psychoanalysis a science. Psychoanalysis is certainly not a “hard science.” It is often difficult to get two observers in the same room to agree on the diagnosis of a given patient. What can we expect of their ability to identify the presence, or lack, of a positive outcome, and how might they recognize the components responsible for therapeutic change? And even if the observers were all properly trained and a respectable scientific study were conducted, what would analysts of another theoretical orientation have to say about their observations and conclusions? We like data to be quantifiable so that we can analyze it, but qualitative research might be more suitable for psychoanalytic research—if the observers can at least agree on what they saw and what they made of what they saw. Questions of repeatability and predictability become difficult if not impossible from one therapeutic pair to the next, but perhaps the attempt itself is worth the effort and may lead to new knowledge.
Eric R. Kandel (1999), Nobel laureate in Physiology or Medicine in 2000, addressed what he felt was the importance of psychoanalysis embedding itself in the sciences of human cognition: “A closer relationship between psychoanalysis and cognitive neuroscience would accomplish two goals for psychoanalysis, one conceptual and the other experimental. From a conceptual point of view, cognitive neuroscience could provide a new foundation for the future growth of psychoanalysis, a foundation that is perhaps more satisfactory than metapsychology… From an experimental point of view, biological insights could serve as a stimulus for research, for testing specific ideas about how the mind works (pp. 505-506).”
“To return to its former vigor and contribute importantly to our future understanding of mind, psychoanalysis needs to examine and restructure the intellectual context in which its scholarly work is done and to develop a more critical way of training the psychoanalysts of the future (p. 522).”
But what is the nature of metapsychology in psychoanalysis? Is the id a thing to be measured? If we operationalize ego functions, can they be usefully measured? Is the unconscious Freudian? Jungian? Embedded in the group? Or just everything beyond the horizon of awareness? Can we measure object relations? Freud spoke of the “I,” the “over I,” and the “it.” It was Strachey who scientificized “I” into “ego,” “over I” into “superego,” “it” into “id,” and, perhaps most fatally, “soul” into “mind.” My old mentor Nathan Adler used to say, “There is no ego, only egoing. There is no mind, only minding.” But if the ego is not a thing, perhaps it is a way of speaking about something that is difficult to speak of. Perhaps it is an analogy. In The Question of Lay Analysis, Freud (1926/1959) confessed, “In psychology we can only describe things by the help of analogies. There is nothing peculiar in this; it is the case elsewhere as well. But we have constantly to keep changing these analogies, for none of them lasts us long enough” (SE 20, p. 18). But how do we conduct scientific research on analogies?
Observations of unconscious motivation are fascinating. They are clearly based on empirical data but require analogical thinking and speculation as well. In this regard, they are similar to Freud's psycho-anthropological work Totem and Taboo (1913/1955b). Most sciences rely heavily on logical thinking, and psychoanalysis does as well, but the distinctive mode of thought in psychoanalysis is analogical thinking—thinking in analogy, in metaphor, in symbolism.
One of the cornerstones of psychoanalysis is the theory of infantile sexuality, but it has been said that Freud didn't discover anything in this regard that every nanny in a nursery doesn't already know. But seeing the analogues of adult sexuality in the behavior of children and the analogues of infantile sexuality in the behavior of adults is still upsetting, if not subversive, for many.
Paracelsus (1493/94–1541) wrote, “Medicine is not only a science; it is also an art. It does not consist of compounding pills and plasters; it deals with the very processes of life, which must be understood before they may be guided.”1 Writing 500 years ago, Paracelsus seems to suggest that the processes of life are best apprehended by way of art. Is that still the
case? Perhaps psychoanalysis is part science and part art. But what kind of art is this?
Is psychoanalysis a hermeneutic art? A literary endeavor? A mode of applied philosophy? A way of looking at the configurations of human behavior? Is psychoanalysis the co-construction of narrative? What might we say about the music of the session or the theater of dream interpretation? How much of clinical work can be described as an aesthetic treatment of erotic and aggressive engagement through the transference and countertransference? How much of the existential engagement of two subjects is science and how much is dance? And how much of the ancient ritual and shamanic healing traditions remains a vital part of modern psychoanalysis?
Freud, citing Leonardo da Vinci, reflected on the art of painting as per via di porre, the art of putting paint onto the canvas, and the art of sculpture as per via di levare, the art of removing parts of the matrix to reveal the figure within. He described psychoanalysis as per via di levare, because the analyst carefully removes the obstacles to disclosure (interprets the resistance and the transference) thereby making the unconscious conscious (Freud, 1905/1953, SE 7, p. 260).
Peter Gay wrote,
One of the Nobel prize winners who refused to support Freud's candidacy was Albert Einstein, who wrote to [Heinrich] Meng on February 15, 1928, that he could not offer any dependable opinion on the truth of Freud's teaching, ‘much less offer a verdict that should be authoritative for others.’ Moreover, Einstein cautions, it seemed doubtful to him that a psychologist like Freud should really be eligible for the Nobel prize in medicine, ‘which is I suppose, the only one that could be considered.’ (Gay, 1988, 456n)
And Richard Feynman (1963–1965) wrote, “Psychoanalysis is not a science: it is at best a medical process, and perhaps even more like witch-doctoring.”
Much of the concern about whether psychoanalysis is a science or an art pertains to its respectability, perceived reality, professional status, and, of course, the question of who is qualified to practice it. While both
Einstein and Feynman expressed serious doubts about the scientific status of psychoanalysis, the theoretical physicist J. Robert Oppenheimer consulted several psychoanalysts for personal concerns in London and Paris in the 1920s and participated in Siegfried Bernfeld's psychoanalytic study group in the late 1930s in San Francisco (Benveniste, 2006). While I have found no reference to Oppenheimer regarding psychoanalysis as either a science or an art, he clearly had a more positive view of the value of psychoanalysis, whether it was a science or not.
In the collection of articles to follow, we will hear from a number of distinguished psychoanalysts who have strong arguments for their differing positions. Following each article, another distinguished author, or authors, will offer discussion allowing us all to witness and share in the debate. The editors of IJCD hope that in bringing these authors and their articles and discussions together, we will stimulate further thought and productive debate on this important and controversial topic in psychoanalysis.