Interdisciplinary thinking at its best  -
an introduction to some neuroscientists

“In the relevant sciences the style of discourse can no longer be demonstration, as from empirical data to true conclusions. Rather it must be dialogue, recognising uncertainty , value commitments and a plurality of legitimate perspectives. “ (Sardar)

A focus on integration in psychotherapy has coloured at least the last decade of psychotherapy, particularly for the UKCP. In this article I would like to take a broad overview of integrative trends in neuroscience and psychotherapy theory by briefly summarising the contributions of a few  major thinkers.  These key figures – including Allan Schore, Colwyn Trevarthen, Mark Solms, Jaak Panksepp, Antonio Damasio and Douglas Watt -  are all distinguished by their remarkable breadth of reference and detailed knowledge of several fields.  [i]Its intruiging how as individuals they have each made strong creative bridges between neuroscience and various traditions of psychoanalysis, psychology and social theory in the twentieth century. [1][1] It is  somewhat arbitary to name six figures. Schore, Solms, Panksepp and Damasio have clearly established themselves via the publication of important books. Trevarthen has produced a great many influential papers, and Watt, though not prolific is active in promoting integration. Many of them are members of the Society of Neuro-Psychoanalysis which was founded in London in July 2000, and which produces a the Journal of Neuro-psychoanalysis where important debates are taking place. For further information see www.neuro-psa.com.

What follows is a brief indication of the scope of thinking and the variety of roads into and out of neuroscience made by these theorists. They are each proposing models that are relevant to psychotherapy and which together form a matrix of genuinely creative and divergent contributions. Each has in different ways emphasized  holism and‘depth’ of self: that potent unconscious representations of the self derive from older, more primitive parts of the brain; and that  the self’s most basic foundations are in systems that represent the body (Watt, Damasio) Above all they have participated in the ambitious project of trying to integrate different levels of description, which suggest  ways that dynamics at the neural level are coupled to the dynamics of an internal world and of external behaviour.

Allan Schore has made an impressive synthesis of neuroscience  (neurobiology, behavioural neurology, neuropsychology) with  developmental studies, including the  infant research work of Daniel Stern and Colwyn Trevarthen. Using attachment theory as an important over-arching model he has drawn widely on psychoanalytic theory, including object relations and self-psychology.  Schore  argues that “attachment theory  has spawned one of the broadest, most profound and creative lines of research in twentieth century psychology” because it is a heuristic complete theoretical model which can “shift back and forth between the psychological and biological levels”. (Schore interview)

 

In his landmark book Affect Regulation and the Origin of the Self  Schore argues in meticulous multi-disciplinary detail that the early social environment, mediated by primary caregiver, influences the evolution of structures in the infant’s brain. He shows how the maturation of the orbitofrontal cortex, the executor of the right cortex, is influenced by dyadic interactions of the attachment relationship. This is critical to the child’s future capacity to self-regulate emotions, to appraise others’ emotional state, and manage stress. He puts forward a comprehensive  theory of affect which integrates neurobiology and psychology, and charts the development of emotional capacities in their increasing complexity. Schore has specifically recontextualised the study of development in terms of non-linear dynamic systems theory. This has enabled him to create an integrative model, which can embrace a wide spectrum of perspectives. (Schore Interview, Schore 1997)

Meanwhile Colwyn Trevarthen, who has made extensive use of video analysis of infants and mothers for research, turned to Habermas, the philosopher and social theorist, for the concept of intersubjectivity. Habermas’ theory of intersubjectivity was used to designate both an individual capacity and a social domain. Trevarthen grasped the relevance of this for infant psychology which he argued is founded in ‘innate intersubjectivity’. He has been able to demonstrate that even very young babies  “possess an active and immediately responsive conscious appreciation of the adults communicative intention”. (Trevarthen,  5) 

Trevarthen’s continued elaboration of the concept of intersubjectivity places him closer to social and communications theorists - and indeed he refers to radical social theorists like Bahktin, Bateson and Chomsky – whilst maintaining a strong emphasis on the biological grounding of human sociability.  This theory counterpoints attachment theory in important ways, emphasising as it does reciprocity, mutuality and agency in the infant, which are down-played in the affect regulation emphasis of attachment theory. He  also makes a robust rebuttal of the psychoanalytic concept of symbiosis as the dominant mental-emotional feature of early infancy. This illustrates how different disciplines can inform, dialogue with and set boundaries for one another. The case against Mahler’s formulation of an autistic stage in development is now thoroughly and rigorously made, though other aspects of her separation-individuation model remain influential. (Trevarthen 6, 18)

Trevarthen is a particularly independent thinker, who nevertheless is happy to be in alliance with Panksepp and Damasio, when it comes to emphasising the centrality of the body and intrinsic affective capacities. Jaak Panksepp is a neurobiologist and psychiatrist who has made substantial use of ethology, the study of animal behavioural biology, to map out the common emotional operating systems in mammals. With  as much precision as has been garnered by recent scientific advances, and with due consideration for the distinct differences of humans from animals, he has put forward a very compelling account of the fundamental neurological organizational principles of emotions.

 These emotional operating systems, distinguished by specific neural circuits and integrated cognition/affect /behaviour patterns, come close to what we might call ‘instincts’.   Panksepp regards these not as drives but as regulatory mechanisms emerging from the intrinsic potentials of the nervous system.  Neurobiologically, the systems identified are: the seeking system (governing curiosity, searching and meaning making); the rage system (aroused by frustration); the fear system (fight/flight/freeze); the panic system (separation distress); the lust system (sexual behaviour); the care system (maternal behaviour); and the play system. Whilst some of these categories are predictable, others radically re-formulate our established categories of affect with surprising implications. (Panksepp 1998)

Antonio Damasio is the closest of this group to pure neuroscientist although he’s also very much a humanist (he brings opera, art and poetry into his argument). He joins other well-know neurologists, including Freud, Oliver Sacks and Heinz Kohut, in bringing to a wider world the psychological insights to be gained from neurology.  Damasio’s work on emotions, coming from a perspective relatively uninfluenced by the complexity of psychoanalysis or infant observation, has a vital phenomenological edge.  His  proposal is that the brain represents not just objects but a primitive self, and also represents the basic manner in which the self is being altered by interaction with the object(s). This hypothesis that the brain represents the interaction of the self and object is radical for neuroscience, but actually a fundamental proposition of object relations in psychotherapy. Damasio actually uses the term ‘internal objects’ without reference to Klein, though he refers to other thinkers such as Freud, Nietzche, Kant and Merleau-Ponty.

Damasio’s theory could potentially be utilised as a link between Klein’s objects  and Reich’s grasp of the embodiment of object relations in autonomic and motoric patterns. [ii]He also refers to the work of Johnson (a philosopher) and Lakoff (a linguist)  who argue that metaphor - one of the chief cognitive structures by which we make sense of the world  – derives directly from bodily experience and capacities; the body, they suggest, is indispensable to the representation of abstract meaning, reason and imagination. [iii]

With the work of Mark Solms, we come right back to the rigour of psychoanalytic thinking. Here we have a Freudian psychoanalyst who is also a neuropsychologist treating patients with neurological damage analytically. His hypothesis about the neural basis of ego and unconscious draws convincingly and equally on psychoanalytic concepts and neuroscientific research. The research, carried out  on his and his wife Karen Kaplan Solms’ patients is both psychoanalytic and neurological case history.  In contrast to the very wide integrative projects of, for example, Schore, Solms is a scholar of a very particular tradition which he pursues in great depth and with precision.  He follows the thread of Freud’s work and its development by the Russian psychologist Luria. Luria combined neurological modelling with analysis of his subjects and proposed that dynamic functions of the mind arise from ‘structured internalisations’, significant connections established and modified in the brain by life experience.

Solms’ work  provides a counterpoint to Panksepp, Trevarthen, Schore and Damasio who all emphasize the bodily and non-linguistic roots of experience.  Whilst acknowledging  the embodied basis of emotional processing, Solms  focuses on the complex neurodynamic structures involved in language which penetrate deep into the apparatus of the brain. The case studies of work with patients with damage to different parts of the brain are doubly insightful, bringing light to bear on psychoanalysis and neuroscience. Solms manages to construct a detailed hypothetical model of the neurological basis of ego and id functions that remains remarkably close to Freudian metapsychology, and constructively challenges neuroscientific concepts unmodified by psychoanalytic thinking.

Finally Douglas Watt a psychiatrist and neuropsychologist has been a strong advocate of bridging neuroscience and psychoanalysis, with a clear overview of the many connecting threads between them. He has made hypotheses about a range of clinical phenomena, from psychiatric diagnostic categories to  therapeutic phenomena, such as  transference, countertransference and repetition compulsion – integrating neuroscience with a broad grasp of contemporary metapsychology.

What is particularly inspiring about these developments in thinking is that integration is occurring not just across disciplines but between levels, the micro to the macro. Whilst appreciating the ‘hierarchy of logical types’ which requires making distinctions between different ‘levels of description’ (Bateson), integational theorists are overcoming the obstacles created by perceived hierarchies of discourse (which is about politics and power).

Further Reading

Damasio, A. (1999) The Feeling of What Happens: Body, Emotion and the Making of Consciousness (Heineman, London)

Damasio, A. (1994) Descartes Error: Emotion, Reason, and the Human Brain (Putnam, London)

Pallly, R.  (2000) The Mind-Brain Relationship (Karnac,London)

Panksepp, J (1998)   Affective Neuroscience: The foundations of human and animal emotions (Oxford University Press)

Rothschild, B (2000) The Body Remembers: The Psychophysiology of Trauma and Trauma Treatment (Norton, London)

Sardar, Z Introducing Chaos (Icon books, 1999)

Schore, A (1994) Affect Regulation and the Origin of the Self (Lawrence Erlbaum, Hove)

Schore, A. (1997) Early organisation of the non-linear right brain and development of a predisposition to psychiatric disorders’ Development and Psychopathology 9 (1997) 595-631.

Interview with Allan Schore, July 2001 ‘The American Bowlby’ – www.psychotherapy.org

Trevarthen, C & Aitken, K.J. (2001) ‘Infant Intersubjectivity: research, theory and clinical application’ Journal of Child Psychology and Psychiatry vol 42, no 1 pp3-48

Solms, M. & Kaplan-Solms, K. (2000) Clinical Studies in Neuro Psychoanalysis (Karnac, London)

Watt , D  ‘Emotion and Consciousness http://server.phil.vt.edu/Assc/watt/default.html

Watt, D (1986) “Transference: a right hemispheric event? An enquiry into the boundary between psychoanalytic metapsychology and neuropsychology. Psychoanalysis and Contemporary Thought, 9 43-7