Psychoanalysis, science and the seductive theory of Karl Popper

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  • Psychoanalysis, science and the seductivetheory of Karl Popper

    Don C. Grant, Edwin Harari

    Objective: To present a critique of the ideas of Karl Popper, the philosopher of science,whose depiction of psychoanalysis as a pseudoscience is often used to justify attacks onpsychoanalysis.Method: Published sources are used to provide a brief intellectual biography of Popper, asummary of his concept of science and a summary of criticisms of Poppers view of science.His depiction of psychoanalysis and Freuds reply are presented. Clinical, experimentaland neurobiological research which refutes Poppers view is summarized.Results: There is a vast scholarly published work critical of Poppers falsifiability crite-rion of science. Less recognized is Poppers misunderstanding and misrepresentation ofpsychoanalysis; his argument against it is logically flawed and empirically false. Even ifPoppers theory of science is accepted, there is considerable clinical, experimental andneurobiological research in psychoanalysis which meets Poppers criterion of science.Conclusion: Attacks on psychoanalysis based on Poppers theory of science are ill-founded and reflect inadequate scholarship.Key words: evidence, falsifiability, philosophy of science, psychoanalysis, science.

    Australian and New Zealand Journal of Psychiatry 2005; 39:446452

    Attacks on psychoanalysis and the long-term therapiesderived from it, have enjoyed a long history and muchpublicity [14]. Yet, the justification for such attackshas been challenged on many grounds, including theirmethodology [5] and the empirically demonstrable va-lidity of core psychoanalytic concepts [6,7]. Also, bur-geoning neuroscience research, some of which is sum-marized below, indicates likely neurological correlatesfor many key clinically derived psychoanalytic conceptssuch as self-coherence [8], repression [9] and projectiveidentification [10].

    Furthermore, the effectiveness of psychoanalysis andits derivative therapies has been supported by empiri-cal research [11,12], particularly for patients with DSM

    Don C. Grant, private practice (Correspondence)

    1021 Malvern Road, Toorak, Melbourne, Victoria 3142, Australia.Email: dcgrant@ausdoctors.net

    Edwin Harari, Consultant Psychiatrist

    St. Vincents Hospital Area Mental Health Service, Melbourne, Australia

    Received 9 May 2004; revised 7 September 2004; accepted 13 September2004.

    axis II pathology. Despite this evidence, the attacks onpsychoanalysis continue unabated, not only from somepsychiatrists [13,14] but also from the highest levels ofpolitics and health bureaucrats [15], although what ex-actly is being attacked is often unclear.

    An equally unfocused reply hardly constitutes a schol-arly discourse, so before proceeding further, we wish toclarify our focus when discussing psychoanalysis in thispaper. The term psychoanalysis encompasses several dis-tinct but related domains. First, it is a method of observa-tion of mental functioning; second, it is a group of theoriesof the mind; and finally, it is a method of psychotherapy.In this contribution, we are limiting our discussion ofpsychoanalysis to one issue in the first domain, namelyPoppers misunderstanding of Freuds method of verifi-cation of psychoanalytic interpretations. We inevitablytouch upon other aspects of psychoanalysis, but they arenot our focus here.

    Popper believed that psychoanalysis could not befalsified and was therefore not scientific. This much-publicized view of Popper, uncritically accepted, oftenseems to be coupled with the assumption that it is also

  • D.C. GRANT, E. HARARI 447

    acceptable not to bother looking at the actual evidence.Before discussing in detail Poppers belief about falsifia-bility in psychoanalysis, we shall briefly outline some ofthe influences on the development of his thinking.

    Karl Popper and his theory of science [1618]

    Karl Popper was born in Vienna in 1902, into a dis-tinguished legal family. He studied at the University ofVienna to become a teacher and youth worker beforebeing drawn to mathematics and philosophy. A youth-ful flirtation with a rather extreme form of Marxism wassoon replaced by what might be described as Fabian-style socialism. Psychoanalysis, particularly the ideas ofAlfred Adler, was considered by these democratic social-ist reformers to be relevant for workers and intellectualsseeking to understand the shared difficulties they facedin trying to improve society. Popper grew disillusionedwith socialism, apparently disappointed by the equivo-cation of the Viennese democratic socialists who werereluctant to ally themselves with the bourgeoisie againstthe emerging forces of fascism in the 1930s [16, pp.328329]. Later, he adopted a form of small-l liberalism whichrejected grand political or social revolutions and central-ized government-sponsored 10-year plans in favour ofwhat he termed piecemeal social engineering, whereinsmall social changes for the betterment of society are im-plemented and their effects reviewed before attemptingfurther change.

    Poppers Logic of scientific discovery [19] was pub-lished in 1935, though it received little attention at thetime. Having unsuccessfully sought an academic posi-tion in the UK, he left Vienna for New Zealand shortlybefore the outbreak of the Second World War and settledin Christchurch, where he lectured at the then CanterburyCollege of the University of New Zealand and from wherehe wrote his influential The open society and its enemies[20]. He finally went to the UK in 1947 and spent mostof his remaining professional life at the London Schoolof Economics. He died in 1994.

    Popper [18, pp.3738] recounts that while in Vienna in1919, he was overwhelmed by a lecture he attended, givenby Albert Einstein, which described some of the amazingdiscoveries in the New Physics of the atom and quantummechanics. It was in the same year that Eddingtons ex-pedition conducted observations during an eclipse of thesun to test Einsteins general theory of relativity using thepredictions that theory made about the effects of gravityon light waves. Eddingtons observations supported therisky predictions made by the theory. Popper contrastedthis with what he claimed were theories of Marx, Freudand Adler, then in vogue in Vienna, theories which Popperclaimed were always confirmed irrespective of whether

    or not the predictions which followed from the theoryactually occurred.

    The philosophers, scientists and mathematicians whoconstituted the Vienna Circle had proposed a theory ofmeaning based on the idea that a statement is meaningfulif it can be verified by experience. This doctrine of log-ical positivism held that verification of a (theoretical)statement by experience (observation) was the hallmarkof science. Central to such an understanding of sciencewas the role of inductive reasoning (i.e. generalizing fromknown observables to as-yet unobserved situations).

    Unlike the Vienna Circle, Popper argued that the ver-ification of predictions derived from a theory is not thedistinguishing feature of science. Rather, it is the pos-sibility of specifying what observations, if they were tooccur, would stand as a refutation of a given theory whichis the hallmark of the scientific method. For Popper, it isdeductive (i.e. reasoning from observation which maydisconfirm a theory) rather than inductive reasoning (rea-soning from any number of observations which appear tohave confirmed a theory) which is the characteristic of ascientific theory.

    Popper [21, pp.3435] writes:

    I found that those of my friends who were admirersof Marx, Freud and Adler, were impressed by a num-ber of points common to these theories, and especiallyby their apparent explanatory power. These theories ap-peared able to explain practically everything that hap-pened within the fields to which they referred. The studyof them seemed to have the effect of an intellectual con-version or revelation, opening your eyes to a new truthhidden from those not yet initiated. Once your eyes werethus opened you saw confirming instances everywhere;the world was full of verifications of the theory. What-ever happened always confirmed it . . . every conceivablecase could be interpreted in the light of Adlers theory,or equally of Freuds. I may illustrate this with two verydifferent examples of human behaviour: that of a manwho pushes a child into the water with the intention ofdrowning it; and that of a man who sacrifices his lifein an attempt to save the child. Each of the two exam-ples could be explained with equal ease in Freudian andAdlerian terms. According to Freud the first man sufferedfrom repression (say of some component of his Oedipuscomplex), while the second man achieved sublimation.I could not think of any human behaviour which couldnot be interpreted in terms of (either) theory. It was thisfact, that they always fitted, that they were always con-firmed which in the eyes of their admirers constitutedthe strongest argument in favour of those theories. Itbegan to dawn on me that this apparent strength was infact their weakness.

  • 448 PSYCHOANALYSIS, SCIENCE AND THE SEDUCTIVE THEORY OF KARL POPPER

    What Popper has described here is the attribution ofunconscious motives to people on the basis of a theory,with no supporting clinical evidence. That is not psycho-analysis! It is, in fact, a caricature of psychoanalysis of atype specifically condemned by Freud [22] as wild psy-choanalysis, that is, coming to conclusions about uncon-scious motives, without going through the long painstak-ing process of overcoming the specific defences usedby that individual, in order to be in a position to under-stand their particular unconscious motives. Indeed, it wasonly by ignoring the way psychoanalytic theorizing pro-ceeds from transference and defence analysis in the clin-ical situation that Popper could construct his caricatureof psychoanalysis, which he was then able to demolishwith such ease. Mistaking wild psychoanalysis for realpsychoanalysis, Popper incorrectly concluded that realpsychoanalysis claimed to be right about everything andcould not be falsified.

    Poppers falsifiability criterion of science is seductivein its simplicity, but its simplicity is achieved by itsfailure to address not only the clinical issues but alsothe many philosophical issues, which have been raisedin the extensive scholarly published work critical ofPoppers account. Curiously, this published work is ig-nored by those who invoke Popper to criticize psycho-analysis. The main criticisms may be summarized as:

    1 Historians of science [23,24] using the case-studymethod of theory change in science, including psy-choanalysis [23], have shown the inadequacy of Pop-pers criterion as a description of how scientists ac-tually work and how theories change in the practiceof science. In these accounts, inductive reasoning andthe verification of hypotheses play a crucial role.

    2 Some medical scientists describe Poppers criterionas counterproductive in the real world [25]. For ex-ample, in formulating epidemiological hypothesesconcerning the spread of HIVAIDS, which havepublic health and clinical implications, a Popperianapproach which insists on strict falsification of hy-potheses is less useful and less frequently used inactual practice than one which uses induction to gen-eralize from observations in a professionally disci-plined way.

    3 Popper neglected the crucial role played by conceptsand models in scientific theorizing [24,26]. Conceptsand models (including ideational, mathematical andmaterial models) are not epiphenomena produced asan incidental by-product of scientific thinking, butactively shape the way scientists think about theirfield and the questions they ask. Watson and Cricksuse of a material model to discover the double helixstructure of DNA is a well-known example.

    4 The probability calculus posed difficulties forPopper as did Heisenbergs Uncertainty Principlewhich challenged a strict falsificationist view of sci-ence and led to some personal friction between Pop-per and Heisenberg [16, pp.257259].

    5 Popper insisted that there is but one scientific method,equally applicable to the natural sciences (mathemat-ics, physics, biology, astronomy, geology) social sci-ences (anthropology, linguistics, sociology, ethnol-ogy, history) and all other endeavours which claim tobe scientific [27,28].

    6 Popper misrepresented historicism in general andMarxist theory in particular [29,30]. The term his-toricism was used by historians long before Popper torefer to the historians attempt to empathize with peo-ple about whom they were writing so as to understandthem and their social conditions as they understoodthemselves and which gave rise to certain actionsand events, that is, a contextualist, empathic methodof historical scholarship. Popper used the term his-toricism in an idiosyncratic way to mean a belief indeterministic or teleological laws governing histor-ical change which he attributed to Plato, Marx andHegel. Thus, Popper claimed that some of Marxspredictions, such as the increasing pauperization ofthe working class under capitalism which would cre-ate the conditions for revolution, were clearly falsifiedby the time he (Popper) was writing, almost a cen-tury after Marx. In response, some scholars have ar-gued that two World Wars and the rise of the WelfareState served to distract the working class in devel-oped society from its lack of economic and politicalpower, while the pauperization that Marx predictedhas occurred in the so-called underdeveloped coun-tries. Other commentators believe that the pauperiza-tion of the working class has in fact occurred, relativeto the advance of other socioeconomic groups. Stillothers hold that the Welfare State was a direct re-sponse to Marxs theory, raising the question of howhuman will operates in the social sciences in waysthat make them radically different from the naturalsciences. So social sciences may still claim to bescientific but Poppers falsification criterion is irrele-vant/inappropriate to social science.

    7 Contrary to Poppers claim against psychoanalysis,the use of a theory to save itself from apparently fal-sifying instances does not, prima facie, render it un-scientific. Most scientific theories include so-calledauxiliary statements, including those which guide theuse of instruments and methods of observation thatmay be relevant to the apparent falsification of thetheory in question [31]. Thus, the fact that an aero-plane crashes on take-off is not a valid refutation

  • D.C. GRANT, E. HARARI 449

    of the Newtonian mechanics which were applied tothe design of the aeroplane. On the contrary, auxil-iary hypotheses to do with wind resistance, surfacefriction and metal fatigue are invoked to explain theaccident, explanations which are themselves derivedfrom Newtonian mechanics.

    Beginning in the 1970s, several alternative models (toPoppers) of scientific practice and theory change wereproposed, including those of Kuhn [32], Feyerabend [33],Lakatos [34] and Bloor [35], which, to varying degrees,allow for political, sociological and contextual factors aswell as both inductive and deductive logic to have validroles in science.

    Popper [36] eventually revised his account of humanknowledge, proposing a three-world doctrine: world 1is the world of external objects; world 2 is the world ofexperience; and most controversially, world 3 is the worldof culture and its artefacts and institutions, including thebooks, libraries and microchips which house conceptsand ideas. Rather than truth, Popper proposed verisimil-itude as the aim of a scientific theory. Critics, includingsome hitherto staunch admirers [37], found these ideasincreasingly muddled or lapsing into the Platonic essen-tialism that he [20] had condemned in his wartime anti-totalitarian essay, The open society and its enemies.

    However, few of these criticisms of Popper specificallyaddress his attack on psychoanalysis, to which we shallnow return. Despite the doubts which these criticismscast on Poppers falsifiability criterion, let us concedethat falsifiability is an important issue in science (thoughnot the only one) and continue our examination of psy-choanalysis from that perspective.

    Psychoanalysis and its falsifiability

    Freud himself answered Poppers criticism that psy-choanalysis cannot be falsified in his 1938 paper, Con-structions in analysis. He began [38, p.257]:

    It has always seemed to me to be greatly to the credit ofa certain well-known man of Science that he treated psy-choanalysis fairly at a time when most other people feltthemselves under no such obligation. On one occasion,nevertheless, he gave expression to an opinion upon ana-lytic technique which was at once derogatory and unjust.He said that in giving interpretations to a patient we treathim upon the famous principle of Heads I win, tails youlose. That is to say, if the patient agrees with us, then theinterpretation is right; but if he contradicts us that is onlya sign of his resistance, which again shows that we areright. In this way we are always in the right against the

    poor helpless wretch whom we are analyzing, no matterhow he might respond to what we put forward.

    Freud then discussed in detail the clinical method ofconfirming or falsifying interpretations in an analysis.Freud made the point that while the patients No is nottaken at its face value, neither is Yes. The evaluation ofthe truth or falsity of an interpretation or construction inanalysis is not made simply on the grounds of the patientsagreement or disagreement with it. This does not meanthat there are no grounds for evaluation of the truth in ananalysis. It means that the method of evaluation is not sosimple. It certainly does not mean that all interpretations(or constructions) are assumed to be true regardless ofthe patients response. Freud makes this point explicitly.He says [38, p.262]:

    It is true that we do not accept a No of a person underanalysis at its face value; but neither do we allow hisYes to pass. There is no justification for accusing us ofinvariably twisting his remarks into a confirmation . . . .The Yes has no value unless it is followed by indirectconfirmations . . . . A No from a person in analysis isquite as ambiguous as a Yes.

    Freud then proceeded to discuss four effects an inter-pretation might have on a patients mental processes, thatmay serve to assess the truth of falseness of an interpre-tation in psychoanalysis.

    The first is a form of words that is used [38, p.263].Freud says that if a patient replies to the interpretationby saying, I didnt ever think [that], or I shouldntever have thought that, then we may suspect that theinterpretation is on the right track. Most psychoanalyststoday would not rely heavily on the patients use of thisparticular form of words as substantiating the truth of aninterpretation. However, in conjunction with some otherindicators (below) it might add a little more weight.

    The second is An association which contains some-thing similar or analogous to the content of the construc-tion [or interpretation] [38, p.263]. This may be a thoughtabout some present or past event with a similar affectivecontent or relationship pattern, a similar affective contentor pattern in the transference, a dream of similar contentetc. This sort of direct similarity nowadays is regardedby psychoanalysts as stronger evidence that the analystsunderstanding of the patient as expressed in the interpre-tations is accurate.

    The third is indirect similarities in the form, structureor content of the associations. Discussing this Freud said:

    It is particularly striking when, by means of a parapraxis,a confirmation of this kind insinuates itself into a directdenial. [38, p.264]

  • 450 PSYCHOANALYSIS, SCIENCE AND THE SEDUCTIVE THEORY OF KARL POPPER

    An example was given by a 30-year-old unmarriedmale who had sought therapy for panic attacks occur-ring against a background of recurrent difficulties inmaintaining relationships with women. In the context ofthe emerging transference, his fear of closeness (whichseemed unconsciously to underpin his panic attacks) andhis denial of his wish for closeness (the latter being whatthe therapist sensed the patient wanted from him) wereboth expressed by the patients response to an interpreta-tion, I want to keep you at arms link, when he meantto say, at arms length.

    The fourth is what Freud called a negative therapeuticreaction, about which he said [38, p.265]:

    If the construction is wrong, there is no change in thepatient; but if it is right or gives an approximation to thetruth he reacts to it with an unmistakable aggravation ofhis symptoms and of his general condition.

    A strong reaction of any type to an interpretation sug-gests that the interpretation does mean something to thepatient. Of course, blatantly offensive remarks will causea reaction in anyone, patient or otherwise, but a compe-tently conducted analysis should be free of that sort ofgross countertransference acting out. It is then and onlythen that a negative therapeutic reaction assumes thestatus of evidence. Although some negative therapeuticreactions may be in response to an interpretation which,although true, may be unwelcome to a patient and assuch, can provide a clue to the validity or falsity of aninterpretation, not all negative developments in treatmentcan be mindlessly counted as evidence of correct inter-pretations. Such mindlessness would not be analysis.

    The clinical evidence for the truth or falsity of an inter-pretation provided by the above four types of observationis neither exhaustive nor absolute and analysts need tobe mindful of its limits and the danger of distortion fromtheir own unconscious. Yet, it is evidence. In a debateabout evidence in psychoanalysis, at least one shoulddiscuss the merits of the types of observation that Freuddescribed and analysts use of them, rather than the spu-rious argument that analysts claim to be right whateverthe patient says or does.

    We are not trying to claim the idea that many psy-choanalytic hypotheses are falsifiable, as something newthat we have discovered. It is a mainstream view in thephilosophy of science, but does not seem able to pen-etrate psychiatry or health bureaucracies. For example,the eminent contemporary philosopher of science, AdolfGrunbaum [39], who has his own criticisms of psycho-analysis, which we have discussed elsewhere [40], pullsno punches in his rejection of Poppers view that psycho-analysis cannot be falsified. He says [39, p.108],

    Even a casual perusal of the mere titles of Freuds papersand lectures in the Standard Edition yields two examplesof falsifiability . . . . The first is the paper, A Case ofParanoia Running Counter to the Psychoanalytic Theoryof the Disease (S.E. 1915, 14:263272); the second is thelecture, Revision of the Theory of Dreams (S.E. 1933,22:730, especially pp.2830).

    That is to say, Freud himself observed evidence to fal-sify some of his own theories.

    In addition to the method of clinical evaluation, con-siderable empirical research with the capacity to falsifypsychoanalytic hypotheses has now been undertaken andpublished. A comprehensive review is beyond the scopeof this paper, but a few examples can be cited.

    One extensive study is Luborskys [6] transference re-search using the Core Conflictual Relationship Theme(CCRT) method. It is manually based and has good in-terrelater reliability. It validated the concept of transfer-ence by showing that attributes that patients usually as-cribe to others in their lives become attributed to theiranalysts or psychotherapists in therapy. However, report-ing this positive result is not our aim here; the pointwe wish to make is that these studies have the potentialto confirm or falsify the psychoanalytic hypothesis oftransference.

    Graff and Luborsky have studied transference and resis-tance in psychoanalysis [7]. In successful analyses trans-ference and resistance were high in the initial stage oftherapy. In the middle stage the level of transferenceremained steady but the level of resistance fell. In theunsuccessful analyses the resistance rating did not fallin the middle stage. This study too, has the potential tofalsify a core psychoanalytic hypothesis, namely that suc-cess in an analysis depends upon the patients success inovercoming resistance to unconscious contents becomingconscious.

    Attachment studies also have much to offer in regardto the evaluation of psychoanalytic hypotheses. System-atic empathically attuned experimental observations withthe potential to falsify the psychoanalytic theory of thesignificance of a childs play for his or her develop-ing sense of self have been reported [41, pp.253289],as have systematic observation studies of motherinfantinteraction which test the conditions required for thedevelopment of an emotionally attuned, competent self[42].

    Numerous other experimental methods with the poten-tial to falsify psychoanalytic concepts have been devised.Most of these studies have been included in Doidges[43] overview of empirical evidence for the core con-cepts and efficacy of psychoanalytic therapy, includingits cost-effectiveness.

  • D.C. GRANT, E. HARARI 451

    Neuropsychoanalysis: a new intellectualframework for psychiatry?

    Now that imaging of brain functioning as well as struc-ture has become a reality, the study of the neurosciencecorrelates of conscious and unconscious psychic pro-cesses has advanced as a new field of study. Kaplan-Solms and Solms [44] have coined the term neuropsy-choanalysis to describe a new discipline, which bringstogether the dynamic localization method of the Russianneuropsychologist Luria, and psychoanalysis. Solms[4447] has proposed a neurological model of the mindcongruent with psychoanalysis. This development hascreated an important new observational and experimen-tal domain in the continuing work of testing psychoan-alytic hypotheses. The contribution now required frompsychoanalysts is to articulate clear hypotheses, whosebiological correlates (in a model such as Solmss) can bestudied by objective experimental means. This issue hasbeen addressed elsewhere in more detail by one of theauthors of this paper [48].

    An example of such a study is Shevrins [9] exper-iments on the neurological correlates of repression. Heshowed that words related to a patients unconscious con-flicts, when flashed subliminally, evoke brain potentials.Control words unrelated to the patients conflicts do notdo so. Interestingly, when the same words were flashedsupraliminally the result was reversed and recognition ofthe conflict-related words took longer than the controlwords. These results suggest that some type of repressionor inhibitory process is active. Theoretically, they couldjust as easily have falsified the hypothesis that repressionof conflict occurs.

    Melanie Klein [49] introduced the clinical concept ofprojective identification to explain certain primitive statesof mind. This was extended to psychoanalytic expla-nations of empathy [50], of unconscious communica-tion [51] and trans-generational transmission of psychictrauma [52]. Integrating a vast amount of clinical andextraclinical research, Schore [51] has proposed neuro-biological correlates of a healthy and pathogenic pro-jective identification in motherchild interaction and inpsychotherapy. The recently discovered system of mirrorneurons provides possible biological correlates for suchunconscious perception and communication. Greatrex[10] says:

    It [the discovery of mirror neurons] suggests that themechanism of inference is based on unconscious phys-iological and psychological matching capacities. Ourspontaneous matching capacity . . .may be part of a sys-tem that is a key to intentional communication on manylevels.

    Studies such as these are providing psychoanalysis witha new dimension in science, advancing towards the re-alization of Kandels [53] vision of a psychoanalyticallyinformed science of psychiatry; a psychiatry which trulystudies the mind and its disorders.

    Conclusion

    Popper, like many others, was understandably dazzledby the New Physics at the beginning of the twentieth cen-tury. At that time, Otto Neurath [16, p.95], a philosopherof the Vienna Circle, tartly noted that he [Popper] tookthe Eddington experiment and turned it into a methodfor the whole of science. Bedazzled as he was, Popperseemed unable to see the relationship between psycho-analysis and evidence. Granted, much of the empiricalevidence we have quoted above has accumulated since1919 when Popper first contrasted psychoanalysis withthe New Physics, yet the fact remains that psychoanalysiswas no more inherently unfalsifiable at that time than itis now. Even in 1919, at the time of his bedazzlement,the first of the Freud papers referred to by Grunbaum(above) was available to Popper, and by 1935, whenPopper published The logic of scientific discovery, thesecond was also available. How Popper, with his un-doubtedly acute and incisive mind, could so misunder-stand psychoanalysis despite the evidence available tohim, must remain in the field of conjecture; but mis-understand it he did. As a recent detailed and otherwiseadmiring biography of Popper notes, his brief critique ofpsychoanalysis never accounted for his intense hostilitytowards it [16].

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