Why Public Discourse Needs a Dose of Psychoanalytic Insight
Bringing depth to collective understanding
Austin Ratner, MD, is a prizewinning author of two novels, a history of psychoanalytic epistemology (The Psychoanalyst’s Aversion to Proof, 2019), and a coauthor of a physiology textbook. His work has appeared in The New York Times Magazine, The Wall Street Journal, The Lancet, and many other outlets. As former editor-in-chief of The American Psychoanalyst (tapmag.org, americanpsychoanalyst.substack.com), he rebooted the magazine of the American Psychoanalytic Association as a public-facing vehicle for psychoanalytic conversation about mental health, the arts, and culture.
Young sciences boil with controversy, mature ones cool down into consensus. The relatively young mental sciences are maturing. Among experts, there’s a growing bilingualism in the languages of clinic and lab, a pluralistic dialogue across faultlines that once isolated competing orthodoxies. The public conversation, however, seems to lag behind.
The problem of public misinformation isn’t unique to psychology and psychiatry, of course. Much has been written on the subtle biases that influence what well-meaning academic journals publish and what popular-science reporters cover. But for a number of reasons, the mental health field may be particularly vulnerable to media misinformation. And the results of that misinformation can be especially damaging. The psychological constructs that laypeople absorb from the media directly impact how they go about solving their own problems, negotiating conflict, caring for one another, and how they form identifications with larger social groups and movements—to whom they pray and for whom they vote.
It’s tempting to attribute media misinformation about psychology to the usual suspects: a simple language barrier or knowledge gap between journalists and scientists, maybe, or a media bias toward the latest studies, from which reporters then draw premature conclusions. I think it’s a lot more complicated than that.
My own research has focused on the role of defense mechanisms in how we talk about psychoanalysis—very meta, I know. Freud’s conviction that people’s defenses biased them against his theories provoked in him a deep pessimism about the prospects of public validation of his claims. For a long time that pessimism passed as conventional wisdom within the field of psychoanalysis and a nominal excuse to deprioritize research. While defensive reactions to psychoanalysis have certainly occurred and still do, my research suggests that Freud and many later psychoanalysts also had their own aversions to the work of validation, aversions rooted in their own discomfort with talking publicly about controversial subjects like sex, aggression, and repression. Their historical refusal to engage in normal scientific discourse has contributed significantly to the current position of psychoanalytic psychology. Psychoanalytic aversions to the task of proof only deepened the convictions of skeptics. As the evidence-based medicine movement took off, the psychoanalytic community was left behind. They lost academic credibility, leadership roles in psychiatry, access to research dollars, and their numbers shrank. A lot of fine psychoanalytic research is now being published, but psychoanalytic researchers are at a disadvantage due to this history. Most psychological research is not psychoanalytic, so any journalistic bias toward “the latest studies” directs attention away from psychoanalysis, which compounds the disadvantage. As one of the oldest perspectives in psychology, the psychoanalytic view is furthermore inherently less newsworthy.
Consider two recent representative examples of narrow discourse in the “Well+Being” section of The Washington Post and what misimpressions might result. On March 4, 2026, the Post ran a guest column with the headline “Can’t stop overthinking? Here’s what experts say actually helps. From zooming out to changing your environment, these research-backed strategies can turn the volume on noisy thoughts down.” The column offered solid evidence-based advice, but it didn’t touch upon the relationship between feeling and thinking, a relationship that has of course long been the province of psychoanalytic psychology.
In Macbeth, Shakespeare famously makes a connection between a kind of overthinking, an obsession, and a feeling, namely the feeling of guilt. In Act V scene i, a servant describes Lady Macbeth’s obsessive-compulsive handwashing to a doctor like this: “It is an accustomed action with her, to seem thus washing her hands: I have known her continue in this a quarter of an hour.” While sleepwalking, and not fully conscious, Lady Macbeth reveals to the doctor the secret motive behind her handwashing: she’s repeatedly imagining washing the blood of the murdered King Duncan off her hands. The doctor notes that “infected minds / To their deaf pillows will discharge their secrets.”
Even feelings of guilt more mundane than Lady Macbeth’s can still be quite painful to acknowledge and difficult to relieve—guilt along the lines of, say, “I disappointed my loved one” (and not “I murdered the king”). Guilt may not be the explanation for every obsession, nor does all “overthinking” necessarily qualify as obsession. Could it benefit some “overthinkers,” however, to ask themselves whether their overthinking does not to some extent reflect an unconscious effort to relieve a sense of guilt—a sense of guilt that they’re keeping secret from themselves because it’s too painful to feel consciously?
Lady Macbeth’s handwashing is not exactly breaking news. But recent scientific evidence actually does support the link, first proposed by Freud, between guilt and obsessive symptoms. So why didn’t the Washington Post article include the psychoanalytic view? If it’s only because cognitive-behavioral researchers dominate psychology departments today and they’re the ones who answer the phone when journalists call, well, that’s not a great reason.
A second “Well+Being” article published recently in the Post likewise takes such a narrow approach to its subject that it leads to alarming conclusions, ones that could have been avoided through a more holistic approach. The article cites a study’s finding that “Difficult people in your life might make you age faster.” The study labels such people “hasslers” and the study’s lead author offers the following reckless advice, according to the Post journalist: “The obvious advice, Lee said, is to consider relationships carefully, avoiding hasslers whenever possible and cutting ties if you feel like someone is adding lots of negativity and stress to your life, although that can be an incredibly difficult decision.”
The article sounds only one small note of caution, briefly quoting Debra Umberson, a sociologist and aging expert not involved with the study. “That’s the definition of relationships, they have hassle, right?” Umberson told the Post, commenting on the new research. “I mean, you can get support and love from them, but they all come with hassles.”
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, seeing someone else as the problem when the problem originates within us. Family members notoriously hassle one another, and a mistaken conclusion that might be drawn from the Post is that we’ll live longer if we estrange ourselves from our hassling siblings or if we divorce our hassling spouses. Clearly, there are times when you need to break up with somebody. But eliminating all “hasslers” would be like spraying buckshot from a 360-degree swivel, likely to hurt the innocent and to shoot off your own feet.
So often, we unconsciously create our own trouble in relationships. We can sometimes hassle ourselves and then project the hassle onto others, seeing someone else as the problem when the problem originates within us.
Another important psychoanalytic concept that would have improved the “hassler” conversation is ambivalence. According to psychoanalytic psychology, we often love and hate the same thing, the same person, at the same time. Such ambivalence is a product of internal conflict and it’s normal. What feels like a hassle that could kill you may really be a sign you’re alive, feeling all the conflictual feelings that go with the territory. A psychoanalyst might argue for hanging in there in your relationships, trying to work out your hassles in dialogue with your loved ones and with yourself, before rushing to label and avoiding or excising “hasslers” or “negative people” from your life.
In fairness to the Post, just a month later, their “Optimist” column featured an article called “How to deal with chronically negative people” that was more sophisticated about emotions and defenses. Instead of recommending avoidance, the article quoted experts who encouraged readers to think through the emotions involved and coached them to use reflective listening to make negative friends and relatives feel heard.
Articles that incorporate a psychoanalytic perspective still feel like the exception, however. It continues to be common for journalists and experts to cite the urban legend that psychoanalysis has been categorically discredited, a claim that is ironically not itself “evidence-based.” Humanity needs every available tool in the doctor bag as we embark on a new millennium, pregnant with possibility, peril, and strain. At The American Psychoanalyst, we’re by no means ignoring or whitewashing the missteps in the history of psychoanalysis, but we’re working to keep psychoanalysis in the public conversation. A new era of psychoanalytic openness is dawning. The real conversation has just begun.
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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.