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A Basic Theory of NeuropsychoanalysisReview - A Basic Theory of Neuropsychoanalysis
by W. M. Bernstein
Karnac Books, 2011
Review by Roger Hunt
Feb 26th 2013 (Volume 17, Issue 9)

Naturally, neuroscience has become the baseline for thinking about the mind.  For decades, nay millennia, those interested in the mind have been forced to focus on descriptions of so-called mental phenomena, but with the advent of neuro-imaging, the mind is readily available for viewing, at least in so far as neuroscientists and neurophilosophers understand this new technology.  Since many people in specialized fields such as psychology, theology, aesthetics, ethics etc. are devoted to some quasi-scientific notion of "seeing -is-believing", they seem to feel the urge to cast their seemingly antiquated notion of the mind in terms of these images.  Effectively reducing every idea they hold dear to a series of images.

Bernstein's approach, luckily, seems to resist this compulsion.  Rather than reduce psychoanalysis to something purely brainy, he parochially allows neuroscience to inform it.  This is a difficult balancing act given the obvious adolescent refrain from the neuroscience community: "we don't need you, psychoanalysis!"

Attempts at integrating brain science with psychoanalysis dates back to it inception.  Freud's first foray into psychology (he was a neurologist by trade) attempted to understand the mind in terms of the causal relationships between neurons.  Throughout his career he seems to abandon this project, favoring instead metaphorical depictions of the psyche.  However, young bold scientists since have sought to connect psychoanalysis back to its roots.   Eric Kandel, for instance, notes that he began studying neurology in the 50's to discover the neural-correlates or Freud's structural model of id, ego, and super-ego.  While he still appreciates psychoanalysis today, the master of implicit and explicit memory has since abandoned the project.   In the early 2000's, Marc Solms attempted to reconstruct Freud's topological model of conscious-preconscious-unconscious using neuroscience.  The result was the correlate to a comma splice, which left the reader unsure of where the brain ends and the mind begins, or if they are different things at all.

Bernstein's gives a go at neuroscience using Freud's final and most controversial metaphor: dual-drive theory, otherwise known as the infamous hydraulic model.  I would venture to guess that most classical psychoanalysts would consider themselves drive theorists, believing that the psyche is the result of conflict between repetition compulsion and pleasure seeking.  Pleasure seeking, or Eros, involves the complex striving to both avoid pain and find pleasure.  Repetition compulsion, or Thanatos, is the most basic destructive recourse of the psyche causing us to repeat actions which we have previously experienced to be unsuccessful i.e., leading to pain.  The psyche copes with this build-up of tension between the drives through a variety of discharge mechanisms such as obsessive compulsions, creating hallucinations, or producing anxiety.  Bernstein's thesis is that "understanding the relationship between repetitive processes and approach pleasure/avoid pain operations (the pleasure principle), is a key to understanding mind-brian." (p. xi, his italics).

Chapter 1 and 2 are overviews of psychoanalytic theory and contemporary psychological theories riddled with Bernstein's personal reflections and criticisms.  Psychoanalysts are often very creative theorists and story tellers, and these chapters are certainly reflective of this tendency.   These chapters offer an excellent introduction to a contemporary understanding of mental phenomena from a psychological perspective, outlining for the lay reader the various schools of thought and the disagreements.

Chapter 3 outlines the heart of Bernstein's approach.  Following the work of neuroscientists Allan Snyder and John Mitchell, Bernstein understands neuroscience from a conceptual perspective.  Conceptualists (my terminology) understand the mind in a very straight-forward way: the mind-brain receives inputs from a variety of sense-organs, and then organizes these sense-data into particular categories (concepts), which are made available to the subject through self-reflection.  Bernstein's basic theory of neuropsychoanalysis suggests that the repetition compulsions and pleasure principle fit nicely into this framework, and he produces several diagrams to demonstrate this.  In my view, this piece, the starting point, is the most problematic.  This notion of the conceptual mind-brain dates back to Bertrand Russell and the Vienna Circle, who described the mind in the very similar terms.  While Freud was certainly interested in producing a scientific model of the mind at least tenuously acceptable to the positivist dogma, it is not clear this is what he ultimately had in mind.  The attraction of psychoanalysis is that it presents us with a radically different and fundamentally complex view of the mind, rather than a relatively straight forward conceptual view.  I would hope Bernstein is appealing to this model in the therapeutic mode of joining, where the analyst purports to share the emotional and intellectual space of the patient to recreate the experience of being in the womb, but this is merely a wish and not a critical comment. 

This chapter stakes out another lackluster description of something crucial to psychoanalysis: feelings.  He prefers to use the term "meaningful sensations", and understands them at a meta-level beyond raw sense-data.  The sense-data cause feelings, which are subsumed under various concepts.  So the concept "cat" is composed of various attributes such as "furry tail", "purring", "four legs" etc. and feelings such as "gives me pleasure" or "fills the gap left by my daughter leaving for college".  Again, this is relatively straight forward understanding.   That is, the book seems to promise a revolution of our thinking about mental life, but ultimately disappoints.

Bernstein utilizes these ideas to outline a view of psychopathology as a misappropriation of attributes to concepts (my terminology).  He writes, "in psychotic thought disorders a concept such as 'cat' might be overpopulated with attributes, for example 'representation of the devil'.  Or one attribute of the cat might become magnified and its other qualities ignored."(p.36)  Understanding feelings, psychopathology, and the mind-brain in these ways almost seems like a bait and switch: 'I'm going to use neuroscience to make psychoanalysis more palatable, but I will use a particular version of neuroscience, which already employs a psychoanalytic terminology and doesn't require any further theorizing.'  Psychoanalytic theory thrives on exploring the strange in the normal.  Freud upset Victorian sexuality.  Lacan got very weird with structuralism.  Winnicott was a notorious therapeutic cavalier.  But I don't get that sense of progress from Bernstein's work.  From a therapeutic stand-point his approach makes perfect sense: go where the patient, in this case the neuroscientific community, is and work from there.  While this strategy will hopefully draw more people to reconsider psychoanalysis, I get the feeling it is disingenuous; but then, perhaps my mind-brain is having trouble organizing sense-data into the proper concepts.

The rest of the book uses this model to understand other aspects of mind: time, sexuality, aggression, memory and mental illness.

As with all psychoanalytic writing, the shining star of this book is the primary case presentation, in which Bernstein haphazardly uses his model to understand one of his patients.  Naturally the model falls to wayside and we become engrossed in the life of Mr. K, a public school administrator, who lived a very successful life but has trouble with aggression.  This case is continually elaborated upon through three chapters, and I hope new readers make it past the dubious theoretical material of chapter three to explore the essence of psychoanalysis: the analyst and patient.


© 2013 Roger Hunt


Roger Hunt, Boston Graduate School of Psychoanalysis


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