building controversies



Considerations on the debate about the scientificity of psychoanalysis

The advantage of getting into a controversy when it seems to be ending is being able to assess your bankroll. And most of the time, when it is an intellectual polemic based on rhythm, impact phrases and images typical of the media, its balance is very close to zero. Perhaps this is the case of the last national version of the already centenary debate on the scientific nature of psychoanalysis, promoted by a researcher in the field of biologicals, Ms. Natalia Pasternak, and her journalist husband, Mr. Carlos Orsi.

And it is good to remember the centenary nature of this debate, because we would have the right to hope that its national version could bring some novelty, some astute argument, some new research to a discussion about the fate of a clinical practice that, for better or worse, rather, it shaped Western sensibility regarding issues as central as: family, sexuality, corporeality, memory, desires and their conflicts. For it is materially impossible to describe the XNUMXth century, its aspirations, tensions and transformations, without understanding how our culture is, to a large extent, a “psychoanalytic culture”. This means: a culture forged by the circulation of psychoanalysis in offices, hospitals, schools, films, literature, but also in peripheries, social struggles, among others.

Understanding such a force of influence on a clinical practice requires work on the sociology of ideas that could add a lot to the debate. Work that could bring elements to respond, in a more objective way, to questions such as: why did psychoanalysis insert itself in such an organic way in the history of western societies? Was it because Freud was a “great publicist”, a “cunning sleight of hand”? Or was it because psychoanalysis actually says something relevant about the structure of our subjectivity and culture?

olav was right

Before addressing this point, it would be a case of making a historical context. Books against psychoanalysis have been counted in droves for decades. In 2011, for example, Brazil received a translation of one of them, the then famous Black book of psychoanalysis. Anyone who rereads it will find practically all the arguments and criticisms that animate the How silly! Pseudoscience and other nonsense that doesn't deserve to be taken seriously. The former must even be cheaper, as its destination was mainly second-hand used bookstores. Because when the black book was translated, its reception was lukewarm, like someone who hears the same joke told over and over again.

What then happened to Brazil for the same discussion to appear now in a more explosive way, without any new element or relevant data being added to the debate? It is possible to credit part of the phenomenon to the disorientation produced by the pandemic. In the face of a government that committed a systematic sequence of crimes against public health, there was no lack of those who found themselves in the midst of a veritable re-enactment of the war of lights against superstition, science against obscurantism, civilization against barbarism. Researchers in biological and exact sciences were elevated to the condition of guardians of reason to which politics should submit if it did not want to embrace the paths of populism or some “irrationalism” in politics.

But now perhaps it's time to say that, in this case, fear made critical thinking regress two places. First, because we have never been in a battle between science, enlightenment, civilization, reason, kindness, etc. against the forces of regression and delay. It would be good to start by remembering how much shadow there is in the lights, how much barbarism there is in civilization, how much obscurantism there is in scientific positivism. A little dialectic of enlightenment goes a long way in these moments.

The fight against national fascism was not and is not a fight against obscurantist forces, a term more appropriate to theological debates than to political analyses. Analytically, “obscurantism” doesn’t say anything, especially because, if I may say so, you are always someone’s “obscurantist”. What could not be different, since the concept of rationality is a historical concept and in dispute, science is not a mirror of nature, and there is nothing “relativist” in this position. Not being a struggle against “obscurantism”, our war against fascism is a political struggle (I emphasize, a political struggle) against a devastating combination of economic ultraliberalism, social indifference, state violence and the organization of society based on the generalization of the logic of militias.

Having said that, I would suggest that those who would like to hold science outreach debates for the general public should not forget another biologist, Mr. George-Louis Leclerc, better known as Count of Buffon, who reminded us that “the style is the man himself”. A way of saying that the roughness of the style is an expression of the simplicity of the content of the thought. No one discusses anything seriously with the good-natured tone of the common-sense monopolist who looks at so-called “pseudoscientific verbiage” and exclaims, as if he were reprimanding a teenager’s impertinences: “What nonsense!”. That should be left to the late Olavo de Carvalho and his followers.

So much so that simply everything is missing, from the point of view of a serious epistemological reflection, in this most recent version of the national debate on the scientificity of psychoanalysis. There is a large recent bibliography, both national and international, of epistemological reflections on psychoanalysis and its regimes of objectivity. It would be necessary to take it into account and take a stance on it. There is a history of responses to the classic arguments against psychoanalysis. It would be necessary to take it into account and take a stance on it.

I am not going to play the role of the professor of theory of human sciences here and pass on the exhaustive and absent list, but the least that can be said is that a serious debate about the objectivity of psychoanalysis would take into account, for example, the discussions of those who thought in recent years psychoanalysis and neurosciences (such as Mark Solms and the reflections of Nobel Prize winner for medicine Erick Kandel).

He could also carry out research with patients who underwent psychoanalysis and felt important changes in their lives, carry out the same research with patients who did not notice such changes and evaluate the results. It would be interesting to do such research in Brazil in recent years. All of these would be significant contributions to the debate, but nothing was done, which leads us to that feeling so well described by Shakespeare: Much ado about nothing… once again.

Suffering and self-reflection

I say “one more time” because the debate on psychoanalysis as a pseudoscience has always been very poor intellectually, since it was largely carried out by those who saw themselves more in the position of exorcising a primary hoax than of effectively analyzing a clinical practice and a critique of the complex culture that deserves, at least, patience in the analyses. For example, one of these figures, whose criticism returns for the umpteenth time in the pages of the book we are analyzing, is, it could not be otherwise, Karl Popper.

After all, Popper was responsible for the idea that psychoanalysis could not be science, since an analyst's interpretations are not statements that can be verified. If the patient accepts such interpretations, the psychoanalyst feels confirmed; if he refuses, the analyst can always claim the analysand's resistance and continue to feel confirmed.

However, it is not difficult to imagine that the criticism is pedestrian. Psychoanalytic interpretations can indeed be incorrect. The correctness criterion in an analysis is linked to the production of new associations. If the analysand simply does nothing with the interpretation, it is incorrect; if he or she is open to new associations, it is correct. Of course, the criterion is not in a correspondenceist version of truth, that is, in the idea that a true statement would correspond to something in a state of affairs endowed with epistemic accessibility and metaphysical autonomy. The criterion of truth is pragmatic and consequentialist.

This is not strange for an unmedicated clinical practice, that is, one that does not understand psychic suffering as a causal expression of biological markers, as if we were obliged to assume a strictly biunivocal relationship between brain state and mental state, or as if mental states were only “metaphorical” ways of talking about brain states. Because it is unmedicated, psychoanalysis operates through a very specific and unique form of recognition. This could not be different because, when we are talking about psychic suffering, the way in which a patient understands himself interferes with his clinical picture.

Leading a depressive person to understand himself in a different way does have effects on his clinical condition. But, of course, this is not a simple “symbolic redescription”. Our forms of self-understanding are rooted in social and historical experiences, in repeated violence, in the form of circulation of discourses and practices, in appointments that have the weight of the apparently insurmountable. Such self-understandings are organized through our use of language, our dispositions for action, the history of our desire, which is always a social history composed of the dead and the living, of conscious and unconscious dispositions.

Changing this picture does not happen with corporate incitements to the “will to change”. It occurs through the deepening of conflicts and criticism, it is faced with various forms of anguish and its defenses, it burns narratives that we had about ourselves, it is not afraid of the disorientation that such combustion produces, it must deal with repetitions that they will change despite our will. This is what an analysis is made up of.

The place of human sciences

Here it is worth a general consideration about what we call “human sciences”. We can say that the fundamental ontological difference between the human sciences and the so-called exact sciences is the self-reflexivity of their objects. You can pick up a stone and explain to it, in several languages, the law of gravity. She will behave the same way. The same does not happen with human beings and their social productions. They integrate the explanations we make about their behavior, their suffering, their affections. Such explanations produce new effects. That is, the explanation is not just a description. It has performative power.

This explains why any and all human science is inseparable from intervention modalities. A sociologist who describes society as an antagonistic totality marked by class struggles necessarily intervenes in his object, because if society understands itself in this way, it will produce effects that it did not previously produce. Having this awareness is something much more honest than hiding under the cloak of any axiological neutrality.

The human sciences are not neutral in relation to values, as their explanations and descriptions will be reflexively integrated by the objects themselves, re-dimensioning their horizons of action in the present, in the past and in the future. It is, therefore, more honest to understand the indissoluble link between description and value in the field of human sciences, continually asking oneself about the values ​​based on which human sciences researchers intervene in the social body and in its subjects.

In this sense, psychoanalysis is effectively a model human science, and that is why it is so attacked. For she is fully aware of the performative character of her explanations and interventions. This explains why the axis of its clinical rationale is found in what we call “handling transference”. One way to explain it is to remember that authority relationships make us suffer.

They determine obligations, norms, laws, ways of being, dispositions of conduct, values ​​and moral feelings. I socially constitute myself by internalizing principles and authority figures. The doctor, the medical discourse, the psychiatrist are also authorities that have the constituent power of subjects and subjectivities. Our psychic life is a constant intersubjective relationship with the marks of these figures, with their internalizations, their idealizations. Therefore, there are always many others in an I.

A psychoanalyst is someone who understands that changes in a patient's self-understanding are inseparable from the ability to modify such constituent and ever-repeated authority relations. And the main one ends up becoming the relationship with the analyst himself, that is, with someone I sought to assume knowledge about my desire, someone who, for a series of reasons, entered a chain of figures and representations that constitute knowledge.

For this reason, the experience that psychoanalysis seeks to put into practice is an experience about the constituent nature of relations of knowledge and power that are present in various social structures, not least because transference is not an exclusively clinical phenomenon. It is present wherever there is a constitutive relationship of authority. The psychoanalyst acts on these relationships, tries to embody them in a clinical situation in order to allow them to fall and become helpless. He will then deal with such helplessness, in the belief that it will be a path capable of producing emancipation and turning symptoms into a field for the production of singularities.

What not to say in a controversy

Finally, it would be worth remembering that a polemic is always composed of what it says and what it does not say. In this sense, it is symptomatic that in a debate on clinical practices of psychic suffering, nothing is said about the true epistemic aberrations that we find in the current psychiatric situation. I say “aberrations” because we see a science that has shown an absolutely anomalous development in the last 60 years. For example, when it was published in its first version, in 1952, the DSM (Diagnostic and Statistical Manual of Mental Disorders) contained 128 categories for describing types of psychological suffering. In 2013, in its latest version, it had 541 categories. In other words, in around 60 years, 413 new categories were “discovered”. There is no sector of science that has seen such an anomalous and impressive development since the end of glacial melt.

Well, it would be interesting to ask yourself why this is happening now. Are we going through, at this very moment, a true scientific revolution that would have allowed us to see what we were unable to see before? As if, for decades, we had not realized that there were people among us suffering from “hoarding disorder” (behavior characterized by excessive acquisition of items and inability to discard them) and “oppositional defiant disorder” (excessive behavior of those who are generally angry, irritated, or questioning authority figures)? Or is there something else happening that concerns the extension of technologies of intervention in bodies and desires through the extension of pathologization procedures?

Some would have us believe that we are heading towards the uncontested clarification of biological markers for the structures of psychic suffering. But we could ask ourselves, just to use a pedagogical example, what then are the biological markers for histrionic personality disorder? Its diagnostic criteria are, among others, “discomfort in situations in which he or she is not the center of attention”, “constant use of physical appearance to draw attention to oneself”, “demonstration of self-dramatization, theatricality and exaggerated expression of emotions ”.

Should such criteria be evaluated as the expression of specific biological markers or as refusal behaviors, unconscious or not, to socialization patterns that, by the way, are quite imprecise? Because if we are talking about “exaggerated expression of emotions”, we have to ask where the definition of an “appropriate pattern” of emotions would be, if not in the subjectivity of the doctor or in our grandmother's manual of good manners.

In fact, this demonstrates the profound epistemic insecurity that runs through what the shouting about “pseudosciences” makes a point of forgetting to discuss. It would be a good idea to reflect at length on the reasons that led our societies to so dramatically modify their way of intervening through the distinction between health and disease, why it extended its pathologies so much and what consequences we can expect from this.

It would also be a good idea to remember the profound problems that the pharmacological shift in contemporary psychiatry has produced. For example, studies by Michael Hengartner and Martin Plöderl published in the journal Psychotherapy and Psychosomatics argue that adults starting treatment with antidepressants to treat depression are 2,5 times more likely to commit suicide than those who use placebos. Yes, you read that correctly, that's right. If the results of studies of this nature are reiterated, well, we have a serious problem to solve. A good epistemological discussion would not be indifferent to such questions and dynamics. But, once again, we lack it.

*Vladimir Safatle He is a professor of philosophy at USP. Author, among other books, of Ways of transforming worlds: Lacan, politics and emancipation (Authentic).

Originally published in the magazine Cult.

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