By Paul Broks, a senior clinical lecturer and honorary consultant neuropsychologist based at the University of Plymouth. He is the author of Into the Silent Land: Travels in Neuropsychology. ‘150 years of Sigmund Freud‘ (THE GUARDIAN, 06/05/06):
One Sunday morning, when he was four years old, my son climbed into bed with his mother. I was downstairs making coffee. «Mum,» I heard him saying as I returned, «I’d like to kill Daddy.» It was a dispassionate declaration, said serenely, not in the heat of a tantrum or the cool spite of a sulk. He was quite composed. Shouldn’t you be repressing this, I thought. Rather than openly contemplating patricide, shouldn’t you be identifying with your father so as to accommodate your Oedipal impulses? The machinery of his unconscious motivations seemed disconcertingly transparent. In fact, I was less disturbed by what he’d said than by the revelation that there might be a grain of truth in a theory of infant development that I’d always dismissed as absurd and irrelevant. But where else had it come from? I had trained in experimental psychology. I was a professional neuropsychologist conducting research into the psychopharmacology of memory. There was no place for Freud. And yet – out of the mouth of babes …
Today is Sigmund Freud’s 150th birthday and his ghost haunts us all. Freudian language has seeped into common parlance like that of no other writer since Shakespeare. The core ideas of his psychoanalytic theory have become part of the fabric of our culture. Accounting for human behaviour in terms of unconscious thoughts and hidden motivations has become commonplace. We all know about wishful thinking, about denial and defence mechanisms, repression, narcissism, Freudian slips and the anal personality. We all scrape at surface reality for signs of deeper meaning. (I keep typing «Fred» rather than «Freud». Is this a neuro-muscular quirk of finger control, or is that my grandfather down there in the basement?) As WH Auden wrote, in memory of Freud, «To us he is no more a person / Now but a whole climate of opinion.»
Freud had a clear view of his place in intellectual history. He claimed, in the Introductory Lectures on Psycho-Analysis, that his theory was the third of three major blows to the «naive self-love of man». First there was Copernicus, who dislodged us from the centre of the cosmos. Darwin then tipped us from the pinnacle of divine creation by revealing our evolutionary continuity with the animal kingdom. The next step on the road to humiliation was for Freud to show that «the ego is not even master in its own house, but must content itself with scanty information of what is going on unconsciously in its mind.» In sum, we are self-deluded beasts adrift in a vast and indifferent universe. A veneer of civilisation masks the true, animal nature of our fundamental drives: sex and aggression.
Freud ranked himself not only with the likes of Copernicus and Darwin but also with that fellow icon of 20th-century thought, Albert Einstein. By his own estimation, he was as much a pioneer of psychology as Einstein was of physics. The Copernican view is irrefutable. Darwin’s theory of evolution is acknowledged to be one of the greatest of all scientific achievements. Einstein bent the universe and humbled time. But what is Freud’s standing in this century of neuroscience, when, through technical wizardry undreamt of in his era, we can view the movements of mind in the machinery of the living brain? What traces of Freud’s footsteps do we find in the neural pathways?
A neuroscientific evaluation of Freud’s achievements is appropriate. In the early part of his career he was firmly oriented towards biomedical science. As a student at Vienna University he made meticulous studies of the reproductive system of the eel (sometimes an eel is just an eel) and went on to study neuroanatomy, the field in which he made his first scientific observations. While working in the Vienna general hospital, mainly with neurological patients, he wrote a landmark paper on the medical and psychological properties of cocaine – substantially based on self-experimentation – and later published a book on neurological disorders of language.
As well as being the father of psychoanalysis, Freud might also be considered one of the founders of neuropsychology. Inspired by a stay in Paris with the French neurologist Jean-Martin Charcot, famous for his pioneering work on hysteria, Freud’s interests became increasingly psychological and he set out to build a comprehensive theory of the mind. Although believing that, ultimately, such a theory must be grounded in biology, he recognised the methodological limitations of the neurological science that was available to him. Had he been born a hundred years later, with the technical apparatus of modern brain science at his disposal, he would doubtless now be at the helm of an MRI scanner pursuing a career in cognitive neuroscience.
Neuropsychology has flourished since the time of Freud’s death in 1939. New neuro-imaging methods, in combination with traditional «lesion studies», which examine the effects of localised brain damage, have produced ever more refined models of brain function. We know a great deal more than Freud ever could about how different neural systems construct the perceptual world from the raw materials of sensation, and we are mapping the mechanisms that control language, memory, and voluntary action. Brain circuits underlying emotional and motivational states are also under close scrutiny. The study of emotion, in particular, has been reinvigorated over the past decade, so much so that there is talk now of an «affective revolution», echoing the «cognitive revolution» of the late 1950s and 1960s.
Evolutionary theory and experimental neuroscience have combined to produce a framework for understanding the emotions at every level, from the chemical to the cultural. We know much more, too, about the interrelation of emotion and thought, partly through the development of cognitive behavioural therapy, currently the psychotherapeutic treatment of choice for depression and anxiety states. Most neuroscientists are suspicious of Freud, but with its newfound enthusiasm for understanding the emotions and the rapid growth of research into the brain bases of psychological disorder, it might be said that neuroscience has nevertheless been moving steadily in the direction of the central Freudian preoccupations. While neuroscientists and psychoanalysts generally remain, at best, indifferent to each other’s concerns, some researchers and clinicians are working to integrate Freudian theory with brain science. Given his unfulfilled ambition to construct a biology of the mind, Freud would have approved.
How does his theory hold up? His model of the mind evolved over the course of a long career but the idea that our motivations are largely hidden to us, buried in the unconscious, remained a core feature of Freud’s theorising. It was not simply that we find some mental processes difficult to excavate – like time-faded memories – rather that they are actively being denied access to consciousness by a repressive mechanism whose function is to shield the individual from uncivilised thoughts and impulses.
According to Freud’s later formulations, each of us has three sub-personalities: the id, the ego and the super-ego. The id is an amoral beast, driven by instinct and seeking immediate gratification. The ego is the mind’s executive apparatus; the rational, decision-making part that enables us to distinguish inner from outer, fantasy from reality. I want it now, says the id – food, sex, whatever – give it to me now. Hang on, says the ego: this is hardly the time or place. But the ego is expedient rather than moral. It will steal a fiver or scratch its genitals if no one is looking. Moral purpose is the function of the super-ego. It loads the ego with guilt if it acts out of turn. Without the repressive influence of the ego, acting under the guidance of its moral superior, the forces of the id manifest themselves through fantasy and sexual and aggressive impulses. Mental illness results when repression fails.
Modern neuropsychology provides compelling evidence for unconscious mental processing. For example, it can be shown experimentally that the behaviour of brain-injured patients can be influenced by memories that are unavailable to conscious recollection. Antonio Damasio’s patient «David» is unable to recognise photographs of people he has met but, when asked who he might approach if he needed help, will pick out those who have treated him well. This illustrates the well-established distinction between «explicit» (conscious) and «implicit» (unconscious) memory systems. Similar dissociations are found in our perceptual apparatus such that certain «nonconscious» perceptual pathways have relatively direct access to the brain’s emotional memory centres. Moods, memories and emotions can be triggered by events that we fail to register at a conscious level. Freud’s core contention, though, was that ideas and impulses arising in the unconscious mind are actively repressed and that we carry a whole bag of tricks for the purposes of self-deception: denial, rationalisation, reaction formation, projection.
The eminent neuroscientist Vilayanur Ramachandran, for one, believes that neurology clinics are teeming with examples of behavioural disorder that can be viewed in a Freudian light, so providing evidence of a brain basis for repression and other defence mechanisms. Denial of illness, anosognosia, is certainly commonplace among neurological patients. I recall a man, paralysed from the neck down, telling me about his plans to go rock climbing at the weekend. «Confabulation» – the inadvertent construction of false, sometimes fantastical, memories – can also be interpreted as a breakdown of the «reality principle» that normally governs the rational ego. It is typically associated with damage to the brain’s frontal and limbic systems. Inner and outer become confused; wishful thinking overwhelms realism.
A head-injured patient I was interviewing at a rehabilitation centre in the north of England casually informed me that he’d been to Australia for the weekend. Didn’t I know about the exchange visit? A group of our patients had swapped beds with their counterparts at a hospital in Sydney. He had always wanted to visit Australia, his wife told me. As well as the confabulation, there were other glimpses of the unrepressed id. «That looks nice,» he said, helping himself to a sausage from another patient’s plate. «Lovely tits,» he told the new registrar. This was mild disinhibition compared with the id-like raw aggression and unrepressed sexuality that are sometimes associated with damage to the frontal lobes. Ramachandran believes that observations of neuropsychological disorder not only support Freudian theory but also offer ways of advancing it: «We can carry out experiments that Freudian analysts have only dreamed of.»
I am almost convinced. But I think we honour Freud unduly. The dynamic, unconscious mind has a long history in philosophy and literature, from Plato to Dostoevsky, via Shakespeare and Austen. Prior to the development of Freud’s ideas, Francis Galton was speculating about «strata of mental operations, sunk wholly below the level of consciousness, which may account for phenomena as cannot otherwise be explained». And Krafft-Ebbing had discerned that unconscious sexual desires were detectable in dreams. That a good part of our mental life and behaviour is unconsciously motivated is a long-recognised fact. While some of Freud’s core themes may well turn out to match the facts of brain function, attempts to transpose the entire gothic edifice of Freudian thought to the laboratories and MRI suites of neuroscience are misguided.
It is not just that so much of Freudian psychology seems nebulous and fanciful: in certain regards it is patently wrong. His ideas on female sexuality, for example, are rightly derided (penis envy, the inferiority of the clitoral orgasm). Neuroscience should resist buying wholesale into Freudian mythology. What neuroscience can learn from Freud’s grand enterprise, however, is a greater curiosity about the nature of human personality and selfhood. We may know a good deal about specific domains of psychological function: about how the brain processes sensory information, how it organises language and memory, how it solves problems and guides behaviour. But we still have scant knowledge about how such processes give rise to a coherent sense of self, and here I agree with Ramachandran, that this is the greatest scientific and philosophical riddle of all. It is quite possible that there is no solution to be found, that the self, like the soul, will turn out to be an illusion. This, after Copernicus, Darwin and Freud, would be a fourth, and possibly fatal, blow to human pride.