III. The Depth Psychologies

In his monumental work on the history of dynamic psychiatry (1970), Henri Ellenberger has traced the origin of the modern depth psychologies back into the mists of time. Both ills of the body and ills of the mind were origin­ally handled by the priest‑physician of primitive societies along much the same lines. But there came a parting of the ways. Glimmerings of an empirical approach to the external world led to some degree of objectivity and to the pri­mordial elements of science. Some physical illnesses could be traced to physical causes, and an understanding of causation led in course of time to rational therapy along physical lines. But mental illnesses remained refractory. It was only in a small area of their vast extent that their causes could be attributed to bodily conditions and thereby to physical causes. Over a great reach of time up to the present day, or at least till yesterday, it was generally believed that, as bodily illnesses had physical causes, the illnesses of the mind must have psychological causes. It proved beyond the powers of priests or physicians to identify them; and there was no way of accounting for the variable course, outcome and responsiveness to treatment of mental disorders.

   However, it is not the way of mankind to submit to ignorance. In every age leading spirits have grappled with the unknown, have found their own solutions for problems of an ultimate complexity, have claimed the discovery of the truth, and have inspired disciples with the same delusion. Even when one doesn't know anything about causes, one may light by guesswork on a successful treatment. In the case of mental illnesses it is possible to do a great deal for the patient merely by attending to his symptoms. Moreover, symptoms are susceptible to influence by suggestion; and useful results could often be obtained in a school firmly convinced of the rightness of its doctrines and prepared to apply them in an impressive way. Any system, whether of treatment or of non‑treatment, can rely in many of the disorders of the mind on a tendency to spontaneous remission. So it is that the history of dynamic psychiatry has been from the be­ginning the story of one gifted healer after another, while the theoretical understanding of mental disorders progressed little or not at all. In fact, it only progressed where some link between mental and physical events could be established. The nature of mental events is hardly less mysterious now that it was two thousand years ago. We can make some generalizations about human behaviour which will be accepted as valid by everyone, but nothing about the internal world of endo­psychic processes. The cumulative self‑corrective growth of knowledge, which we see in science, has indeed begun to throw some light on mental illnesses in their objective or phenomenal aspects, but seems incapable of throwing light into that dark interior world.

   Modern Western depth psychologies, which flourish in great diversity, stem from the trinity of teachers, Adler, Freud and jung, who pioneered the field at the end of the last century and the beginning of the present one. On the scientific time‑scale, this is a very long time ago. All of these men founded schools, rather in the manner of the old philosophical schools of Graeco‑Roman antiquity. Scholastic and fissi­parous tendencies have not been lacking in medicine itself, with its ancient origins; and homoeopaths and allopaths are not entirely integrated to this day. The existence of separate schools is, however, foreign to the tradition of science. Before Freud, the great Janet remained faithful to the idea of a unified science. Freud made psychoanalysis a tight organization, with its official doctrine, rules of membership and even its own publishing house. Both Freud and jung demanded heavy sacrifices of their disciples in the compulsory training analysis. Adler formed a more open organization, but he expected his patients to join the movement. His aim was through them as well as through his disciples to educate and so to transform the world.

ADLER

    Adler never claimed status as a scientist. He had no gift for systematizing knowledge, and he aimed at a humane rather than a scientific understanding of human nature, Menschenkenntnis, a concrete and practical know­how. He tried to help large sections of the community, and not merely a few wealthy patients. He worked as doctor and educator in the fight against alcoholism, infections, venereal diseases, tuberculosis and child mor­tality, and in school hygiene and in advice on the education of children. He had remarkable clinical gifts, especially in establishing contact. He made his discoveries by objective clinical enquiry, and not, as in so much of the work of Freud and jung, through the instrument of directed introspection and exploration of the world within.

   Adler sees the human being as one and indivi­sible, everyone absolutely unique, a rational and social being, endowed with free will and the ability to make conscious decisions. For Adler the family is the total family, with a child's relation to his sibs just as important as his relation to his parents. A man is part of the community, and he needs to live in conformity with it with family and social ties. The human community is an organic and creative whole. It, too, is part of a larger whole; it is part of nature and must live with nature. A man is a child of his time, and is placed in time. His symptoms, as well as everything else about him, exist in the present, embody the past, and point towards a future. Adler's world is teleological. People strive towards a hidden goal of which they are unaware. This determines both the guiding line of life and the perspective in which they see the world. Everyone has his tactics and from them he gets his life‑style. A man must be diagnosed by his actions.

   Adler sees the neurotic as a pitiful individual who makes use of tricks and evasions to escape his life duties. The aim of Adlerian psycho­therapy is the uncovering of fictitioss goals and of insincerities and contradictions in life style, and the retraining of the individual in an orientation towards the community. Above all it is necessary to help the patient to gain courage. A favourite idea of Adler's is organ inferiority. This depends on an organic basis, perhaps a maldevelopment or delayed development or hormonic imbalance or a minimal brain syn­drome. To this the individual reacts with various forms of compensation, such as a neurotic denial or over‑compensation, or by rising to the challenge may make the area of disadvantage the scene of achievement. Where Freud taught the doctrine of penis envy, Adler was more impressed by the prevailing male fear of the greater strength, durability and potency of the sexuality of women, and he revealed the mascu­line protest and aggressiveness that masks the inferiority complex of the male. To overcome an inferiority insight is not enough. The man must act, and for that he needs courage. By an act of courage a man may change his goal, and thereby gain the power to change his life style. It must be a basic aim for the educator to endow a child with this courage.

   The cardinal differences between the psy­chologies of Freud and Adler may be traced to a temperamental difference between them and to their orientation towards time. Freud was a natural pessimist. He looked backwards in time towards the causes of things, and he sought to make his metapsychology a scientific study. He saw infancy as a time of subjective omnipotence; and all that follows from relationships with the parents and the repressions of society, in destroy­ing this illusion, leads to the individual be­coming divided against himself. The impact of civilization is to create and to reinforce the internal divisions that lead to neurosis. Adler's constitutional optimism went with an orienta­tion towards the future. He saw motivations as teleological forces. He was less interested in causes, and his emphasis was laid not on the cause but on the aim and intentionality of psychic processes. The individual is not divided against himself but throughout his life remains an integral whole. He begins from small begin­nings in an infancy overshadowed by inferiority to the greater power and dominance of adults. The Oedipus situation existed neither for Adler nor for Jung as a universal; they saw it as Freud's personal discovery about his own past. For Adler it is only one possible result of the family education of a spoilt child, which of course Freud was. Neurosis is not an inevitable consequence of the process of socialization and the repressions that adapt a child to live in the community, but rather a subterfuge and an evasion of a necessary task.

   Adler's ideas, in fact, unlike Freud's, were common‑sense to the point of being common­place. Though many of them had the originality of a clinician of genius, none of them bear the air of the outré, the outrageous, the totally surprising, which we would wish to get from one who has dared to cross the threshold into another world. Adler's ideas were unsyste­matized, and they could be and were digested piecemeal. Contemporary clinical psychology has been penetrated by such Adlerian ideas as inferiority feelings, style of life, organ inferiori­ties, masculine protest. Adler inaugurated psychosomatic medicine. He was the fore­runner of social psychology and the social approach to mental hygiene. His conception of the creative self being in its goal‑directedness responsible for the life style makes him the father of ego psychology. Group therapy and community therapy are the legitimate offspring of his thought and work. If modern psycho­analysis has undergone a re‑orientation and now focuses more on the present than the past, more on ego problems, and more on inter­personal than on intrapersonal relationships than in a past era, it is due to the slow but persisting infiltration by the Adlerian approach. In Ellenberger's appreciation, there has been a massive adoption of Adlerian ideas, for instance by Harry Stack Sullivan, Karen Homey and Erich Fromm. It is, then, strange and sad that there has been such a widespread collective silence about the greatness of Adler's achieve­ment. His ideas are used and the man is forgotten.

THE UNCONSCIOUS

    Freud and Jung stand in stark contrast with Adler in their common absorption in the problems of the inner life. According to Ellen­berger, both of them went through some years of a disturbed state of mind, calling for intense and intrepid self‑examination and self‑analysis. Ellenberger compares the creative illness of the pathfinder with the mystical experiences of St. Teresa of Avila and St. John of the Cross. Those who pass through such an illness, and they are many, emerge from it possessed of indisputable truths. For both Freud and jung the illness took a highly personal and original form; and both of them made it a model to be followed by their disciples under the name of training analysis. Characteristic of the imposed as well as of the spontaneous creative illness is the recovery with an enrichment of mental life from the questionings and the experiences passed through. Above all, there remains the deep certainty that the entities encountered are no mere abstractions, but are living realities more tangible than any conceptualizations on offer from the scientists. Freudians cannot be expected to accept the objections of epistemolo­gists, since they have personally experienced the truths of psychoanalysis in a way which widely transcends in forcefulness and con­vincingness the evidence of logic (Hans Kunz, quoted by Ellenberger).

   However, the journey through the un­conscious which is made in a training or a therapeutic analysis is a very different journey in the two cases. Those who undertake a Freu­dian analysis develop a transference neurosis, have Freudian dreams, and discover their Oedipus complex, childhood sexuality and castration anxiety. Those who undertake a Jungian analysis have Jungian dreams, en­counter archetypes, meet their anima and confront their shadow. There are other signi­ficant differences between the schools. Whereas Freud declared that the psychoanalyst should not try to re‑educate his patient, jung, like Adler, maintained that the patient should be helped from the start and through all the stages of the analysis; any insight he gained should be integrated into a more rational conduct of his everyday life.

   It has been objected that Freud had no business to reify unconscious mental processes in substantival form as 'the unconscious'. There were great advantages in doing so from his point of view; but it was a departure which led to an ever‑widening gulf between Freudian thinking and the main line of scientific thought. Janet before him had also employed the term 'unconscious', but he called it a façon de parler, a figure of speech, and so earned Freud's contempt. He used it, in fact, like a scientific fiction. Hans Vaihinger (1911) has made clear the difference between a hypothesis and a fiction. While a hypothesis makes a claim for truth, and should be confronted with objective reality, the fiction plays another role. It is a way of looking at things, a metaphor, which is retained as long as it is useful and is abandoned when it has served its purpose or when it can be replaced by a better. An example is the notion of freedom of will,[1] an indispensable idea which, however, cannot be substantiated. One could multiply similar examples of useful fictions beyond number. Adler thought of his ideas as fictions, as convenient ways of under­standing; but Freud thought that his were hypotheses. Indeed, in due course he believed he had proved them realities. Jung, too, thought and wrote of his concepts as psychic realities, but he did not claim scientific status for them.

JUNG

There are many kinds of 'psychic realities', all of them touched with unreality. They are often contradictory, or incompatible with one another. But to the initiate who works with them they have the certainty of something directly experienced, something not to be negated by argument.[2] Jung had no doubt­who has?‑that there are other approaches to truth than the way of science. He realized, as Freud did not, that psychic realities elude the scientific method, and if they are grasped it is not by the hand of science. Thus, on the subject of archetypes he writes (1951):

Clear cut distinctions and strict formulations are quite impossible in this field, seeing that a kind of fluid interpenetration belongs to the nature of all archetypes. They can only be roughly circum­scribed at best. Their living meaning comes out more from their presentation as a whole than from single formulation. Every attempt to focus them more sharply is immediately punished by the intangible core of meaning losing its luminosity. No archetype can be reduced to a simple formula. It is a vessel which we can never empty, and never fill. It has a potential existence only, and when it takes shape in matter it is no longer what it was. It persists throughout the ages and requires inter­preting ever anew. The archetypes are the im­perishable elements of the unconscious, but they change their shape continually.

And again:

The picture is concrete, clear, and subject to no misunderstanding only when it is seen in its habitual context. In this form it tells us everything it contains. But as soon as one tries to abstract the "real essence" of the picture, the whole thing becomes cloudy and indistinct. In order to under­stand its living function, we must let it remain an organic thing in all its complexity and not try to examine the anatomy of its corpse in the manner of the scientist, or the archaeology of its ruins in the manner of the historian. Naturally this is not to deny the justification of such methods in their proper place.

    Jung saw in science a strictly and deliberately limited attempt, with only certain intellectual functions of the human mind for a tool, to attain to an understanding of an all‑embracing reality; and thereby imagining, perceiving and understanding only one aspect of that great whole. 'Science is the tool of the Western mind. It obscures our insight only when it claims that the understanding it conveys is the only kind there is.' Eastern wisdom teaches us another more profound understanding. Jung was con­cerned above all with the self. The self is all that we are. 'The self is centre and circum­ference, the whole man, all that is felt to be good and all that is felt to be bad, maleness and femaleness, thinking, feeling, sensation and intuition, conscious and unconscious.' It con­sists 'in the awareness on the one hand of our unique natures, and on the other of our intimate relation with all life, not only human, but animal and plant, and even that of inorganic matter and the cosmos itself. It brings a feeling of "oneness" and of reconciliation with life, which can now be accepted as it is, not as it ought to be.' (Quotations from Fordham, 1968). Jung's psychology has, then, a strongly mystical slant, while being founded upon a biological world‑view which seems to lie close to pan­theism. The idea of the wholeness of the per­sonality contrasts strongly with the analytical approach of Freud. In the course of a Jungian indoctrination, the analysand is taught to recognize and to accept what on first acquaint­ance might have been unacceptable, the shadow, his own darker side. He finds his place, not only in the here and now, but in a human, indeed a global consciousness, extending without limit back into time. With this understanding he can find his way, at any age of life, towards further enrichment of his potentialities and further individuation. Jungian analysis is, then, like Adler's, more strongly directed towards the future than is that of Freud, but resembles Freud's in focusing motivations on the self while Adler's directs motivations away from the self towards the community.

   Since Jung made no claim for the scientific validity of his concepts, he can be excused from facing test and refutation. His holozoism, his metaphysics, philosophy and ethics, which are the foundation of his psychology rather than the other way round, are either felt to be sym­pathetic‑or not. His place is among the reli­gious thinkers, the poets and prophets, artists one might say of the soul. And 'who will refute a Mass of Palestrina, or convict Raphael's Madonna of error?' All works of art, the statues of the gods, temples and cathedrals, paintings, symphonies and poems, are communi­cations from one human mind to another. In terms of communication theory their content in 'bits' is astronomically vast. They are full of a meaning which is not to be conveyed in pro­positions. These messages are not capable of translation into the language of science. Indeed, we can only read the message by the reverbera­tions it calls up within us, in our own subjectivi­vities. Like all great achievements of these kinds, Jung's work opens to us perspectives into which we may look, or from which we may turn away. He gave us the possibility of seeing a spiritual world as it had been revealed to him; and its greatness is an evidence of what the reach of the human soul may be.

FREUD

   Freud abides our question if jung is free. His enterprise was on as vast a scale as that of Jung, but his motivation was very different. For him religion was an illusion, and he aimed at a science and not at an understanding of spiritualities. He took from science the analytic method of breaking down wholes into their parts, the guiding directive of reductionism and the aim at understanding by mechanical models. He was concerned with causes, and he adopted the principle of psychic determinism. Unfortunately he took it to connote not only that psychic events are caused but that they are psychically caused. In practice, if not in his formulation of basic theory, he excluded from consideration the organic causation of psychic events; and in so doing he set himself, a new Columbus, adrift on an uncharted sea, without benefit of the aids of science or scientific tech­nology. Ellenberger says that Freud's aim was to incorporate into scientific psychology those hidden realms of the human psyche that had been grasped intuitively by the Greek trage­dians, Shakespeare, Goethe and other great writers. If so, his method consisted in stripping away all magic, all the glamour that irradiates the strivings of the spirit, and in bringing human motivations down to their earthiest rudiments.

   In this quest he penetrated into the recesses of his own and his patients' minds, above all into his own. His genius, equal in its powers of clinical penetration, analysis, model‑building and literary command, has provided imaginative masterpieces which the world will surely treasure for all time. But he never became aware of the fact that the knowledge we can get of the endo­psychic world, either our own or that of others, is of a different kind from the knowledge we can gain of the external world. Our private worlds are indeed private; and scientific know­ledge is knowledge of a public world, shared by or open to all. Perhaps because so much of Freud's most basic work was done by self­observation, he became more and more con­cerned, in the end almost exclusively concerned, with mental phenomena, that is with subjective experience. Bit by bit behaviour lost its interest, as it became but a pale reflection of the more vivid subjective world. This was disastrous for the scientific advance of his hypotheses, since by neglecting behaviour, which is the public aspect of our experience, they lost contact with the possibility of empirical check. There seemed to be no point in formulating a hypothesis on which a behavioural prediction might be based, to be confirmed or refuted by subsequent observation, when behaviour was to be thought of as a mere translation into other terms of the language of the unconscious. More tempting, then, to seek for explanations by which not only public conduct but also the most intimate experiences of the mind could be understood. It proved a nuisance to Freud when such beha­vioural correlates of his hypotheses as suggested themselves proved erroneous. Freud had the idea that scientific method could not lead to error (when, as Popper has shown, error is what it seeks, and must always find). Over the years he worked on his theories to save them from such a fatal flaw. And he succeeded. In a tremendous work of orchestration he found a voice for all the contending elements of endopsychic processes. Liberated from any com­pulsory ties with the objective phenomena of the external world, nothing could possibly happen that his theories could not satisfactorily explain. Nothing could prove his theory wrong. Therefore it must be true. The conviction that this was a scientific achievement remained with Freud till the end of his career. Even when dis­appointed by the interminability of psycho­analysis and losing his faith in it as a method of treatment, he was still sure that the future would vindicate psychoanalysis as the science of the unconscious. There are now many contemporary schools of psychoanalysis deriving from Freud; and many of them have radical doctrinal incompatibilities with others. Very likely there is not one of his major tenets which is not disregarded, or even denied, in one or another of the daughter schools. Nevertheless, the declaration by Freud that psychoanalysis is a science is constantly reasserted and reaffirmed by his disciples. It is on that basis that psycho­analytic theories are taught in so many medical schools. It is the purpose of what now follows to examine this claim; and if it appears in­admissible, to try to come to some conclusion on what the epistemological nature of Freudian theory is.

FREUD AND THE LOGIC OF SCIENCE

   Freudian theory has been accepted over a very great range of fields of study, though often uncritically, and often by some but not all of the workers in these areas. Nowhere has it been so ignored and neglected as in the field of science, the field it would take as its home ground. The persistence of Freudian psychiatrists in pressing the claim of scientific status for psychoanalytic theory has led to repeated careful consideration by a number of thinkers. Nearly all of them have come to the conclusion that, though psycho­analysis might be a protoscience, might even, say by a series of operational definitions, be transformed into a science, it is, as it stands, something radically different.

   As long ago as 1949 Aubrey Lewis pointed out that there was 'an unbridged gap' between the postulates of Freudian theory and any possibility of check by experimental or empirical observable fact. In 1958 a symposium was held by the New York University Institute of Philosophy, in which this and other points were taken up by five psychoanalysts, two psycholo­gists, two sociologists and nineteen philosophers. All the philosophers were highly critical, but perhaps the distinguished epistemologist Ernest Nagel (x) was the most devastating. Freud­ian theory, he says, does not satisfy two basic requirements which any theory must satisfy if it is to be capable of empirical validation. First, it must be possible to deduce consequences from the theory, and show that an alleged conse­quence is indeed implied by it. That comes even before examining the empirical data. For unless this requirement is fulfilled, the theory has no definite content. Questions as to what the theory asserts cannot be settled except by having recourse to some privileged authority. In the case of psychoanalysis the privileged authority was available until the death of Freud, but is so no longer. Nagel's second requirement was that some, at least, of the theoretical notions must be tied down to definite and specified observational materials. Here was the gap to which Lewis referred. We might say that it is quite all right for a theory to be built up on unobservables, such as protons, neutrons and electrons, or on unconscious entities, but there must be a rule of correspondence by which the unobservables are rigidly linked with obser­vables; and such a rule Freudian theory does not provide. With regard to his first require­ment, Nagel asked, are there any statements which are unmistakable instances of deduction from Freudian theory? Or does the theory have, rather, the remarkable feature that a statement can be shown to be a theorem only if it is first accepted as a postulate? He suspected that Freudian theory could always be so manipu­lated that it escapes refutation, no matter what well established facts might be.

   The answers of the psychoanalysts to these and other criticisms at the 1958 symposium were rather disappointing. They claimed, for instance, that psychoanalysis is something special, to which ordinary rules do not apply. Analytic hypotheses are devised for use with the analytic method, and cannot be assayed except in that context. They drew attention to the immense amount of data available in even one single case. The task of processing this makes the analytic method in the analytic situation the via regia to the psychology of personality. Freud's achievement was to show how the apparently chaotic lawless world of inner life could be subject to a rational order. 'He sugges­ted a cause for what seems to have no cause, and a purpose behind the apparently purposeless.' None of this meets Nagel's criticisms; they have even been called unfair, though both Farrell (1970a) and Ricoeur (1970) have admitted them. They can only be met if, like Ricoeur, one applies a new understanding of the nature of psychoanalysis to see it as something other than an empirical science.

   As yet this does not seem to be generally acceptable. The defence of psychoanalysis has been undertaken by Sir Denis Hill (1970), claiming for it the status of a scientific discipline, although he clearly sees the fundamental ways in which it differs from the physical and life sciences, including ethology. Psychoanalysis, he says, is concerned not with physical but with psychic realities. Psychic realities cannot be perceived directly through the senses, but can only be indirectly experienced in the self; they are inaccessible to the methods used in the physical and biological sciences. In consequence the truths of psychoanalysis are of a different order from the truths of science. Moreover psychic realities are related to one another not so much by links of cause and effect as by links of meaning:

The causal connections between the past sequences of psychic experiences are themselves dependent upon their future significance for the individual, and this is constantly changing. Also involved is above all a purpose, which is dependent on the future. Together they contribute its meaning, some­thing exclusively human. If this is so then psycho­analysis should admit to being a causal theory in the teleological rather than the mechanistic sense, and the hypothetico‑deductive method of physical science is not logically applicable, except in a very limited sense.

Conclusions based on psychoanalytic evidence 'cannot be tested except by consensus'. Psycho­analysis asks, not How?, but Why?

   All this firmly places psychoanalysis among the non‑sciences. Against this placement Hill urges Freud's scientific purpose, his psychic determinism, and the consistent attempt by him and his followers to fit their theory ever more closely to clinical fact. Psychic realities like conflict and guilt cannot just be left un­explained; and if they are to be explained it must be by Freudian methods, i.e. by means of an act of identification with the subject making oneself aware of the meaning of what he says and does. This leaves us where we were. There are non‑scientific as well as scientific modes of explanation; scientific explanations, by Popper's criterion, are refutable and certainly not 'un­testable except by consensus'. Nagel's criticisms still apply, and Lewis's 'unbridged gap' has not yet been bridged.

   This gap is the root cause of all the trouble. Also in 1970 there was an animated debate between Cioffi and Farrell. Cioffi accused psychoanalysis of shunning any procedure by which its theories could be tested and dis­confirmatory states could be discovered. It is a pseudoscience which employs procedures which in fact prevent or obstruct such discovery. 'There are a host of peculiarities of psychoanalytic theory and practice which are apparently gratuitous and unrelated, but which can be understood when they are seen as manifestations of the same impulse: the need to avoid refutation.' Freud advised against filling up gaps in the patient's history by enquiries among relatives, for thereby confidence in the analysis is shaken and a court of appeal is set up over it. For Freud, symptoms, errors, etc., are not simply caused by but also 'announce', 'express', 'realize', 'represent' or 'allude to' this or that repressed impulse. We are given a feeling of understanding, without any logical commit­ment. Psychoanalytic theories do not play the role of hypotheses in the lives of those who use them. 'We do not interpret dreams, symptoms, errors, etc. because it was discovered they were meaningful, but we insisted that they were meaningful in order that we might interpret them.'

   In his rejoinder Farrell (1970c) pointed out that, in the passage italicized, Cioffi was finding meanings and motives in the Freudian pattern. The understanding he gives us of Freud is the same sort of understanding as Freud gives us of human conduct and mental disorder. It finds its support in the fact that it brings into view and makes sense out of the material available. However, Farrell continues, Freud was con­stantly changing his views all through his life. Much of Freud is not now regarded as good psychoanalytic procedure. We cannot accept Freud's descriptions of his own activity as reliable. He was a participant observer in a therapeutic situation, and therefore not in a position to give us reports that can be accepted with confidence. Contemporary analysts are increasingly aware of this. Freud may have thought he was providing a pretty good scientific story about human functioning. If so, he was mistaken. But even if it is not good science it is not necessarily worthless. One of the striking 'and puzzling' [why puzzling?] features of psychoanalytic history and practice is the fact that psychoanalytic theory and methods are in some way or degree affected and controlled by empirical fact. Farrell's third defence is that the psychoanalytic interpretations should only be considered in the psychoanalytic situation and assessed in the light of the patient's subse­quent behaviour. We have met this idea before; it would probably be maintained by the great majority of analysts. But if it is upheld, it deprives psychoanalysis of any general applica­bility and circumscribes its 'truth' to a particular communication between two persons on a particular occasion.

   Michael Sherwood (1969) has attempted to vindicate the logic of psychoanalysis by aban­doning Popper's criterion and substituting the evaluation of explanations for the dialectic of hypothesis and refutation. 'Psychoanalysis must be made to stand or fall according to the same criteria by which all other sciences are judged and ... not be accorded a private domain with its own private rules of procedure' (1973). The three criteria by which he thinks both psycho­analytic and other 'scientific' explanations should be evaluated are those of appropriateness, adequacy and accuracy. To be appropriate an explanation must cover the questions raised; for adequacy it must be self‑consistent, coherent and comprehensive. These are qualities that help to make an explanation intellectually satisfying. The truth claim of an explanation is based on accuracy which is, essentially, correspondence of empirical assertions with what is actually found to be the case. Explanations can be more or less complete or shallow or deep, and cannot be judged solely by the two‑valued standard of logical validity appropriate to deductive systems. They are evaluated rather than verified or proved. Explanation and predic­tion are not the same thing. Sherwood's propo­sals make a notable advance on the previous lack of all standards by which one could assess expla­nations involving subjective data. Perhaps these are the appropriate criteria for psychoanalysis to use. But if psychoanalysis is no longer 'privileged' it is only because Sherwood relaxes the rules for distinguishing sciences from non­sciences. Explanations are multi‑purposed and are to be evaluated along a number of different dimensions, into all of which enter the factor of human judgement and the possibility of irre­soluble disagreements. Popper's criterion of refutability does not apply; and the rigorous standards of the sciences are still beyond reach.

   Hypothesis and explanation, though they overlap, differ in their nature and purpose. Explanation is the wider concept and does not necessarily involve hypothesis. While a hypo­thesis is framed to explain a problem, or part of one, it is in its essence a guess; its primary purpose is to act as a tool, to make a prediction and to suggest a test. It raises questions which demand answering and stimulates curiosity, uncertainty and unrest. Never, not even in the physical sciences, does it explain the whole of the relevant data; and there is always a mass of unexplained material to feed further conjec­tures. The hypothesis looks forward, explana­tion looks backward. Explanation is applied post hoc to phenomena already observed and it can be made to fit them as neatly as desired, if necessary by ad hoc adjustments. Its psychological effect is to set doubts at rest and to replace unease and uncertainty by a satisfying feeling of under­standing. A well designed non‑refutable expla­nation has an answer for everything. Sometimes an explanation involves generalizations which entail empirical consequences which can be tested; then the explanation has generated a hypothesis. However explanations of past or present conditions often involve no testable consequences. If they do not, they are non­hypothetical, riskless and irrefutable‑but can still retain all their charm to satisfy and soothe the questing intellect.

   The claim of psychoanalysis for scientific status constituted a challenge which in the end the philosophers could not ignore. Their dis­missive answer earned them no thanks Working scientists on the other hand have thought it the better part of valour to leave the subject alone. An exception is Sir Peter Medawar. In his Romanes Lecture of 1968, republished in 1972, he took the view that psychoanalysis is not a science but a mythology. 'It brings order into incoherence, it hangs together, it makes sense, leaves no loose ends, and is never (but never) at a loss for explanation.' He considers that Freudian psychology, and the psychology of the existentialists, are mischievous and impede the growth of our understanding of mental illness. Freudian and other quasi‑scientific psychologies are getting away with a concept of truthfulness which belongs to imaginative literature, 'that in which the opposite of a truth is not falsehood but... another truth.'

   This is indeed true, and it goes to the heart of our problem. Freud declared that the uncon­scious contains no contradictions. It is not necessary that the various meanings of a symp­tom should be compatible with one another. At a naïve level, we all know from personal experience that feelings of love and hate may coexist or alternate; or feelings of doubt and certainty; or passionate convictions that both of a pair of contradictory beliefs are true. As Samuel Johnson said, 'inconsistencies cannot both be right; but, imputed to man, they may both be true.' This implies that a description of a subjective experience, especially of any emotional experience, is refractory material for any two‑valued logical system. One of the basic axioms of logic is that p and not‑p cannot both be true. The consequences of abandoning that axiom are far‑reaching. Not only can one rear on such a basis a structure of argument which, already self‑refuted, is immune to refutation; but, as logicians have shown, the basic self‑contradiction can be shown to entail any proposition whatever, in any imaginable context. With it one can 'prove' or 'explain' anything one likes. In fact, with the abandoning of self‑consistency one enters a world which may well abound in 'meanings' in a non‑logical or emotional sense. But it is a world barred to the logic of science, a world in which sense may be nonsense and nonsense sense.

   Medawar illustrates the insubstantiality of psychoanalytic explanation by discussing in some detail a selection from the authors' sum­maries of their papers presented to the 23rd International Psycho‑Analytical Congress, choosing the proceedings of a congress rather than the work of a single author so as to get a cross‑section of psychoanalytic thought. The five extracts he gives illustrate very vividly the point he wishes to bring home when he writes:

The contributors to this Congress were concerned with homosexuality, anti‑Semitism, depression, and manic and schizoid tendencies; with difficult problems, then‑far less easy to grapple with or make sense of than anything that confronts us in the laboratory. But where shall we find the evidence of hesitancy or bewilderment, the avowals of sheer ignorance, the sense of groping and incompleteness which informs an international congress of, say, physiologists or biochemists? A lava‑flow of ad hoc explanation pours over and around all difficulties, leaving only a few smoothly rounded prominences to mark where they might have lain.

    Medawar's image reminds us of the work of the oyster which, irritated by a grain of sand in its sensitive entrails, secretes around it a protective layer of pearl. If psychoanalytic explanation of difficult human problems is so universally successful as to submerge them, however thorny, we may consider the possibility that this is its true function.

   Summarizing the situation we find that:

   1. Psychoanalysis is concerned, not with what happens to a man, or has happened to him in childhood and infancy, but with how what has happened has been experienced. Its world is the endopsychic one of internal subjectivity. Its only realities are 'psychic realities'. Within this world it is concerned not with hypotheses but with explanations.

   2. Psychoanalytic theory and method to­gether form a closed system. The method is validated by the 'truths' revealed, and the truth of the revelations is proved by the infallibility of the method. The circularity is common to a number of disciplines in the humanities, e.g. the law; but it puts psychoanalysis outside the discourse of truth‑finding by rational processes. The fact that psychoanalysis has no truths in the objective or scientific sense does not deprive it of purpose or meaning or usefulness. What psycho­analysts do does not bear the least resemblance to what scientists do. Psychoanalysts are interested not in criticizing and investigating the truth of their theories, but in applying them to obtain answers to questions arising in particular cases.

   3. As Farrell maintained, psychoanalysis does have some empirical content. It is difficult to say just what it is, and no one has yet written a text giving a stripped down account of ob­served, tested and confirmed empirical data on which psychoanalysis relies. That there is empirical content means nothing in itself; even 'a message intended to transmit an affective state is bound to employ a cognitive medium' (Parry, 1967). But as psychoanalysis has no rules of correspondence tying theory to em­pirical fact it runs no risk of conflict. It faces no 'court of appeal'. No observation, not even one which conflicts with an accepted interpre­tation of the theory, can ever be fatal to it, since the theory can at will be modified to make room for it. The theory does evolve and produce daughters, in part under the pressure of clinical observations, but in all its forms is unrefuted and irrefutable.

   4. Psychoanalysis does not exercize the familiar functions of a science. It does not join up with other disciplines, nor share with them either its language or its concepts. Relevant work in biology and the medical sciences has made no impact on it. But science is universal, and all the sciences are members of a family. Science leads to a unified world view, a view that is of the external world. Psychoanalysis is concerned with the internal world, about which science has nothing to say. Science can dispense with psychoanalysis, and psychoanalysis can dispense with science. Psychoanalysis is no part of science, but is complementary to it. In claiming to be a science it mistakes itself and lays itself open to attack. Psychoanalysis has other duties to perform than scientific ones. The claim made by psychoanalysts that their disci­pline is not one of the humanities but a science has met with emphatic rejection by both philo­sophers and scientists. This rejection is painful on both sides. Psychoanalysis should not try to team up with strangers who want none of it, but should seek the company of its friends.

PSYCHOANALYSIS AND PSYCHOBIOLOGY

    Attempts have not been wanting by psycholo­gists friendly to psychoanalysis to follow the advice of the philosophers of science. They have tried to break down the immense integrated structure of Freudian theory into part‑hypo­theses, which could then be subjected to test. Reports of such work have been provided by Kline (1972), Lee and Herbert ('970) and Sarnoff (1971). As an example of one of the more successful experiments one may mention the careful study by Beloff, republished by Lee and Herbert. Beloff successfully identified a cluster of traits of the 'anal' character, defined by questionnaire tests and validated. However this proved, despite the demands of Freudian theory as ordinarily interpreted, to bear no relation to the history of bowel training in childhood. What it did relate to was the 'anal' score of the mother. In other words, the 'anal' character revealed itself as a misnomer, having nothing to do with the anus. If we rename it 'obsessional', we find, as we might have expected from classical psychiatric family studies, that it bears evidence of being in part caused by hereditary predisposition.

   It seems that some of the implications which one might deduce from Freudian theory have found some support, but often ambiguously, and in the overall picture with remarkable sparseness. These partial results are universally found unsatisfactory. Hilgard (1970) notes that psychoanalysts are sceptical or hostile to such attempts at empirical validation. A depth psychology, they think (pace Medawar), needs a depth method for its study; and psychoanalytic theory is very complex, so that tests of separate propositions seem trivial or irrelevant. Divided from the unity of the grand whole, part­hypotheses take on a quality at once crude and paltry which, without physiological correlates, makes them uninteresting. A number of Freudians, Anna Freud (1969), Hartmann ('gg), Kreitman (iyji) and Ricoeur ('970), have protested against the frivolity of this niggling approach.

   Much more interesting is the review by Stoller (1973), who has discussed the clinical implications of Freudian theory in relation to recent advances in sex research, with particular reference to bisexuality, infantile sexuality and the Oedipus complex, libido theory and the primacy of the penis. The results of this dis­cussion would seem to suggest the propriety of heavy pruning. Stoller finds that Freud used the concept of bisexuality in so many different and irreconcilable ways that his ideas are un­testable. Freud's biological thinking: the concept of psychic energy, life instinct v. death instinct, libido theory, Lamarckian inheritance of past experience of the human race, should be abandoned. While Freud's theories of infantile sexuality get high praise, especially for the research they have stimulated, his notions about the sexual development of little boys and little girls and the conflict aspect of gender development were mistaken. Close association with the warm feminine mother feminizes, but with the father masculinizes. So the boy does not have the straightforward heterosexual development Freud supposed. 'Instead he has a major impediment on the way to hetero­sexuality; he must rid himself of whatever femininity may develop in the mother‑infant symbiosis . . . Little girls are shaped in the direction of femininity right from the start… Clear‑cut femininity is routinely seen by a year or so of age.' Freud's theory of the sex aberra­tions postulated trauma and conflict, and left no room for constitutional, nor even for environ­mental but non‑conflictual causes. His observa­tions on zonal phases of libido development have been confirmed, but they have no relation to neuroses and psychoses. 'Libido theory as an explanation of neurotogenesis has been so far off base that it has never attracted serious attempts to test it by scientific methods.' It is significant that, when Freudian theory seems to have been holed at so many points below the waterline, Stoller can still conclude that the good ship sails on. From all these advances in sex research, he says, 'the measureable impact on psycho­analytic theory has been mild.'

   One might go further and say that the measurable impact has been negligible. This is not really a matter for wonder. Freudian theory, as an irrefutable system, is not seriously touched by facts of any kind; if there appear to be discrepancies between observation and theory they are a matter of no consequence. As Kreitman (1971) puts it, one should not imagine that psychoanalysis will remain viable only as far as it is capable of independent confirmation.

This is to misrepresent the complex relationship between clinical practice and academic investiga­tion in this field. The scientist provides interpreta­tions of phenomena; the psychotherapist may find these interesting, but his main need is for something rather different, namely a method of coming to grips with the patient's experience. He also requires a theory which will enable him to effect change through the elucidation and manipulation of emotions. It is just this hope that psychoanalysis and its derivatives provide, and it will not be given up easily whatever the "scientists" may say.

    Rather special interest attaches to the relation between psychoanalysis and ethology. The tech­niques of ethology demand that animal life should be observed in its natural environment and in all its complexities, without any kind of interference. Observation should be compre­hensive, conducted over a substantial time span, and meticulously recorded. The information gained will be too abundant for any simple method of processing entire, and much too complex for understanding except in the light of a general theory. Complex, subtle, over­abundant information is just what emerges in an analytic session; and psychoanalysts may find themselves well trained for dealing with an ethological approach to their problems. They are much concerned with mother‑child relation­ships, as an area in which neurotic or psycho­pathic developments in later life might take their source. Both ethologists and analysts are interested in instinctive behaviour, conflict, affectional bonds and sensitive phases of deve­lopment. Analysts, by themselves, have never been able to develop a scientific methodology; ethology supplies it. Hence the fruitful marriage of psychoanalytic theory with ethological obser­vation of mothers and babies, as it has been systematically applied by John Bowlby (1972, 1973) among others.

   Bowlby went into ethological work from an originally orthodox psychoanalytic position, and psychoanalytic ideas no doubt determined the observational approach and were used in the interpretation of the findings. What particularly interests us is that the first volume of Bowlby's tripartite work on Attachment and Loss could have been written without any reference to Freud, and without mention of psychoanalytic ideas or use of psychoanalytic terminology. Certain equivalences are offered, and transla­tions from ethological into psychoanalytic termi­nology. But they could have been spared. In Bowlby's second volume psychoanalysis plays a much more important part. But he finds it necessary to discard great themes of Freudian teaching: Freud's whole theory of motivation (in favour of a model from ethology and control theory); the entire economic aspect, with psychological energy being distributed along paths of least effort; Freud's distinction between realistic and neurotic anxiety; and nothing is heard of the Oedipus complex, nor of id, ego and superego. Necessary additions are also made: Bowlby distinguishes between the causation and the function of a behavioural system. For instance, the causative factors determining sexual activity are the hormonal state, the presence and the characteristics of a partner, reciprocal reaction and feedback. The function is reproduction.

   Bowlby's synthesis is on a Darwinian and evolutionary basis, to which he attaches great importance. It falls in line with modern bio­logical ideas, and identifies itself with the ideals of science. It has departed a very long way from Freud, not least in the style of thinking. His final words on this aspect are:

On reflection it becomes clear that Freud's increasingly deep commitment to a Lamarckian perspective, to the exclusion of Darwinian ideas about differential survival rates and the distinction of causation and function, has suffused the whole structure of psychoanalytic thought and theory. With the remainder of biology resting firmly on a developed version of Darwinian principles and psychoanalysis continuing Lamarckian, the gulf between the two has steadily and inevitably grown wider. There are thus only three conceivable outcomes. The first, which is barely imaginable, is for biology to renounce its Darwinian perspective. The second, advocated here, is for psychoanalysis to be recast in terms of modern evolution theory. The third is for the present divorce to continue indefinitely with psychoanalysis remaining per­manently beyond the fringe of the scientific world.

FREUDIAN THOUGHT IN THE WIDER WORLD

   Though Freud believed that psychoanalysis was a science, he did not believe that it belonged in the public world, as does all science. Psycho­analysis was his own personal possession. He insisted that the founder of psychoanalysis must be the person best qualified to judge what was psychoanalysis and what was not. He parted with colleagues, with Adler in 1912 and with jung in 1913, because he wanted not collaboration among equals but discipleship. If we think of him as an artist, we can under­stand that he should demand that the per­formance of the tremendous symphony he had written should be guided by his sense of the fitting. He made many changes as over the years he elaborated his system; but it was only he who had the authority to make such changes, or to sanction them for a pupil.

   Freud's theories had a far wider impact than the theories of Adler or of jung. Adler's ideas were too unsystematic, and Jung's too mystical, and neither of them made any pretence of being scientists. Freud's system had the concrete and mechanistic features characteristic of nineteenth­century science. Directing attention to the psychic experiences mediated by the mouth, the genitals and the anus, one might say that it got down to well known fundamentals. The approach was satisfyingly reductionist, breaking down the complexities of subjective thought and feeling to interactions between primitive entities. These entities were hypothesized as universally part of the human make‑up and common to all mankind. The search for causes, even if con­ducted in metaphysical terms, was sympathetic to the spirit of the age. It is only over the lapse of decades that we have become aware that Freudian causation is non‑empirical, and that his causative entities are not hypotheses but fictions.   

   There were other great attractions. Freud's analysis of motivations could be applied in a wide variety of fields. In fact motivational problems had only to be translated into Freudian terms for an explanation to present itself. In controversy the superficially rational argument of one's opponent could be under­mined by interpreting his motives. Karl Popper (1957) has described the almost magical appeal of the two great all‑explanatory theories, Marxism and psychoanalysis, as they made widening circles of converts at the turn of the century:

Theories appeared to be able to explain everything that happened, within the fields to which they referred. Their study had the effect of an intellectual conversion or revelation‑of opening your eyes to the truth hidden from those not yet initiated. Once your eyes were thus opened, you saw confirming instances everywhere: the world was full of verifications of the theory. Whatever happened always confirmed it. Thus its truth appeared obvious; and unbelievers were, clearly, people who did not want to see the truth‑either because it was against their class interest, or because of their repressions which were still "unanalysed" and crying aloud for treatment.

   Marxism and psychoanalysis were the crea­tions of two men of genius, built up by intellec­tual effort sustained over many years. These men were trying to understand and explain processes so complex that they were far beyond the grasp of the human mind. They were then, and they are still. Any solution proposed was bound to prove erroneous and misleading, and indeed could only by a miracle contain any truth at all. Both Freud and Marx chose, or chanced on, lines of thought that led to irrefuta­bility. They found ways of handling the data which could always be applied in post hoc explanation, e.g. by postulating opposed forces which could lead either to a balance or to a shift either to one side or the other. If the theory was so constructed that it was impossible to base any specific prediction on it, it was shielded against refutation. Whatever happens, the Marxist says, must confirm the theory. But if this is so, and if all eventualities are equally explicable, it is not possible to say why things work out in one way rather than in any of the

others. In the scientific sense these explanations are not explanations at all. But in human affairs any way of arranging apparently chaotic material is better than none at all. Some order, even an unreal one, at least permits discussion; and from discussion one may make progress. To be sure, progress cannot be made if one is convinced that the solution has already been found. In very complex situations one can only inch along by trial and error. One learns from one's errors‑if one recognizes them as such; and it is necessary to make errors in order to learn. This is where the irrefutable systems fail us. If they are always right, they bar the way to free enquiry.

   It has been said that no other original thinker has had such a wide effect as Freud on the psychological thought of our time. Great as the range of his influence has been, it has not always been for the good. His ideas certainly transformed psychiatry in the United States, causing a rift between it and medicine which is only gradually being healed. His influence has also been great, though less petrifying, on the psychiatry of other countries of the Western world. Freud himself applied his theories in anthropology, biography, mythology and reli­gion. Sociology has been deeply influenced by him; and Freudian ideas have penetrated into aesthetics, criminology, economics, educational theory and practice, history, literary criticism, political theory, administration and govern­ment. There is hardly one of the humanities that has not become indebted to Freudian ideas. It is only the sciences that have remained immune; and in general medicine, apart from the psychosomatic area, their influence has been negligible, an unexpected failure for a study which presents itself as medical psychology. All this is symptomatic of the greater kinship of psychoanalysis to the humanities than to the sciences.

   In the humanities Freudian ideas have proved useful by the facility with which they can be applied in explanation. In all the fields men­tioned complex problems arise which are not capable of empirical solutions. They are not open to scientific method. Yet it is humanly impossible to work in any field of study without encouraging oneself with the feeling that one 'understands' it. Any theory which provides the internal certitude that basically one does understand helps the worker to continue. Freud's theories were especially well adapted to sustain this very necessary delusion. The model of opposed forces was often extremely useful. The reinforced irrefutability of the theory protected the interpreter from being shown to be in error. Against all the erosion of time, Freud's system has remained alive bearing the brand name, and classical Freudian ideas are constantly being applied today despite the nineteenth century shadow that lies over them. Many successors [3] have taken parts of his theory, maintaining a discreet silence on the rest, and have held a place of right in the psycho­analytic establishment.

   The profound effect Freud has had on social theories, particularly in child‑upbringing and education, has been traced by the sociologist La Pière, with emotions which seem to have verged on horror. He would agree with the proponents of psychoanalysis that 'the child­rearing practices of much of the Western world have been influenced for some three generations by his dicta', but, he would believe, disastrously. La Pière's main complaint is that Freudian ideas have undermined the American ethic which in the past has always seen the man of enterprise as the founding figure of a vigorous national social life. From permissive child­rearing practices, based on the idea that re­pression is the source of neurosis, through permissive‑progressive schooling, through a university life in which the goal is adaptation, rather than emulation, into conformist citizen­ship under a maternalist government, everything is done to encourage dependence rather than initiative, self‑reliance and enterprise. The Freudian ethic excuses one and all from any real responsibility for his actions, whether criminal or otherwise.

   Perhaps La Pière may not carry us with him all the way in the view that a highly competitive society is the greatest gift that man has wrung from a reluctant nature, or that maternalism in government is debasing. But he does bring out a paradox in the conceptualization of the relationship between society and the individual which lies at the centre of Freudian ontogeny:

It is a miracle, which Freud never attempts to explain, that for countless generations men have been surviving and in the process developing the complex social systems that, according to Freud, are the total negation of man's natural needs and inclinations.' 'To Freud ... the instinctive equip­ment of man is antisocial and never gains ex­pression.' 'Man is not born free with the right to pursue life, liberty and happiness; he is shackled by biological urges that can never be freely expressed and that set him in constant and grievous conflict with his Society.' [The Freudian ethic] 'makes the world about him a hostile and in­hospitable place, and it makes him a terrified (unconsciously, of course) and reluctant inhabitant of that world . . . Not only is his external world inimical to his psychic welfare, but this world has been "internalized" to the end that a part of him intimidates the rest. There is therefore no escaping psychic agony. Should he withdraw from the external world, he will still be at odds with himself.

    This inherent contradiction has been identi­fied by recent Soviet critics (Rollins, i7), but in different terms. They point out that there is no good reason to believe that conscious and unconscious processes are necessarily in conflict. On everyday biological principles we can be sure that, in the main, they are synergistic; and of course there is abundant evidence that a great deal of productive thinking, both of a routine and of a creative and original kind, go on in the recesses of one's mind without conscious aware­ness. Nevertheless the Freudian way of seeing things has its uses. It reflects the way that society often appears in the eyes of the neurotic or the paranoid patient, and the way that the neurotic may feel at odds with himself. It has never been a disadvantage in psychoanalytic practice to have adopted a paranoid‑one might even say psychotic‑conception of the relationship be­between society and the individual.

PSYCHOANALYSIS AS THERAPEUTICS

   It is commonly supposed that psychoanalysis has for its main purpose the treatment of patients suffering from psychiatric illnesses. Certainly psychoanalytic ideas are used both in group therapy and individual therapy. But it may be less for the relief of symptoms than for the resolution of personal problems in living; and it may be less with patients suffering from illnesses than with normal but temporarily troubled or maladjusted persons. Medawar (1972) has properly insisted that, if it is a contribution to medical practice, psychoanalysis must be justified by results: 'For this reason the notion of cure is so important. It provides the only criterion by which the validity of psycho­analytic notions can be judged.' New insight and deeper understanding of oneself are not the point for Medawar, who is looking at the situation from the standpoint of the doctor rather than the priest. One has to show, he says, that patients get better under psycho­analysis, and (a) that a patient who does get better would not have got better anyway, (b) would not have benefited equally by another treatment, and (c) that it was something specific to psychoanalysis alone among treatments which produced the benefit. These are the kinds of criterion which the medical scientist will apply in, say, trying out a new treatment for a para­sitic disease, and they are necessary for a conclusive test. Unfortunately there is practic­ally no treatment, psychoanalysis or any other, available to psychiatry which could claim success by these standards. We have to make do with more probabilistic grounds for acceptance; but even with inferior testing processes treat­ment has advanced, for instance in the field of drug therapy.

   The task of obtaining reliable evidence bearing on the therapeutic effectiveness of any of the psychodynamic or depth psychotherapies has proved to be a practical impossibility. No adequate controlled trial has ever been staged. Items of evidence, individually inconclusive, have accumulated, and have shown no consis­tent trend showing that these therapies do either much harm or much good. To quote Greenblatt (1972): 'The extraordinary thing is that although everyone believes that human be­behavior, thinking and feeling can be pro­foundly affected by the interaction of one individual upon another and so much time, effort and money is expended on individual psychotherapy, it is still remarkably difficult to obtain convincing proof that individual therapy, as conventionally practised, is worth all the effort.' A thoroughgoing examination of the pretensions of the various therapies in psychiatry has been published by Mechanic (1969), and he has to point out the deficiencies of all of them. He finds it impossible to justify the individual psychotherapies on a cost‑effective basis.

   In the last few years, however, leading psycho­analysts and psychoanalytically oriented psy­chiatrists have abandoned the claim that the merits of psychoanalysis are to he discovered in the field of therapeutics, that is, in a medical sense, in the relief of symptoms, the mitigation of suffering and the rehabilitation of the socially incapacitated. Anna Freud (1969) concedes 'that where quantitatively massive upheavals of the personality are concerned, such as in the psychoses, the purely psychological methods by themselves are inadequate and the organic and chemical means have the advantage over them.' What psychoanalysis has to offer, she says, for instance in the neuroses, is something quite different from treatment in the medical sense, something 'unique, i.e. thoroughgoing personality changes, as compared with more superficial symptomatic cures. Unfortunately, the former is not always aspired to by the patients, who aim above all at immediate relief from suffering.' Similarly Sir Denis Hill (1970) observes that the objectives of psychoanalysis go far beyond alleviation of symptoms.

Symptoms in this context are regarded as inci­dental and often painful expressions of psycho­logical defences against unacceptable impulses or aflèct, the true source of conflict and mental illness. It is these in the psychoanalyst's view which the patient must be helped to cope with, accept and integrate in the personality; having done so the patient is free to pursue the goal of personal self­realization.

    This restatement of the objectives of psycho­analysis does not dispose of the need to show that they are attainable. There is an implied contract between the psychoanalyst and his patient, and the psychoanalyst must be able to show that he is actually able to provide the far‑reaching personality changes he offers. Some sort of validation of his methods is still called for. In fact, it is further away than ever. The aim of thoroughgoing personality changes is not a therapeutic one in any normal sense, and what the change of personality is to be proves in­capable of definition. It becomes impossible to determine the end‑point at which the patient has achieved the required personality change and has become free to pursue the egoistic goal of personal self‑realization. As Freud discovered, the analysis becomes interminable. The aban­donment of a clinical aim designed to serve the needs and wishes of the patient for one to be imposed on him by the demands of theory, indifferent to his suffering, takes psychoanalysis clean out of the range of medical therapeutics. It is hardly surprising that the relationship of analyst to analysand is such a different one from the doctor‑patient relationship.

   With this, the divorce between psychoanalysis and medicine seems to be complete. They have proved to be alien to one another in their basic concepts, their methodology, their attitude cowards empirical knowledge, and finally their notion of what constitutes treatment. It becomes difficult to resist the view that psychoanalysis has no place in medicine. It has long been tacitly agreed that medicine has no place in psychoanalysis. If we unwisely identify psy­chiatry with psychoanalysis, it follows that medicine has no place in psychiatry; and the American Board of Psychiatry and Neurology has decreed in effect that the year of internship in the training of the psychiatrist is a waste of time, a decision not without its critics (Engel, 1972). If, however, experience shows that psychiatry is a medical specialty after all, then the alternative consequence has to be drawn, that psychoanalysis has no place in psychiatry. If practising psychiatrists wish to make use of psychoanalytic ideas and methods, this will not be for psychiatric purposes but for other reasons. Kreitman (1971) has given us a clue to what they might be. The psychotherapist, he says, needs a theory 'which will enable him to effect change through the elucidation and manipulation of emotions.' This is what the psychotherapist needs to do, and his reward is to have influenced another being, not by drugs, but by the depth of his understanding and the power of his wisdom. The relationship between psychotherapst and patient is a symbiotic one,

and each needs the other. The need can be so great that it becomes an addiction. The immense vitality of psychotherapy as a vocation shows the intensity of the drive that takes some dedicated young people into it, despite its slender claims to effectiveness.

THE NATURE AND FUNCTION OF PSYCHOANALYSIS

    If psychoanalysis is not a science and is not one of the medical arts, we are led to consider what it is and what are the needs that it fulfils. For that there are such needs, and that it does go some way towards fulfilling them, can hardly be denied in view of its success as a marketable commodity. If we attempt to classify and label psychoanalysis, we must not be surprised if it fits no classification exactly and might well carry more than one label. Farrell (Ig7oa, b), after discussing and rejecting the view that it is a scientific theory,[4] considers a number of possibilities in turn. It might be thought of as the doctrine of a faith: an analysis, especially a training analysis, resembles a technique of religious conversion; the graduate trainee, once through the process, is no longer interested, or even able, to enquire into the truth of the doctrine. But it does have some empirical matter, and it is possible to make some enquiry into its empirical truth or falsity. Farrell compares it with Yoga, in which also some parts are occult and untouchable by logic, and other parts are open to empirical support or refutation. Psychoanalysis might also be a 'pre‑scientific myth', prolific of interesting psychological suggestions, not yet in testable form but capable of such a development; psychoanalysis has mythic qualities, and indeed recalls and re­incarnates the conflict and drama of Greek tragedy. This label, also, he finds unsatisfactory.

   Farrell finds in psychoanalysis features which are incompatible with each and every designa­tion, but he does not give adequate consideration to the number of categories which it does fit in one way or another. Psychoanalysis is capable of being a great number of things to a great variety of people. It is certainly for some people the doctrine of a faith, satisfying needs of the personality which in others are met by a religious belief, true with the truth of irre­futability, an armour for the soul, explaining, sustaining, consoling. Its doctrines have some of the valuable qualities of a body of occult knowledge. He who has it is, within the bounds of its relevance, omniscient. There is a complete interpretation available for any human beha­viour: the task is simply to extract once again from the newest story the eternal verities that are there only waiting to be uncovered. Psycho­analysis is also a language, a lingua franca for all who understand it from all over the globe, and for all who have not been initiated an impenetrable code which, if attempted by the Ephraimite, discloses at once the difference between the sayers of 'shibboleth' and 'sibboleth'. We may think of it, too, as an art form, offering to one's imagination the raw material of words, symbols and images for the creation of a fantastic literature. Freud was a great stylist as well as an imaginative genius, and his work as literature will live as long as Nietzsche's. Most seriously regarded, psychoanalysis is a highly integrated body of metaphysical or metapsychological doctrine, a system for organizing into a humanly comprehensible form a chaos of unknowables.[5]

   Can we find a highest common factor in all these varied functions? We see that the process of psychoanalysing is essentially concerned with communication between one person and ano­ther. The content of the communication centres round the report by one of them about his subjective processes. The theory provides a framework in which these processes can be put in relation with one another and discussed. The terminology gives the means by which a message in one set of terms can be translated into another set. These seem to be its most essential functions, and in these terms psycho­analysis operates as a language. Religious faiths, myths and occult knowledge are all attempts to order and describe subjective experience, and they have their languages for the purpose. The arts, more directly, themselves are languages for the communication of affective experience. In all these activities subjective processes at a variety of depths below consciousness are un­covered, and affects are released and may be purged or abreacted. The prepositional calculus has no relevance to any of them. Empirical knowledge, though nowhere absent, has only a servant's role, such as for the painter a know­ledge of his pigments. Finally, the equivalent of irrefutability is a requirement for a language, in that there should be no ideas beyond its capacity to express, and if some gap appears an ad hoc adjustment has to be made to cover it. The conceptions of Adler, Freud and Jung all provide ways in which processes of the mind, motivations, fears, blocks, internal projections of the outer world, etc., can be sorted out. The content of the message so conveyed is its 'meaning'. No reasons are needed for preferring any one of these systems to the others, certainly no logical ones since they have nothing to do with logic. One's choice of language is an open one.

   The view that psychoanalysis serves princi­pally as a language has been advanced more than once by Freudian thinkers. Charles Rycroft (1970) maintains that psychoanalysis should be recognized as a semantic theory, not a causal one. The psychoanalyst (Adlerian, Freudian, Jungian, Kleinian or existentialist) knows some­thing of the syntax and grammar needed to describe the way in which 'repudiated wishes, thoughts, feelings and memories can translate themselves into symptoms, gestures and dreams', and can 'interpret them back into the communal language of consciousness.' The analyst is concerned to make contact with his patient, and to understand phenomena which interfere with the communication. He investigates the language his patient is using, in a way com­parable to linguistic analysis. Psychoanalysis interprets human behaviour in terms of the self that experiences it and not in terms of entities external to it. Rycroft believes that psycho­analysis might be 'a semantic bridge between science and biology on the one hand and religion and the humanities on the other'.This seems very doubtful.

   The work of Paul Ricoeur (1970) is on the grand scale, covering the history and all the philosophical aspects of Freudian theory, and is intended as a defence. He accepts the criticisms of the epistemologists, logicians, semanticists and philosophers of science. He agrees with them that psychoanalysis does not satisfy elementary requirements of a scientific theory. But, he says, we shall admit this and then turn the admission into a counter‑attack. Psychoanalysis is remote from science because there is no possible transla­tion from causal language into motive language, nor vice versa. Explanation through motives is irreducible to explanation through causes. Psychologists concern themselves with environ­mental variables. For the analyst these are not the relevant facts. What is important to him are the dimensions of the environment as believed by the subject, not the fact but the meaning the fact has assumed in the subject's history. For the analyst behaviour is a segment of meaning. The real history is merely a clue to the figurative history through which the subject arrives at self‑understanding. The psychoanalyst is neutral between social demands and instinctual de­mands; he sides neither with society nor with the infantile demands of the patient. This is because he is not concerned with adjustment but with 'true discourse'. Psychoanalysis, as seen by Ricoeur, is not science but hermeneutics. Its doctrines must be interpreted as myth. Psychoanalytic experience unfolds in the field of speech, and what comes to light is another language which has to be deciphered through its meaningful effects in such things as dreams.

   If one accepts Ricoeur's view the conse­quences are far‑reaching. In the discourse between analyst and patient the significance of external events is nullified and replaced by the meaning these events have in their projection into the internal world of the patient. The arena, the drama that is staged there and the protago­nists that take part are all within. The endo­psychic world subsists in space of its own and shares no point in common with the external space of objectivity. The analyst engages in a discourse with his patient by which he can to some extent enter into the same subjectivity. There can be no check on the extent to which analyst and analysand are communicating. When the analyst says something to his patient he does not know that the patient has under­stood from what he heard what the analyst had it in mind to convey. If he asks the patient to enlighten him, he cannot be sure from the reply whether he has rightly understood what the patient consciously wanted to tell him and what he wanted to conceal, not to mention what was unconsciously hidden or revealed. Every step in understanding demands interpretation, and the reasons for an interpretation should them­selves be interpreted. The regress is infinite as long as it remains endopsychic, and a halt can only be called by facing it with an objective test.

   Looked at from another side, the limitation appears even more serious. If, for instance, it does not matter whether or not the patient's early sexuality actually met with a punitive attitude, but matters only if he now believes that it did; if the real historical fact can be ignored and only the mythical historical fact signifies; then truth and falsity become irrele­vant, indeed meaningless. Who can ever say whether a man is telling the truth about his motives, whether he is mistaken, or is telling a lie? Truth and falsity are concepts founded on objective knowledge and belong to the external world. They are standards by which to judge the accuracy of our mental processes that focus on external realities; to the mind that concerns itself only with its own internal gongs‑on they are insubstantial. Truthfulness of mind has to be measured against behaviour. Private com­munications between analyst and patient then become relevant to them only and to no others, not even those concerned with the patient's welfare, his family, his doctor, employers, state agencies, or the ladies and gentlemen of the jury.

   If psychoanalysis wishes for the logical autonomy and self‑sufficiency of a language, then like other languages‑like music for instance‑it must restrict itself to being a medium and disembarrass itself of any empirical content of its own. To be capable of conveying everything it must be committed to nothing. Freud's psychic realities would be no more than conventional constructs, valuable for their usefulness in communicating subjective mental processes otherwise difficult to grasp. Ricoeur has said that psychoanalytic concepts can and should be criticized, perfected or even rejected. This would have to be in terms of their efficiency in aiding communication, and the appropriate discipline for the task would be some form of linguistic analysis. Psychoanalysis, so reduced, would still provide a service universally desired, a breakthrough from isolation and imprison­ment within the self, the opportunity of confession to an all‑tolerant hearer, and the dis­covery and better understanding of one's own nature. So much might be enough for the Adlerian and the Jungian, though surely both of them would use the contact and the under­standing actively to help the patient to adjust to his world and to himself.

   It seems doubtful whether Ricoeur's proposal will prove acceptable to analysts of Freudian schools. But if they wish to take the opposite path and to develop their teachings into a science the task that lies ahead is a daunting one. The first step would be to use the one test they have, that of consensus, to prune a rather elaborate theory of all unnecessary or in­sufficiently substantiated elements. What then remained could be reformulated in a simplified and perhaps rather imprecise way, but one which could be the basis for operational definitions and rules of correspondence. Then would start the work of conjecture and refuta­tion. It would bring back human behaviour into the centre of the picture, taking pre‑eminence over the 'psychic realities' of the endopsychic world. Perhaps this too will prove unacceptable. If so all that would then remain for the Freudian psychoanalysts would be to stay where they are in a no‑man's‑land between the sciences and the humanities, proliferating and diversifying but neither advancing nor retreating; and to await the fate of adventures that lose the courage to go on.

 

[1] Introspectively, one is aware of one's freedom to act in one way or another, and the idea of freedom of will seems to be self‑evident. His own freedom of will, indeed, is equally self‑evident to the normal man and to the psychotic, even though the former might wish to deny it to the latter. Objectively, it is impossible to support this notion with any evidence from the study of human behaviour. Logically, it proves to be self‑contradictory if analysed in any depth, as Vaihinger has shown. Never­theless it is a working assumption in ordinary social affairs, in planning our own behaviour and in 'understanding' the behaviour of others. As 'nens ren it is a basic assumption for the criminal law; and without it the law would have to be widely different from what it is.

[2] Ellenberger attributes Freud's confidence in his discoveries to the creative illness through which he passed, of which they were the natural consequence. He writes: 'Among the characteristic features of the creative illness… is the subject's conviction, after his recovery, that whatever he has discovered is a universal truth ... Those who have known Freud report that he talked of the Oedipus complex and the libido as absolute truths that could not suffer any doubt.’

[3] e.g. Aichhorn, Ferenczi, Anna Freud, Fromm, Homey, Klein, Moreno, Rank, Reich, Sullivan.

[4] He believes that, if not scientific, the theory is rational, and in this respect comparable with other rational disciplines such as history, economics, jurisprudence, social anthropology and sociology. But he admits that no analysis has been made to show whether psychoanalytic theories attain the internal consistency and logic that these and other studies have in their own domain.

[5] Psychoanalysis is, of course a skill, an expertise. As such it provokes playful display. It can be adapted as a game with almost unlimited possibilities, for the analyst to do psychoanalysis on himself, his friends and unfriends, his colleagues, his contemporaries, on historical per­sonages and on the characters of fiction. Professionally, it is a game for two, analyst and analysand, a form of blind­man's‑buff, with one partner knowing all the rules and getting the other to chase him round and round the endopsychic space.