“…The discussion would have benefited from the psychoanalytic approach to introspection. So often, we unconsciously create our own trouble in relationships. We can sometimes hassle ourselves and then project the hassle onto others…”
I would add that this problem originates from higher education itself, not the folk psychology of the masses or the media.
If you visit any reputable psychology program today you find from freshmen year through the doctoral program is a banishing of the word “introspection” and “projection”. Indeed, thinkers like Dan Kahneman (e.g. judgement and decision making paradigms) and Sam Harris (pure rationalism and extreme skepticism) have convinced entire psychology & neuroscience departments that humans cannot ever trust their own experiences nor senses, and cognitive science’ obsession with “biases” and “shortcomings of perception” have caused multiple generations to be taught to doubt themselves and then project that doubt onto their future audiences (or worse, patients). Instead, we are taught that the only acceptable path is to ignore the first-person and focus on abstract and de-contextualized statistical patterns in datasets, and how well they “fit” into a brain tissue sample or gene polymorphism. Hence why qualitative methods remain shunned and quantitative methods are the only means of lengthening a CV.
And open any advanced research methods book today and flip to the index for the word “Intuition”. It will appear in the first or second chapter that an say it’s “unreliable and cannot be trusted in science, ever” or otherwise portrays it as some “mysterious” Jungian social-construct.
But don’t worry, Dr. Ratner, there are plenty of wonderful psychodynamic and phenomenological-styled thinkers through “philosophy of psychiatry” to follow if you too are as disappointed as I am..
It is important to bring the depth and range of psychoanalytic ideas into public conversations — it is usually the discredited or outdated aspects of the theory that are most often referred to. Regarding guilt, I’m in the middle of reading Yalom’s text on Existential Psychotherapy and I like the notion that existential guilt often underlies symptoms (such as obsessive thinking). Existential guilt is not about what I have done to another person, but about how I have not answered the call to be myself in the world. If I am avoiding taking responsibility for my life, avoiding facing my own values and avoiding feeling the weight of my deepest striving toward meaningful action, I might suffer from obsessive overthinking or anxious rumination instead.
I think that, in even thinking about the title of this excellent piece, there are those who see "psychoanalytic insight" and experience a mix of eye-roll and curiosity, as if they ( the public and the press) know that there is definitely something to it but think it's beyond their ability to understand or make use of it. So part of it is a language problem, and for those of us who know that PA has much to offer, we have to thread the needle of how to engage people without what they see as jargon which puts them off. Ironically, the public loves to use PA jargon but is wary when we use it.
It takes a different kind of effort to translate PA terms into plain English, but it's necessary. I've done a lot of collaboration with other doctors, and I find that using admittedly imprecise but still meaningful terms like "worry" or "mixed feelings" or "feeling torn between two choices" gets my foot in the door more effectively than saying "anxiety" or "ambivalence.". If a surgeon only spoke of "lesions," s/he'd be communicating nothing. Know your audience.
Also, to be (I hope) funny to make a more serious point, since the world still is pretty sure psychiatrists might indeed be able to read everyone's mind, we have to tread lightly with our language and engage them in this exploration without implying we really know what's true in the first place. That's how we put others off and discredit what we have to offer.
I was trained with PA teachers and mentors, but also with other viewpoints and never understood the appeal of the psychoanalytic viewpoint. I think it helps as a starting point to exploring thought and behavior, but because it rarely comes upon a behavior that it cannot “explain” in some manner, it seemed a way of justifying an explanation. I agree with the concept of unconscious processes and that we operate mostly on a superficial level but also that it is successful most of the time.
And I am not wanting to get into a battle here on if PA is correct or not, I think most of our behavior models are incomplete, but I would like to see a new model of thinking that includes biology and evolution and social systems that is not more flying buttresses built on the alchemy of psychoanalysis. I also do not feel the “brain model” and the quantitative model is very useful either.
Many of the scientific theories of the past 100 years in other fields have been replaced with more modern thinking and they have accepted the new data and gone on from there. In psychiatry and the behavioral sciences I think we have difficulty even agreeing what is “evidence” and that has slowed our progression.
I agree with much of your article, though:
“…The discussion would have benefited from the psychoanalytic approach to introspection. So often, we unconsciously create our own trouble in relationships. We can sometimes hassle ourselves and then project the hassle onto others…”
I would add that this problem originates from higher education itself, not the folk psychology of the masses or the media.
If you visit any reputable psychology program today you find from freshmen year through the doctoral program is a banishing of the word “introspection” and “projection”. Indeed, thinkers like Dan Kahneman (e.g. judgement and decision making paradigms) and Sam Harris (pure rationalism and extreme skepticism) have convinced entire psychology & neuroscience departments that humans cannot ever trust their own experiences nor senses, and cognitive science’ obsession with “biases” and “shortcomings of perception” have caused multiple generations to be taught to doubt themselves and then project that doubt onto their future audiences (or worse, patients). Instead, we are taught that the only acceptable path is to ignore the first-person and focus on abstract and de-contextualized statistical patterns in datasets, and how well they “fit” into a brain tissue sample or gene polymorphism. Hence why qualitative methods remain shunned and quantitative methods are the only means of lengthening a CV.
And open any advanced research methods book today and flip to the index for the word “Intuition”. It will appear in the first or second chapter that an say it’s “unreliable and cannot be trusted in science, ever” or otherwise portrays it as some “mysterious” Jungian social-construct.
But don’t worry, Dr. Ratner, there are plenty of wonderful psychodynamic and phenomenological-styled thinkers through “philosophy of psychiatry” to follow if you too are as disappointed as I am..
It is important to bring the depth and range of psychoanalytic ideas into public conversations — it is usually the discredited or outdated aspects of the theory that are most often referred to. Regarding guilt, I’m in the middle of reading Yalom’s text on Existential Psychotherapy and I like the notion that existential guilt often underlies symptoms (such as obsessive thinking). Existential guilt is not about what I have done to another person, but about how I have not answered the call to be myself in the world. If I am avoiding taking responsibility for my life, avoiding facing my own values and avoiding feeling the weight of my deepest striving toward meaningful action, I might suffer from obsessive overthinking or anxious rumination instead.
Ambivalence, indeed.
I think that, in even thinking about the title of this excellent piece, there are those who see "psychoanalytic insight" and experience a mix of eye-roll and curiosity, as if they ( the public and the press) know that there is definitely something to it but think it's beyond their ability to understand or make use of it. So part of it is a language problem, and for those of us who know that PA has much to offer, we have to thread the needle of how to engage people without what they see as jargon which puts them off. Ironically, the public loves to use PA jargon but is wary when we use it.
It takes a different kind of effort to translate PA terms into plain English, but it's necessary. I've done a lot of collaboration with other doctors, and I find that using admittedly imprecise but still meaningful terms like "worry" or "mixed feelings" or "feeling torn between two choices" gets my foot in the door more effectively than saying "anxiety" or "ambivalence.". If a surgeon only spoke of "lesions," s/he'd be communicating nothing. Know your audience.
Also, to be (I hope) funny to make a more serious point, since the world still is pretty sure psychiatrists might indeed be able to read everyone's mind, we have to tread lightly with our language and engage them in this exploration without implying we really know what's true in the first place. That's how we put others off and discredit what we have to offer.
I was trained with PA teachers and mentors, but also with other viewpoints and never understood the appeal of the psychoanalytic viewpoint. I think it helps as a starting point to exploring thought and behavior, but because it rarely comes upon a behavior that it cannot “explain” in some manner, it seemed a way of justifying an explanation. I agree with the concept of unconscious processes and that we operate mostly on a superficial level but also that it is successful most of the time.
And I am not wanting to get into a battle here on if PA is correct or not, I think most of our behavior models are incomplete, but I would like to see a new model of thinking that includes biology and evolution and social systems that is not more flying buttresses built on the alchemy of psychoanalysis. I also do not feel the “brain model” and the quantitative model is very useful either.
Many of the scientific theories of the past 100 years in other fields have been replaced with more modern thinking and they have accepted the new data and gone on from there. In psychiatry and the behavioral sciences I think we have difficulty even agreeing what is “evidence” and that has slowed our progression.