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One hundred years after Freud's Project, the “Decade of the Brain” of the twentieth century has given us a plethora of new drugs to treat mood and cognitive disorders, identified neurotransmitters and receptors, and given us an understanding—with pictures—of neural networks and neuroplasticity that is revolutionary for our practice. Or is it? That skepticism is immediately present in Sidney Pulver's lead article entitled “The Astonishing Clinical Irrelevance of Neurosciences” in the Summer, 2003 edition of the American Journal of Psychoanalysis. Linda Mayes who writes the forward to the six scientific papers properly states that psychoanalysts must find ways to participate in collaborative efforts with our neuroscience colleagues so as not to get into reductionistic, clinical dead ends. She cites Richard Hertel's paper as an example of clinical observation potentially guiding research hypotheses and methods as early partial visual impairments are postulated to dispose towards defensive choices and character and, I would add, a view of a personal reality.
The second half of Pulver's printed version of his 2001 Plenary address to the American Psychoanalytic Association is cautiously optimistic that the hypothesis-testing role of neuroscience may help us choose metapsychological theories of (1) motivation—rejecting object relationship (Melanie Klein), attachment (Bowlby, Lyons-Ruth, Fonagy), defense (Anna Freud), narcissism (Kohut), he endorses Panksepp's and Lichtenberg's comprehensive motivational system; (2) a theory of affects which sees them as not just discharge products of instinctual drives but complex motivational entities arisng developmentally; and (3) modifying structural theory by replacing the Ego with an Executive System including perception, representation, planning, reasoning, memory, learning, consciousness, self-awareness, empathy, emotional modulation, decision, and the organization of conceptual knowledge ; the Superego might be renamed the Regulat