Mark Solms, Luba Kessler and Teaching Neuropsychoanalysis.

Teaching neuroscience to candidates at our psychoanalytic institute has always been a chore that they have abhorred.  OK, in the parlance of psychoanalysis, they have resisted the opportunity to learn about neuropsychoanalysis.  I went to a presentation today by the Department of Psychoanalytic Education at our annual Psychoanalytic Convention in which they were asking four questions:

1. What is neuropsychoanalysis?
2. How do we integrate information from two realms – objective (neuroscience) and subjective (psychoanalysis)?
3. What are the implications of bringing neuroscience to bear on psychoanalysis?
4. How should we teach neuropsychoanalysis?

The lead speaker was Mark Solms, and whenever Mark Solms speaks, I do my best to be there to listen.  I don’t always understand what I hear, but I think he is in the process of getting something very important about the working of the mind.  I have had a hard time conveying that to students, though.  They find what I have to say experience-distant and filled with jargon.  So the fourth question – how do we teach neuropsychoanalysis – was most on my mind.  Solms stated that he wouldn’t really address that part – and he didn’t directly talk about it directly – but he did something better – he showed how to do it.

The issue (as I see it) is that neuroscientists are interested in the mechanical properties of the mind.  This leads them to think as mechanics – as engineers – and as scientists.  They want to know what the parts of the mind are and how they interact.  So when they teach, they frequently show pictures of the brain – or draw neurons – and they talk about structures of the brain and how they function.  This style of thinking and communicating is dry, precise, and technical.  And dull - especially to people who are looking for an interesting story.

Clinical psychoanalysts, then, are interested in and communicate through narrative.  They listen to and tell stories.  They use metaphor.  Where the neuroscientist is likely to be concrete and visual the psychoanalyst is likely to be abstract and auditory.  They are talking about the same thing – the human mind – but those who can speak to the other – or speak the other’s language – are few and far between.  Antonio Damasio is one of these and Mark Solms is another.

Today Solms chose to speak not with slides, and not by drawing on a black or white board, but just to talk.  He decided to tell a story – the story of how he became interested in neuroscience – and how his primary interest (he maintains) is psychoanalytic.  And this is just what the doctor ordered.  Let’s talk to the analysts in the analyst’s language.  I think his conscious intent was to manage psychoanalyst’s anxiety about being taken over or dictated to by a science that feels like it is not their own.  The question posed in the conference brochure was, after all, "Is Neuroscience the New Basic Science of Psychoanalysis?"  But in the process of assuaging our fears, he may also have introduced a means of communicating.

Solms began by talking about a critical incident in his childhood.  His brother fell from a height and had a head injury.  When his brother returned home, he looked the same, but he was not the same person.  It was not just that he had cognitive challenges, but that his personality had changed.  In that moment – as a pre-scientist – Solms realized that the brain and the mind are related.   His relation with his family also changed.  His achievements, as he began to surpass his brother, were not celebrated in the way that they would have been.  He stated that he had a revelation in the moment of speaking, that the sense of family grief over his brother’s death may have been the critical element in his choice to minister to those with neurological damage – that he may well have wanted to help address something that was damaged not just in his brother, but in his brother and in himself and in the family as whole.  A psychoanalytic insight.

In any case, he studied neuroscience, but something was missing.  The brain was being studied, but not the mind - and that was his true interest.  He travelled from South Africa to London to study psychoanalysis so that he could learn something about the mind.  He then began talking to his patients – something that had, to that point, been unheard of in neuroscience.  Doing that, talking to his patients, led him, very quickly, to discover low hanging fruit – new unheard of things in neuroscience.  So, for instance, he discovered that in those patients who had strokes and lost their ability to use their left sides and also had denial of this loss that the denial sounded like psychoanalytic denial – not, as had been assumed to that point, a neurological inability to be aware of the loss.  So by talking with the patients he was able to help them work through the denial and to “cure” the denial so that they could acknowledge that they had difficulties - thus making their treatment, and lives, better.  He gave two other examples of work that he published early on – and I made notes of that, but just discovered that I have lost the notebook I was using.  Not sure whether that is a neurologically or psychoanalytically determined loss – it is on the last plane I was on, flying back from New York as I was beginning to type this….

Oh, I remembered one!  Solms used neuroscientific methods to study dreams.  This involved tracking REM sleep – which neuroscientists discovered was related to dreaming by waking people up in the middle of REM.  But once they tied them together, they quit asking people if they were dreaming and just used REM sleep as the marker of dreaming.  By waking people up, Solms was able to clarify that the part of the brain that is responsible for REM sleep is NOT the part of the brain that is responsible for dreaming.  When the dreaming part is injured, if the REM part is unscathed, people continue to have REM sleep but they don’t dream.  On the other hand, if the REM part is damaged, but the dream center is not, people will stop having REM sleep, but they will dream.  Amazing how a scientific paper appears when you ask people questions!

The point of the illustrations (one of which I’m still trying to remember – I think it also had to do with dreams), is that Solms was using psychoanalysis and psychoanalytic insights to inform his understanding of neurological conditions, not the other way around.  This was intended to reassure us that he did not want to use neuroscience to reduce psychoanalysis, but rather to use psychoanalysis to inform our understanding of neuroscience.  That said, he acknowledged that once the bridge was built, it becomes a two way street and we can traverse it back and forth.  Neuroscience is getting to the point where it can begin to inform psychoanalysis and we should be aware of that and ready to include neuropsychological work in our thinking about the mind.  If we don't do that, he warned us ominously, we will become obsolete (as if that wasn't already a worry).

His intent here was to point out that we should be aware, but not wary.  His position, with which I agree and have already stated in slightly different form, is that psychoanalysis and neuroscience are actually engaged in the same undertaking, but using very different methods.  He proposed a re-visioning of psychoanalysis not as something that is based on a particular theory of the mind or on a particular perspective, but considering it to be the study of mind from the position of the subjectivity of mind.  Neuroscience is, then, the sister study from an objective perspective of the same thing - the mind.  Solms’ evidence, from his brother and many clinical interactions, is that the brain and the mind are intimately linked – and that we can’t study the one without, in some form or fashion, studying the other.  So he ends up continuing to find that Freud’s neurological hypotheses – which Freud did not have the apparatus to test – hold water: the brain (when viewed objectively by neuroscientists) functions as a close observer of the mind (through describing subjective experience to someone deeply interested in that and prepared to listen to it) would imagine that it does.

Solms took us back to Descartes' Mind/Body distinction – to the difference between the objective and the subjective – with a simple illustration.  If we close our eyes, all that we experience is the subjective self.  That is the mind.  If we open our eyes and stand in front of a mirror, then we are in contact with our objective selves – we are able to see what that self looks like and to treat it as an object. 

Another of the lovely turns of mind that Solms engaged in was to point out that Freud chose – in opposition to those around him – not to have the phenomena fit the methodology (the behaviorists decided that the only thing that could be studied scientifically was what could be studied objectively – so the mind was left completely out of their thinking about psychology – so it became a psychology without a psyche).  So Freud created a method – listening to dreams and listening to patients – that allowed him to hear the mind at work.  We will be able to hear that mind more clearly, Solms maintains, when we understand the structure that supports it.  And this is what Freud called metapsychology - the structures that make the subjective experience of the mind possible.

Solms was presenting as a member of a panel.  The next two panelists – a neuropsychoanalyst, Richard Kessler, and his psychoanalyst wife, Luba Kessler, presented on neuropsychoanalysis as well.  Richard Kessler’s presentation was largely in the neuroscience style.  Luba Kessler’s presentation used psychoanalytic understandings of the self – focusing primarily on the work of Kohut – to point out the neuropsychology of the self.  This was a second, lovely example of providing a narrative framework around and through which to present neuroscientific principles.  It worked from psychoanalysis towards neuroscience, rather than the other way around.  I think this is likely to be an approach that will be better received within a curriculum. 

The challenge for a psychoanalytic faculty is to find faculty members who are conversant in both neuroscience and psychoanalytic theory and are able to create a psychoanalytic narrative that weaves in neuroscientific principles.  This requires a kind of neuroscientific fluency that Solms and both Kessler’s were able to demonstrate, but one that is going to be difficult for the neuroscientific layperson to engage in – which is necessary if one of the laudable but stretch goals of the department of psychoanalytic education is to be achieved – to infuse neuroscience into the entire curriculum at psychoanalytic institutes.

When someone is able to speak both languages delightful moments occur.  For instance, there was a question from the audience about neuroplasticity, and Solms was able to clarify that the promise of neuroplasticity is turning out to be less pervasive than originally thought.  It is more prevalent in neurological registers that focus on the external world – and there was a technical name here which might be in my lost notes – and Solms suggested that these registers are the equivalent of Freud's Ego.  These are also neurological registers that are focused on the internal experience – and Solms equated these with the Id – and they are much less neuroplastic and take much more work to make changes in their functioning.  He quipped that it is hard for these registers to learn and to forget.  He used this as a jumping off point to suggest that it might explain why psychoanalysis takes so long – we are working with recalcitrant neuronal structures.

[I have a weird example of the differences between the registers that involves this post.  I was linking to this post from a post on Anton (Tony) Kris that I wrote almost 10 years ago.  I remembered that, in the talk I am writing about here, Solms had referred to the difference between episodic memory (the technical term I could not remember above for the registers focusing on the external world) and semantic memory (the registers focusing on the internal world).  The intriguing thing is that I remembered them by the term that I could not remember after the flight and the lost notebook referenced above.  The terms had been encoded in episodic memory and were gone - temporarily - but the concepts were recorded in semantic memory - and could, ironically, be reference more that two years later (it is now May of 2021) by those terms because the terms are links to the semantic - meaning level and more firmly encoded idea)

Having just finished Antonio Damasio’s new book, The Strange Order of Things.  It was reviewed by Solms last year and it has helped me learn a bit more about the relationship between the brain and the mind.  I will link to that when I have written that post.  In writing about it, I will learn more – and perhaps become a tad more familiar – learn a bit more of pidgin neuropsychoanalysis – and in reporting on it – and your reading the book, you may advance a bit as well.  We are standing on the edge of a brave new world and I think we need to figure out how to teach about it with enthusiasm so that our candidates can both understand and become excited about the possibilities that exist for connecting across that bridge.  That said, I think that the fluency with which both Solms and Kessler spoke is something that I, and may other analysts will not be able to emulate easily.  It will take considerable work for us to be comfortable enough to speak knowledgeably and competently about both of these worlds in plain English.


I report on Solms presenting the following year (2020) at the same conference, along with Antonio Damasio here.  I have also written about Solms book (2022) The Hidden Spring.

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