Damasio and Solms – A Neuropsychoanalytic Double Header at the American Psychoanalytic Association Meeting.

Antonio Damasio spoke on Friday at the American Psychoanalytic Association meetings.  He was offering clarification on the directions that his research has taken him since the publication of his book “The Strange Order of Things.”  In that book, he articulated a vision of consciousness emerging from a base of feelings – and he proposed that humans have had an evolutionary advantage by being able to utilize their feelings to better integrate and understand the world than does a non-sentient creature.

Perhaps because he was presenting at the psychoanalytic meetings, Damasio clarified some of his thoughts in ways that were psychoanalytically meaningful.  He noted that consciousness is all about reminding the person that has a consciousness and that this thought, this image, this smell, this perception is mine.  Over and over, the feeling world says that this reaction belongs to me because something is happening to me or within me.  Consciousness is – and he didn’t use this word – a terribly narcissistic force.  It organizes us as a single, cohesive entity.  And I don’t mean to be using narcissism in a pejorative fashion, though that is how it is mostly used these days.  In fact, we all have a narcissistic developmental line – we all, more less, come to inhabit ourselves by identifying what belongs to me and what does not – and Damasio clarifies that this is an essentially human enterprise – one that is essential to creating a consciousness.  Developmentalists like Daniel Stern clarify that we are born knowing where we end and others begin, but I think Damasio clarifies that we go on reifying this sense of ourselves throughout our lives – and having a sense of that at the beginning – I’m thinking – might help us be able to have a consciousness – there is a me to refer all of these sensations and perceptions to, right from the get go.

If we think about consciousness from this vantage point for a moment and think clinically about disorders of consciousness – the dissociative disorders for instance – part of what creates them is trauma – and part of what is traumatic, from Damasio’s point of view, is that we are unable to maintain our own position during traumatic interactions – we can’t hang onto me because of the intensity of the power of the physical or sexual or psychological experience we are undergoing – in fact, we may not want to be me during these times.  This may create gaps in our consciousness and resulting gaps in our identities – and we may learn how to “leave ourselves” when we need to.  While Damasio did not make this point, I think it is worth noting that we can think clinically about neuropsychoanalytic ideas, which Solms directly encouraged us to do.

On Saturday, Mark Solms discussed a case that Chuck Fisher presented.  I can’t talk about the details of the case because of confidentiality, but I can say that a somewhat surprising (at least to me) thing happened.  Solms opened up not just psychoanalysis or psychotherapy from a neuropsychoanalytic perspective, but he also gave a very different view of psychopathology than I had heard before, but one that I found quite compelling. 

Solms started by articulating the seven drive systems that Panskepp has developed.  These drive systems are:

1.           Foraging or seeking (this is Freud’s broad libido drive – a life force that draws us into the world).
2.           Lust (this is Freud’s narrow libido drive – sex – that is expressed through foraging for Solms).
3.           Fear (which is an important drive to protect us from threatening others).
4.           Rage (which is the equivalent of aggression in Freud’s system – and the death drive).
5.          The drive to attach to caregivers (which, when frustrated, leads to despair).
6.          The need to care for and nurture others.
7.          Play (this is seen as an important drive that helps us learn about social hierarchies).

In the particular case that was presented, there were problems in each of these areas.  Solms, noting humorously that we had an embarrassment of riches, suggested that this meant that the individual’s drive for play was being thwarted as this is the place where many of the other drives intersect and get worked out.  Indeed, the case material supported this intuition, and the case, and the provision of care that occurred in it, crystallized and fell into place.

Solms warned ahead of time that the presentation would be reductionistic.  There was simply not enough time to go into detail.  Despite that, a number of us commented to each other after the presentation that the case conceptualization was quite useful.  I do think that the case was, despite the number of areas of impaired functioning, a case with a very high functioning individual, and I would be curious about a similar presentation with an individual who was more severely impaired.  I think we might, ironically, find that the impairment was more “localized” to one, two or three of the drive areas, but I’m not sure of that.  I think that when there are considerable limitations in one area, those tend to generalize not just because the play function is impaired, but because all of the systems are interrelated.  But, as I said, I would be interested to a case exploration with a different more functionally impaired patient.

I have not reported on all of what each of these speakers said in very packed presentations.  What I hope is apparent is that we can communicate as psychoanalysts with neuroscientists in ways that are enriching to us – and that psychoanalytic ideas also help neuroscientists put together the observations that they are making in cogent ways.  It is truly exciting to see reification of some basic psychoanalytic principles and I think that this can, in turn, help lead us to more clearly articulate our understanding of the interpersonal process that plays out on our couches and that resonates through the lives of our analysands.

Previous posts on Solms are here and here.  A previous post on Damasio is here.  Since this post, I have written on Solms book The Hidden Spring.

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