Abstract
Keywords
How should psychoanalysis situate itself with regard to disciplines in the academy? Some have argued that psychoanalysis is a unique discipline whose theory and methodology will derive little or nothing from other disciplines (Green 2000), while others have looked outward to other disciplines and attempted to integrate their findings with accepted psychoanalytic knowledge (Solms 1995, 2013; D.N. Stern 2000). The prevalence of psychoanalytic papers related especially to the arts and humanities gives the appearance of robust interdisciplinary work on the part of psychoanalysts. In this regard, it may be useful to distinguish between interdisciplinary work and applied psychoanalysis.
Interdisciplinary work in the academic world happens naturally, as scholars regularly attend university presentations in adjoining fields for the betterment of their own. Scholars look to neighboring disciplines to find data to support or disconfirm their hypotheses, to provide metaphors for new hypotheses, and to generally enrich their thinking about their home discipline. Researchers and scholars will often investigate border phenomena, those aspects of another discipline that border one’s own. Interdisciplinary thinking is thought to counter the effects of an excessively narrow expertise, leading to isolated information silos and epistemological solipsism. For psychoanalysis, the goal of interdisciplinary work would be the consideration of data and methodology from other disciplines to improve our theory and praxis.
In contrast, applied psychoanalysis is the application of psychoanalytic knowledge for the purpose of enriching the discipline to which it is applied. Thus, psychoanalytic studies of, say, the work of Shakespeare are intended to deepen our appreciation of his characters, particularly their conflicts and motivations, but one does not expect such work to redound in any significant way to psychoanalytic theory or practice. Applied psychoanalysis has allowed the richness of psychoanalytic thinking to be profitably applied to many aspects of the arts and humanities, with no expectation of altering psychoanalytic thinking itself.
Historically, opportunities for true interdisciplinary work have been the exception rather than the rule in psychoanalysis. Freud’s determination to stay outside the world of universities was a fateful decision, one that has cost us dearly, leading to our virtual isolation from the academic community. This isolationist trend was there from the beginning, as memorialized in a series of letters between Freud and Bleuler in 1910 (Alexander and Selesnick 1965). 1 Bleuler was the leader of Swiss psychoanalysts and one of the few international figures in psychiatry who had accepted psychoanalysis. He ultimately resigned from the newly organized International Psycho-Analytical Association over its lack of openness to scientific inquiry. That is, he disagreed with Freud’s decision that psychoanalysis should develop as a movement, a self-contained community isolated from the rest of the medical establishment. In America, A. A. Brill further cemented our isolation from the academy by promoting psychoanalysis as a subspecialty of psychiatry and impeding its practice by nonmedical professionals (Gay 1988).
Writing about this fateful decision in an essay honoring the hundredth anniversary of the birth of psychoanalysis, Arnold Cooper (1984) asserted that our
boundaries cannot and ought not to be kept too sharply delineated. . . . One aspect of our maturity is that there will be increasing difficulty defining the boundary between psychoanalysis and other disciplines. It seems clear that, with increasing speed, psychoanalytic knowledge spills into other fields, and information not psychoanalytically derived, whether about the nature of infant attachment or the biological determinants of anxiety, will be important for the psychoanalyst. . . . An excessive concern with protection of its boundaries may retard our future development. At a time of rapid growth, and this is such a time, it is a good strategy to keep porous boundaries and to allow our discoveries to define our field rather than to risk that excessively sharp boundary-setting might inhibit discovery [pp. 254–255].
In the thirty-four years since Cooper’s plea, psychoanalysis has largely remained outside the structures and norms of academic institutions, unfamiliar with knowledge bases that would have enriched it, unfettered by rigorous academic standards, and cut adrift from the habits of mind that constitute scientific investigation. In these respects, the psychoanalytic establishment has ignored Cooper’s exhortation:
We have to build a research establishment. We must establish closer ties to the intellectual and scientific communities. . . . We must work toward achievement of the full-time analytic school, about which we have dreamed for years. . . . One might say that psychoanalysis is far too important to be left only to psychoanalysts, and it is certainly too important to be confined solely to the conduct of psychoanalytic treatment. The enlightened spread of psychoanalysis in the culture is an obligation in the best psychoanalytic tradition and was part of Freud’s bold vision. . . . The institutes might begin their own eventual transformation by reconstituting themselves as university-like structures . . . in which the traditional training of the practitioner will be one important pursuit embedded in our broadened research and scholarly tasks [pp. 262–265].
2
Contact with neighboring disciplines helps us set parameters on the hypotheses we generate. The corrective function that data from other disciplines can serve is illustrated by Freud’s erroneous supposition that infant mentation consists of hallucinatory wish fulfillment until the infant finally recognizes the futility of attempts to satisfy its own needs, and reluctantly turns to reality. All the developmental literature of the last half-century has demonstrated just the opposite: that the infant is, in fact, highly reality-oriented from birth. Of course, Freud cannot be blamed for being ignorant of findings that postdate him by over a century, but it has taken a long time for this knowledge to permeate psychoanalytic circles, and, as I have noted elsewhere (Erreich 2017), the implications of these findings are still not fully accepted by many psychoanalysts.
In our more recent history, standing apart from relevant disciplines has led to other erroneous assumptions. Following the lead of Kanner (1943) and Bettelheim (1967), psychoanalysts tragically told generations of parents that their autistic children’s condition was due to environmental deficiencies in mothering, epitomized in the phrase “refrigerator mothers.” This was the standard psychoanalytic belief at a time when developmental psycholinguistics already understood that language acquisition, the absence of which was an important diagnostic criterion for autism, was a brain-based critical period phenomenon in all children. This conclusion was supported by many findings, including the universal observation that the syntactic and phonological fundamentals of one’s native language are fully in place by age three or four, within a wide range of intelligence, cultural customs, and parenting styles. Thus, the absence of language would most likely indicate a neurological rather than environmental deficit. Our ignorance of the basic facts of child development has led to errors that have harmed patients, as well as the reputation of psychoanalysis in the popular imagination.
But contact with other disciplines is not a one-way street, with psychoanalysis on the receiving end only. Psychoanalytic clinicians and researchers are in possession of important data that could never be discovered by academic researchers focusing on nomothetic rather than idiographic data. I have argued elsewhere (Erreich 2017) that the unique data of psychoanalysis, particularly clinical data from very young children, require a reconsideration and reformulation of findings in developmental psychology regarding infant memory, particularly in relation to traumatic events. Litowitz (2007) cites another contribution from clinical work to developmental psychology: the reversal of subject and object, a defensive maneuver variously referred to as “turning passive into active” or “identification with the aggressor” (A. Freud 1936). This phenomenon is exemplified by instances of sexual abuse in which the victim sees herself as having caused it, and, even more commonly, by instances in which a child who feels traumatized, say, by a visit to the dentist, later plays dentist, with a younger sibling the unwilling victim. Using a methodology that explores unconscious fantasies, psychoanalysts have learned that the first instance is probably motivated by the presence of antecedent forbidden unconscious sexual wishes, while the latter instance is motivated by the developing child’s attempts at mastery and magical control. As Litowitz notes, this reading of such events is unique to psychoanalytic theory and technique; it cannot be gleaned using the usual observational or experimental methodology of academic psychology. In this regard, Piaget and Inhelder’s use of the term “egocentrism” (1969) is epiphenomenal, while the underlying dynamics are related to the defenses described above. As Litowitz (2007) aptly notes, “psychoanalysts are in the best position to provide data for academic researchers on topics such as identifications, intersubjectivity, interpersonal relations, and defensive maneuvers” (p. 217). Thus, the integration of psychoanalysis with other disciplines works in both directions.
In recent decades, analysts have shown signs of turning outward toward neighboring disciplines. This welcome change raises the question, Which disciplines are most relevant to psychoanalysis? Freud was ecumenical in this respect, borrowing from the arts and humanities (visual art, literature, mythology, philosophy) as well as medical science (neurology and neurophysiology).
Attention to the arts and humanities has been most fully exploited by various hermeneutic and postmodern schools of psychoanalysis, especially in North America. These analysts have rejected Freud’s metapsychology, and ego psychology in general, as a failed project, and have declared that theory-making is itself a positivist undertaking to be avoided, insisting that psychoanalysis should concern itself solely with subjective meaning and its novel creation and interpretation in the analytic dyad.
But some of us, like Freud himself, aspire to a psychoanalytic science, a discipline that fits into an overall science of mind, rather than one focused only on aesthetics or hermeneutic subjectivity. We hope to contribute to a conceptualization of how the mind works and develops so as to better help our patients; we are like the mechanic who needs to understand the workings of an internal combustion engine in order to fix the carburetor.
Not long ago, I used the phrase “psychoanalytic science” in reviewing a book for a prominent American psychoanalytic journal, and was reprimanded by its editor because he insisted that I could no longer assume that most readers would agree with the characterization of psychoanalysis as a “science.” I believe this view poses an existential threat to the continuation of clinical psychoanalysis, at least in North America.
In 2008 Redmond and Shulman surveyed 150 highly ranked U.S. colleges and universities. Their goal was to determine which academic departments offered courses including some study of psychoanalysis. They found six times as many such courses outside of psychology departments as were found within them. The courses that contained references to psychoanalysis included offerings on film, gender and queer studies, media, and mythology. In these courses, psychoanalysis was treated as a “form of reading,” with no mention of it as a form of treatment. Redmond and Shulman reported that the material of these courses was steeped in Lacanian or postmodern thinking, with psychoanalytic terminology used in a manner that would be unfamiliar or jarring to psychoanalytic clinicians. Sadly, psychoanalytic ideas were rarely found in courses in psychology departments, and where they occurred, there were virtually no references to psychoanalytic thinkers beyond Freud and Lacan. 3 There was little mention of how psychoanalytic thinking had evolved in the post-Freudian era, a limited view also shared by the popular American press, as evidenced by articles in the New York Times, The New Yorker, and the New York Review of Books, where psychoanalysis is almost exclusively identified with Freud’s work rather than as an evolving discipline.
A 2006 review of introductory psychology textbooks by Park and Auchincloss found similar results: references to psychoanalysis failed to characterize its central contributions, or described it as lacking scientific merit. The one topic that is represented in psychology departments and the popular press is attachment theory. The attachment literature, which began its life in academic psychology journals on child development, was accepted only belatedly in psychoanalytic journals, once it was finally understood to have bearing on the psychoanalytic understanding of child development. However, in academic journals attachment constructs have been understood in the most superficial behavioral terms, with little or no awareness that the richness of the attachment construct, and the research that supports it, is based on assumptions regarding unconscious fantasies and defensive maneuvers in very young children (Erreich 2003, 2017).
Clearly the situation is that psychology departments do not introduce psychoanalytic thinking to their students because their faculties, like the general public, believe that psychoanalysis is an old-fashioned, “unscientific” option for treating psychological problems. In this context, a recent issue of JAPA (64/3) was devoted to the crisis regarding the very legitimacy of psychoanalysis as a discipline, beginning with a target paper by Kernberg and Michels (2016) on psychoanalytic education.
Given this state of affairs, we cannot afford the luxury of dispensing with scientific inquiry in psychoanalysis, the kind of inquiry that naturally seeks dialogue with disciplines whose empirical research can enrich our thinking and set appropriate parameters on our theorizing. In my opinion, the future of the psychoanalytic project, at least in North America, depends on progress toward the establishment of a scientific discipline, one with its own unique database. As Cooper wrote more than three decades ago, “Even if we do not feel impelled by our scientific and theoretical curiosity, we might respond to the demands of a society that will not forever allow us to practice clinical psychoanalysis without evidence of its efficacy” (1984, p. 259).
In this essay, I will try to illustrate some points of contact between psychoanalysis and other disciplines whose findings have the potential to enrich our thinking and to support our claims to be a scientific endeavor. These other disciplines—linguistics, cognitive and developmental psychology, and contemporary philosophy of mind—have been in dialogue with each other rather intensely at least since the 1960s, and their findings have converged on a set of overlapping assumptions and data that point to some shared conclusions. I will try to illustrate how their shared assumptions and findings reveal nontrivial points of contact with psychoanalysis, often shoring up our claims from multiple directions.
Much of the impetus for current thinking in these disciplines owes its motivation to the work of Noam Chomsky, who, beginning in the late 1950s, offered his theory of generative transformational grammar as a challenge to both structural linguistics and behaviorist psychology (1957, 1959, 1965). I entered graduate school in psycholinguistics in the 1970s, around the time I entered my first psychoanalysis. The encounter with unconscious aspects of my mind, though remarkable, nevertheless seemed fully compatible with the view of mind held by linguists, then in thrall to Chomsky’s ideas. The Chomskyian revolution significantly affected a remarkable number of disciplines, obvious ones like cognitive and developmental psychology, but also computer science, neuroscience, and philosophy of mind; even music theory was affected, as demonstrated by Leonard Bernstein’s 1973 Harvard lecture series (Bernstein 1976), which included talks on “Musical Phonology,” “Musical Syntax,” and “Musical Semantics,” modeled on Chomsky’s proposals regarding the three major components of all human language. Over time there has been some convergence regarding mental structures and processes among these disciplines, and that is what I wish to highlight, by illustrating several overlapping assumptions that constitute points of contact between psychoanalysis and these three disciplines.
The Infant’s Capacity for Sophisticated Out-of-Awareness Mentation
Psychoanalysis has been intimately tied to language, especially in its early years when the importance of enactment was not yet understood. However, psychoanalytic writers have generally assumed that language consists of words and their meanings. Though word meanings are of greatest interest to psychoanalysts, this linguistic component has been of less importance to linguists, for whom the study of syntax and phonology has been more useful in generating hypotheses regarding the power of innate structures and functions of the human mind. Findings in these two domains provide significant support for seminal assumptions in psychoanalysis, particularly with regard to out-of-awareness mentation.
Chomsky’s work and that of his colleagues provided empirical support for the notion that much of mental processing occurs out of awareness, as evidenced by the obvious fact that by age three or four, neurotypical children, regardless of differences in intelligence, culture, or parenting styles, manage to acquire the basic phonological and syntactic rules of their native language without instruction or conscious awareness. (In contrast, the acquisition of the semantic component of language, that is, vocabulary, continues over a lifetime, and occurs via more ordinary processes of learning.) These ideas were put forth at a time when the notion of mind, let alone out-of-awareness mentation, was still under attack in academic settings.
In the U.S., psychology since the 1920s had been dominated by the behaviorist model as exemplified in the work of psychologists like John Watson and B. F. Skinner. Behaviorism had emerged partly in reaction to the Gestalt psychologists’ previous interest in introspection and mental phenomena. The behaviorists called a halt to investigations into the “black box” of mind, declaring that only behavior that was observable and measurable was of any value; mind was an irrelevant construct.
However, the final death knell for behaviorist psychology, and for the empiricist tradition in which it was grounded, was sounded in 1959 by Chomsky. In a brilliantly argued review of Verbal Behavior, Skinner’s attempt to account for language, Chomsky demonstrated that language acquisition and use could never be adequately accounted for by behaviorist principles. Taking a rationalist stance, Chomsky criticized Skinner’s view that the child is essentially a tabula rasa and that language could be accounted for by principles of contingent reinforcement. Instead Chomsky proposed that infants must be genetically endowed with linguistic structures and hypothesis-testing mechanisms that allow for the rapid, automatic character of the language acquisition process. Despite the ensuing years of debate in linguistics regarding the accuracy of the details of this proposal, Chomsky continues to maintain the evolutionary uniqueness of the human capacity for language:
A newborn human infant instantly selects from the environment language-related data, no trivial feat. An ape with approximately the same auditory system hears only noise. The human infant then proceeds on a systematic course of acquisition that is unique to humans, and that demonstrably goes beyond what any general learning mechanism can provide, from word learning to syntactic structure and semantic interpretation [Berwick and Chomsky 2016, p. 98].
Chomsky proposed that the study of language was part of a larger investigation into the operation of all higher mental functions, including perception, memory, and reasoning. His work ushered in the “cognitive revolution,” as a result of which academic psychology returned to an interest in mind.
The opportunity for collaboration with psychoanalysis was now possible, but still some years away. The proven existence of sophisticated out-of-awareness mental processing capacities in infants would certainly have supported Freud’s proposals regarding unconscious mental processes and the existence of unconscious fantasies in very young children, had psychoanalysts been aware of that research. Given my training in linguistics and psycholinguistics, it appeared quite reasonable to attribute oedipal fantasies to four-year-olds when by that age they had managed to acquire, without instruction, the phonological and syntactic systems of their native language.
The Epiphenomenal Nature of Observable Behavior and the Role of Errors in Revealing Underlying Mental Processes
Psychoanalysts and academic researchers alike are faced with the same epistemological problem: how can we know the subjective mental states of others when all we have access to is their manifest behavior?
Chomsky had provided the metaphor of the child as a little linguist: The child must discover the rules of the linguistic system into which she has been born by testing innate linguistic hypotheses, derived from what he called universal grammar, against the language data she hears until she generates an approximate adult grammar of her language. On this view, children’s errors are important because they provide clues about the kinds of hypotheses children are testing. For example, common errors such as “childrens,” “goed,” and “wented” could not be the result of imitation, which behaviorists had assumed to be a powerful explanation for language acquisition. Instead, such errors indicated that children had inferred, for example, the general rules for English plurals and past tense, but had not yet learned that there are exceptions to those rules. Thus, what manifestly appear to be errors are in fact indicators of rule-governed, out-of-awareness processes at work.
This notion is analogous to Freud’s principle of psychic determinism and his interest in parapraxes. Similar to the linguists’ interest in errors, Freud had argued that parapraxes were errors that gave insight into the unconscious motivations of his patients. Elsewhere I have argued that parapraxes result when an unconscious fantasy is activated as an individual is faced with circumstances analogous to an earlier trauma (Erreich 2017). For example, after a female psychiatry resident relocated her training to live with a man she had dated for some years, he summarily ended the relationship, and she was forced to find other housing to complete her training before returning to her home state. Her outpatient work required that she write her name in a space that said “therapist” on a slip of paper that her patients gave her from the admissions desk. In her own treatment, she reported that she continually kept “misreading” the word “therapist” as “the rapist.” She quickly realized that this parapraxis represented her conscious belief that she had been violently abused by her boyfriend; nevertheless, the “misreading” continued to overrule her conscious awareness for many months. Over time, we came to discover that her recent traumatic romantic experience was analogous to an episode of childhood sexual abuse in which she had also felt “tricked” into following a man to “his place,” where she was vulnerable to his sexual advances. Thus, an unconscious fantasy regarding that first traumatic experience was manifest in an epiphenomenon, a parapraxis, that revealed underlying mental processes.
Chomsky made a crucial distinction between linguistic competence, a native speaker’s knowledge of her language, and linguistic performance, the use of that knowledge in day-to-day life. It is obvious that people’s speech does not always reflect their competence; that is, under the influence of various performance factors, say, time contstraints or anxiety, people produce the performance errors common to speakers everywhere, even at linguistic conferences. For example, they repeat words, make grammatical errors, or speak in incomplete sentences or phrases. These are to be distinguished from rule-based errors such as the children’s errors cited above, which were thought to reflect a child’s linguistic competence at a given point in time.
The competence-performance distinction borrowed from linguistics is pertinent to how analysts think about patients’ speech and behavior. Psychoanalysis has been caricatured as attributing unconscious meaning to an individual’s every thought and behavior. But as all practicing analysts know, sometimes a slip of the tongue is simply a slip of the tongue due to performance pressures. There are performance errors in our language and behavior, and we look to distinguish those from meaningful, motivated errors, though this is not always self-evident. In the example of the resident above, her insistence on seeing a gap in the word “therapist” where there was none so that it appeared to her as “the rapist” was clearly a motivated error. Perhaps the gap represented the gap in her memory for the original abusive encounter; in any case, the persistence of the error once it was recognized signaled something more than a performance error.
The epiphenomenal nature of observable data and the difficulty of discovering its latent meaning underlie disputes regarding the relation between psychoanalysis and infant research. Analysts like Peter Wolff (1996) and André Green (2000) have insisted that adult analytic data are privileged over infant observational research because patients can report on their affects, conscious fantasies, and dreams, while infant research is based only on behavior. The strong version of this argument cannot be true. One can claim direct access to adult patients’ affects and unconscious fantasies only if one believes that a patient’s manifest presentation in words or behavior represents subjective experience that can be taken at face value. However, most of our training is focused on teaching principles of decoding manifest presentations to get at the “real” meaning. We speak of derivatives of unconscious fantasies precisely because we lack direct access to them, and it is clear from our collegial disputes that we often disagree about how to understand patients’ subjective experience from clinical data. More important, subjective states of intention, desire, and affect are not evident to patients themselves, who often disavow or distort them. Dreams and fantasies all demand interpretation from manifest data via principles of clinical inference. The same task faces infant researchers, who must also subject manifest behavior to an inferential process, as is the case in the analysis of young children.
As psychoanalysts, we have much to offer academic psychology regarding the epiphenomenal nature of observable data. Studies of attachment were first published in academic journals, not psychoanalytic ones, and their findings were limited to the interpretation of manifest behavior. In early articles by Sroufe and Waters (1977a,b) published in developmental journals, the authors struggled to explain the behavior of avoidantly attached children: those who show no overt distress when their mothers leave them alone with an experimenter, and avoid or rebuff their mothers when they return. To some observers, the manifest behavior of these children made them appear precociously independent. Yet Sroufe and his colleagues had demonstrated that despite these children’s observable indifference to their mother’s leaving and returning, their heart rates spiked when the mother left the room and when she returned. Mary Ainsworth had previously documented that the mothers of avoidantly attached children were unempathic and rejecting when their children sought them out in distress (Ainsworth et al. 1971, 1978). Sroufe and his colleagues struggled to explain why these children “appeared” unperturbed while their hearts raced with anxiety.
Their conclusions seem strained and incoherent. Because their work was published in an academic journal, they could not make reference to psychoanalytic constructs like unconscious fantasy, conflict, and defense, constructs that clearly account for the defensive behavior that results from these children’s wish to be close to their mother when stressed, and the fantasy (based on previous experience) that their mother will reject their neediness, leaving them no safe space when frightened (Erreich 2003).
While the academic literature on attachment suffered from ignorance of such psychoanalytic constructs, psychoanalytic accounts suffered from lack of attention to the actual nature of the mother-infant dyad. Developmental research on attachment theory has provided insight into how misattunement and lack of empathy can result in early cumulative trauma (Erreich 2003), yet for a long time the psychoanalytic community rejected this research because it was based only on “behavior.” Given the findings from Sroufe and Ainsworth, it should have been obvious to a psychoanalytic reader of this literature that the manifest behavior of the avoidantly attached children provides stunning evidence of organized defensive activity at the age of twelve months, indicating that the mental capacities that underlie defense formation are present even earlier. That is, the manifest behavior of avoidantly attached children can be seen to reveal underlying defensive processes, a seminal insight in psychoanalytic theory.
The Competent Infant
“What does the infant know and when does she know it?” has always been paramount in psychoanalytic theorizing. As early as 1942, Ives Hendrick questioned the picture of early infantile experience that some analysts had provided:
Some analytic portrayals of the actual infant seem far more the projection of analytic theory and adult passions than scientific observation. . . . what does require our attention is the frequency with which our conclusions concerning infancy imply the untenable assumption that the unconscious mental life of the adult (or of the post-infantile child) is a replica of the infant’s experiences [p. 33].
Lampl–de Groot (1939) had called this the “transporting back” fallacy. Hendrick argued that the need to do things, to master the environment via sensory, motor, and intellectual means is at least as important as pleasure-seeking mechanisms during the first two years of life, functions Freud referred to as ego instincts, though he never elaborated them.
Oddly enough, it has been the common view of both behaviorist psychologists and Freudian psychoanalysts that the infant is essentially a tabula rasa. For analysts, this view necessitated the belief that the all-important ability to differentiate self from other, and inner from outer reality, takes about thirty-six months to accomplish, in accord with Mahler’s timetable (1972). In contrast, Chomsky’s proposals regarding infants’ innate linguistic ability and the developmental research that followed on its heels demonstrated infants’ sophisticated capacities for accurate perceptual discrimination in all modalities: visual, auditory, tactile, olfactory. By the 1970s, some of this thinking had permeated even psychoanalytic circles, rendering Mahler’s account highly improbable.
This was Daniel Stern’s conclusion (D.N. Stern 1982, 1985) after reading the research literature in developmental psychology. His investigations into what cognitive and developmental psychologists were calling the “competent infant” led him to reject Mahler’s findings. He argued against the presence of undifferentiated merger states as characteristic of normative infant mentation, given infants’ acute capacities for perceptual discrimination. He concluded that such states in older patients cannot be viewed as regression to an earlier normative infant state. The presence of undifferentiated or symbiotic states represents neither normal infant mentation nor a deficit in the ability to move from merger to separation; rather, such states represent motivated ways of being-with-an-other. Contrary to long-held psychoanalytic beliefs regarding infant mentation, developmental research on neurotypical infants suggested that they are highly reality-oriented from birth; in fact, they are designed to discriminate between self and other, and inner and outer reality, from the earliest days of life. Thus, symbiotic and self-object ties cannot be a regression to an earlier undifferentiated phase, but rather are adaptive or maladaptive developmental constructions; that is, their appearance in either children or adults indicates the presence of defensive maneuvers. 4
Since the 1970s there has been an explosion in infant research by both academic and psychoanalytically informed researchers. In a recent comprehensive review of the developmental literature on concept formation, Carey (2009) suggests that evolutionary selection pressures have favored our ability to understand others and endowed humans with “core cognition.” The latter includes innate knowledge of concepts such as agents, their goals, their communicative interactions with each other and the physical world, their attentional states, and causal potentials. Developmental research indicates that infants are intentional (goal-directed) agents; Carey argues that they encode symbolic content in the form of mental representations, and that their behavior is goal-directed and mediated by these mental representations of the world (Erreich 2015).
Anecdotal evidence for very early visual and auditory discrimination and memory appears in the simple act of the infant’s recognition of its mother’s face and voice. In fact, there exists experimental evidence that there is strong preference for the iconic representation of a human face postnatally (Mondloch et al. 1999) and even prenatally (Reid et al. 2017). In addition, there is abundant research evidence for early discrimination and memory encoding, including what appears to be prenatal memory: that is, newborns are able to recognize a Dr. Seuss story when it had been read aloud to them by their mothers in the third trimester of pregnancy, and they are able to differentiate between two different Dr. Seuss books (DeCasper and Fifer 1980). Meltzoff (1990) concludes from this that “there is a kernel of some higher level memory system right from the earliest phases of human infancy” (p. 25).
In the experimental literature on infant cognition we find evidence for object representations by two months of age, for comprehension of intentional agency by three months, and for representations of causality by six months (Carey 2009). For example, three-month-olds can distinguish video figures that act as either helpers or hinderers with respect to another video figure struggling to climb a mountain; infants prefer helpers, demonstrating that very young infants can identify and interpret others’ goals, as well as a preference for pro-social behavior (Hamlin, Wynn, and Bloom 2010).
Elsewhere I have argued (Erreich 2007) that psychoanalytic researchers and practitioners have demonstrated that preverbal memory exists for both cumulative and discrete trauma, that such memories can be represented symbolically in bodily sensations and behavior in later childhood and adulthood, and that when expressive language develops it too can be recruited to represent these autobiographical experiences.
The notion of a “competent infant” with robust perceptual and recall capacities is also relevant to a philosophical issue regarding what has been called “theory of mind.” In recent decades, philosophers (Dennett 1987; Fodor 1992; Block 1986; Chalmers 1996), along with developmental psychologists, have been investigating the nature and origins of our ability to attribute mental states to others. This work has focused on the “intentional stance” as an evolutionary adaptation that helps predict the behavior of other agents. As noted earlier, Carey (2009) argues that even young children are “belief-desire” psychologists who attribute desires, beliefs, goals, and emotions to others as explanations for their actions.
These philosophical investigations underlie the work of Fonagy and his colleagues regarding “mentalization” (Fonagy 2001; Fonagy et al. 2002). They argue that favorable conditions of mothering help the infant come to understand interpersonal behavior in terms of mental states, that is, to attribute thoughts and affects to self and others. Fonagy and colleagues claim that the capacity for mentalization or reflective function is critical for the development of self-organization and affect regulation. It stands to reason that the ability to mentalize others requires the ability to distinguish inner from outer reality, and internal mental processes from interpersonal events. Fonagy and colleagues have proposed that an understanding of self and others as mental agents grows out of interpersonal experience in primary relationships occurring between the ages of two and five.
An alternative to Fonagy’s interpersonal view of the dyad as the source for infants’ understanding of mental agency is presented in Carey’s (2009) proposals regarding infants’ innately endowed “core cognition.” On this view, the capacity for mentalization would be present at birth, but can be distorted for defensive reasons due to threatening experiences in the maternal dyad. Fonagy’s view represents a “competent infant,” one that requires interpersonal experience to develop notions of agency in self and other, while Carey’s view, if correct, represents a highly “competent infant” in whom the capacity for this knowledge is present at birth.
I have suggested that dialogue with border disciplines can set parameters on psychoanalytic theorizing. Thus, the current view of the “competent infant,” one with an innate ability to register and represent conscious or unconscious subjective experience, in combination with abundant research demonstrating the infant’s early, acute capacity for perceptual discrimination (e.g., Carey 2009; D.N. Stern 1985; Erreich 2003), may pose a significant challenge for psychoanalytic theories that espouse so-called “primitive mental states” (e.g., Grotstein 1980; Bromberg 1996; Caper 1998; Ogden 2016) or “unrepresented,” “unformulated,” “unsymbolized” experience (e.g., D.B. Stern 1997; Levine 2012; Diamond 2014). Rather, both research and clinical findings regarding the innate capacity to register and represent subjective experience, and the later capacity to verbalize it, suggest that the presence of fantasies of split or merged objects, “empty” minds, or other distortions of subjective and objective reality, are defensively motivated and arise as the result of parenting experiences after birth, rather than being characteristic of inborn infant mentation. It seems fair to say that there is a burden on theories that claim the existence of such states to specify their nature in a manner that does not violate our growing knowledge of infants’ mental capacities (Erreich 2017).
What’s Past is Prologue
One of Freud’s seminal discoveries has been that, as aptly noted by Faulkner, “the past is never dead, it’s not even past” (1951). Often unknowingly, our histories reenact themselves in small ways and in grand, overarching trends in our lives. Fortunately, there is ample research in cognitive and developmental psychology to support this seminal psychoanalytic assumption, one that has been mocked as a quaint anachronism in some quarters.
Contemporary memory research has shown that autobiographical memory appears to be organized along networks of associations representing admixtures of content that is both in and out of awareness. Freud, with his technique of free association, fortuitously stumbled into this finding. He discovered that discrete traumatic events, those stored in declarative memory, could be unconscious but still influence his patients’ lives. What about cumulative trauma, events stored in procedural memory that are so much the fabric of relatedness in the mother-infant dyad that they are recalled not as discrete events but as ways of being-with-others?
To systematically investigate implicit/procedural memory networks, researchers have employed a technique called priming. Priming is a procedure that indicates whether previous exposure to some stimulus influences an individual’s subsequent judgment or behavior. Priming studies demonstrate that individuals can be influenced by stimuli they are unaware of when the stimuli are presented either subliminally, that is, below the level of conscious awareness, or supraliminally, but masked or altered.
For example, subjects are subliminally primed with the word dog; then they are asked to press a button when they recognize that sets of letters flashed on a screen represent an actual word rather than random letters. Subjects who have been primed with the word dog respond significantly faster to words like terrier and poodle than subjects who have not been primed (Westen 1999). Despite no awareness of the subliminally presented word, the subjects are hyper-alert to words that are part of the associative network of the prime dog; the priming procedure renders words representing dog breeds more accessible.
Priming effects show robust durability over time even for rather trivial stimuli. In one remarkable finding, subjects were asked to identify fragments from black-and-white line drawings, some of which had been presented to them in a lab seventeen years earlier, and some of which were new (Mitchell 2006, reported in Stoycheva and Weinberger 2014). Recall rates were significantly higher for previously seen fragments than for novel fragments, even in individuals who reported no memory of the lab experience seventeen years earlier. Mitchell (2006), who performed these experiments, argues that implicit memory is “an invulnerable memory system that functions below conscious awareness,” which leads other researchers to conclude that “implicit memory—like the dynamic unconscious—is timeless” (Stoycheva and Weinberger 2014, p. 107). Priming effects have also been implicated in models of PTSD: because traumatic events appear to act as robust primes, they have rendered individuals hyper-alert to elements reminiscent of those original traumatic events (Ehlers and Clark 2000).
For purposes of psychoanalytic theorizing, we would want to know how early in life children are able to encode events in memory to allow for priming effects, so that we can generate accurate hypotheses regarding the effects of both discrete and cumulative trauma on infant experience. Surely traumatic events are likely to have more salience for babies than neutral ones.
The behavior of avoidantly attached children in the Strange Situation provides evidence for the encoding of cumulative trauma, that is, ongoing defects in maternal attunement and empathy in the mother-infant dyad within the first year of life, and its later recall at twelve months in the Strange Situation. Early object-relational patterns “prime” infants to seek out or re-create those kinds of object ties in later life (Erreich 2003, 2017).
Bernstein and Blacher (1967) present clinical evidence for the encoding of discrete traumatic events and priming in very young infants. The youngest case, Laura, was born with hydrocephalus that required several painful surgical procedures at three months. The hospital was undergoing renovation, resulting in constant loud banging during her pneumoencephalogram; she awoke screaming and terrified. At twenty-eight months, Laura became terrified at the sound of hammering from next door and would awaken from her nap frightened. A “man is knocking,” she explained; “. . . in the hospital the man knocked my head off,” reminding her mother about the construction work during her procedure. When questioned further, Laura said the “man stuck me in the tushie and knocked my head off,” indicating that the procedures had hurt her head. Here we have evidence of the priming effect of sounds that accompanied a discrete traumatic experience encoded in declarative memory at three months.
Coates (2016) presents additional clinical material from children who experienced discrete traumatic events at ten months and twelve months. She also describes the fascinating case of a two-year-old boy who had been traumatized by his mother’s grabbing him by the neck and shaking him during her rages, until she finally brought her son for treatment. During the treatment, which terminated at age eight, he reported a “weird feeling” when his guinea pigs fought, adding that his neck would get “hot and cold.” This boy returned to Coates fourteen years later, when he was twenty-two, for help with a strange symptom: whenever he watched violent scenes on TV or film, his neck would feel weak and he felt he had to put his hands around it to hold it up, a posture mimicking what his mother had done to him twenty years earlier. Here we have evidence of a discrete traumatic event encoded symbolically in somatic sensations and behavior by a two-year-old boy.
Thus, we have evidence that very young infants are able to encode cumulative trauma in procedural memory, to encode discrete traumatic events in declarative memory, and, with the onset of expressive language, to add verbalization to the somatic and behavioral representation of these experiences. All these capabilities allow very young children to be “primed” by past traumatic experiences, which can be reawakened when they are faced with analogous circumstances in later life.
It is not a trivial matter to find experimental evidence that supports one of the seminal claims in our field, one frequently mocked as an outmoded shibboleth: that is, that the past matters because it contours our subjective experience in the present, and that the power of the priming phenomenon for both declarative and procedural memory is robust and long-lasting.
Concluding Remarks
Scott Page, professor of complex systems, political science, and economics at the University of Michigan, argues in favor of diversity in organizations (2007). He observes that when faced with complex problems, people who think in the same ways will get stuck in the same place, while people who think differently may be able to come up with novel solutions. He suggests that breakthroughs in science come from teams of bright, diverse people, and that interdisciplinary work is the most important trend in scientific research.
We psychoanalysts have been far too jealous of our autonomy. I believe our survival depends on a willingness to engage meaningfully with other disciplines. To cite Cooper’s thirty-four-year-old plea once again, “psychoanalysis is far too important to be left only to psychoanalysts, and it is certainly too important to be confined solely to the conduct of psychoanalytic treatment” (1984, p. 264).
Footnotes
Faculty and Training and Supervising Analyst, Institute for Psychoanalytic Education affiliated with NYU School of Medicine; Clinical Professor of Child and Adolescent Psychiatry, NYU Langone Medical Center.
1
I am grateful to Werner Bohleber for directing me to this correspondence.
2
The International Psychoanalytic University in Berlin, a unique entity with undergraduate and graduate programs in psychoanalytic studies, a degree-granting university with funded research devoted to psychoanalytic ideas as well as links to other universities and neighboring disciplines, appears to be the sole realization of Cooper’s dream.
3
A more recent study cited in The American Psychoanalyst (Riker, Dobson, and Wong-Appel 2018) seemed to find a greater prevalence of psychoanalytic courses in top-rated universities and colleges; their distribution among departments, however, is in keeping with these earlier findings: “it is clear that the vast majority of courses dealing with psychoanalysis occur in the humanities and social sciences . . . .”
4
On this view, deficit models, such as Mahler’s and Kohut’s, are understood to reflect conflict rather than psychogenic deficit. True deficits are thought to be neurological in nature, wherein distortions in self-other differentiation result from neuropathology, such as autism, rather than psychodynamic factors in the mother-infant dyad.