Crews’ vs. Freud’s need for Certainty
Click Here to Read: Physician Heal Thyself Part I by Frederick Crews in the New Review of Books September 29. , 2011.
Click Here to Read: Physician Heal Thyself Part II by Frederick Crews in the New Review of Books October 13, 2011.
Crews’ vs. Freud’s need for Certainty
By William J. Massicotte and Harold J. Bursztajn
On Crews’ Physician, Heal Thyself: the scientific studies showing clinical effectiveness for the psychodynamic psychotherapies have detached the issue from Freud the person.[1]. Within Crew’s piece Freud’s discovery of countertransference attitudes are implicitly mentioned when discussing Freud’s own occasional unhelpful attitudes towards patients. One condition required for effectiveness is the management of countertransference, including both consciously rationalized and unconsciously motivated desires for diagnostic and therapeutic certainty, which shadow much of clinical and medical practice.[2] In psychoanalytically informed therapy, when countertransference is not recognized and managed this becomes one predictor of therapeutic failure.[3]
Freud himself quite often changed his mind both about theory, the causes if his patients’ suffering, and how best to be of help. We continue to learn with our patients’ help. Crews’rehash of his own clever, nowcocaine focused, ad hominemcertainties as to Freud’s cocaine use being responsible for the limitations in Freud’s theories, arefantasies reminiscent of Newton’s religious and alchemistic views being held responsible for the limitations of Newtonian mechanics on the quantum level. By way of full disclosure neither of the authors below is a cocaine or opiate user.
William J. Massicotte Ph.D., FIPA
Co-Chair, Public Information Committee, International Psychoanalytical
Association
Montreal West, CANADA
Harold J. Bursztajn, M.D.
Associate Clinical Professor of Psychiatry
Harvard Medical School
Cambridge, Ma USA
[1]E.g., Jonathan Shedler’sThe Efficacy of Psychodynamic Psychotherapy (American Psychologist, vol 65, p 98). The letter signed by 54 credible scientific researchers (The New Scientist, 27 October 2010) all of whom have produced evidence. The JAMA piece by Leichsenring and Rabung, Effectiveness of Long-term Psychodynamic Psychotherapy: A Meta-analysis, JAMA. 2008;300(13):1551-1565.
[2]Bursztajn HJ, Feinbloom RI, Hamm RM, Brodsky A. Medical Choices, Medical Chances: How Patients, Families, and Physicians Can Cope With Uncertainty. New York: Delacorte, 1981; New York: Routledge, Chapman & Hall, 1999.
[3]Therapeutic outcome success is commonly defined as an effect size on a scale out of 2. For psychodynamic therapies, the effect size is between .69 and 1.46 depending on the initial condition; compared to the common antidepressants, between .17 and .31. (Shedler).
September 30th, 2011 at 2:27 pm
About Crews, a professor of English literature at Berkeley, discussing
substantive issues on psychoanalysis, without ever training or
practicing in the field.
Could we imagine Crews writing a scientific critique of quantum theory
, mitochondrial RNA, or global warming without ever training in these
fields? (Would the NY Review of books ever ask someone never trained
in a field to write about the substantive issues in a field?)
There is an oddity about our discipline that we even take someone like
him seriously. Of course he can engage in ad hominem attacks: he could
do this about Einstein (did he really rely on his first wife for his
ideas) or Kekele (did he really use hallucinogens to imagine the
benzene ring), but ad hominem attacks take not expertise.
October 1st, 2011 at 1:39 am
Comment from Nathan Szajnberg:
Why Crews Shouldn’t Matter
N. Szajnberg, MD IP.net 9-30-11
The New York Review of Books, one of the preeminently read “psychoanalytic” journals next to the New Yorker (check your waiting rooms), runs two ad hominem attacks on Freud and his ideas about the soul written by Fredrick Crews, a professor of English at Berkeley. Yes, a professor of English is writing about a clinical practice in which he has no known training nor clinical experience. And he is taken seriously.
http://www.nybooks.com/articles/archives/2011/oct/13/physician-heal-thyself-part-ii/
Crews, like Grunebaum (trained in philosophy), has made a career criticizing a field in which he never trained nor practiced. We could ridicule Crews’ lack of knowledge about psychoanalysis — his first successful book was the Pooh Perplex, before he turned to using psychoanalytic concepts for literary criticism, until he recanted his “conversion,” with his 1975 Out of My System: Psychoanalysis, Ideology, and Critical Method. But, this would be engaging in the kind of ad hominem criticsm that is now Crew’s speciality: after all, one may know nothing about a discipline, but knowing how to attack a person takes little training or knowledge. Clever rhetoric gives an edge.
Rather, let’s reflect on the nature of psychoanalysis as a discipline that people like Grunebaum and Crews can blithley write about it critically and are taken seriously enough not only by prominent “psychoanalytic” journals such as NYRB and the New Yorker, but even by official psychoanalytic journals.
Try a thought experiment. Imagine that “Shmews,” a professor of English Literature at Murky University, decides to write a critical essay on quantum mechanics, or mitochondrial RNA, or, to be topical, global warming. This Professor Shmews admits that he has never had training nor practiced in the respective disciplines — physics or molecular biology or climatology. He simply states that he is qualified to call their findings bunkum. He is articulate in his critique, although it is clear to those trained in the disciplines that he can’t do a differential equation, parse a cell or calculate a weather system. He is clever enough to attack the founding members of the discipline: for instance, claiming that all organic chemistry is falderol because the nineteenth century scientist Kekule allegedly “saw” the six-carbon ring while hallucinating from a drug he ingested, imagining a snake consuming its tail. (Kekule claimed it was a daydream.)
Now, most physicists or molecular biologists or climatologists or organic chemists would either ignore or possibly scoff at such untrained silliness: they certainly wouldn’t feature Professor Shmews article along with rebuttals in their respective journals.
Yet, analysts do. (Look at this piece I am now writing. How long need I go on?)
There are scholars who leap disciplines because of their genius: this was particularly so in the Renaissance, even as late as the nineteenth century when a genius such as Goethe could write a well-regarded text on color, Zur Farbenlehre. But, paraphrasing Ronald Reagan on Jack Kennedy, Crews is no Goethe. One of my teachers, Paul Ricoeur, wrote a seminal text on psychoanalytic texts: he begins by admitting that he has no training in psychoanalysis, nor experience with it. Then he proceeds to constructively help us see how Freud’s dream interpretation technique shares qualities with techniques for interpreting the Bible, introducing us to hermeneutics. There may be few other such geniuses who can grasp other disciplines with cogency.
But, I return to psychoanalysis. What does it speak about our discipline (I avoid the charged term “science” which the unscientifically-trained Crews’s of the world will state is a pseudoscience) that we are easily thrown like bait into the maws of whomever professes himself to be expert, to then pounce on this discipline? And what does it say about our discipline that we even engage untrained people in such debates? It may very well be that we have a unique discipline. But, when Michele Bachman or Governer Perry deride the majority of climatologists about whether global warming scientifically exists, the New York Review of Books is not likely to invite them to review scientific books on the subject.
The intent of this piece is to rouse us as a discipline: for us to become more disciplined about our profession.
–
Nathan Szajnberg, MD