The Brain, the Mind and the Self: A psychoanalytic road map

173 Pages·2015·0.7 MB·English

by  Arnold Goldberg

The Brain, the Mind and the Self
Psychoanalysis enjoyed an enormous popularity at one time, but has recently
fallen out of favor as new psychiatric medications have dominated the treatment
of mental illness and a new interest in the brain and neuroscience begins to domi-
nate the theory as to the cause and cure of mental illness.
How do we distinguish between the brain, the mind and the self? In his new
book, Arnold Goldberg approaches this question from a psychoanalytic perspec-
tive, and examines how recent research fi ndings can shed light on it. He reposi-
tions psychoanalysis as an interpretive science that is a different activity to most
other sciences that are considered empirical.
Giving clear coverage of the various psychoanalytic models of the mind and
the self, Goldberg examines how these theories fare against neuroscientifi c evi-
dence, and what implications these have for psychoanalytic clinical practice.
The Brain, the Mind and the Self: A psychoanalytic road map sets up evidence-
based, robust psychoanalytic theory and practice that will give psychoanalysts,
social workers and practicing psychologists a valuable insight into the future of
psychoanalysis.
Arnold Goldberg, M.D. was born and raised in Chicago and trained at the Uni-
versity of Illinois, Michael Reese Hospital and the Institute for Psychoanalysis in
Chicago. He is recently retired from the Cynthia Oudejans Harris MD chair, and
Professor of Psychiatry at Rush Medical Center.
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The Brain, the Mind
and the Self
A psychoanalytic road map
Arnold Goldberg
First published 2015
by Routledge
27 Church Road, Hove, East Sussex, BN3 2FA
And by Routledge
711 Third Avenue, New York, NY 10017
Routledge is an imprint of the Taylor & Francis Group,
an informa business
© 2015 Arnold Goldberg
The right of Arnold Goldberg to be identified as author of this work
has been asserted by him in accordance with sections 77 and 78 of
the Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this book may be reprinted or
reproduced or utilised in any form or by any electronic, mechanical,
or other means, now known or hereafter invented, including
photocopying and recording, or in any information storage or
retrieval system, without permission in writing from the publishers.
Trademark notice : Product or corporate names may be trademarks
or registered trademarks, and are used only for identification and
explanation without intent to infringe.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging-in-Publication Data
Goldberg, Arnold, 1929– , author.
The brain, the mind and the self : a psychoanalytic road map /
Arnold Goldberg.
p. ; cm.
I. Title.
[DNLM: 1. Psychoanalysis. 2. Psychoanalytic Theory. 3. Mental
Processes. 4. Neurosciences. WM 460.2]
RC504
616.8917—dc23
2014042825
ISBN: 978-1-138-78832-9 (hbk)
ISBN: 978-1-138-78833-6 (pbk)
ISBN: 978-1-315-76561-7 (ebk)
Typeset in Times
by Apex CoVantage, LLC
“The essence of something is not at all to be discovered simply
like a fact; on the contrary, it must be brought forth, since it is
not directly present in the sphere of immediate representing and
intending. To bring forth is a kind of making, and so there resides
in all grasping and positing of the essence: something creative.”
Martin Heidegger
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Contents
Introduction 1
PART I
Distinguishing the brain, the mind and the self 5
1 The brain, the mind and the self: three conundrums
in psychiatry and psychoanalysis 7
2 On understanding “understanding”: how we
understand the meaning of the word “understanding” 17
3 On the scientifi c status of psychoanalysis
and psychotherapy 29
4 A psychoanalysis independent of psychiatry 39
5 The concepts of normality and psychopathology
in psychoanalysis 53
PART II
The newer models of the mind and the self 67
6 Being kept in mind 69
7 The many meanings of empathy 77
8 Self-empathy 101
viii Contents
PART III
Clinical examples of the special role
of psychoanalysis 109
9 The danger in diversity 113
10 Refl ections on enthusiasm 123
11 On outrage and the need to be mad 135
12 Carving out a place for psychoanalysis 143
13 The future: epilogue 151
Bibliography 153
Index 161
Introduction
The brain, the mind and the self:
a psychoanalytic road map
Inasmuch as I have lived through the heyday of psychoanalysis and am now expe-
riencing what seems to be its ultimate decline, an autobiographical account seems
both permissible and warranted. Those of us who decided to pursue psychiat-
ric training after medical school were united in the view that becoming a psy-
choanalyst was our ultimate goal. Our training during psychiatric residency was
primarily based on treating patients with psychoanalytic concepts of treatment.
The few somatic treatments, such as electroshock therapy or insulin comas that
were available were reserved for the “inpatients” who were usually psychotic and
beyond “talk therapy.” There were no drugs, save the barbiturates, until Thora-
zine came upon the scene – soon to be followed by legions of medications. Psy-
chiatrists who eschewed psychoanalysis seemed primarily to care for these very
sick inpatients and resorted mainly to these few somatic therapies. Some psycho-
analysts, however, did choose to apply psychoanalytic ideas to psychoses, and
long hospitalizations of over a year were commonplace. Although the change was
slow, it was dramatic, albeit mightily ignored by many psychiatrists; drug therapy,
changed everything. Beginning with the anti-psychotics and followed by the anti-
anxiety drugs and antidepressants, a new breed of psychiatrist evolved, and with
this rather noteworthy historical movement, psychoanalysis as practiced in the
training of psychiatrists began its decline. No doubt many psychoanalysts main-
tained a stalwart faith in what they did and how they did it, but overall this became
a vanishing breed.
T he medical student who chose to become a psychiatrist was once the primary
candidate or student to enter a psychoanalytic institute in order to become a psy-
choanalyst, but now fewer physicians make this choice, and alongside the new
institutes that trained non-medical students, the older institutes began accepting
social workers and psychologists for training. Concurrent with the decline in the
usual form of psychoanalytic treatment, there arose a somewhat watered-down
form of therapy initially termed psychodynamic therapy. This was distinguished
from what was called “classical” psychoanalysis by being less frequent and less
lengthy, as well as less costly. It may have started from the efforts to treat patients
with psychoanalytic ideas by those who were not yet full-fl edged psychoanalysts,