9 the Neuropsychology That Would Have Interested Freud Most: Commentary by Oliver Turnbull (Bangor, UK)

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    The Neuropsychology That Would Have InterestedFreud Most: Commentary by Oliver Turnbull (Bangor,UK)Oliver Turnbull

    a

    aCentre for Cognitive Neuroscience, School of Psychology, University of Wales, Bangor,

    383670, Gwynedd, Wales, LL57 2DG, U.K. e-mail:

    Published online: 09 Jan 2014.

    To cite this article:Oliver Turnbull (2001) The Neuropsychology That Would Have Interested Freud Most: Commentary byOliver Turnbull (Bangor, UK), Neuropsychoanalysis: An Interdisciplinary Journal for Psychoanalysis and the Neurosciences,

    3:1, 33-38, DOI: 10.1080/15294145.2001.10773334

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    Psychoanalysis and Cognitive Neuroscience

    (Kosslyn, 1999). Language activation studies show

    discrete regional responses in classical language areas

    when the brain is

    sliced

    axially or coronally. My

    colleagues at the Brain Imaging Research Institute in

    Melbourne, Graeme Jackson and David Abbott, have,

    for analytic purposes, viewed the brain

    as

    a series of

    decreasing concentric volumes. Voxel counts are pro

    jected onto the surface of each volume. This approach

    yields a rather different view. What appear

    to

    be dis

    crete regions in conventional cuts through the brain,

    can now be appreciated

    as

    continuous transcortical

    ribbons of activation. This finding has something in

    common with Freud's aphasiological model, and is

    interesting from that point

    of

    view. The difficulty that

    remains, however, is that cognitive activation para

    digms do not contain within them the broad mental

    reach

    of

    psychoanalytic concepts. The most we can

    hope for at this stage is a cerebral map

    of

    fragments

    of the Freudian view of mind. Working memory is

    a favorite topic amongst the neuroimaging fraternity;

    perhaps the mystic sketchpad would allow one to

    claim working memory as a fundamentally Freudian

    concept

    Along similar lines, the notion

    of

    verbal memory

    is crucial in censor-ego function (Gilmore and Nerses

    sian, 1999). There is a growing body

    of

    literature on

    the functional neuroanatomy

    of

    verbal memory. It is

    becoming clear that this function is underpinned by

    a widely distributed cortical system that includes the

    highest levels

    of

    neocortical association cortex (Dolan

    and Fletcher, 1997), and pathways to the hippocampus

    via perirhinal and entorhinal cortices (Saling and

    Weintrob, 1999). This system clearly has one foot in

    the external world, and the other in the inner world.

    But does this finding lead us to the seat

    of

    ego?

    While I find it difficult to accept the idea

    of

    a

    special and natural nexus between cognitive neuropsy

    chology and psychoanalysis, I applaud Semenza 's

    contribution to the search for a link between the two

    cultures of psychology, for its desire

    to

    bring to an end

    the century of misunderstanding (Whittle, 1999).

    References

    Dolan,

    R

    J., & Fletcher, P. C. (1997), Dissociating prefron

    tal and hippocampal function in episodic memory encod

    ing. Nature, 388:582-585.

    Freud, S (1891),

    On Aphasia.

    New York: International

    Universities Press, 1953.

    Gilmore, M.,

    Nersessian, E. (1999), Freud's model of the

    mind in sleep and dreaming.

    This Journal, 1 2 :225-232.

    Kosslyn, S M. (1999), If neuroimaging is the answer, what

    is the question? Philosoph. Trans. Roy. Soc. Lond., B.,

    354: 1283-1294.

    Saling, M. M., Weintrob, D. (1999), The functional neu

    roanatomy of verbal memory in focal epilepsy. In

    ternat. Neuropsycholog. Soc., 5:274.

    Whittle, P. (1999), Experimental psychology and psycho

    analysis: What we can learn from a century

    of

    misunder

    standing.

    This Journal, 1 2 :233-245.

    School of Behavioural Science

    Department

    of

    Psychology

    The University ofMelbourne

    Victoria

    3

    Australia

    e-mail: [email protected]

    The Neuropsychology

    That

    Would Have Interested

    Freud

    Most:

    ommentary

    by Oliver Turnbull (Bangor, UK)

    Carlo Semenza has offered a thought-provoking dis

    cussion on the relationship between the theoretical

    foundations of psychoanalysis, and those of modern

    cognitive neuropsychology. In doing so, he reviews

    the core features

    of

    the cognitive approach, and sug

    gests that psychoanalysis shares much in common

    Oliver Turnbull, Ph.D., is Senior Lecturer in Cognitive Neuroscience

    at the University

    of

    Wales, Bangor, and Consultant Neuropsychologist at

    The Anna Freud Centre, London.

    with modern cognitivism. It is a radical, and rather

    interesting, argument. The idea is interesting because

    there are unquestionably

    some

    similarities between the

    two fields, which is (to some extent, see below) cap

    tured by Semenza's use

    of

    Howard Gardner 's list

    (1985). For example, there is much merit in the argu

    ment that both fields are investigating the mental appa

    ratus, and that they do so using the language of

    representation. Semenza's idea that Freud can be

    regarded

    as

    a diagram maker has some appeal. In addi-

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    tion, Freud was clearly of the opinion that the mental

    apparatus consists

    of

    a number

    of

    component parts,

    each

    of

    which is relatively independent, and that such

    systems can be (at least to some extent) independently

    modified (though the process is one of over- or under

    activation, rather than by lesion). These arguments

    make Semenza s suggestion rather interesting.

    The Modern Opinion of Semenza s Position

    However, Semenza s argument is radical because

    one can already hear the howls

    of

    objection from both

    sides. I can think of very few cognitive neuropsycholo

    gists who would blithely accept that their discipline

    shares its core assumptions with psychoanalysis. Cer

    tainly, such scientists would be wondering why the

    core assumptions and methods

    of

    the two disciplines

    appear to be so different (for a review

    of

    these con

    cepts see the introductory chapters of Ellis and Young

    [ 9 8 8 ] ~ McCarthy and Warrington [ 9 9 ] ~ Parkin

    [1996]). For example, where are the concepts of mod

    ularity and dissociation in psychoanalysis? Where are

    the painstaking experimental attempts to localize a

    deficit to a single component

    of

    a model

    of

    mental

    apparatus? There are no doubt ways in which such

    questions can be countered by Semenza, but only with

    difficulty. However, I feel that the most important ob

    jection relating to a link between psychoanalysis and

    cognitive neuropsychology relates to the type

    of

    pa

    tient that is studied. Where in psychoanalysis would

    you find the investigation of

    neurological patients with

    focal brain lesions? It is true that there has been some

    work

    of

    this sort, especially recently (e.g., Kaplan

    Solms and Solms, 2000). However, it has been almost

    entirely absent from the earlier history

    of

    psychoanaly

    sis. I will return to this point later in this discussion.

    The objections against an analogy between psy

    choanalysis and cognitive neuropsychology would

    also be strongly heard from the psychoanalytic side.

    Where, analysts would doubtless ask, are the great

    questions

    of

    motivation, emotion, and personality to

    be found in cognitivism? This is, I feel, the weakest

    aspect of Semenza s argument. He claims, from Gard

    ner s list, that the two fields share a common founda

    tion in the (momentary) deemphasis of affect and so

    on Such an argument is difficult to defend. It seems

    that psychoanalysis is, in many respects, directly con

    cerned with context, culture, and history. Indeed, it is

    beyond dispute that affect is

    of central

    concern to

    psychoanalysis, and it almost certainly

    is

    not a viable

    enterprise if the role of emotion is deemphasized. The

    Oliver Turnbull

    obverse side

    of

    the coin is also true: The absence of a

    consideration

    of

    affect lies at the core of the cognitive

    approach. For this reason, in particular, I doubt that

    many analysts would agree with Semenza.

    Freud s Opinion of Semenza s Position

    Semenza s argument is all the more interesting be

    cause

    of

    the matter of historical precedent. As he

    points out, modern cognitive neuropsychology has ex

    plicitly looked to the behavioral neurologists

    of

    the

    late 19th century as intellectual forebears (Shallice,

    1988). Of course, we also know that psychoanalysis

    was predated by Freud s substantial academic career

    as a neurologist during the same period. Thus, we are

    in the interesting position

    of

    having a clear set

    of

    his

    torical documents in which Freud gives

    his

    opinion

    of

    the acknowledged forebears

    of

    modern cognitive

    neuropsychology. In one sense, then this allows us to

    ascertain Freud s position

    on

    Semenza s claim.

    Freud had a variety of opinions about the state

    of

    behavioral neurology in the late 19th century. On

    the one hand, he was sufficiently interested in the topic

    to have followed the literature, investigated a number

    of

    patients, and published

    on

    the

    topic the

    best ex

    ample being Freud (1891). This sort of behavioral neu

    rology was the forerunner of neuropsychology in

    general (rather than cognitive neuropsychology in par

    ticular), and it clearly held great interest for Freud in

    the period before psychoanalysis.

    However, it is

    also well known that Freud s admi

    ration for the neuropsychology of his time was far

    from total. From one perspective, Freud was unhappy

    with some specific aspects

    of

    the data collected in the

    field (see the early chapters

    of

    Freud [1891]). More

    importantly, in the present context, he disagreed with

    his cognitive colleagues

    on

    some core theoretical

    points. For example, he seems particularly uncomfort

    able with the narrow localizationist view, which

    is (arguably) the forerunner of modularity, and hence

    cognitive neuropsychology. Thus, in the famous chap

    ter 6

    of Aphasia

    he describes the thought-pro

    voking model that offers a reinterpretat ion

    of

    the

    classic aphasiological data. In its place he suggests a

    nonmodular account of the dissociation evidence,

    which stands up well to modern scrutiny (cf. Pribram,

    9 6 2 ~

    Shallice, 1988, pp. 245-257). However, it is a

    position that

    is

    more-or-Iess incompatible with modu

    larity. Given that modularity is central to modern cog

    nitive neuropsychology (Ellis and Young, 9 8 8 ~

    McCarthy and Warrington, Parkin, 1996) this

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    Psychoanalysis and Cognitive Neuroscience

    makes it difficult to regard Freud

    as

    a founder of the

    discipline.

    However, while Freud was clearly

    interested

    in

    the neuropsychology of his time, the interest was not

    sustained through his career-he described problems

    of this sort as a silly game

    of

    permutations (Solms,

    2000, p. 83).

    Of

    course, the clearest evidence of his

    waning interest in neuropsychology

    is

    his growing in

    terest in what was to become psychoanalysis. This

    intellectual shift was (arguably) a result of the fact

    that many patients (notably those with hysteria) had

    no demonstrable brain lesion at autopsy, and could not

    adequately be explained in terms

    of

    the box-and-arrow

    diagrams offered by the neuropsychology of Freud's

    time. One of the reasons for this may have been that

    such models focused on cognition at the expense of

    emotion and motivation. Indeed, by dealing with this

    omission, affective neuroscience and modern neuro

    psychiatry are making great strides in establishing the

    biological basis of disorders which were previously

    classed as functional rather than organic. The

    absence of knowledge of this sort in the neuroscience

    of

    Freud's time is likely to have been one

    of

    the rea

    sons for his shift of emphasis to psychoanalysis, where

    Freud developed a theory that

    was

    capable

    of

    ex

    plaining the deficits of his patients. We can observe

    the period of transition in the fact that the 1895 Proj

    ect for a Scientific Psychology is an attempt to de

    velop a neurological model which incorporates affect

    and motivation. It was,

    of

    course, famously aban

    doned-and marks the turning point in Freud's inter

    est in the neurobiology

    of

    the mental apparatus.

    What Sor t of

    Neuropsychology Would Have

    Interested

    Freud?

    This presents us with an interesting question. Freud

    would have had no real desire to investigate the neuro

    biology of, say, language and vision, when his inter

    ests had moved on to those of emotion and motivation,

    which lie at the core

    of

    psychoanalysis. However,

    as

    the years passed, Freud had access to an increasingly

    well-developed model of the mental apparatus, which

    could potentially be tested using the method which

    was familiar to him from his earlier career. If he had

    pursued this line

    of

    enquiry, then he

    would

    have been

    able to establish the biological basis

    of

    psychoanaly

    sis-the problem which he had failed to deal with in

    the Project. This begs the question of why Freud

    did

    not

    investigate the biological basis of the psycho

    logical topics that

    were

    of interest to him. Had he done

    35

    so, then the discipline that we have recently named

    neuropsychoanalysis

    would have emerged decades

    earlier than it now has. Why did he not begin to inves

    tigate the neuropsychology that would have been of

    greatest interest to him? One way to view this issue

    is in the context of the standard detective novel, where

    one evaluates evidence using three criteria: means,

    motive, and opportunity. We should briefly examine

    each.

    Means, Motive, and Opportunity

    First, it would seem that Freud had the

    means

    to study

    the psychoanalytic aspects of the changes seen after

    brain injury. This is the question of

    whether he had

    the knowledge and skills necessary to carry out the

    task. The evidence here seems, at first sight, fairly

    clear. For example, Freud had all the clinical tools

    required to make an assessment of an appropriate pa

    tient. He was, after all, not only a neurologist and

    neuropathologist, but also an experienced psychoana

    lyst. His years of experience in various domains of

    neurological science leave us in no doubt that he had

    sufficient knowledge of neuroanatomy and neuropa

    thology to carry out such a study. In fact, clinicoana

    tomicallocalization

    of

    function was a subject

    of

    very

    special interest to

    him

    (Solms, 2000,

    p

    80). Finally,

    he was extraordinarily familiar with the detail

    of

    psy

    choanalytic theory, having developed the theory him

    self. Thus, it seems self-evident that Freud had the

    necessary knowledge and skills.

    Second, Freud clearly had a

    motive

    We have es

    tablished above that Freud had little taste for the neu

    ropsychological investigation

    of cognitive

    abilities in

    his later

    career-they

    no longer held any great interest

    for him. However, he would have had

    very

    good rea

    son to investigate the biological basis of psychological

    functions of psychoanalytic interest. Some evidence

    of this comes from the fact that he lived to see the early

    emergence of the science of psychopharmacology, and

    appears to have followed the progress of

    the discipline

    with some interest. More importantly, he frequently

    made statements to the effect that our understanding

    of

    various depth psychological functions would be all

    the easier

    if

    we knew their biological basis. Finally, he

    made frequent reference to the fact that the separation

    between psychoanalytic theory and neuroscience was

    'The deficiencies in our description would probably vanish if we

    were already in a position to replace the psychological terms by physiolog

    ical or chemical

    ones

    (Freud, 1920, p 60).

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    only temporary, and that the disciplines would one

    day be reunited.

    2

    Thus, Freud would have been de

    lighted to see the present-day moves toward interdisci

    plinarity. One surely cannot claim that he would have

    been anything but highly motivated to investigate the

    neurobiological basis of psychoanalysis.

    This leaves the final

    question-of

    whether Freud

    had the opportunity Would he have been able to carry

    out such investigations, even if he had both the skills

    and the motivation to complete the task? One should

    recall that Freud was seeing patients more or less

    all

    day, every day

    of

    the working week, for the duration

    of his analytic career (Jones, 1956). Thus, we may

    assume that he would not have had the time to visit

    hospitals and to investigate the appropriate patients.

    Indeed, he would certainly not have considered a brief

    interchange with a patient at the bedside to be suffi

    cient to draw any sort

    of

    reliable psychoanalytic infer

    ence about them. It would be necessary to meet

    regularly with the patient, in a setting like that

    of

    his

    analytic consultation room. Without this, he would not

    be investigating the depth psychological issues that

    were

    of

    real interest to him.

    However, the lack of time to visit hospitals need

    not be such a major objection to the claim of lack

    of

    opportunity. Freud was spending a great deal

    of

    time

    seeing patients, and he could have perhaps taken on

    someone as an analytic patient who had suffered a

    neurological injury. In such a case, Freud would not

    have to travel to the hospital to see the patient, and he

    need not be hurried in making a premature diagnosis

    at the bedside. Instead, he would be able to take his

    time in assessing the mental apparatus in all its com

    plexity. If the proposal that Freud could have seen

    neurological patients in his consulting room is valid,

    then Freud would have had the opportunity (as well

    as the motive and means) to investigate the biological

    basis

    of

    psychoanalysis. To the best

    of

    my knowledge,

    he did not do so. Why did he not choose this strategy?

    There are a range of possible reasons for Freud s

    reluctance to take

    on

    neurological patients. Perhaps

    (1) no one would refer neurological patients to him.

    This seems unlikely, given that psychiatry and neurol

    ogy were closely allied disciplines, that Freud was

    well connected in the medical community in Vienna,

    and that he received a huge number of international

    referrals (Jones, 1956). Another option is (2) that

    Freud may have been of the opinion that such patients

    would not

    benefit

    from analytic treatment, and hence

    2 We must recollect that all of our provisional ideas will presumably

    one day be based on an organic substructure (Freud, 1914, p 78).

    Oliver

    Turnbull

    seeing such cases would have been unethical. This ar

    gument has a slightly stronger basis, given that the

    talking cure was designed for the treatment

    of

    neu

    rosis, and that Freud was always skeptical

    of

    those

    who attempted its use for other disorders (such s

    schizophrenia). Finally, for those who favor conspir

    acy theories, there is the unlikely possibility (3) that

    Freud did see such patients, but chose not to report

    them.

    The Claim of Lack of Means

    To the best of my knowledge, there has only been one

    attempt to explain why Freud did not embark

    on

    an

    analytic investigation of neurological patients. Solms

    (2000) claims that Freud did not attempt to investigate

    the problem because t he clinico-anatomical meth

    od

    was incapable

    of

    providing the correlations he

    sought (p. 81). Thus, he suggests that Freud did not

    have the means (the theoretical and methodological

    tools) necessary to undertake this line of enquiry, be

    cause

    of

    the limitations of the currently available

    method. Now, we should recall that the clinicoanatom

    ical method has been a central feature

    of

    neuropsy

    chology for some 150 years, and was the technique

    by which so many of the great discoveries of the disci

    pline were made (aphasia and the language areas of the

    left hemisphere; recent memory and the hippocampus,

    etc.). It is not a method that lacks reliability; it is also

    the tool that is

    currently

    being recommended as an

    excellent candidate method for pursuing modern neu

    ropsychoanalysis (Solms, 1998a,b, 1999,2000; Kaplan

    Solms and Solms, 2000). Thus, it is of some impor

    tance that we clarify why Freud may have rejected this

    approach, and also how it is that Solms et al. now

    come to recommend it.

    Solms s claim is that Freud rejected the clinicoa

    natomical method, as it existed during his lifetime

    because it was incapable of accommodating (1) the

    functional nature of neurotic pathology and (2) the

    dynamic nature of normal mental processes (p. 81).

    This situation, Solms argues, has now changed; he

    dates this change to the work of Aleksandr Romano

    vich Luria (1902-1977). The claim is that Luria s in

    troduction of the concept of a functional system

    adapted the clinico-anatomical method to accommo

    date the essentially dynamic nature of the mental pro

    cess (Solms, 2000,

    p

    98). This method was not

    available during Freud s lifetime, because it was de

    veloped by Luria after the Second World War (see

    Luria s [1979] autobiography for an account

    of

    the

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    Psychoanalysis and Cognitive Neuroscience

    chronology). This argument suggests, then, that Freud

    did not feel able to undertake the task

    of

    developing

    a depth neuropsychology because of the inadequacy

    (real or merely perceived)

    of

    the available methods in

    neuropsychology. He lacked the means

    to

    do so. It

    may well be that there are problems with Solms's

    claim; for example, why did Freud not have another

    attempt at developing a dynamic neuropsychology, as

    he did in the 1895 Project ? He might well have

    had greater success in the 1930s, in the context of

    developments in psychopharmacology. However, the

    one merit

    of

    Solms's argument is the best one: that it

    explains the evidence that Freud does not seem to

    have tried to develop neuropsychoanalysis.

    Semenza's Argument Reconsidered

    What does this mean for the argument suggested by

    Semenza: that Freud came close to developing by

    himself the central tenets of cognitive neuroscience ?

    I think there are two points that can be made. First,

    Freud clearly

    did

    involve himself in the neuropsychol

    ogy

    of

    his time. Had he continued to work

    in

    neuro

    psychology proper (instead

    of

    moving to

    psychoanalysis) he would have continued

    to

    make a

    contribution perhaps

    even a more substantial one

    than he is currently credited with (cf. Pribram, 1962).

    However, I doubt that he would have made the sub

    stantial contribution to

    cognitive

    neuropsychology that

    is suggested by Semenza; for example, because

    of

    the

    great importance

    of

    cognition to Freud's interests,

    and because of his attitude to modularity. Thus, Se

    menza's claim is interesting, but probably overstated

    on this point.

    Second, one might rephrase Semenza's position

    to consider Freud as the founder

    of another

    sort

    of

    neuropsychology, which investigated the neurobiol

    ogy

    of

    the psychological functions that

    were

    of interest

    to him. This discipline, now called neuropsychoana

    lysis, is the neuropsychology that would have inter

    ested Freud most, and the field that he would have

    liked to have founded. It seems that he did not make

    the attempt. The one argument in his favor

    on

    this

    point is that his repeated suggestions that such a disci

    pline would be inevitable, given that neuroscience

    would grow across the decades, has laid the ground

    work for the new field. It will be

    of

    some interest to

    see what happens to psychoanalysis in the process, for

    Biology is truly a land

    of

    unlimited possibilities. We

    may expect it to give us the most surprising informa

    tion, and we cannot guess what answers it will return

    7

    in a few dozen years to the questions we have put to

    it (Freud, 1920, p 60).

    In summary, Semenza contends that Freud

    founded a discipline that I believe he would not have

    wanted to found (cognitive neuropsychology). In addi

    tion, it is clear that Freud did not found a discipline

    that I believe he would have wanted to found (neuro

    psychoanalysis). To make a set

    of

    claims other than

    this would, I think, not do justice to Freud's attitude

    to the neuropsychology

    of

    his day and its relationship

    to psychoanalysis. Freud made substantial contribu

    tions to both psychoanalysis and neuropsychology, but

    it seems that we have identified some areas in which

    he did

    not

    make a radical contribution. We should

    remind ourselves

    of

    the enormous contribution that

    Freud made (in several domains), but also recall that

    excellence in one domain does not imply omniscience.

    References

    Ellis, A. W., Young,

    A

    W. (1988), Human Cognitive

    Neuropsychology.

    Hillsdale, NJ: Lawrence Erlbaum.

    Freud, S (1891), On Aphasia. New York: International

    Universities Press, 1953.

    (1895), Project for a scientific psychology.

    Stan

    dard Edition

    1:281-391. London: Hogarth Press, 1966.

    (1914), On narcissism: An introduction. Standard

    Edition 14:67-102. London: Hogarth Press, 1957.

    (1920), Beyond the Pleasure Principle.

    Standard

    Edition

    18:1-64. London: Hogarth Press, 1955.

    Gardner, H. (1985), The Mind s New Science. New York:

    Basic Books.

    Jones, E. (1956),

    Sigmund Freud: Life and Work

    Vol.

    London: Hogarth Press.

    Kaplan-Solms, K., Solms, M. (2000), Clinical Studies

    Neuro-Psychoanalysis. London: Karnac Books.

    Luria,

    A

    R (1979),

    The Making

    Mind: A Personal Ac

    count

    Soviet Psychology. Cambridge, MA: Harvard

    University Press.

    McCarthy,

    R

    A., Warrington, E.

    K

    (1990), Cognitive

    Neuropsychology: A Clinical Introduction.

    Orlando, FL:

    Academic Press.

    Parkin, A J (1996), Exploration in Cognitive Neuropsy

    chology.

    Cambridge, MA: Blackwell.

    Pribram, K H (1962), The neuropsychology of Sigmund

    Freud. In: Experimental Foundations

    Clinical Psy

    chology ed.

    A

    J Bachrach. New York: Basic Books.

    Shallice, T (1988),

    From Neuropsychology

    to

    Mental Struc

    ture. Cambridge, U.K.: Cambridge University Press.

    Solms, M. (1998a), Towards an integration of psychoanaly

    sis and the neurosciences. Part

    I:

    Neuroscientific roots

    of

    psychoanalysis.

    Forums der Psychoanalyse

    14:193-202.

    (In German)

  • 7/25/2019 9 the Neuropsychology That Would Have Interested Freud Most: Commentary by Oliver Turnbull (Bangor, UK)

    7/7

    38

    (1998b), Preliminaries for an integration of psycho

    analysis and neuroscience. Brit. Psycho-Anal. Soc.

    Bull., 34 9 :23-38.

    (1999), Towards an integration

    of

    psychoanalysis

    and the neurosciences. Part 2: Syndrome analysis of psy

    chic functions.

    Forum der Psychoanalyse, 15:58-70.

    (In German)

    (2000), Freud, Luria and the clinical method. Psy

    choanal. Hist., 2:76-109.

    Centre rCognitive Neuroscience

    School

    Psychology

    University

    Wales, Bangor, 383670

    Gwynedd, Wales

    LL57 2DG, U

    e-mail: [email protected]

    Carlo Semenza

    Response to Commentaries by

    Carlo

    Semenza (Trieste)

    General

    While waiting for relevant case studies, neuropsychoa

    nalysis, as I think this journal is trying to promote,

    can only be an intellectual exercise. This exercise of

    exploring the fields of psychoanalysis and neurosci

    ence primarily consists

    of

    the search for concepts that,

    while developed in one

    of

    the two disciplines, may

    turn out to be useful if somehow incorporated into

    the other.

    The shared belief is obviously that psychoanaly

    sis and neuroscience, while differing in aims and

    methods, are ultimately about the same

    thing-the

    hu

    man mind. We know that the two disciplines have

    been separated almost from the very beginning, and

    that adepts of one field have generally gone their own

    way without knowing too much about the other field.

    In many respects this separation was desirable,

    and dictated by theoretical necessity and lack of em

    pirical findings bridging the two fields. In the past

    decade, however, the opinion emerged that there was

    no longer a reason for this state of affairs. It was intu

    ited that the advanced knowledge in neuroscience

    could now allow useful interaction with psychoanaly

    sis. I am also convinced that the reverse is true: Psy

    choanalysis can indeed inspire interesting

    interpretations

    of

    findings in neuroscience.

    Within this framework I felt I could offer a few

    suggestions. These were by no means prescriptions, as

    some of my commentators, notably Green, understood

    them to be. My aim was only to provide some food

    for thought. In short, my main suggestions were the

    following:

    Carlo Semenza, M.D., is Professor of Neuropsychology at the Univer

    sity of Trieste, Italy.

    If psychoanalysis is to benefit from neuroscience,

    this could better and more naturally happen with

    the mediation

    of

    cognitive psychology.

    2 Cognitivism is not a psychology entirely extrane

    ous to Freud s thought. If Freud s scientific back

    ground and his

    work on

    aphasia in particular are

    closely considered, his familiarity with ideas and

    methods that would later be the basis of cognitive

    psychology is revealed.

    3 Cognitive neuropsychology and psychoanalysis

    have methodological affinities. The supremacy of

    single case methodology, valid in both disciplines,

    stems from what cognitive neuropsychologists

    have called the principle of transparency: Pathol

    ogy, provoking an imbalance among working struc

    tures and processes, may highlight, in specific

    cases, functions that are obscured by the harmoni

    ous flow of a relatively undisturbed mind.

    4 Connectionist models should be adopted with the

    utmost caution. Shallow analogies will not work

    and would make any theorization more prone to

    criticisms of Popper s type (while I believe that,

    properly defended by the same sort of arguments

    that cognitive neuropsychologists use, psychoanal

    ysis could instead be virtually immune to such dev

    astating objections).

    5 Somehow, against immediate intuition, the modu

    larity theory may be useful, especially in a less rigid

    form than Fodor s. There are indeed theoretical

    distinctions within memory functions that are neu

    rologically implemented. These distinctions may be

    useful when considered within psychoanalysis. A

    key concept in Fodor s theory, that of informa

    tional encapsulation, may perhaps be specula-