"How we wish that you had been differently employed"
January 6, 2011
This one is for some folks I’ve been engaging with on the Twitts about Uncle Siggy…
Don’t forget DrZen’s comment:
Freud was a comparative neuroanatomist who made significant discoveries: http://bit.ly/vf3qK
DrugMonkey 
January 6, 2011 at 9:54 am
Hasn’t everyone heard this song already? Or is my childhood really that weird?
Anyway, what did Freud do that you think is so critical to recognize as science? I’ve got no issues with crayfish, but you implied the psych stuff proper had merit as science, and I can’t quite see that.
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January 6, 2011 at 10:01 am
DM — This clip is cute, but your exchange with the twitts was even funnier. When a person who attends transhumanist conventions accuses Freud of being a “cult figurehead,” now that’s comedy gold…
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January 6, 2011 at 10:49 am
@becca, The Freud wikipedia article lists some of his non psych work. Some of cocaine work was unquestionably solid science. It hasn’t all stood the test of time, but being relevant 100+ years later is a high standard. The wiki mentioned work with cerebral palsy, which I hadn’t known before.
Even focusing just on Freudian therapy, he laid major groundwork on how we think of the brain and treatment of mental illness. Much of the better work was done in attempts to prove Freud’s theories right or wrong. The idea that you can treat a significant portion of mental illness by having an expert sit in a room and talk to a person is still a fundamental aspect of modern treatment even if classic Freudian psychotherapy is now on the fringe.
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January 6, 2011 at 10:56 am
I just got done reading wiki when I asked the question.
On cocaine- if solid science leads to prescribing a drug to your friend and having them die of it, I don’t wanna be a solid scientist.
The cerebral palsy thing just says he *didn’t* think lack of oxygen was important, which I don’t think is particularly enlightening.
I don’t want to completely minimize talk therapy, because it is very valuable, but it is not a shining example of a scientific approach. The approach freud in particular took… might be argued to be poor medicine, even violating the hippocratic oath. And it’s almost by definition impossible to tell if your intervention was what enabled a particular recovery. Particularly when the disease you are treating is ‘hysteria’, with all the political and anti-scientific baggage that term carries.
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January 6, 2011 at 11:19 am
@Becca, you can go beyond that one anecdote to learn about his cocaine research.
Scicurious wrote a bit more a while back.
http://scientopia.org/blogs/scicurious/2010/08/02/uber-coca-by-sigmund-freud/
The best writeup I read was in “Who goes first” by Lawrence Altman where the designs of some of his cocaine studies were outlined along with the other scientists of his time.
As for CP, the oxygen theory is still alive today although I think it’s currently considered wrong (though is the source of many of the CP malpractice lawsuits against obstetricians)
You’re holding Freud’s science and choice of words to modern standards. What clinical mental health research from 1900 do you consider science? How much work from that time period would you consider science at all? Remember the t-test is from 1908 and wikipedia says the first randomized controlled trial for human disease was 1948.
I’d even argue that hysteria is a very scientific term. It was a condition that was hypothesized to originate from a specific bodily organ. The hypothesis was completely wrong. Perhaps Freud is to blame for disconnecting the term from that hypothesis, but perhaps that’s also what brought an end to the term’s usage.
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January 6, 2011 at 12:06 pm
My argument is not that Freud shouldn’t be considered a scientist, because I absolutely think he should. Nor is it (as some would argue) that “nobody takes him seriously anymore,” because there are still plenty of psychodynamic researchers and clinicians, who are heavily informed by his work. I would even argue that there are at least a handful of psychopathologies for which the best explanation (at least, as far as treatment is concerned) is still the psychodynamic one.
However, the initial question was whether Freud should be considered a neuroscientist – at least with respect to his psychodynamic theories – and I’d still argue ‘no.’ I’m happy to be convinced otherwise, but the way I see it, the neuroscientific approach to psychopathology is to find biological etiologies for the various mental disorders and pathologies. Given that, based on what I know of Freud and his work, he had no interest in determining the biological cause for mental disorder.
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January 6, 2011 at 12:39 pm
Jason, To rephrase, “Ignoring all the clearly neuroscientific work Freud did and focusing just on psychodynamics, is Freud a neuroscientist?”
To expand this, lets remove the disorders where the major symptoms were cognitive or motor (i.e. Alzheimer’s Disease, Parkinson’s Disease, Aphasias) and focus on the purely behavioral disorders (i.e. what we now call depression, schizophrenia, ADHD, autism, …). This is the domain where Freud was applying psychodynamics. Who is the first person you consider who studied the brain, not just theorized, to find biological etiologies for these disorders? I’m not a historian, but I can’t think of when this became a common part of dialog. It was definitely part of the discussion by the early 1950’s when NIMH was founded with clinicians & neuroscientists under one roof.
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January 6, 2011 at 1:15 pm
Kraepelin is generally considered the first biological psychiatrist. Kraepelin thought that mental disorder should be considered a disease, just like any other medical pathology, superimposed onto an otherwise healthy individual. Psychodynamic theorists would argue that a mental disorder is fundamental to the organization of the individual’s personality.
The early conflicts between the neo-Kraepelinian biological psychiatrists and the Freudian psychodynamic theorists can be seen in the organization of the DSM: Axis 1 reflecting the disease model of psychopathology, and Axis 2 reflecting the personality model.
Kraepelin actually predated Freud, lost ground in the early part of the 1900s as Freud was becoming popular, but in the later part of the 1900s, as neuroscience itself developed, became popular again.
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January 6, 2011 at 2:29 pm
he had no interest in determining the biological cause for mental disorder.
How do you know that? and where exactly do you think antecedent events that influence later behavior act if not upon biology and indeed, the brain?
becca, you are still totally wound up with the fact that Freud was so spectacularly incorrect in his theories (given modern thinking, things might change in the future, you know) hampered by an overfondness for his own grand theories (not something that we lack for today, btw) that you are not even trying to think straight about the broader picture of what he attempted. bsci is providing you with some good clues here. being wrong is not the same thing as being nonscientific.
The whole idea of talk therapy is an interesting one, if a bit aside from the current discussion. I tend to favor the E Fuller Torrey approach in Witchdoctors and Psychiatrists, myself. It basically holds that the surface theories that all the traditions use to argue their way over others’ way is bollocks. What matters are elements that are common to all and have nothing to do with psychodynamics, cognitive blahdeblah or even religious tradition.
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January 6, 2011 at 5:05 pm
Given what the NIH website says about CP, I think it’s overly simplistic to say the low-oxygen thing is wrong (http://www.nlm.nih.gov/medlineplus/ency/article/000716.htm).
However, I do know from a friend’s anecdotes that we really don’t know nearly as much about CP as we should, and it appears that the causes (and even the prognosis!) of any given case are not going to be known with any accuracy. That makes holding physicians responsible for things awfully messy.
As far as what went *right* with contemporary research of that time, Freud’s teacher Jean-Martin Charcot did a lot of good work. Not necessarily with the psychology, but his medical and neuroscience credentials are pretty solid, even by today’s standards. If DM had been defending *him* as a neuroscientist, I would have had no issue; even though he loved the phrase ‘hysteria’ too.
Actually, reading about Charcot’s students, I think the one that most influenced *me* (indirectly of course) has to be William James. The James-Lange theory of emotion- the notion that emotions are a reflection of physiological processes… I find that satisfyingly concordant with science.
And for all it’s many (MANY) drawbacks, I think that the work Alfred Binet laid in studying intelligence is somewhat valuable. Keep in mind, Binet was pretty wonky about hypnotism. So it’s not like we can say he was an optimal scientist. But he brought a *quantitative approach* to something; not scientific in itself, but it sure doesn’t hurt.
Also, DM, keep in mind- if wiki is any accurate guide, we might owe the notion of ‘past experiences influencing current behavior’ much more to Pierre Janet than Freud anyway.
“I’d even argue that hysteria is a very scientific term. It was a condition that was hypothesized to originate from a specific bodily organ.”
Aghhh. Yes, but even as of Freud’s time people were figuring out what was wrong with it, Freud was just too invested in the status quo to *listen* to what people like Charcot were saying about men getting it. Or see this for another pespective: http://mothershandbook.net/2010/07/penis-envy/
What I am arguing is: IN THE CONTEXT OF HIS TIME, there were generally clues (in retrospect obvious signs, but at the time, merely clues) that he might be incorrect about his theories about the *whys* of how things happened. Many of his contemporaries were much closer to what we now think of as truth. But I agree that the wrong answer doesn’t necessarily make him unscientific.
However, I think he had the wrong approach. There really were people making ENORMOUS progress studying things using more mechanistic and biological approaches during the same period he was working. I think, overall, Freud added to the dualist type thinking that mind and body were separate, and that this is essentially harmful to progress in understanding the human condition both in health and disease.
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January 6, 2011 at 6:24 pm
The discipline of neuro-psychoanalysis has its own Facebook page, featuring these endorsements:
“At long last, psychoanalysts and neuroscientists are together in the same forum, as they were in some manner in Freud’s own person.” “Freud’s insights on the nature of consciousness are consonant with the most advanced contemporary neuroscientific views”
-ANTONIO DAMASIO
“Psychoanalysis is still the most coherent and intellectually satisfying view of the mind.”
– ERIC KANDEL
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January 7, 2011 at 9:52 am
Jason, I think the core Freud/Kraepelin conflict is still alive today and, to an extent, they were both correct. Freud was much more of a theorist. To my best understanding, he believed there was biology behind his theories, but he considered the hunt to understand that biology to be irrelevant to the clinical practice of the time. Kraepelin was trying to link everything to biology/genetics, which laids the seeds for good future treatments, but his hunt for useful medications based on biology didn’t reach fruition until well after his death.
For what it’s worth, here are two nice, but slightly contradictory comparisons I found:
http://pn.psychiatryonline.org/content/41/8/31.full
http://www.springerlink.com/content/m4x582772k134552/fulltext.html
We still have the basic science reductionists who say the only way to get optimal treatment is to understand the systems we’re treating and others who are facing patients every day and trying to figure out what they can do that’s useful. Freud seems to have been very much part of the neuroscience conversation and basic concepts which he either originated or popularized are alive and well today.
Becca, I think we’ll need to agree to disagree on this. I still think you’re setting up a huge hind-sight standard. “Because others’ theories ended up right and Freud’s wrong and there was a chance he could have put together the dots and realized he was wrong. Therefore he was not a scientist.” I still see that has a huge stretch.
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January 7, 2011 at 9:59 am
exactly.
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January 7, 2011 at 11:32 am
I was very explicit in how my beef with him was not that he was wrong (the fact that many of his contemporaries got many things more right was only pointed out because you seem to think he couldn’t have possibly have known how whack-a-doo some of his approaches were. I maintain he probably didn’t realize how whack-a-doo they were because he was a crazy mfing cokehead, but I can’t prove he wasn’t just an eejit).
My issue is, you will reach the wrong conclusions if you take an unscientific (and, arguably, even anti-scientific) approach. In Freud’s case, the unscientific aspect is the unwarranted assumption is that the emotions can be analyzed independently of the body. The mind *is* the physiology of the brain, not some disembodied identity made up of soulparts.
It was wrong when Plato said it, it was wrong when Descartes said it, and it was wrong when Freud said it. It’s philosophy*, not science.
*Actual “Ultimate Reality” models may vary, of course. but you can have whatever whacko pink unicorn metaphysics you like, as long as you recognize that thoughts and emotions are the outcomes of actual chemicals in actual cells when it comes to modeling medicine.
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January 7, 2011 at 5:19 pm
Emotions can and are analyzed independently of the body. That’s not dualism. That’s designing a study or theory that can be tested. There are many modern emotion evaluations and treatments that have minimal relation to what’s happening in the brain. They might be informed by some rudimentary theories of brain structure/function, but it’s mostly tangential. The anti-scientific line is crossed when you say mind/body are distinct. As far as I understand, Freud did not believe that.
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