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The Metaphysical Aspects of Psychology
Psychoanalysis Defined
In Defense of Psychoanalysis - Introduction
By Sam Vaknin
Author of "Malignant Self Love - Narcissism Revisited"
No social theory has been more influential and, later, more reviled
than psychoanalysis. It burst upon the scene of modern thought, a
fresh breath of revolutionary and daring imagination, a Herculean
feat of model-construction, and a challenge to established morals
and manners. It is now widely considered nothing better than a
confabulation, a baseless narrative, a snapshot of Freud's tormented
psyche and thwarted 19th century Mitteleuropa middle class
prejudices.
Most of the criticism is hurled by mental health professionals and
practitioners with large axes to grind. Few, if any, theories in
psychology are supported by modern brain research. All therapies and
treatment modalities - including medicating one's patients - are
still forms of art and magic rather than scientific practices. The
very existence of mental illness is in doubt - let alone what
constitutes "healing". Psychoanalysis is in bad company all around.
Some criticism is offered by practicing scientists - mainly
experimentalists - in the life and exact (physical) sciences. Such
diatribes frequently offer a sad glimpse into the critics' own
ignorance. They have little idea what makes a theory scientific and
they confuse materialism with reductionism or instrumentalism and
correlation with causation.
Few physicists, neuroscientists, biologists, and chemists seem to
have plowed through the rich literature on the psychophysical
problem. As a result of this obliviousness, they tend to proffer
primitive arguments long rendered obsolete by centuries of
philosophical debates.
Science frequently deals matter-of-factly with theoretical entities
and concepts - quarks and black holes spring to mind - that have
never been observed, measured, or quantified. These should not be
confused with concrete entities. They have different roles in the
theory. Yet, when they mock Freud's trilateral model of the psyche
(the id, ego, and superego), his critics do just that - they relate
to his theoretical constructs as though they were real,
measurable, "things".
The medicalization of mental health hasn't helped either.
Certain mental health afflictions are either correlated with a
statistically abnormal biochemical activity in the brain - or are
ameliorated with medication. Yet the two facts are not ineludibly
facets of the same underlying phenomenon. In other words, that a
given medicine reduces or abolishes certain symptoms does not
necessarily mean they were caused by the processes or substances
affected by the drug administered. Causation is only one of many
possible connections and chains of events.
To designate a pattern of behavior as a mental health disorder is a
value judgment, or at best a statistical observation. Such
designation is effected regardless of the facts of brain science.
Moreover, correlation is not causation. Deviant brain or body
biochemistry (once called "polluted animal spirits") do exist - but
are they truly the roots of mental perversion? Nor is it clear which
triggers what: do the aberrant neurochemistry or biochemistry cause
mental illness - or the other way around?
That psychoactive medication alters behavior and mood is
indisputable. So do illicit and legal drugs, certain foods, and all
interpersonal interactions. That the changes brought about by
prescription are desirable - is debatable and involves tautological
thinking. If a certain pattern of behavior is described as
(socially) "dysfunctional" or (psychologically) "sick" - clearly,
every change would be welcomed as "healing" and every agent of
transformation would be called a "cure".
The same applies to the alleged heredity of mental illness. Single
genes or gene complexes are frequently "associated" with mental
health diagnoses, personality traits, or behavior patterns. But too
little is known to establish irrefutable sequences of causes-and-effects.
Even less is proven about the interaction of nature and
nurture, genotype and phenotype, the plasticity of the brain and the
psychological impact of trauma, abuse, upbringing, role models,
peers, and other environmental elements.
Nor is the distinction between psychotropic substances and talk
therapy that clear-cut. Words and the interaction with the therapist
also affect the brain, its processes and chemistry - albeit more
slowly and, perhaps, more profoundly and irreversibly. Medicines -
as David Kaiser reminds us in "Against Biologic Psychiatry"
(Psychiatric Times, Volume XIII, Issue 12, December 1996) - treat
symptoms, not the underlying processes that yield them.
So, what is mental illness, the subject matter of Psychoanalysis?
Someone is considered mentally "ill" if:
1.. His conduct rigidly and consistently deviates from the
typical, average behavior of all other people in his culture and
society that fit his profile (whether this conventional behavior is
moral or rational is immaterial), or
2.. His judgment and grasp of objective, physical reality is
impaired, and
3.. His conduct is not a matter of choice but is innate and
irresistible, and
4.. His behavior causes him or others discomfort, and is
5.. Dysfunctional, self-defeating, and self-destructive even by
his own yardsticks.
Descriptive criteria aside, what is the essence of mental disorders?
Are they merely physiological disorders of the brain, or, more
precisely of its chemistry? If so, can they be cured by restoring
the balance of substances and secretions in that mysterious organ?
And, once equilibrium is reinstated - is the illness "gone" or is it
still lurking there, "under wraps", waiting to erupt? Are
psychiatric problems inherited, rooted in faulty genes (though
amplified by environmental factors) - or brought on by abusive or
wrong nurturance?
These questions are the domain of the "medical" school of mental
health.
Others cling to the spiritual view of the human psyche. They believe
that mental ailments amount to the metaphysical discomposure of an
unknown medium - the soul. Theirs is a holistic approach, taking in
the patient in his or her entirety, as well as his milieu.
The members of the functional school regard mental health disorders
as perturbations in the proper, statistically "normal", behaviors
and manifestations of "healthy" individuals, or as dysfunctions.
The "sick" individual - ill at ease with himself (ego-dystonic) or
making others unhappy (deviant) - is "mended" when rendered
functional again by the prevailing standards of his social and
cultural frame of reference.
In a way, the three schools are akin to the trio of blind men who
render disparate descriptions of the very same elephant. Still, they
share not only their subject matter - but, to a counter intuitively
large degree, a faulty methodology.
As the renowned anti-psychiatrist, Thomas Szasz, of the State
University of New York, notes in his article "The Lying Truths of
Psychiatry", mental health scholars, regardless of academic
predilection, infer the etiology of mental disorders from the
success or failure of treatment modalities.
This form of "reverse engineering" of scientific models is not
unknown in other fields of science, nor is it unacceptable if the
experiments meet the criteria of the scientific method. The theory
must be all-inclusive (anamnetic), consistent, falsifiable,
logically compatible, monovalent, and parsimonious.
Psychological "theories" - even the "medical" ones (the role of
serotonin and dopamine in mood disorders, for instance) - are
usually none of these things.
The outcome is a bewildering array of ever-shifting mental
health "diagnoses" expressly centred around Western civilization and
its standards (example: the ethical objection to suicide). Neurosis,
a historically fundamental "condition" vanished after 1980.
Homosexuality, according to the American Psychiatric Association,
was a pathology prior to 1973. Seven years later, narcissism was
declared a "personality disorder", almost seven decades after it was
first described by Freud.
-------------------------------------------------
Sam Vaknin is the author of Malignant
Self Love - Narcissism Revisited and After the Rain - How the West
Lost the East. He served as a columnist for Central Europe Review, PopMatters,
Bellaonline, and eBookWeb, a United Press International
(UPI) Senior Business Correspondent, and the editor of mental health
and Central East Europe categories in The Open Directory and
Suite101. Until recently, he served as the Economic Advisor to the Government
of Macedonia. Visit Sam's Web site at http://samvak.tripod.com
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