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The Psychoanalyst and the Neurobiologist: A Conversation About Healing the Soul and Telling Stories of the Mind, Brain, Self, and Culture Elio Frattaroli and Paul Grobstein

Elio Frattaroli is a psychiatrist and psychoanalyst on the faculty of the Psychoanalytic Center of Philadelphia and author of "Healing the Soul in the Age of the Brain: Becoming Conscious in an Unconscious World". Paul Grobstein is a neurobiologist at Bryn Mawr College and Director of the College's Center for Science in Society whose published work includes "Revisiting Science in Culture: Science as Story Telling and Story Revising" and "Making the Unconscious Conscious, and Vice Vera: A Bi-directional Bridge Between Neuroscience/Cognitive Science and Psychotherapy". The two have been sharing thoughts over monthly lunches since 2001-2003 when Grobstein was an academic fellow of the Psychoanalytic Center and Fratarolli was one of his mentors. The conversations have been generative for both, seem likely to continue to be so, and touch on a number of matters that may be of interest to others as well. With the thought that their conversation might usefully be broadened, Fratarolli and Grobstein decided in the fall of 2005 to add the on-line component of their conversations provided here and an on-line forum for contributions by others interested. The exchange begins with brief reflections by both Fratarolli and Grobstein about where the conversations between them have been, what has been productive about the so far, and where there seem to be disagreements that are likely to be generative in the future, and will be updated monthly. Join the conversation yourself in the On-line forum or email us.

Reflections

From Paul to Elio - It HAS been quite a while since we first started talking together. I've learned a lot from and thought a lot about our conversations over the years since. Partly that has to do with your clinical experiences and expertise, neither of which I have. You've given me a window into what I think of as "applied neurobiology" for which I have been and continue to be very grateful. But there is much more to it than that: your inclination to reflect critically on your own experiences and to share that kind of metathinking, your curiosity about ways other people make other kinds of stories about similar things, and your willingness to test different stories by bumping them up against one another. That I think is a major part of what has made these such good conversations, with the promise they will continue to be so. We've found lots of common so far, including a mutual dissatisfaction with "quick fix" approaches to mental health problems, a common belief in the value of "talk therapy" as an important component of mental health care, and a shared sense that the underlying issues are as much matters of social and cultural as they are of individual well being. Having gotten to those similar places via very different routes (science/biology/academia as opposed to literature/medicine/clinical practice) encourages me to believe there is a there there, and I hope it does for you as well. We've also, I think, been developing together some conceptual tools to help in addressing these sorts of issues, deriving in large part from your inclination to try and get beyond some of the older formalisms of psychoanalysis and my own to try and move neurobiology in some more expansive directions. A recognition of important distinctions between the conscious and the unconscious is one part of this, as is an understanding that conflict (both interpsychic and interpersonal) is a central part of human experience, one needing to be better understood and not always to be done away with. Another useful direction we've been developing, I think, has to do with efforts to make sense of what you call the "repetition compulsion", the tendency of humans to repeat actions that any outside observer would say make no sense. And then, perhaps, there is a developing common recognition of the importance of "story" as a distinctive feature of human behavior and experience, a feature that, among other things, helps to make sense (for me at least) of transference as an important construct? There is, I think, great promise in what we've been able to develop that we agree on, but at least as much as well in the places we've been to again and again without (yet?) finding a common vocabulary. Can one make sense of all that we are trying to make sense of in terms of a material object, the brain, as I am inclined to do? Does one instead need, as you prefer, terms like "soul" and an independent "higher consciousness"? One might for matters like these simply agree to disagree, but that's not your style or mine. The game instead is to presume that there is in each of us something for the other to learn from and to keep working at discovering what it is. If psychoanalysis and neurobiology can learn from each other and find shared ways to think about the brain/mind/self, maybe dualists and materialists can as well? (Hmmmm, maybe there's something common to both conflicts?) Anyhow, very much looking forward to this new phase of our conversations.

From Elio to Paul - What I have most appreciated about our conversations has been that you are trying to grapple with the same phenomena and the same problems of human nature that I am, specifically self-reflective consciousness, inner conflict, and free will/intentionality. These phenomena/problems are at the center of psychoanalysis but neuroscientists feel entitled to have strong opinions about them - and they assume their opinion should take precedence over those of psychoanalysts - even though the phenomena/problems in question are being observed every day by psychoanalysts and are strictly speaking NEVER observed by neuroscientists (simply because they are outside the domain of what can be studied using the methods of neurobiological research). Here's what most neuroscientists would say about self-reflective consciousness, inner conflict and free will: "Current neuroscience can't explain them but they are obviously products of neurobiological activity because everything mental is a product of neurobiological activity and we are confident that eventually this will be proven by neuroscience research. Therefore, psychoanalysis should use neuroscience research to guide its theorizing; otherwise it won't be scientific." (The logic here is specious but that is the way most neuroscientists think.) Here's what I like to think you would say: "Neuroscience will probably never be able to prove that self-reflective consciousness, inner conflict, and free will are products of neurobiological activity but I personally (along with most other scientists) believe that they are. On the other hand it is obvious that psychoanalysts have a whole lot more information and ask much more interesting questions about these phenomena/problems than neuroscientists do, because they actually observe these phenomena/problems every day while neurobiologists never observe them directly, only their correlates in the brain. Furthermore, it is obvious that self-reflective consciousness, inner conflict, and free will are of overriding importance in human nature, so neurobiology should use what psychoanalysis is learning about them to guide its research program; otherwise it runs the risk of being largely irrelevant to what really matters." The only catch is that you really really wants to believe that self-reflective consciousness, inner conflict, and free will are entirely products of brain activity, properties of a highly evolved nervous system, even if you know that is an article of faith that it will never be possible to prove (which on a good day, you acknowledge). I, on the other hand really really want to believe that there is something beyond neurobiology --- something spiritual is probably the best way of describing it --- that is absolutely necessary to account for self-reflective consciousness, inner conflict, and free will/intentionality. In other words, you and I tend to agree on the facts but our emotional needs compel us to think about those facts in different philosophical frameworks, materialism versus dualism. You can justify your position by saying that, as far as we know, brain activity is a necessary condition (although not necessarily a sufficient condition -- that's the unknowable part) for self-reflective consciousness, inner conflict, and free will, so a materialist explanation for these phenomena is plausible. I can justify my position by saying that there is no way of avoiding epistemological dualism (different and incompatible ways of knowing and different incompatible languages to describe the external world studied by the physical sciences and the inner world of conscious experiences studied by psychoanalysis) so ontological dualism is plausible. With this background, you and I agree that it can be potentially quite interesting and fruitful for people like us - of incompatible belief systems who prefer incompatible ways of knowing --- to try to study and think about the same phenomena from our mutually exclusive perspectives, and then try to use the other person's ideas/observations to stretch and illuminate our own perspectives.

PG to EF - 5 January 2006

Rich conversation yesterday, as always. I was intrigued particularly by our ability to acknowledge to each other that we each have a preference for how to try and understand things that goes beyond what can be definitively validated: me for trying to make sense of everything in terms of the brain, you for prefering to use as well more "spiritual" notions. And by our shared sense that for each of us part of the enjoyment of these conversations is the opportunity, in a supportive but critical context, to see how far we can push one or the other approach.

Along these lines, I think it interesting and significant that we both, independently, have been intrigued by Freud's denial, at the beginning of Civilization and Its Discontents, of ever having had an "oceanic feeling", one that a correspondent of his suggested was the basis of religious experience. One can, of course, read that, as perhaps you do?, as an explanation of Freud's failure to give significant attention to more "spiritual" dimensions of psychotherapy. Alternatively, one can read Freud's denial, as I do, as a way of better understanding why the early development of psychoanalysis paid less attention than it might have to interpersonal and social issues (cf Cassandra's Daughter by Joseph Schwartz). It was fun talking about this together and led in some directions worth exploring further, so let me briefly sketch the alternative interpretation here.

My sense is that you and I (unlike Freud) both recognize the "oceanic feeling" and identify it with something like "the experience of being an integrated part of something larger than oneself". The question, of course, is what the larger thing is and how engagement with it gives rise to the feeling. A parallel, for me, is occasional feelings of very deep interpersonal connectedness, what I have called "interconnected vastness" or "ivy" for short. In these states, "one experiences 'fit' in the sense that ... issues of power and control disappear because power and control are rapidly and unconsciously passed back and forth ... fears of loss or inadequacy disappear, as do concerns about the past and the future, because the current activity is completely satisfying all current wants/needs ...".

Among the things that makes ivy interesting in this context is that there is nothing fundamentally mysterious or "mystic" involved. One can readily point to a well-defined "something larger than onself". It is an interpersonal assembly (a dyad, a family, a basketball team, etc) of which one is an interdependent element. Moreover, one can perhaps account for the feeling itself in a relevant and extendable way: it is the state of the nervous system in the absence of any experience of conflict. It is what one experiences when there are no signals of mismatch.

The intriguing extension, of course, is the idea that the presence or absence of conflict can exist on the interpersonal level (at scales ranging from the dyad all the way up to societies/cultures) but can also exist in terms of interactions between the self and the non-human world (so that one might have "oceanic feelings" when one is alone and, for example, gazing at a star filled sky). Perhaps most importantly, the presence or absence of conflict can exist simply within oneself, independent of who or what is around one.

Freud may have lacked openness to some supernatural entity or "higher consciousness". Alternatively, he may have been largely unable to resolve conflicts, interpersonal or otherwise. Either might, in different ways, shed new light on the history of psychoanalysis. Leaving Freud aside, the more general question, of course, is what use we can each make of the fruits of the other's approaches. What use can be made of thinking of "oceanic experiences" as fundamentally rooted in the brain as opposed to being indicative of an opening to something else?

Looking forward to further conversations on this theme and others that we touched on to which I think it relates. I'm very much intrigued by your bringing "nonviolent communication" to the table; it connects not only to psychoanalytic practice but to some thinking I've been doing about Serendip and to something a colleague recently mentioned to me about the improv "rule of agreement" as described in Malcolm Gladwell's Blink. The rule might be more aptly described as "non-denial of possibility" and could, I think, operate both in intrapsychic and interpersonal situations to make conflict less troublesome/more generative. Interested as well in your distinction between two ways of dealing with emotion: "expressing" it as a way of avoiding feeling it as opposed to "being fully conscious". Lots (more) to talk about, as usual.

To be continued ...

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