Response to Commentaries

Obviously well chosen by the Editors, the commentaries on our article reflect the range of reception of neu-rosciences by psychoanalysts, from strong skepticism about the validity of neuroimaging and experimental procedures (Peter Freed) to very specific ideas on how to match anatomy and functioning of certain brain networks to hypotheses derived from psychoanalytic theories (Robert Scharf).

To start out with the skeptic: What is wrong with numbers? Most patients and study participants do not find it difficult to rate their affective states or cognitions when presented a scale with items and numbers anchored in clear verbal descriptions. The same is true for psychoanalysts assessing psychic structure or areas of conflict based on the operationalized psychodynam-ic diagnostic (OPD) system, to give just one example. The concerns that Peter Freed raises are usually discussed under the headings of reliability and validity of scales. There are still too few scales and questionnaires operationalizing psychoanalytic constructs—for example, of depressive experience by Sidney Blatt (2004) or of differentiating grief and depression (Beutel, Deckardt, von Rad, & Weiner, 1995)—and I do not see any reasons why psychoanalysts should not be more active in developing scales and measures pertinent to psychoanalytic concepts.

It seems to me, however, that Freed underestimates the importance of the paradigms presented in the scanner. As exemplified by our studies, word stimuli can be constructed to induce affects and concerns characteristic for certain disorders (e.g., threat-related words in panic disorder patients) or to idiosyncratic experiences (e.g., evoking traumatic memories). In these contexts, “numbers” measured during or after the scan (e.g., affect ratings; button-press responses and their latencies for specified orthographical cues; proportions of errors and omissions; recall of words presented previously) can be taken as direct or indirect measures for mental processing of