Leo Rangell (2007) pointed out the need for replacing either/or thinking with both/and formulations to better advance our field. We should apply his recommendation to the science/art binary. Psychoanalysis not only defies such binaries, it goes beyond hybridization. Psychoanalysis is both scientific and artistic, yet it does not fit comfortably with either science or art.
Science makes use of empiricism and rationality to understand reality, and to discover laws of nature. Art makes skillful use of a variety of materials and methods, aiming for originality and an enhanced sense of wonder and beauty. Science also relies on original thinking for solutions to empirical problems. Among the defining elements of psychoanalysis is that much mental functioning is out of awareness, and involves non-rational mental operations.
British scientist and novelist C.P. Snow's 1959 Rede Lecture had as its thesis that “the intellectual life of the whole of western society” was split into two cultures—the sciences and the humanities; he claimed that this split was a major hindrance to solving the world's problems. In 2008, The (London) Times Literary Supplement included Snow's The Two Cultures and the Scientific Revolution on its list of the 100 books that most influenced Western public discourse since World War II. We might expect that six decades of influence would have made for some reconciliation, but Snow's thesis has been both elaborated and disputed, while science and the humanities (including the arts) are still considered in many quarters to be antimonies. The theme of this initial issue of The International Journal of Controversial Discussions addresses this vexing post-Snow state of affairs.
Jaak Panksepp (2012) counted curiosity as one of seven inherent human drives, not merely a sublimated sexual voyeurism. The science or art question addresses psychoanalytic epistemology: how do we slake curiosity and come to know anything? Knowledge acquisition began pre-historically, and led to the survival and dominance of our species. Like
the Tower of Babel story, a pluralism of epistemologies ensued, with intuition and revelation the first of these, and shamans and priests the earliest non-warrior tribal leaders. The 18th Century Enlightenment and the technology revolution of the last 140 years defined distinct disciplines to expand knowledge and appreciation of the world: theology, philosophy, history, biography, linguistics, mathematics, natural sciences and the arts among them. Advancement and refinements generated subspecialties within each discipline, seeking more nuanced means of increasing human understanding, adaptation and control of natural events. Psychoanalysis emerged from the creative mind of a single genius, claiming as its domain a heretofore little known or dismissed realm of human nature. Freud's ambition went beyond therapeutics; he sought a complete theory of mind and its products. His limitations have provided opportunities for his successors to correct, modify, redirect and expand upon his work.
As Freud (1923) wrote of the Ego, psychoanalysis itself serves three masters. It is a treatment method (in fact the theory informs several related treatment methods usually referred to as “psychodynamic”). In the eyes of its founder and of many contemporaries it is a natural science. It is also recognized as a contribution to the history of ideas, that status marked by inclusion in the Great Books of the Western World (1952). These disciplines—therapeutics, science, and intellectual history—differ in their criteria for disciplinary membership; psychoanalysis has aspirations in each, but does not fit easily within them. In a voice recording made in his final year of life, Freud stated that psychoanalysis is “a part of psychology, not medical psychology.” I will argue that psychoanalysis is unlike other sciences, but is and must be scientific. Nor is psychoanalysis art, as that term is commonly and sometimes disparagingly understood, but it includes a central therapeutic enterprise that relies on the creative intuition of clinicians and theorists: its practice is artistic!
Like medical treatment, the practice of psychoanalytic psychotherapies is informed by best evidence. For psychoanalysis, the treatment situation is exquisitely individualized, relying nonetheless on tentative generalizations about the mind's regularities and variations. As a scientific discipline, psychoanalysis rests on a systematic observational methodology that does not lend itself to rigorously-controlled experimental design. Its primary database is comprised of 125 years of clinical reportage, and
attempts at theoretical integration. There is however a vast literature (hundreds of thousands of Google hits) for “psychoanalytic research” that tests hypotheses within and outside the confidential clinical situation. Its scientific aims include validation of therapeutic work, and testing and refining psychological propositions and the general theory of mind. The work of the late Sidney Blatt, commemorated in a special issue of Psychoanalytic Psychology (Auerbach, 2019), underscores the essential privacy of the clinical situation, which makes extra-clinical validation essential for scientific acceptance.
Those who dismiss psychoanalysis as unscientific use a narrow definition of science, limited to methodologies that would exclude Darwin and Einstein as well as Freud. I prefer the definition offered by philosopher Francis Bacon , the father of empiricism, cited by Brenner (2006). Bacon spoke of science as “an attitude toward the universe in which observations are made using the best methods available; logic is employed; and contradictions or magical, supernatural, and ad hoc solutions are rejected.” Brenner added that all sciences are inferential and influenced by the observer's psychology, but “facts must rule.” Experimentation may be employed but is not required (e.g., Galileo's astronomy); quantification is a tool of science, not its essence. Two additional principles: scientific conclusions are tentative, and although “psychological reality” is rife with contradiction and paradox, as Freud (1900) showed in his dream book, its methods are rational and empirical. Scientific advances may occur without scientific methods, as with Kekule's dreaming discovery of the benzene ring, and Fleming's incidental observation of the anti-bacterial effects of penicillin.
A clear definition of art is harder to come by. Definitions are verbal; art is not limited to—or by—language. When poets are asked to explain their work, they typically decline, saying the poem speaks for itself. Art history reveals great variety of forms and subject matter, and striking cultural differences. And art forms evolve: the invention of photography led to obsolescence of still life painting and portraiture. Non-representational art forms emerged early in the 20th Century, with visual aesthetics redefined by Picasso and others. Music also underwent changes in the last century, from tonality to atonality, to jazz and rap, among other new genres. Art exceeds its limits through the creative imagination of those who become recognized as artists, often with delay and sometimes
posthumously. “Fine” art came to share the word with commercial art and graffiti. Literature evolved to include violation of rigid grammars and “stream of consciousness.” Craft is considered essential, but the forms art takes seem limitless. Art is created to express and evoke an experience of beauty. Great artists change the world by expanding collective aesthetic experience.
While the term “applied psychoanalysis” has traditionally been reserved for non-clinical realms, primarily the arts and humanities, therapeutics still comprise the best known applications of the psychoanalytic paradigm. Scientific applications extend their effectiveness with standardization and generalization, while recognizing the probabilistic and tentative nature of scientific findings.
As with medical applications of science, practice—especially the exquisitely individualized practice of psychoanalytic therapeutics—can only approximate what theory suggests. Jerome Groupman, in a New Yorker essay reviewing “psychiatry's fraught history” (2019), states, “For a psychiatrist, writing a prescription remains as much an art as a science (p.68).” Thomas Insel, on retiring from his long-term position as NIMH director, stated: “I spent 13 years at NIMH really pushing on neuroscience.… I don't think we moved the needle in reducing suicide, reducing hospitalizations, improving recovery for the tens of millions of people who have mental illness. I hold myself accountable for that.”
Marvin Goldfried (2019), a prominent psychotherapy researcher, considers the lack of consensus after over a century to indicate that psychotherapy is “pre-paradigmatic” in Kuhnian terms. Irwin Z. Hoffman , to great applause at a plenary session of the American Psychoanalytic Association, disparaged the entire research enterprise within psychoanalysis. Others demean psychoanalysis as merely an art, unacceptable therefore as a clinical treatment.
Yet applications of an evolving body of scientific understanding must be as incomplete and inexact as the state of the science; psychoanalytic practice calls for a talent beyond programmatic skills. Since individual talent is involved, psychoanalysis is artistic. In Insel's judgment, a biological focus reached a dead end: narrow scientism is a premature confidence in current findings, even risking a dystopic and dehumanizing
Brave New World.
Arlow (1979) discussed the creative phase of interpretive work, which was to be followed by a reflective, thoughtfully-focused phase, in order to lead to the fashioning of an intervention. Bion famously described psychoanalytic listening as without memory or desire; the Kleinian psychoanalytic tradition emphasizes the countertransference as experience generating thoughts and feelings in the analyst that can help the patient in the moment. Athletes and actors speak of being “in the zone,” where focused thinking seems to disappear, but with effective result. Poser (2019), in a recent presentation, played several recordings based on Debussy's Reverie to demonstrate a theme heard differently. He then showed an interview with Jazz saxophonist Sonny Rollins, who described his music-making as without focus, but using what he calls his “subconscious experience” of the music to determine what emerges from his instrument. Rollins has surely mastered his craft—the melodies, chords, and scales, without which he could not perform—but the performance itself, like the authentic communication of a psychoanalyst in the immediacy of the moment, does not arise solely from focused, evidence-based rationality.
The application of psychoanalysis as paradigm to therapeutics can be described as artful in the same way that mathematical propositions can be considered things of beauty. Freud's Goethe Prize treated his writing as highly artistic literature. The art of Freud's writing is discussed by Blass (2019), commenting on a paper by Joan Riviere (1958). The artful work of clinical psychoanalysis refers to authentic, spontaneous interactions with patients that turn out, though not necessarily immediately, to be helpful.
The curiosity drive (the Kleinian epistemophelic instinct) is renewed with each human birth. We cannot know who will be the next Mozart or Einstein, advancing the range of human experience and knowledge. Curiosity is not to be sated; humans remain novelty-seeking and curious; we become bored with sameness. A Grand Unifying Theory is likely to remain elusive. If there is a god's-eye view of the universe, we lack the capacity to see it; human limitation must be acknowledged by the godless as well. Ignorance is often motivating, and can lead to exploration and discovery. Advancing knowledge requires originality, unbound
from contemporary methods. Psychoanalysis is not medicine, nor is it science. Psychoanalysis is a set of ideas, a paradigm, not a fixed entity or restricted domain. The study of the human mind and its products is limitless, and subject to ongoing indeterminacy and generative controversy.
Each new patient presents a challenge to a therapist's knowledge, skill and talent. Stone's “physicianly attitude” does not require a medical education. Despite all prior experience, therapists are ignorant when meeting a new person. We are also ignorant as to what the next meeting will reveal. We must accept Keats's “negative capability” (rather than philosophical certainty) as essential to achieving understanding that will enhance the adaptation, creativity and joy of the patient. Ulric Neisser (1958), the psychologist who coined the term “cognitive psychology,” taught that, while the brain has a finite number of synapses, billions, the mind's ability to generate thought is infinite.
Artists may promote art for art's sake; it is its own explanation, ultimately inexplicable but central to the good life. Psychoanalysis is neither science nor art per se, but both scientific and artistic, and its clinical applications are often effective. Yet an art whose claims are more than aesthetic needs more than claims to affirm its value (Golland, 2016). Psychotherapy must be more than an art.
Engaging in psychoanalytic practice enhances knowledge and creativity, and can also provide joy for the practitioner. The quest to satisfy curiosity is incomplete but gratifying, and involves debunking false antimonies while providing better resolutions of inner conflict. Irving Steingart (1977) saw the psychoanalytic relationship as “a thing apart,” a special case in which the more we learn, the more we recognize the complexity and paradoxical nature of its subject matter. Neither science nor art, but both scientific and artistic, psychoanalysis is itself “a thing apart.”