PETER BUCKLEY, M.D.*
THE WIDENING INTELLECTUAL SCOPE OF PSYCHOANALYSIS
In a recent featured article in The American Journal of Psychiatry,1 the distinguished neuroscientist and psychiatrist, Eric R. Kandel, exhorted psychoanalysis to undergo an intellectual renaissance by embracing both the insights of the neurobiological sciences and a true scientific tradition. He commented: "It would be unfortunate, even tragic, if the rich insights that have come from psychoanalysis were to be lost in the rapprochement between psychiatry and the biological sciences. With the perspective of time, we can readily see what has hindered the full intellectual development of psychoanalysis during the last century. To begin with, psychoanalysis has lacked any semblance of a scientific foundation. Even more, it has lacked a scientific tradition, a questioning tradition based not only on imaginative insights but on creative and critical experiments designed to explore, support, or, as is often the case, falsify those insights." Kandel's paper is provocative on many levels-he contends that in the course of psychoanalysis, interpretive and other interventions produce biological changes in the patient's brain. He observes that a neural basis for a set of unconscious processes has been discovered, albeit an unconscious quite different from that postulated by psychoanalysis, and he challenges psychoanalysis to establish the neurobiological properties of its unconscious.
A review of aspects of the recent psychoanalytic literature would suggest that Kandel's clarion call has been anticipated if not yet wholeheartedly embraced. Olds and Cooper2 recently observed: "Now that the cognitive and neuroscientists are studying the brain at higher levels of function, and are asking questions about memory, motivation, consciousness, emotion, and symbolism, we psychoanalysts are suddenly in the position of having an enormous amount of information to offer them." They cite recent work on the effect of stress on the hippocampus, that part of the brain which is the site of episodic memory (the memory of specific autobiographical events). Intense stress (such as child abuse), by a distinct neurobiological mechanism involving the inhibitory effect of glucocorticoid steroids, results in vague memories or general hyperarousal states that lose their time and space markers as opposed to clearly or accurately registered memories. They note that "memory of trauma may be distorted, obscured and reduced to non-specific fear and dread and it may be rendered timeless, never really relegated to the past, seeming always present, but because of the biology of its original registration, it cannot ever be 'restored' or 'recovered' with accuracy. As Freud described, such memories, may be `constructed,' but never 'reconstructed'." Olds and Cooper point out that such biological information provides confirmation for psychoanalytic inferences of trauma in a particular patient's past while "making us doubly suspicious of precisely recovered memories under such circumstances. …