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Neuropsychoanalysis, Revisiting Freud, and Living Well: A Conversation with Dr. Mark Solms
247 Plays3 months ago
In this episode of Doorknob Comments, Fara and Grant are joined by Mark Solms, a renowned neuropsychologist and psychoanalyst. Dr. Solms discusses his groundbreaking work in neuropsychoanalysis, which bridges the gap between neuroscience and psychoanalysis. He shares insights from his 30-year project of retranslating Freud's complete works, including previously untranslated neuroscientific papers, revealing how this process has deepened our understanding of Freud's ideas. The conversation explores the fundamental role of emotions and consciousness in brain function, the importance of understanding subjective experience in mental health, and the potential future of artificial consciousness. Dr. Solms also touches on the relevance of Freud's work in modern neuroscience and psychotherapy, offering valuable perspectives for both professionals and those undergoing psychotherapy
We hope you enjoy it.
Resources and Links
Doorknob Comments
https://www.doorknobcomments.com/
Mark Solms
https://x.com/Mark_Solms
Dr. Fara White
https://www.farawhitemd.com/
Dr. Grant Brenner
https://www.granthbrennermd.com/
https://www.linkedin.com/in/grant-h-brenner-md-dfapa/
Recommended
Transcript
Freud's Methodology and Subjective Experience
00:00:00
Speaker
Freud's view was the opposite. It was, you've got to adjust your methods to the object of study. You don't adjust the object of study to your methods. So Freud studied subjective experience, which is part of nature. It exists. Please notice. Here we are. We're busy experiencing it. Empirically, it exists. Feelings exist. Fantasies exist. And he tried to bring that into science. And I think that's a very important thing, to to not airbrush out of science our very selves.
Introducing Hosts and Podcast Theme
00:00:30
Speaker
Hello, I'm Dr. Farah White. And I'm Dr. Grant Brenner. We're psychiatrists and therapists in private practice in New York. We started this podcast in 2019 to draw attention to a phenomenon called the doorknob comment. Doorknob comments are important things we all say from time to time, just as we're leaving the office, sometimes literally hand on the doorknob. Doorknob comments happen not only during therapy but also in everyday life. The point is that sometimes we aren't sure how to express the deeply meaningful things we're feeling, thinking and experiencing. Maybe we're afraid to bring certain things out into the open or are on the fence about wanting to discuss them. Sometimes we know we've got something we're unsure about sharing and are keeping it to ourselves and sometimes we surprise ourselves by what comes out.
Meet Dr. Mark Salms: Neuropsychoanalysis Pioneer
00:01:16
Speaker
We're here today with Dr. Mark Salms, a neuropsychologist and founder of the field of neuropsychoanalysis. Mark is a highly celebrated psychologist, author of a recent new translation of The Complete Works of Sigmund Freud, going well beyond the original translation to include a number of Freud's unpublished papers.
00:01:37
Speaker
in neurology, as well as the author of The Hidden Spring, in which he presents a novel and groundbreaking theory of the origin of consciousness. It's ah impossible to cover all of Dr. Solomon's accolades today in the introduction, and it's a real pleasure to have you here today. Thank you for joining us. Thank you for having me. It's a pleasure to be here.
Consciousness and Psychotherapy Overview
00:02:00
Speaker
So I was sort of curious, Grant, because I know that this is um a sort of natural extension for you of some of the interviews and the work that you've been exploring. Can you tell me what Mark's work means to you and um what you're most excited to talk with him about?
00:02:18
Speaker
Yeah, I mean, I i really love um neuroscience, computational psychiatry. I wanted to focus today as we often do on kind of practical matters for a lay audience um and focus in on psychotherapy. And so the the framework we sketched out um was related to ah talking about your work in the Hidden Spring on consciousness and maybe the concept of active inference, which which includes the work of Carl Fristen, who we spoke with a couple of months ago that was really informative, um discuss the the the new pearls,
00:02:54
Speaker
and the myths and misconceptions that you've unearthed in translating Freud for the last 30 years, and then bring it home to kind of what listeners might take away for how to to live better or how to make better use of their psychotherapy. For me personally, it's just a huge honor. you know You're the hero to many people, myself included. I followed your work for many, many years. And um in addition to the ones we mentioned, um the the work that you've elaborated on meta-awareness and how people can most effectively navigate the the internal signals we get in order to make better decisions and make use of um everything that's happening in this complex internal landscape. So that's where I'm coming from and I'm hoping not to geek out too much.
00:03:39
Speaker
but Well, those sound like fine topics to talk about. The only thing that slightly puzzled me in what you said, ah on the one hand you said that we are speaking to a general audience, and on the other hand you said you had Carl Friston. I don't know how you were able to make Carl comprehensible to a general audience.
00:03:58
Speaker
You know, I had the similar thought. And I think that episode, as far as could be done, has some things in it that people can follow. But there's a lot of it that requires technical understanding. And so the focus was, a lot of it was me translating things um and Carl kind of saying, well, you've already answered the question. And and here's what I would say to that. um And even for me to listen to that episode, I get stuff out of it when I re-listen to it, of course.
00:04:28
Speaker
Makes sense. So where do you want to start, Farrah? I've presented you as being sort of more grounded and pragmatic. Not not to put any pressure on you. Not me, nothing. So the hidden spring, right?
Dreaming and Consciousness Research
00:04:44
Speaker
Sure, yes. I would love to hear just briefly about how that work came about and you know how it might be helpful to the layperson. Well, um how that work came about goes all the way back to the very beginnings of my research, ah which was in the 1980s and 1990s, I was studying the brain mechanisms of dreaming.
00:05:06
Speaker
um And it turned out, I'll just, I'll whizz over the details and and just come to the punchline, which was that it turns out that dreaming, unlike REM sleep, ah is generated by ah a dopaminergic, a a ah pathway rather, a pathway is sort of too flimsy a word for it, a sort of massive bundle of fibers.
00:05:30
Speaker
um a part of the medial forebrain bundle. And this is ah this is this arises from the arousal systems of the brain stem, which we're always thought of as a sort of power supply, something that sort of switches on the lights, a kind of prerequisite. like Like if you want to watch television, first you have to plug it in at the wall. you know ah But the the the electricity supply doesn't actually produce the television. So you know that's how we saw that part of the brain.
00:05:58
Speaker
And ah the the interesting thing is that this particular bundle of fibers, it's intensely ah motivational, it has everything to do with emotional life, and it seemed to be something more than just a power supply.
00:06:16
Speaker
I mean, for example, if you upregulate that system, a patient becomes psychotic. If a patient is psychotic, the main line of treatment is to downregulate that system. So you know it has everything to do with with with mental life proper. So dopamine systems have have something to do with like pattern recognition or making connections and and motivation and reward, right?
00:06:39
Speaker
Yes. i mean In a way, you could say that all brain systems have something to do with pattern recognition, but I so i would place the emphasis on the second part of what you said. it's ah and If you stimulate ah that dopamine system ah in in in ah free-range animals, you know they they they become intensely interested in their environment, curious, they explore ah they they They engage with the world with an enthusiasm and an optimism second to none. and In fact, ah some of our viewers might understand what I'm talking about if I say that snorting cocaine acts on that system. you know So you think about what happens, I know and none of you have ever done it, but I'm sure you've observed ah other people who have and they become all sort of manic and hyperactive and you know and sort of supercharged.
00:07:28
Speaker
The salt steam goes up too usually. Yes, yeah this is what I mean. ah They become overly optimistic and and and overly confident and you know and it can flip over into megalomania. So when we treat ah patients with Parkinson's disease, we we give them dopamine boosting drugs.
00:07:48
Speaker
And if you're not careful, you push them in that direction. and And not only do they start dreaming intensely, because remember, that's where my own research in all of this started, but they become a little bit too optimistic and start gambling compulsively and you know and and start developing religious beliefs that they didn't have before.
00:08:09
Speaker
and then you know you know youve you've got to titrate the the dosage.
Consciousness and Emotional Drives
00:08:13
Speaker
but So i it was really through that that my acquaintanceship with that ah brain system that I became interested in the brainstem arousal systems in general and and was led to the realization It was always known that they were absolutely fundamental to consciousness. you know If you have just very small area of damage in those arousal ah nuclei of the brainstem, the patient goes into a coma.
00:08:43
Speaker
um So we always knew they were intimately and fundamentally bound up with consciousness, but we did not realize that they are simultaneously bound up with the generation of feelings, of raw feelings. And it's all of the most ah the primal emotional drives ah come from these very same systems. And so um that's what ultimately led me to ah the the basic premise of the book that you're referring to, The Hidden Spring, which is that you know if we're wanting to understand consciousness,
00:09:21
Speaker
Why don't we start with this a foundational form of it, this elemental form of it, so ah which is prerequisite for any other form of it? We've been focusing on the cortex and on perception. ah Visual perception is sort of the model example of a conscious state that we've studied and tried to generalize what we've learned from that ah to to to other perceptual modalities and to and to other forms of of cognition.
00:09:49
Speaker
um But as I was just saying, all of those higher forms of consciousness are contingent upon brainstem arousal. That suggests that the most basic form of consciousness ah is this affective arousal. and so you know Usually, it's a standard strategy in science that you don't start with the most complex forms of a phenomenon, and ah you start with the most basic forms.
00:10:16
Speaker
So so the the view that I took in the that gave gave the sort of um impetus to that book and the basic argument of the book is that if we focus our attempts to discover ah the the nature of consciousness, how it arises ah ah in nature, and what purpose it serves and all of that,
00:10:39
Speaker
we should start not in the cortex, not with perception or or God forbid even higher forms of of consciousness, but rather down in the brainstem and we should be looking at affect. And that's what that book's about. It's about how the the wellspring of all of our consciousness is is feeling, raw feeling. And then if you once you recognize that, I mean, this is not a philosophy, it's an empirical fact, you know that that's that's where it all starts.
00:11:07
Speaker
ah with those structures and therefore with with that type of consciousness. And if you then take a step back and look at your own life, you realize, hang on, actually, yes, basically what I'm up to is trying to feel good or feel better you know and avoid feeling bad. And all of our cognitive gymnastics, everything that we do ultimately in life, ah is it pivots on feeling.
00:11:35
Speaker
And so that obviously then in turn has implications, not only for the basic science of consciousness, but also for the application ah of that knowledge to disorders of feeling, which is what psychiatry is all about. ah Ultimately, ah emotional disorders. I mean, that's what psychiatry is, sort of bread and butter is. My kids, when when they were little, I overheard my but my then little son, ah one of his children one of his friends asked him, what does his father do? And he said, my father's a doctor for feelings. I think that's a good description of us. that that's So my understanding is that
00:12:18
Speaker
you were interested in dreams and understanding the subjectivity of dreams. As a neuropsychologist, this was like an idea that people thought was kind of ridiculous. And you you really ah are you know someone who has been ah ground like a groundbreaker, a pioneer. And and it it sounds to me like you really had to push through a tremendous amount of professional resistance. And I'm curious what your early experience was like there um and how and how you even became interested in the brain in the first place. Well, there's a very long story that I'll spare you the details of, but how how I became interested in the brain in the first place goes right back to my early childhood, actually, because ah my brother had the misfortune of suffering a brain injury. And I ah could not but
00:13:11
Speaker
ah observe that he as a person changed ah dramatically as a result of that. And so I was in a kind of traumatic way ah confronted by the fact that we are somehow our brains. you know the but the The chap who came back from the neurosurgery department, my brother that is, was not the same person ah that that I had known before. And so and that's yeah Fast forward from that to then I i studied neuropsychology ah because what is more interesting about the brain than the fact that it's somehow mysteriously, semi-miraculously gives rise to us, you know to subjective being in the world.
00:13:55
Speaker
And I thought, ah by studying neuropsychology, I'd learn something about that, about how how does it how does it happen, that the you know that this sentient being of the mind arises from so these these and and anatomical structures and physiological processes. But when in my naive ah enthusiasm, I asked my professors you know these sorts of questions. like what They were teaching us about you know the the brain mechanisms of memory and language and perception. And it was all these sort of information flow diagrams. And ah I asked something like, let's just take memory, for example. I asked something like, but why do we actually have the memory? you know if If these mechanisms are how learning works and how action ah is is influenced by past past events and so on, why do we actually experience the memory?
00:14:52
Speaker
And they they sort of looked at me as if I'd crawled out of cheese and said things like, no, no, no, don't ask questions like that. you know The the the the dirt questions like that are bad for your career. And so I think most of us.
00:15:08
Speaker
Get it beaten out of us. The enthusiasm, the the very reason why we study the brain is because of this unique property. It's the only thing in nature that it feels like something to be. And yet, you know, this is this is an embarrassing topic to to raise with your teachers.
00:15:28
Speaker
And so the only, broadly speaking, of course, I'm talking about consciousness. How does consciousness arise from from brain processes? And ah the only aspect of consciousness ah that was a respectable topic ah in the neurosciences of the 1980s, which is when I trained in the early 1980s, was the sleep-waking cycle, the wakefulness and the control of of of of this rhythm.
00:15:56
Speaker
ah of the sleep waking cycle ah was a respectable topic so i thought well let me let me latch on to that then and so consciousness and wakefulness was sort of synonymous.
00:16:09
Speaker
And I thought the way that I could squeeze into this ah this respectable aspect of consciousness science, ah the topic that really interested me, which is subjective experience, ah not the sleep-waking cycle, was to focus on this um paradoxical fact that the unconsciousness of sleep ah is punctuated by these periods of wakefulness.
Link Between Brain Damage and Dreaming
00:16:35
Speaker
I mean, clearly it's not wakefulness because you're asleep, ah but you're conscious ah and you're having mental experiences. And so I was able to smuggle in through the back door the topic ah of dreams ah under the guise of you know ah so of so of studying ah ah brain mechanisms of sleep.
00:16:55
Speaker
right And you can study patients with different brain damage and see how that affected their dreaming and their sleep. Yeah. So the correlation between dreaming and REM sleep was made in the 1950s, obviously with human beings. you know they They were woken up during REM sleep and asked for dream reports and they gave them an abundance. And if you wake the same people up outside of REM sleep, in non-REM sleep, and they they they report far less dreams. So that correlation, once it was made in human beings,
00:17:25
Speaker
Then the question was, what are the brain mechanisms that generate the REM state? Because REM sleep is clearly the objective physiological equivalent of the subjective psychological thing called dreams, which is a very slippery fish. you know Nobody wants to study fleeting, fugitive first-person states of mind. ah So they focused on the hard stuff, you know the phyi the the the objective physiological, biological marker of of of dreaming.
00:17:54
Speaker
And that then was studied in other animals because the kinds of methods that were used were, you know, lesioning the brain, damaging different areas, um and sticking in electrodes and recording from different areas and whatnot. Invasive techniques, in other words, that couldn't be done in human beings.
00:18:14
Speaker
And so almost all of the research that was done ah elucidating the brain mechanisms of REM sleep, which were taken to be the brain mechanisms of dreaming because they the REM sleep correlates with dreaming, and it was done in cats and and rats. so Which appear to be conscious.
00:18:34
Speaker
Oh, sure. Although they lack human neocortex. the the the that Well, both cats and rats do have cortex, and they also have REM sleep, of course. but And and you know it's a reasonable assumption, ah certainly in the case of cats. And I would be happy to say, certainly in the case of rats, too, that they probably dream. But the problem is, from a methodological point of view, is you can't ask them about their dreams. And so the content of dreams was was was sort of left out of, ah left out of that research. We didn't know anything about the brain mechanism. So that was my idea, that I wanted to ah ascertain what ah what the relative, contribut the differential contributions are of different parts of the brain to the actual
00:19:21
Speaker
experience of dreams. you know They're predominantly visual, they're intensely emotional, et cetera. Presumably, ah damage to visual structures ah in in the cortex will have different effects from damage to non-visual structures in the cortex on the content of dreams.
00:19:39
Speaker
um I thought, for example, I hypothesized that the prefrontal cortex, the the that our human sort of ah yeah evolutionary pride and joy, and the the the thing that distinguishes us most from other primates, let alone other mammals, ah is that is our highly developed prefrontal cortex. Now, when that's damaged,
00:20:02
Speaker
but patients with damage to prefrontal cortex, they they are no longer masters of their mental houses. you know They're no longer in control of their impulses. ah they They're no longer able to set goals and and and and strategies and sort of logically and and and and so on, work through problems. And I thought, well, that's what we are all like in our dreams. We are all just you know at sea.
00:20:27
Speaker
And so I hypothesize that the damage there would have no no effect on dreams and so on. that was I thought maybe the prefrontal lobes are not active during dreams. Maybe that's why they have this disinhibited and and and ah involuntary kind of equality where you can't, except for elusive dreams, you know you can't control things. You can't make things go the way you want them to. So dreams dreams happen to you. Freud called that like primary process.
00:20:54
Speaker
Yes, exactly. so i thought that so I was looking at what happens with damage to different parts of the brain in human beings. I studied 360 odd of them ah ah it and grouped them together according to where the damage was.
00:21:10
Speaker
And there were reliable, ah constant ah changes in the in the quality of the content of dreams, depending on where the damage was. so But as I've already told you, the most interesting finding was that this this dopamine pathway ah is the driving force of dreams, when that's damage, dreaming stops.
00:21:30
Speaker
And at sort of at the heart of consciousness. I had a thought while you were talking about this, you know, that animals, yeah, they have a cortex, but they don't have this human prefrontal cortex. like I sometimes call it the CEO of the brain when I'm explaining how TMS works with people. You know, we start life unconscious, right? Like embryos, you know, aren't conscious. And when you were talking about sleep-wake, I thought, well, in a way, being asleep is more foundational than being awake.
00:21:58
Speaker
Yes. ah Well, in utero, we sleep a hell of a lot, and little babies sleep ah a hell of a lot. um And they also have a hell of a lot of REM sleep, ah ah much more than than the adult does.
00:22:12
Speaker
and You know, so the brain is actually very active when we're asleep. ah it's it's not It's not doing nothing. it's It's doing a hell of a lot. it So dreams are the subject subjective evidence of that, that something's happening ah while we're sleeping. but ah looked at you know from the broad broader perspective than just my own research, one of the most ah robust ah sets of findings about what's going on in the brain ah from a psychological point of view during sleep is is memory consolidation. and It's very important to sifting through the events of the day, decid not deciding in the sense of voluntarily, you know, ah deliberately deciding, but the brain mechanisms involved are, as it were, deciding, selecting, which ah remembered events are to be retained and which are to be discarded. You can't do it. It's part of learning. Yes, absolutely. It's ah it's a massively important part of learning.
00:23:12
Speaker
Like the brain is almost practicing while it's asleep. Yes, it is. And that's easy to demonstrate. You know, if you you you teach somebody to one group of students something and then take a nap and then you test them, and you teach the another group of students the same something, and they don't take a nap and you test them, the ones who took the nap are the ones who remember what you taught them.
00:23:32
Speaker
way better than I remember seeing some study where they would have people do a task and then they would wake them up and ask them their dreams say they were practicing on a skiing machine maybe maybe you conducted this research for all I know and then one person I remember they reported subjectively he was dreaming that he was putting his feet in the footprints in the snow and with rats and stuff they can see the maze actually there's like a map of the maze in their brain when they're sleeping right they're practicing ah All of that's correct. ah so i mean this there as Robert Stickgold did the human research you're talking about. That wasn't me. ah But the ah the the last thing that you referred to there, ah you know you you can record from the hippocampus of the rat while it's learning a maze. You see the pattern of what it's doing ah when it's when it's navigating ah the maze to find the reward and and and the process of learning how to do that. And then you see during dreaming sleep that night,
00:24:27
Speaker
ah the same the very same pattern of of activity in the hippocampus in those rats. ah And so this is the sense of like wonder about the relationship between how we live and what our brains are doing.
Freud's Scientific Psychology Project
00:24:42
Speaker
Farah, can you help just in the interests of time, id I'd love it if we had more time, to start to talk about how how you got into psychoanalysis and into translating Freud. Because Freud, of course, um people may not know, but one of his most famous early works is The Interpretation of Dreams.
00:25:00
Speaker
Yes, as you said, Farah must ask me, but you've asked me yourself, so I'll answer, so ah while Farah thinks of something else to ask me. i am it was ah but I've already told you why I studied brain mechanisms of dreaming. It was because it was the only way I could get into studying consciousness, because it was under the guise of studying sleep and wakefulness.
00:25:24
Speaker
um And then two things happened. The one was that um I started to realize, as my findings unfolded, that the brain mechanisms of dreaming are far from what we were taught. We were taught brain mechanisms of dreaming are the same as those for REM sleep.
00:25:43
Speaker
ah Therefore, they're motivation neutral happens every 90 minutes automatically. you know it's It's driven by a brain chemical called acetylcholine, which has no particular motivational properties and so on. And so um it was a great surprise to me to find that you know The part of the brain that drives dreaming, unlike REM sleep, is the part you would have expected if you were Freud, because that was Freud's whole claim that dreams are motivated, wishful. you know They don't look wishful, ah but Freud said, well, behind the scenes, they are wishful.
00:26:14
Speaker
And I thought, gosh, you know the if there's any part of the brain that's wishful, it's this you know medial forebrain bundle, the the dopaminergic part of it. And so that made me, I mean, my teachers, like ah probably your teachers, when when you were at medical school probably told you Freud was a pseudoscientist and it's all nonsense and so on. and i thought i wanted I wanted to be an analyst when I was like 12. Oh, really?
00:26:41
Speaker
no no I i was i'd shared all the prejudices that you know that that that might of my peers that you know this was not something that a serious scientist ah ah bothered with, but that made me prick up my ears because it was really the most unexpected finding. this It was really the last thing I was expecting to find that while the person is asleep,
00:27:03
Speaker
you know, the the the part of the brain that that that energizes the most intense exploratory activities is switched on like a Christmas tree. um So that made me attend a seminar, which was actually taught in the humanities faculty ah by a professor of comparative literature. And it was on Freud's interpretation of dreams. And, ah you know, so there I learned It just so happened that this um this professor of comparative literature said to us in this open seminar that I attended that you can't understand Freud's theory in the interpretation of dreams unless ah you've read an earlier work of his that that he wrote, never published, and but he wrote it ah five years before the interpretation of dreams. And this was his famous project for a scientific psychology.
00:27:56
Speaker
And this is a ah neuroscientific ah ah ah work. In fact, a fairly brilliant piece of theoretical neuroscience. So I read that. And then i then that's how I learned that Freud was a neuroscientist. I had no idea that Freud was a neuroscientist.
00:28:12
Speaker
And I have the good, ah well, I don't know if it's a good fortune, but in in this respect, it turned out to be fortunate that I i speak German. And so I then ah you know delved into Freud's other neurological and neuroscientific writings. And you know I was just amazed. I mean, this was clearly a great scientific mind at work. In Freud's book on aphasia, which was written in 1891, it was a fundamental contribution.
00:28:41
Speaker
all of that, plus my frustration and disappointment that we weren't studying the mind. Neuropsychology excluded the psyche. And so I thought, well, let me let me ah not jump ship because I never stopped being a neuroscientific researcher. ah But I i jumped ship in the sense that I decided that I would also train in psychoanalysis and then so you know see what I could draw ah from that, ah what I could use ah to bring it into the neurosciences.
00:29:13
Speaker
you know Psychoanalysis and particularly Freud has this very rich conceptual armamentarium that we can use to, two as as Freud said, ah dissect the function, dissect the functions of the of the mind. But by the mind, I don't mean language and memory. I mean the lived life of the mind, the self.
00:29:33
Speaker
ah you know And um so that's what I did. I was in the Department of Neurosurgery at the Royal London Hospital by day, and I was i was in like ah the Institute of Psychoanalysis by Knight Jekyll and Hyde. um And I really don't regret it for a moment. Sorry to interrupt. what what What kind of analysis did you train in then? Was it object relational? or So I had a kind of a funny mixture because and I trained in the British Psychoanalytical Society, which is very Kleinean and are therefore very object relational. ah But my own analyst was anything but Kleinean. He was Anna Freud's successor when Anna Freud ah retired as the director of the what was called the Hampstead Clinic.
00:30:20
Speaker
ah He was her successor. so he was the ah He had been the psychiatrist-in-chief under her directorship, but then when she retired, she appointed him as her successor. so he was I want to say, was it Massad Khan or Wilford Beyond? No, Clifford Yorke. Clifford Yorke. Massad Khan was an object relational guy. Clifford Yorke was the kind of the one of the last Freudians standing in the British Psychoanalytical Society at the time that I trained.
00:30:49
Speaker
So I had a very classical Freudian analysis, but a very Kleinian training, ah to to to to put it simply. Yeah, and um maybe Grant or or Mark, one of you can talk a little bit about what that means um for the lay person, that there are these sort of different theories that it is actually complex. it's but it's It's been characterized by a tremendous amount of um arguing and internecine fighting and more obfuscation. I think that's the most important thing to say about it. you know that it's it's ah It's a highly unfortunate state of affairs in ah in ah in a discipline that purports to be a science that you have to support one or another football team. you know it's ah
00:31:39
Speaker
And that's got something to do with the psychoanalytic method. that as as As heuristic as it is, the psychoanalytical method of investigation reveals things ah which you can't learn in any other way. Like I said about dreams, you know you can't analyze the dreams of a rat. you know So so you know you talking to people, you learn something about this their subjective experience. And this is a very important source of information about how the brain works. yeah Presumably, subjectivity, experience, feeling is all doing something. you know and so if you If you leave that out of a account, you youre you're leaving out half of what you can learn about it. so and There was a lot of infighting among Freud's inner circle. Carl Jung was supposed to be his successor, and then they got odds with friends. It's a long story. I think it's it's got to do with the method. This is what I was going to say. so
00:32:32
Speaker
They all have these different theories its theories derived from the same method and that's because the method can't decide between the theories. ah doesn't It doesn't allow for falsification of of hypotheses because it's not an experimental method, it's an exploratory sort of heuristic method.
00:32:48
Speaker
So that was the whole idea.
Integrating Psychoanalysis with Neuroscience
00:32:50
Speaker
Although i in training as a psychoanalyst, my aim was to bring psychoanalytic concepts ah into neuroscience so that we could put the psyche into neuropsychology. And then it rapidly became clear that ah in doing so, you know you you you can't just make speculations. You've got to do research. You've got to sort of see, OK, what is ah say for example repression and defense and whatnot you got to study and the brain mechanisms of these things by studying these phenomena you know it like for example i studied patients with damage to different parts of the brains ah who then displayed characteristic like there's a phenomenon called anosognosia.
00:33:33
Speaker
where patients are paralyzed down the left side of their bodies. It's absolutely obvious that they can't move their left arm or leg. Obvious to everyone except for them. ah They say they're just fine. Thank you. um So that looks like denial. You know, that's the Freudian defense mechanism of denial, the way in which we can deceive ourselves. I mean, here's a model example. and And yet, yeah, we know which part of the brain is involved.
00:33:57
Speaker
So that gives us the opportunity to start studying the very same psychodynamic processes that ah were postulated ah by psychoanalytic investigation, but now to investigate them using neuroscientific methods. So ah that the the the I think that's the way out of the that this kind of documentation that you were referring to in psychoanalysis that you need to bring empirical methods to bear on these questions which can decide between competing hypotheses and so that's what I've and after doing this dual training.
00:34:35
Speaker
That's what I ended up doing with the rest of my scientific life. and I developed something, you mentioned it in your intro, ah which which has this ah strange name, neuropsychoanalysis, ah which is an attempt to choose ah to bring ah psychoanalytic theories ah into the 21st century by subjecting them to the most rigorous and fantastically enlightening new technologies and you know that we have to be able to
00:35:07
Speaker
to be able to reach more more more definite conclusions about them but at the same time i say again it's a two-way street out i have also and why i called it neuro psycho analysis was because i wanted to make clear because neuro psychology.
00:35:22
Speaker
The neuropsychology I was taught, there was no psyche there, as I said. You might as well have been called neurobehaviorism. so I wanted to use the word neuropsychoanalysis to make plain that what I mean by the mental side of this this interdiscipline between brain and mind, what I mean by the mental side of it is the is the mind the subjective experiencing mind, the real mind, you know not not a flow diagram.
00:35:48
Speaker
Well, I find it bizarre because, as you know, it's many psychoanalysts essentially don't believe that understanding how the brain works in general or their patient-specific issues, some some of which may have a neurological basis, matters, whereas many psychoanalysts pay attention to it.
00:36:06
Speaker
for For me, I think it's it's a no-brainer. If I understand kind of how someone is wired, I find it's very informative to how like I work with them, and especially you know being someone who does transcranial magnetic stimulation. you know like We're doing like network surgery on particular circuits. To your point about an anosognosia, but do you see that, say, with something like OCD, where there can be higher or lower insight?
00:36:32
Speaker
and the level of insight seems to determine how well the patient might do in treatment. How do you how do you think about anosognosia with psychiatric illness? so let me Before I answer that, let me comment on the first part of what you said ah when you said most psychoanalysts are not interested in the brain. ah you know I um have I had ah that argument thrown at me ah a lot. you know i For example, a colleague, ah gosh how interesting from a Freudian point of view, I've forgotten her name. ah Rachel Blass, that was her name. ah She ah had a debate with her.
00:37:09
Speaker
and She said, ah a pianist doesn't need to know how a piano a you know what what doesn't need to know about the what's going on under the lid. You know you just play it yeah it. It doesn't matter what what's going on under the lid. And I said to her, but we are not pianists.
00:37:27
Speaker
we We psychoanalysts and are more like the people who are trying to tune the piano when it's not playing properly, when it's not working properly. And you can't tune the piano if you don't know how the bloody thing works under the lid. And so that's to your point.
00:37:43
Speaker
um yeah We have stuff under our own lids too, right? Yes, indeed. of course this is ah One of the ah and strange things about psychoanalytic training is that you have to be a patient yourself, and I think that's a jolly good thing, you know that that ah you learn and the by your own by understanding your own foibles you know you learn how to empathize and with and and ah and understand the the foibles of your patients but turn you were saying about ocd you were saying how does this relate to psychiatry i mean i'll just give you an example of the top of my head um if you look at.
00:38:24
Speaker
fMRI, functional magnetic resonance imaging of of of patients with OCD, ah the the thing that that lights up more than anything else and correlates with the active symptomatic ah states that that that define the condition, it's the anterior cingulate gyrus. The anterior cingulate gyrus is involved in all these kinds of You know, error monitoring and decision making and so on. That's ah so obviously central to the cognitive as as as state of OCD. But it is also the top end of what we call the panic.
00:39:03
Speaker
system You know there's a circuitry ah in the brain, a new opioid mediated circuitry for attachment bonding, which is absolutely fundamentally important for mammals. Mammals and birds can't look after themselves without a caregiver.
00:39:20
Speaker
So we we become I mentioned opioids for the reason that we become addicted to our caregiver. ah That's what we call attachment. And then if you separate it from your caregiver, then you have separation distress. That's panic.
00:39:36
Speaker
It occurred to me when I looked at these fMRI scans of our OCD patients, I thought, well, it's not just a conflict monitoring in the cognitive sense of the word. and This is also the upper end of the panic system. I wonder if if the the the the quality of the anxiety that these patients suffer, ah whether it isn't Perhaps panic. and know You would have thought it's fear, but maybe it's panic. And so we we we did a study of that. I mean, a self-rating sort of thing where they had just that to check off the patients, had to check off you know questions and ah statements about I am this, I am that. and And they checked off way more panic anxiety ah items than fear anxiety.
00:40:18
Speaker
so That led to an insight you know that actually the the nature of the anxiety ah in OCD is separation distress. It's an anxiety about losing control and and trying to regain ah control over an object that know that that that might run away, in but my might abandon you and so on. So from you know from an fMRI study at the one end, you know you end up with insights of a kind that help you with this understanding the internal psychological struggles of these patients.
00:40:53
Speaker
and Sure. And i I do think that a lot of people could probably relate to this idea that the sort of roots of OCD, certain compulsions or intrusive thoughts can sometimes surround loved ones, something happening to a beloved parent or a baby. And so we just sort of see that natural progression into full-blown OCD symptoms. And the comorbidity the comorbidity between OCD and and major depression and panic disorder, they're all on I think they're all just different facets of one and the same thing, which is this massive attachment and separations system, new opioid-dominated attachment system.
00:41:38
Speaker
Right, and our diagnostic system is not based on, for example, understanding different patterns of brain network um disconnectivity. And
Emotional Disorders and Brain Connectivity
00:41:47
Speaker
it could be. I don't know if you know Glenn Sacks' work. yeah you know ah We're constantly saying in psychiatry that you know we want a biologically based ah diagnostic scheme and so on, and and never getting there. And I think the reason why and is because ah these these these ah you know so the the The kind of neuroscience that that psychiatrists are exposed to, it's it's sort of you go from neurotransmitter receptors you know to to clinical phenotypes. It's like nothing in between. and you know they if you You can't start with molecule and then go to a syndrome. you know the so In between those things,
00:42:29
Speaker
or complex systems and clearly the systems that we need to, but I would say, the systems that we need to take as our kind of basis for ah differentiating between different types of emotional disorder or the different basic types of emotion.
00:42:46
Speaker
And these, ah I've spoken about them you know two or three times already in our conversation now. ah That dopaminergic one, that's one of our basic emotional, it's this sort of its it's engaging with what's interesting and and ah exploring the world. I've spoke about this new opioid-mediated attachment system, and there are many other such and such it so that based in neuromodulators that that that that ah mediate these basic kinds of emotional state. And I think that if we try to ah classify mental disorders or emotional disorders on the basis of those basic types of of of emotion and motivation, we would we would get a lot a lot further than then you know starting with the
00:43:39
Speaker
with different types of serotonin receptors. Right. Yeah, I agree. I think it's also so important really for patients to know, right? Because a lot of the time I'll hear, well, I understand all of this, you know, theoretically, and it all makes sense, but um why can't I stop doing it? And it's hard for me to say, well, this is actually physiological programming.
00:44:06
Speaker
And um there has to be a sort of top-down, bottom-up ah collaborative you know treatment ah to to help the symptoms resolve. yeah let me let me Let me put in here one of the most basic ah in the sense of simple ideas and fundamental ideas you know that i've that I found useful, is that we we must remember that these arousal systems, which are which are the basic um emotional systems of the brain,
00:44:39
Speaker
they're expressing different types of need. i mean that's ah you You become aroused by the fact that you're tranquil and placid if you know your needs are met and you become agitated in these various different ways depending on which of the emotional needs we're talking about when those needs are not met. so Pharmacological treatment you know damps down those systems, ah but the the the need ah you need to learn over a lifetime how to meet your emotional needs.
00:45:09
Speaker
so So I think that ah you know the whole of mental development, you could sort of say fundamentally what it's about is learning from experience how to meet my emotional needs. So what you've just said there, it has to do on the one hand with these chemically mediated arousal states, which is announcing a need not met. And then there are the the the the learning, the memory systems, and the the higher top-down systems, which is what predictions I like to use the word predictions for this. ah Memories are about the past, but they fall the future. the whole The whole purpose of learning from the past is to better predict in future what works and what doesn't work in terms of meeting my needs. So I think psychotherapy acts on those predictions. They're helping our patients to find better predictions, better ways of meeting their emotional needs, and psychopharmacology acts more on their arousal systems themselves. In other words, the announcement of the need.
00:46:08
Speaker
And so I think that they're two sides of the same coin. So if you do therapy, would you teach patients those basic motivational systems? And I'm i'm quite sure you're referring, among other things, to the work of Joc Panksepp, right? Yes. and people want to load that up yeah He was a great, great scientist and a great friend of mine. it's Very sadly, ah passed away, what is it, seven years ago now.
00:46:33
Speaker
And ah yes, he he did more than any other neuroscientist to systematize what we've learned over the last few decades about brain mechanisms of emotion. And he he knew nothing about psychotherapy and and and and and psychoanalysis and so on, but he was very interested in it. And so um I have one of the main things that I've done in the direction of trying to contribute to psychoanalysis.
00:47:01
Speaker
is to import into psychoanalysis a more ah sophisticated modern view of what the basic motivational drives of the human being are. And they certainly are not the ones that Freud thought. ah So so and i've I've drawn much more on Jörg Panksepp than Freud. Freud always looked forward to the day when we would learn more about the biology of of the basic most motivating forces that that he called drives. and um so But not meant not not all of his followers were as interested in revising his views as he himself was. Well, I think this ah you know will be super helpful, particularly for people who are going through their own psychotherapy and um want to have a better understanding of this. so um Grant, do you have any more questions? or
00:47:53
Speaker
Well, you know, I like to stay on script and I know we're a little short on time, but there's a huge thing that I think you've been translating, retranslating Freud's works and finished recently after what, a 30 year project. And my understanding is that.
00:48:09
Speaker
Not only did you translate the original volumes that Strachey had translated, but you also translated Freud's prior entire opus opus of essentially um his neuroscientific work, which undergirds his later psychoanalytic work. and I've heard you talk about some of the distinctions you've made as as a German speaker, where we may have misconceptions. so The rapid fire session, you know what are what are the things that you found out that maybe Freud didn't intend that people have come to ascribe to him? And what do you think are the main things, I like to ask compound questions as you may have noticed, the main things that we can still learn from Freud today and use in our lives? yeah So the the comical fact is that I actually had no intention of ah of doing this thing that took me the last 30 years to do. I was only interested in translating Freud's neuroscientific works because they'd never been translated apart from a handful. You know, Freud published more than 200 titles in neuroscience.
00:49:13
Speaker
And so I thought, because of my own ah experience, which I've already recounted to you, of discovering, wow, Freud was a neuroscientist, then, gosh, you know these psychoanalytical ideas have ah have a foundation in neuroscience. And it made me really better appreciate and better understand what those psychoanalytical ideas were and where they come from, what the underlying assumptions are. you know whole ah whole So I wanted to translate those.
00:49:39
Speaker
And then the publishers of ah Freud's psychological works ah asked me, because I was already busy with this, they said, you know would i would I take on that task? Had I known what what an enormous task it was, um I don't think I would have so so readily agreed to do
Translating Freud: Challenges and Insights
00:49:59
Speaker
it. But I don't regret it, because you know I now, if I may be so immodest as to say this, I think I understand Freud better than anybody.
00:50:09
Speaker
ah You know, because you take sentence by sentence, you know, the German and you have to ask yourself, what is this chap trying to say here? What is the idea that's that's cloaked in these words? Because you have to now cloak them in different words, you know, you have to cloak them in English words. So that's just by way of the background. ah now you ask about what what have I ah had to change and in the in the way that Freud was translated, what new insights do we gain, and you know and why does Freud still matter? I think that's what your compound question was. So I'll give um one example yeah of what we have to change. In German, Freud uses two words to speak about something that's stretchy translated with one word. So the English word instinct
00:50:57
Speaker
Streicher uses, where Freud uses two different words. Sometimes the the word that Freud uses is instant, which sounds a lot like instinct because it means the same thing. ah But at other times, Freud used the word trib, which does not mean the same thing as instant. These are two different words, but Streicher translated trib as instinct two.
00:51:20
Speaker
So the reader doesn't know when is Freud speaking about the one and when is he speaking about the other. So an instant is an instinct. It's a stereotype, behavioral response to a need. A trieb is the need itself. It's the demand made up. It's a drive. The English word I've used for that is drive. um it's what it's it's it's it's the And it is the font of of of feeling. You know, it came back to what I was saying earlier, these arousal states or drive states, they are deviations from where we need to be. It's it's the the basic mechanism is homeostasis, you know, that if you are where you need to be, great. If you're not, then you feel it in the form of, you know, think of, for example, hunger or thirst or sleepiness, you know, and in emotional life, think of fear it means where I need to be is safe. Who should I'm not safe? You know, that's that that that feeling of fear is a drive ah that motivates you to do something. And instinctual behavior is one of the things you might do. You freeze or you flee. ah those are that That's a response to the drive. So that's an example of ah of it ah um and and and ah not only a mistranslation, it it really misleads. Because if you if you're an English speaker and you read about these instincts, you get the wrong idea of what Freud's speaking about. speaking about inbuilt behavior patterns is speaking about the sort of basic as source so of of feeling life and and what what drives us literally, what drives us to do what we do. Another example, maybe I've just quickly mentioned it, but I i don't have time to go into detail. The German word lüst
00:53:00
Speaker
can be translated in English as pleasure, ah which which typically is how stretchy translates it, but lust is also lust ah in the sense that so lust is, ah in in in English we speak of a pettative desire and the consumatory you know satisfaction of that desire. In German, both of them is one word, lust. Lust covers both. Lust is the the appetite and the ah the consummation. um so That has all sorts of implications. i mean as you I'm sure even the most ah the the the the listener ah to this who knows least about psychoanalysis, at least they'll know it's about these things. it's about yeah it's loose trend sound very ah salacious yeah I think you'll get a lot of readers out of this. I think that you asked me what's important about Freud. you know I would say it's been the red thread that's run through our whole conversation. is it's it's Freud was interested in
00:54:07
Speaker
ah First of all, bringing the mind into science. you know if the The behaviorists, for its great adversary, ah they thought we have to change the object of study ah to suit the methods. So we scientists, we can't study subjective states, so we'll just study behavior, and that like excludes the mind. you know it's ah that The mind is subjective? No, we can't study it, so we'll study behavior instead.
00:54:33
Speaker
And that literally excludes you know the mind from science. Freud's view was the opposite. It was you gotta adjust your methods to the object of study. You don't adjust the object of study to your methods. So Freud studied subjective experience, which is part of nature. It exists. Please notice. Yeah, we are. We busy experiencing it empirically. you know It exists. Feelings exist. Fantasies exist. and you know It's it desires and thoughts and you know and and all of that. And he tried to bring that into science. And I think that's a very important thing, you know that it's to to to not airbrush out of science our very selves. you know and um And then, the as I said, it's the red thread running through our whole conversation. The heart of that is feeling.
00:55:20
Speaker
And so, you know, I think that bringing, ah taking seriously not, we don't want to go back to Freud in the sense of, you know, ah this this these are theories that are 100 years old and more.
00:55:35
Speaker
but But the approach to the mind, the the the the embracing of subjectivity as as a serious subject of study, and and and you know recognizing that what the brain does,
Freud vs. Behaviorism in Scientific Study
00:55:48
Speaker
ah you will never understand if you don't take account of its experiences. You know that this is clearly ah you know you will never understand what my behavior, unless you know I have feelings.
00:56:00
Speaker
and and the decisions that i I make and the actions I take are in large measure driven by those things. So, yeah it's a matter of bringing that perspective into modern mental science and neuroscience, a building upon ah what Freud taught us, ah rather than sort of saying, oh, that's not science, you know, we're going to we going to leave it out.
00:56:24
Speaker
You've done that so well. and And, you know, psychoanalytic work, right, is self-exploration. And it creates this framework, which is grounded in neuroscience, in my opinion, too, of being self-evidencing creatures, as Carl Friston says.
Freud's Self-Analysis and Subjectivity
00:56:40
Speaker
But Freud really was that pioneer who started by analyzing himself and kind of opening up his own lid and taking a peek beneath it.
00:56:50
Speaker
Yeah, well, that's the that's the thing about subjectivity is you can only ever observe your own. um This is why it's such an embarrassment to science. But as I said, you know, it's part of nature. That's part of nature works like that. So it's no accident that Freud started out by studying his own his own mind, because that was the only one he could directly observe.
00:57:12
Speaker
and then you know generalized from there. And this is this is ah continues in the tradition that I mentioned earlier, that people who train in psychoanalysis, they have to start off by being psychoanalyzed themselves, ah because you know that's the the the only direct encounter you can have ah with with with mental phenomena is with your own. The only direct encounter you can have is with So do you think there will ever be like an artificial intelligence and machine learning hooked up to some kind of brain scanner, which can tell you what your subjective experience is with any degree of accuracy? ah Well, and I'll tell you where what what I'm I mean, I'm I know we all have to go. So probably we'll end on this on this topic. I would never have ah
00:58:00
Speaker
dreamt ah in in my younger ah years as ah as a scientist that I would end up where I am now. I was never interested in artificial intelligence because I thought these things are not minds. To call them artificial minds is is to completely mislead us. you know the The essence of the mind is that you experience it.
00:58:23
Speaker
And and i've I've said to you, ah the the the driving force of the mind ah is our needs. ah Computers don't have needs. ah There was a there was ah a Canadian philosopher whose name I'm also forgetting. He said, computers don't give a damn. And so I thought, well, yeah. And so I'm not interested in artificial intelligence, got nothing to do with the mind. I'm a mental scientist. But until My work, you mentioned Carl Fristen earlier. I started to collaborate with him. Well, I started to have interesting conversations with him about 10 years ago. And then I started to work scientifically together with him since about six years ago.
00:59:07
Speaker
And to cut a long story short, if you go back to what I said earlier about feelings, that they are the the the the very foundation of consciousness, and they arise from these arousal systems, these arousals, as I keep saying, announce needs, deviations from our homeostatic set points. Homeostasis, therefore, underpins consciousness and feeling. And homeostasis is not a complicated mechanism.
00:59:35
Speaker
it So if feeling is an extended form of homeostasis, then it should be possible to you know write to algorithms that and and and the the computational formalisms you know that regulate it. So that was the work I did with with Carl Fristen was to try to reduce to a simple causal mechanistic explanation ah how feelings arise. And once we had done that,
01:00:03
Speaker
ah Then I realized, well, you know, ah in in fact, there was a famous physicist Richard Feynman when he died on his blackboard was written this phrase, if I can't create it, I don't understand
Artificial Consciousness and Homeostasis
01:00:15
Speaker
it. And so I thought, well, if we really believe that that the that the ah ah equations that Carl and I wrote, well, actually he wrote the equations, but the the the the the causal mechanism whereby feelings arise, if we really have understood it, we should be able to engineer a robot that's has that operates by these mechanisms. In other words, we should be able to create a computer that does give a damn. And so this is what I'm working on now. That's what I said. It was the biggest surprise of my life to find this is where I've ended up, that we are trying to engineer
01:00:51
Speaker
an artificial agent, the the the only principle upon which ah it it operates is it's trying to continue to exist. it In other words, it has to it needs to meet its energy supply. Usually, a computer you just go and plug it in. Our one has to find the energy resources for itself.
01:01:12
Speaker
and it has to maintain its viable temperature bounds and and all of these sorts of things. And so, ah do I think you were saying that there will ever be an artificial consciousness ah or or an artificial um intelligence that is able to ah probe probe conscious states. I think that we're going a step further than that. I think that I really, I'm sorry if we end our conversation with all of our viewers thinking that they've been listening to a Dr. Frankenstein or some kind of nutter, ah but I really do believe we're on the brink, not just my lab. I think that we it's in in in in the computational and neurosciences are on the brink.
01:01:57
Speaker
of being able to engineer an artificial consciousness. I no longer think it's a matter of if, but rather when. Quite exciting stuff. I hope you'll come back and tell us about that. Yeah, I'd be glad to. I'd be glad to. It was really great talking to you. Thank you very much for your interest and and and for your interesting and questions.
01:02:19
Speaker
you Thank you too you. And where can our viewers find you if they are your your books are on Amazon? Do you have a website or i don't have a website? No, that they ah but my books are on Amazon. And, and you know, if you go to YouTube, although I don't operate a YouTube account, you just type my name in on YouTube, you'll find zillions of yeah videos. And also, if you want to contact me on, ah I like to call it x Twitter.
01:02:49
Speaker
ah and ex-iffe from twitter once upon Once upon Twitter, my my um my Twitter handle is is at mark underscore songs. Mark underscore songs. I'm always telling ah my followers on that what's going on. yeah We'll put that in the show notes, too, on the website. Thanks very much. all right it's been a pleasure to Thanks so much. Cheers. Send my best to your father, Farah. I will. Thank you. Okay. Remember, the Doorknob Comments podcast is not medical advice. If you may be in need of professional assistance, please seek consultation without delay.