Bringing the Soul into Neuroscience: An Interview with Mark Solms

Smaller: Who came up with the term “neuropsychoanalysis” and when?

Solms: I think around 1998, the same time we decided to start the Journal (Neuro-Psychoanalysis). Ed Nersessian and I were at Arnold Pfeffer's home. I guess the term was my “brilliant” idea.

Smaller: How long had you and Pfeffer been meeting?

Solms: I began commuting to New York around 1990. Those meetings began with a small group of analysts. We would invite leading neuroscientists to give presentations followed by discussions, much as we now have at the monthly meetings at the Pfeffer Center. It was a real meeting of minds. Our first speakers were selected by James Schwartz, who was working with Eric Kandel, the Nobel Prize Laureate.

Smaller: And your first International Congress?

Solms: It was held in London in 2000. Our seventh will be in L.A. this summer.

Smaller: What were the origins of your interest in neuroscience and psychoanalysis?

Solms: The origins of my interests probably began with a trauma. When I was about three years old, my older brother had a very serious head injury. He would have been about six. I was very close to him. We lived in a remote region of Southern Africa, an isolated village. We were isolated even as a family. We spoke English and everyone else in that village spoke German. My father was sort of the boss of town, which made us even more isolated. My brother was my only real friend. His accident had a devastating effect on me and the family. He was never the same after the accident. He had fallen from a roof deck, maybe five or six meters. He lost his personality.

I kept wondering how did it happen that my brother was no longer the same person? I discovered later in my own analysis that this trauma was probably also one of the main origins of my death anxiety—which has remained with me. That is also a neuro-psychoanalytic problem.

Smaller: How so?

Solms: I was preoccupied with this anxiety. How does it happen that your self is so bound up with your brain? If the self is the brain, then when your brain dies, there is no more self. So what happens to the immortality of the soul?

Smaller: You studied neuroscience at university?

Solms: Yes, but I was still interested in the self and the brain—and their connection. How are you your brain?

By the time I arrived at the University of Witwatersrand in Johannesburg, neuroscience was the obvious choice. That's when I met this very impressive professor, Michael Saling. He was a neuroscientist, but he also knew something about the mind. I learned that maybe things were not so random. I became more interested in neuropsychology. But this was still neuroscience. You were still not allowed to ask things like, “How does the brain produce feelings?” The other stuff was so boring! To his great credit, Saling didn't squash my curiosity in such questions.

Smaller: Had he read Freud?

Solms: Yes, but my interest in Freud began when I attended a seminar taught by a philosophy professor, Jean Pierre Delport. That's when I first read Freud's “Project for a Scientific Psychology.” It was mind-boggling—all the things that I was not learning in neuroscience were discussed there. How does the mind of a real person work? People have traumatic memories that affect the development of their minds, their behavior, their consciousness, and all of this must be reflected in the workings of their brains. It was incredible. Freud also wrote about dreams in the “Project.” I was like a kid in a toy shop.

Smaller: You began reading Freud?

Solms: I read “On Aphasia,” and then Saling and I wrote a paper that was published in the International Journal of Psychoanalysis [1986] titled “On Psychoanalysis and Neuroscience.” That paper was the turning point of my scientific life. Psychoanalysis became my whole way of thinking, especially after I read The Interpretation of Dreams.

Smaller: What was the link?

Solms: Psychoanalysis could provide what neuroscience was lacking—a science of the person, a natural science of subjectivity. I think that was consistent with Freud's ideas. But I had to keep both sides going. By 1984 I began getting articles accepted in neuroscience journals.

Smaller: Things were moving.

Solms: Until 1985. Then Saling, much to my dismay, was offered a position in Melbourne and emigrated. I was in a lurch—lost scientifically. I am a bit of a lone ranger, a loner, but one always needs mentors to learn from.

Smaller: That isolated village again.

Solms: It was a frightening time. I was young and suddenly left in charge of the neuropsychology services in two hospital neurosurgery wards, one in Johannesburg and the other in Soweto. Jo'burg General's neurosurgery ward had 40 beds, and Baragwanath Hospital in Soweto had about 80. I was seeing patients morning, noon, and night. Then they opened a rehab unit with both brain and spine injury patients. That was an important place for me because patients lived there for months, sometimes years, and I talked with them—really got to know them and learned about the impact of their injuries and their trauma on their lives.

Smaller: Your first clinical experience.

Solms: I talked with them and learned about their past relationships. This was also a form of research. Certain brain lesions created certain changes in moods, thoughts, and behavior. These lesions changed the real fabric of their mental and personal lives. These were mostly patients with strokes or brain injuries. The spinal injury patients served as a sort of control group. They had equivalent physical trauma, but not brain lesions. That was a big difference between the two groups. Their personalities did not change in the same ways as the brain patients, even with the same traumatic loss.

Smaller: And with stroke patients?

Solms: Different changes in certain areas of the brain meant different changes in their personalities. That was an incredible thing to witness. You could look at a brain scan of a patient and almost predict what kind of personality changes they would have. And this was not with just a few patients but with thousands.

Smaller: This was still apartheid South Africa.

Solms: In a first world country, a person gets a slight twitch in their eye and they run to the doctor. With these patients in Soweto, they were already blind by the time they came for care. It would have to be that extreme. These were very poor people who would rarely see a doctor.

I was deeply interested in them. I wanted to know their stories. I learned quickly what to pay attention to, what was idiosyncratic to the individual patient, and what was characteristic of their lesion site. I was learning about the structure of the mind.

Smaller: Subjective experience?

Solms: It was what had been so completely lacking in my academic training—the human experience. In South Africa moreover, if a man came with this kind of brain injury, it not only affected him but also the 14 members of his family who were depending on him.

Smaller: The academic neuroscientist became one concerned with the soul and the brain, and the humanity in his work—a good foundation to become a psychoanalyst.

Solms: Well, I was having problems in South Africa. Each year the army would call me up for conscription. Each year the head of the neurosurgery department wrote letters about how I was needed, that I was the only neuropsychologist at the hospital. Three million people were depending on us—the whole township. And they would defer my conscription. But finally they said enough was enough. They gave me a year to train a replacement. That's when I began training Oliver Turnbull [co-author of The Brain and the Inner World].

Smaller: You went to London?

Solms: I went to New York and London for interviews at Columbia and the British Institute. My wife Karen [Kaplan-Solms, co-author of

Clinical Studies in Neuro-Psychoanalysis] and I then moved to London.

Smaller: How did you decide on London rather than New York?

Solms: I remember that in London I felt more personally understood than in New York. Also, they were still discriminating against non-medical applicants and London had nothing like this. There is a great irony about this.

Smaller: With the Arnold Pfeffer Center for Neuro-Psychoanalysis now being housed at the New York Institute?

Solms: Also because the greatest interest in my work began here in the U.S. There was no interest at all in London. They thought, “Why would an analyst be interested in the brain?”

Smaller: What about your clinical work?

Solms: I needed to do some psychotherapy at the local mental hospital, a real old Victorian asylum. And I went for my own analysis every day. And seminars at night.

After that I saw my two control patients.

Smaller: What group did you train with in London?

Solms: The Freud group. I was immersed in Freud, but that was all I had read. I knew nothing of other theorists. I was interviewed by two analysts, one Kleinian and one Freudian, for my training. The Freudian was Clifford Yorke, a good bloke, and he became my analyst.

Smaller: And the training?

Solms: My analytic training was disorienting, bewildering. I felt like the green kid from the countryside. I shut up in class, while everyone else discussed Winnicott, Bion, Klein. Can you imagine me just sitting there and shutting up?

Smaller: Can't imagine!

Solms: But I did and I learned. Karen and I also began seeing neurological and surgical patients at the Royal London Hospital. The records of those patients became our book—Clinical Studies in Neuro-Psychoanalysis. I was also able to conclude my dream research at that time.

Smaller: What was different about seeing analytic patients?

Solms: I think previously it was as if I had found a violin in the jungle. I knew how to play but did not have the correct theory or technique. The analytic training was like learning from a proper violin teacher. I learned how to think about what I was doing and link it with what others had done before me, and learn from their experience.

Smaller: You began integrating the two disciplines.

Solms: In 1990, Morton Ostow invited a small group to meet me. Ostow had written an inspiring paper back in the 1950s in the Neuroscience and Psychoanalysis Quarterly about neuroscience and psychoanalysis. After I had read that, I contacted him. So Ostow invited me over, a real act of kindness, to meet with this small group, maybe 20 analysts. One of them was Arnold Pfeffer. I was to present my work with brain injured patients. We met at the New York Academy of Medicine.

That meeting was terrific. Pfeffer asked if I would take over the monthly meetings he had begun at the New York Institute. I could engage with more analysts. Despite my junior status, I gave a whole year of lectures once a month. Karen and I presented our work with individual patients and their transcripts.

Smaller: Similar to what you are doing each month with Mount Sinai psychiatric residents?

Solms: Yes. We presented transcripts of sessions with five patients with left and five with right side hemisphere lesions, and then discussed differences.

Smaller: The Arnold Pfeffer Center [through support of the Pfeffer Family Foundation] now emerged from those meetings?

Solms: Pfeffer set up a committee to run the lectures and also to offer a course in neuro-psychoanalysis for candidates at New York Psychoanalytic. But it was time to internationalize.

Smaller: Why was this important?

Solms: People in other parts of the world were starting to do the same thing we were doing in New York. A society and journal would help connect these groups. We also wanted to attract younger people interested in psychoanalysis and doing integrative research.

Smaller: Psychoanalysts often react poorly to new ideas. What is the threat?

Solms: I have a different way of thinking about it. I worry that the situation has deteriorated since those early days because rather than a small group of analysts working together for a long time, people began dabbling. We've done serious work. Our collaboration with Jaak Panksepp, an internationally known neuroscientist who has studied, among many things, affect in animals for over 30 years, is a good example. I think the resistance has been directed more at work generated outside our group. The group that Pfeffer and Ostow put together, were real analysts who love analysis and who respect the complexity of the mind.

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Smaller: Which is why solid neuro-psychoanalytic research is so important.

Solms: Neuroscientists are looking at us with great expectations; we want to train real psychoanalysts to do this work—not dabblers.

Smaller: Can you summarize the goal, or mission of neuro-psychoanalysis?

Solms: We want to bring the soul into neuroscience. It's in line with what Freud wanted to do all along.

Smaller: Clinicians wonder, what will be the benefit?

Solms: All patients will benefit if medicine realizes that the brain is a unique organ—it's not like the liver. It has agency. It has feelings of its own. If we can introduce that to psychopharmacologists, we will have done something great for humanity. The brain is NOT a chemistry set! Psychoanalysis will finally get the recognition it deserves—no longer perceived as some occult practice, or as a bunch of greedy doctors whose practices are not evidence based.

Smaller: Is this a problem in psychoanalysis—how we are perceived by scientists and the public?

Solms: Psychoanalysis is fragmented into various schools. Neuro-psychoanalysis might help us to integrate the various views. Somewhere along the way the big picture got lost and analysis became too concerned about itself, rather than about the mind. Psychoanalysis lost its object, and entered into a relationship with itself—rather like a narcissistic patient. My worst nightmare is that neuropsychoanalysis will become just another school of psychoanalysis. Its mission is to bring back the object. The mind is part of external reality—that is why we share it with other disciplines. Neuro-psychoanalysis can help us regain our link with that reality.