Psychoanalysis and Its Discontents

GUEST: Robert Michels
VTR: 11/17/1998

I’m Richard Heffner, your host on The Open Mind. And it’s getting on to a quarter century now since I was first joined at this table by today’s distinguished guest. Then he was Professor and Chairman of the Department of Psychiatry at the Cornell University Medical College as well as Psychiatrist-in-Chief at New York Hospital. Later he became Dean of the Medical College.

Well, today Robert Michels is Cornell’s Distinguished Walsh McDermott University Professor of Medicine and Psychiatry … as well as one of this nation’s most eminent practicing psychoanalysts.

Now, like most interested but not enormously knowledgeable or psychoanalytically sophisticated laymen, I’m of course somewhat aware that there’s trouble in paradise … that today psychoanalysis has perhaps more than its share of discontents.

Indeed, Freud, the father figure, seems at times now quite besieged … though perhaps only as father figures eventually must always be.

But even a Centennial Freud exhibit at the Library of Congress recently occasioned rather unseemly divisiveness and controversy, and I would begin today by asking Dr. Michels to address a question he himself raised at a forum reported not long ago in The Partisan Review. The question: “Why has psychoanalysis been the target of so much other cultural criticism, attack and interest?” Why, Dr Michels?

MICHELS: I like your phrase, “there’s trouble in paradise”. And I’m tempted to start with a very psychoanalytic answer, Dick.

HEFFNER: [Laughter]

MICHELS: Paradise is a myth. And it’s a myth created in order to deny the universality of trouble. So, of course, there’s … as psychoanalysis has taught us always trouble in paradise because if there wasn’t trouble we wouldn’t need paradise.

HEFFNER: Or we wouldn’t need psychoanalysis.

MICHELS: And we wouldn’t need psychoanalysis. Psychoanalysis has been a very powerful and important cultural movement for the last century. And one of its teachings would be that any powerful important cultural movement is going to attract controversy, is going to become a symbol for all kinds of human conflicts and concerns. And there’s going to be trouble around it. Maybe what’s special about psychoanalysis isn’t that it attracts trouble. Because almost any comparable movement has attracted trouble. If the psychoanalysis is itself fascinated by the troubles it attracts, it isn’t the only thing that there’s conflict about, but it’s one of the only things that centers on studying that conflict. It turns its trouble into its subject matter.

HEFFNER: And what have you done with the trouble, its subject matter?

MICHELS: Well, a number of things I think have been interesting. You raised one of them. To what extent is the trouble because Freud is a symbol for something … a father, you said, and one of our popular pastimes, going back to the beginnings of the species is to find out that there’s something wrong with the father. So, books are published speculating or examining the data about whether Freud was neurotic, or whether Freud fudged some data in some of his early publications or whether he was frightened of what he discovered. Or whether he had a girlfriend. All of which are, when you think that we’re talking about a man who developed a major theme of our culture a hundred years ago, and a theme that’s supported now not by the evidence that Freud offered, but by the evidence that thousands of his followers have collected, and we’re still worried about whether or not he had an affair with his sister-in-law. Or whether or not some of his case reports were more imaginative than today’s criteria for validity would allow. You know that we’re dealing with someone who’s become a symbol of something. And attractive of attention because of his symbolic meaning.

HEFFNER: You mean the leader …

MICHELS: The leader.

HEFFNER: … the President?

MICHELS: The President. The head of a movement. The founder of a belief system. The pioneer who went first into a dangerous world.

HEFFNER: Well, you, you talk about in this book review of The Memory Wars: Freud’s Legacy in Dispute, by Frederick Crews. You write in this rather interesting review in terms of all that he covers, you say … there’s something you call “the uncovered secret movement”. Which delights in tracking down the secret truths about revered figures from the past. Whether it was Einstein’s mistreatment of his wife, Mendel’s distortion of his data, Lincoln’s bi-polar disease. But it’s so interesting that you say, in a very appropriate way, the answer to these questions always turns back to the thesis that Freud set forth himself.

MICHELS: Right. That Freud is the person who helped us understand the desire to prove that Freud is a fraud. One of Freud’s contributions, and a very valuable one is that it’s only Freud’s thinking that allows us to understand the Freud-bashers. Their own venom and passion is hard to understand without thinking about the symbolic meaning that Freud and psychoanalysis has for them and that feeds the furor of their critiques and their arguments with him. Often arguments, by the way that have an important, logical content and that are intellectually important if they were devoid of that extra venomous passion that fuels them for reasons that the authors often don’t understand.

HEFFNER: Well, you used the word “venom”, too, in the review. And you use it twice now. Why?

MICHELS: Well …

HEFFNER: … you’re disturbed by that.

MICHELS: … in the moment of reading, yes, because it seems to me unwarranted. On reflection it’s part of the phenomenon that makes it comprehensible. Why would so much of an industry have developed around damaging the reputation of a man who’s been dead for sixty years unless there was something special and symbolic about his meaning that they’re attacking. Freud said that life is meaningful. That things that we don’t see the surface meaning of have underlying or concealed meaning and that we’re not as much in control of our lives, with our conscious intelligence as we once believed we were. A lot of people don’t want to know that. And when someone says it, they attack.

HEFFNER: Even within the psychiatric profession?

MICHELS: Of course. Unfortunately, psychiatrists and psychoanalysts are as human as the rest of us are. And are as vulnerable to the emotional conflicts and reactions. The relationship between psychoanalysis and psychiatry would be an example of that. Psychiatry’s made immense advances in the last few decades. Advances in our understanding of the brain and the relationship of what we know about the brain to important mental illnesses. And in how to use that knowledge in treating those illnesses. There’s no contest or tension between that understanding and the understanding psychoanalysis has offered about human mental life, the conflicts, the wishes, the fears, the passions that shape all of us. Yet discomforts about psychoanalytic notions can lead some people to think that psychiatry is an argument against psychoanalysis and raise the absurd structure to their argument that now that we know more about the brain, we can dispense with the mind. It’s not really important. Clearly, those of us that have brains and minds, treasure both.

HEFFNER: Now that’s an interesting way of putting it. What is the explanation of those who do not treasure both?

MICHELS: They have always been people who say that if there’s more to the mind than I’m aware of, I’m worried by this and want to argue against it. Fearful of what might be there that they’re not aware of and they’ll use any argument that’s possible. A sociologic argument; a religious argument, and in 1998, one of the most fascinating arguments you can use is a neuro-biologic argument. The structure of the argument is the mind is a current fantasy which we use and will continue to use until we know enough about the brain to dispense with it. But what that suggests is thoughts, fears, feelings, wishes, dreams, can be totally understood by synaptic transmission and neurological function. A terrifying idea, when you come to think of it.

HEFFNER: Why? That’s so interesting to me that you say “a terrifying idea”. Why do you, why do you, why does it terrify you?

MICHELS: Because it says there’s nothing emergent about a human being that’s different than a very, very complicated machine. And our culture, our morality, our self-esteem is based on the experience that there is something special.

HEFFNER: Yes, but Bob, isn’t that interesting that it is a sense of self-worth alone, seemingly, from what you say, that leads you to feel terrified by this proposition. Couldn’t I say then, with some validity, “well, come on now, that’s just too bad, your sense of yourself is not a good enough reason for me not to think that that dichotomization between mind and brain is inadequate”.

MICHELS: Oh, I think the dichotimation maybe inadequate. But that doesn’t mean that we’re going to discard everything that our mind, language and mind understanding has taught us and totally shift to a brain model. There may be other models of understanding human life and human thought than mind and brain and there may be integrating models and over-arching models. But it’s clear that we don’t want to do away with mind and be left with nothing more than brain. We want to have a model that makes meaningful feelings, wishes, desires and the very self-esteem you talk about that leads me to say this.

HEFFNER: You say “we want” … does that mean that there are not others who do not want, who do not need?

MICHELS: Well, there are others who argue against because they’re guided by an intellectual structure that argues for a neuro-biologic reductionism. But the intellectual structure that argues for that can’t explain their passion or their desire to argue. Oddly enough …

HEFFNER: Excuse me, may, may I interrupt? Is that so totally true? If you had sitting here with you someone who felt differently from the way you do, but someone, if one could imagine it, as articulate, as Robert Michels, isn’t there a response to what you have just said?

MICHELS: Well, you are raising the response very articulately, which is … “aren’t I simply protesting the desirability of my preferred delusion”?

HEFFNER: MmmmHmmm.

MICHELS: But that very protest, that very desirability has to be explained because its a very, very widespread phenomenon.

HEFFNER: Historically it can be explained, can’t it? Socially? Culturally?

MICHELS: But history and society and culture are things that come into my mind, they’re not things that are wired into my brain. If culture and history are going to have meaning, they’re going to have meaning because they’re experiences that are symbolically encoded and retained and remembered and transmitted. We know that they have power long before there can be evolutionary adaptation and change the hard wiring in response to them.

HEFFNER: How would you argue the opposite point of view?

MICHELS: That’s a very, very mean rhetorical trick.

HEFFNER: Absolutely.

MICHELS: The most cogent argument … I feel like I’m betraying all that I believe, Richard. I’ve been sandbagged. The most cogent argument is that the systematic attempt to pursue this reductionist agenda has led to brilliant new knowledge, to exciting technological potential, to helping sick people, to understanding how brains work, to the ability to control and influence the development of the brain. Whereas the mind-frame of reference, the understanding of mental life, of thoughts and feelings and passions, which goes back to Plato and Aristotle and was importantly enriched by Freud, is part of a dialogue of thousands of years in which we haven’t seen the same breakthrough yield in the last few decades. And therefore, the fruitfulness of the approach, rather than its compelling logic is the most important defense for it.

HEFFNER: Isn’t that rather persuasive?

MICHELS: It is very persuasive to some. And I would see it as a powerful argument for passionate support for this approach, but not for ignoring alternative paradigms. We’re not in a situation where choice is required. And we are in a situation where there’s social values and human values that we don’t want to discard because in the last thirty years we learned a lot about the nervous system.

HEFFNER: Well, it’s interesting to me to hear you say that because we have spoken about the future of medicine. We have spoken about the lot of medicine today. If you say there’s no reason to choose, aren’t there imposed upon us now social, governmental, cultural, financial reasons to choose. Not adequate in your estimation, not adequate in mine. But reasons that we find very difficult to confront and defeat.

MICHELS: Very complicated phenomena, so there are certainly arguments that doctors should become applied biological technicians working with the cutting edge of what’s been learned in the scientific laboratory. And serving their patients with it. It’s clear that’s not what patients have in mind. It’s clear in the immense popularity of alternative medicine with often no scientific basis. It’s clear in the patients’ insistence on having someone who listens to them and talks to them in addition to administering treatments to them. It’s clear in the public health data where the major variants in the effectiveness of our treatments usually isn’t our knowledge of pharmacology or biology, but the ability of the doctor to establish a relationship where the patient takes the pill that’s been prescribed for them. In all of those ways the patients are arguing very vehemently, and our culture is arguing that medicine is a human profession which uses science and psychoanalysis in a way growing out of medicine is the attempt to codify and systematize the scientific aspects of that human relationship.

HEFFNER: You know when you refer to what it is that patients want, I don’t mean to dismiss that. And I was thinking of a smart ass way of raising that question to dismiss it. But while it’s true, don’t you see that as a manifestation of past cultural patterns. And don’t you see the possibility that we will not … I hope not … but that we will come to a point at which we don’t make those demands upon the, the profession. Either the psychiatric profession or the medical profession generally.

MICHELS: I don’t think so. You say it as a refection of past cultural patterns, which I think it is. But those cultural patterns aren’t accidental. And I think they may be built into the biology of the specie. So one of the suggestions of psychoanalysis, for example, is that the power of human-relatedness in shaping our experience and modifying our behavior is not simply a cultural form, it’s an inevitable derivative of the nature of the parent-child relationship, and the fact that we’re not born autonomous, but helpless and we spend the first decade of our life, while our brain is being formed and while our thoughts are being shaped and while the language that our symbols are encoded in is being acquired, we spend that decade helpless and needing the care of someone who’s invested of taking care of us. And that for the rest of our lives, when we’re in crisis, when we’re frightened, when we’re in pain, when we’re patients, that universal potential for activating those kinds of care-taker, care-taken intimate human relationships is always awakened and is built into every culture. It isn’t as though a culture could come along in which the meaning of parent-infant themes doesn’t get reflected in myths, in history and in doctor/patient behaviors.

HEFFNER: Well, you talked about the biology of this species. You’re not going to posit the notion that this species cannot be modified and that there are not many forces about us that are modifying, or at least providing the framework in which those, what you call biological needs, and in a sense it sounded to me as though you were mimicking the bio-chemical people who want to find the answers in chemistry … “better living through chemistry” … you’re resorting to a … the notion of what we are as a species, without dealing with the potential that we may not be what we are now as a species in the future.

MICHELS: We can change. But there are limits when we’ll no longer be human, if we change. So, for example, if we were to evolve into computers which have no permanent history built into them and have no relationship with each other, it may be a descendent of ours, but it won’t be human at that point. Is a human being possible who doesn’t have built into him or her a permanent psychological theme of relatedness to others? I don’t think so. I don’t think that would be human.

HEFFNER: But you don’t know? You really don’t know. Neither do I.

MICHELS: I think we do know, Richard, Because what’s human is our definition and every cultural, religious, and value tradition we have says the total isolation from all others, including mental relationships from all others is less than human. Every myth we have about man alone on a desert island is a man living in a rich world of other human relationships that he carries on in his mind, even if he’s socially isolated for that period of time.

HEFFNER: Now, I’ll pull the same dirty trick that I pulled before. I’ll ask you, because I have such great respect for the logic that you bring to issues to offer the best possible response to what Dr. Robert Michels just said.

MICHELS: You could design a universe in which highly adaptive units that function, metabolize, are mobile and can construct themselves, exist without mental awareness of the relationships to each other. And it might be a universe that lives, survives longer than the one we’re in now. But it’s not a universe with humans in it. I’m afraid that our notion of human involves inter-human-relatedness.

HEFFNER: Don’t you think that that’s the push of the computer age anyway? And that what you’re describing as your concern about medicine and psychiatry, the notion that these two elements, the brain and the mind can’t function together, would you reject because you want to consider both. Mightn’t you say that this is the new direction, that people are not trained the way you were trained.

MICHELS: I’m saying that this is the frightening image that informs our dialogue, and forces people like me to say what I’ve said earlier in this session. It seems to me that the wonderful thing that attack on psychoanalysis does, and that radical neuro-biologic reductionism or radial technological medicine does is make us aware of what’s really important to us. I think that there’s little doubt that those attacks, although they may serve a useful value in sharpening our thinking can’t win this battle.

HEFFNER: Even if the battle is so largely now a financial one?

MICHELS: Finances are important, and that doesn’t bother me because what they do is make us as efficient as possible in using our minds to decide what priorities or what values will guide the use of the machines and the technology we develop. We need psychoanalysis, maybe not to treat all the patients with mental illness, but certainly to be sitting at the table when we decide who needs treatment more than who else and what our priorities should be.

HEFFNER: I’ve been puzzled, pleased to be given to understand, and I want to ask you whether my understanding is correct, that psychoanalysis is not on the way out, but that in terms of numbers, in terms of persons interested, that they’re building, they’re growing. Is that true, or …

MICHELS: No doubt about it. There are more psychoanalytic institutes than there have ever been before. There are more practicing psychoanalysts in this country, and around the world, in other countries. As the world with fits and starts and difficulties becomes more humane and more affluent and more concerned about the experiences of individuals, this hundred year old strategy for helping people gain greater insight into their own lives and greater autonomy and control over their lives becomes more and more important. Psychoanalytic understanding is not important for somebody who is at the threshold of survival or death or starvation or the ability to conduct minimal aspects of life. But once you have enough resources to stop running, to catch your breath to think, to feel, to love, to hate and to put those together, man soon wants to know what’s going on and to find out why he’s doing it the way he’s doing it and to see if there’s a way he could do it more happily and more effectively. And psychoanalysis is a tool for that. I have no doubt it will grow immensely as a larger and larger percentage of the people on earth have time for those kinds of experiences.

HEFFNER: And resources.

MICHELS: And the resources to make it possible.

HEFFNER: You’re an optimist. Or about this you’re an optimist.

MICHELS: I’m a long-term optimist, no question. Things are much better than they were 2,000 years ago, and I’m convinced they’re going to be much better 2,000 years from now.

HEFFNER: Well, stick around, and we’ll see. Dr. Michels thank you so much or joining me again on The Open Mind. And thanks, too, to you in the audience. I hope you join us again next time. If you would like a transcript of today’s program, please send four dollars in check or money order to: The Open Mind, P. O. Box 7977, F.D.R. Station, New York, New York 10150.

Meanwhile, as another old friend used to say, “Good night and good luck”.

N.B. Every effort has been made to ensure the accuracy of this transcript. It may not, however, be a verbatim copy of the program.