Freud lecture slides - Art of Psychiatry Society

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Freud
Neuroscience
Cognitive psychology
Computer science
The social sciences
Art criticism
Philosophy
Intellectual history
› I know almost nothing about everything and
welcome contributions from the audience on all
of these topics
Complete model links brain and mind
 Science and humanities
 Medicine with evolutionary biology
 Normal and abnormal psychology
 Individual and group psychology
 Past, prehistory, and modern cultures
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Mind can be studied scientifically
 UCS determines much of what we do
 Role of defense and psychic conflict
 Bridge: Darwin to everyday life
 Precursor of evolutionary psychology
 Epigenesis, not degeneracy or genetics
 The Kraepelin of outpatient diagnosis
 Father of all modern talk therapies
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All speak Freud without knowing it
 Furthers modernism, individualism, fem
emancipation, and sexual revolution
 Embraced by intellectuals in their
opposition to Hapsberg status quo
regarding church, politics, bureaucracy,
and morality
 But unlike Adler, Reich, Fennel, From, and
Marxists, Freud was pessimistic regarding
changing human nature and society
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M and N Notebooks (1838-1840)
 On the Origin of Species (1859)
 The Descent of Man and Selection in
Relation to Sex (1871)
 The Expression of the Emotions in Man
and Animals (1872)
 Biographical Sketch of an Infant (1877)
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Human psychology from animal and
retains much of our inheritance
 Understanding baboons tells us more
than reading Locke and the philosophers
 Psychology can be an objective science
amenable to observation and
experiment
 Materialist mind as a brain function: no
vitalism or human exceptionalism
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Natural and sexual selection lead to
evolution of instincts, emotions, and
intellect
 UCS-major rule influencing behavior
 Instinct interacts with environment
 The child is father to the man
 Everything has or once had a purpose
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Compare animal and human behaviors
 Survey human behavior around the
world
 Minute observation of child maturation
 Reactions to facial expressions
 Introspection and dream analysis
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Neither invented idea
› By 1700 UCS conceivable
› By 1800 UCS topical
› 1870-1880 UCS fashionable
Darwin’s UCS is mostly adaptive, nonconflictual reflection of evolution
 Freud adds dynamic unconscious-conflict
between lusty instinctual wishes and
repressive forces, some inborn
 Hartmann adds conflict free sphere
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Darwin entry point is normal function;
Freud’s is the study of psychopathology
 Darwin optimist; Freud pessimist
 Darwin hates conflict; Freud relishes
 Darwin establishment; Freud outsider
 Darwin inborn moral sense to be good;
Freud inborn punishing superego
 Darwin cherished fruits of civilizing; Freud
saw it as discontents
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Helmholz-brain; as electrical machine;
see with out brains, not just our eyes
 Meynert, Jackson- hierarchy of brain
structure and fx; inhibition and regress
 The sexologists: Moll, Ellis, Kraft-Ebbing
 Archeology-dig for deeper UCS layers
 Anthropology-universals in UCS content
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Plato-reality under world of appearance
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Kant-limits of reason and perceptions
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Schopenhauer, Nietzche, Herbart,
Hartmann- UCS sexual and aggressive
forces influence behavior
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Deductive model building not experimental
model testing
A beautiful speculative model must be trueeg humoral, string, neurotransmitter
Becomes dogma-number of horses’ teeth
Freud an exquisite logician-errors come
from false premises, not weak argument
Metapsychology is not a science-closes off
refutation and inclusion of new data
Appeal to authority impedes progress
Lack of validators promotes schisms
Sophocles
 Bible
 Shakespeare
 Goethe
 Dostoevski
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Bridges gap between brain materialism
and psychological romanticism
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Breath-brain anatomist, clinician,
psychologist, anthropologist, art critic
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Intellectual ambition-linking symptoms,
personality, dreams, myths, literature
Smartest person in room-not always right,
but never wrote or said a dull thing
 No one idea entirely new-UCS in the air,
two books in Vienna in 1890’s; sexology
was hot new science
 But brilliant in putting it all together in one
integrated and plausible model
 Literary gifts- reaches general audience
and leaders of all academic disciplines
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Talmud: We don’t see things as they are,
we see them as we are
 Kant/Comte: Beware observer biasimpossible to remove subjectivity
 Relation of observer to the observed
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› Umpire 1: Call them as they are
› Umpire 2: Call them as I see them
› Umpire 3: They don’t exist till I call them
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Subjectivity and projection
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Circular reasoning-sought confirmations
of theories that could not be disproved
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Descriptive reified as explanatory
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If you disagree, must be your neurosis
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Small n study-20 hysterical patients
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Contempt for statistics and experiment
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Subjective: Darwin looked as babies,
studied primitive men, Freud inferred
secondhand from reconstruction
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Focused mostly on intrapsychic lifedownplays interpersonal causes
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Ignores great role of suggestion in theory
confirmation and treatment cures
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Moll- ‘Freud’s theory accounts for clinical
hx; histories don’t prove the theories’
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Inheritance of acquired characteristics
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Freud: “I inherited the defiance of our
ancestors defending the Temple”
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Breuer: “Freud is a man given to absolute
and exclusive formulations”
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Fleiss: “The reader of thoughts reads his own
thoughts into other people”
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Liepmann: “Ingenious artist of thoughts
triumphs over the scientific investigator”
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Bleuler: “Prickly skin-for or against us”
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Jung: “One repays a teacher badly if one
remains only a pupil”
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Freud: “The goody-goodies are no good
and the naughty ones go away”
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Breuer: UCS/talking cure/catharsis
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Fliess: infantile and bisexuality
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Jung: UCS complexes/myth
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Stekel: death instinct
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Adler: aggression/mastery/ego psych
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Groddeck: the ID
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Rank: signal anxiety/separation
anxiety/termination/mother transference
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Ferenczi: transference/countertransferen
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Alexander: correction emotional
experience
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Reich: analyze character resistance first
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No coherent psychology of femininityFreud’s boy’s eye view of girls
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Castration complex, penis envy, clitoris vs
vagina, masochism, passivity
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Conventional views of women as
neurotic, irrational, undeveloped men
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Object of desire, not subject of empathy
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Downplays role of mother/child bonding
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Horney- much fuller female psychology
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His influence greatly liberated women
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Encouraged female analysts
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Strongly influenced by women
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Better father figure to female followers
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Neuron-cell body plus fibrils
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Importance of contact barrier
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Mediating vs. moderating synapses
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Evolution: neurons similar across all
species-crab, lamprey, mammal
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Development in pups, kittens, fetus, kids
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Cells migrate and connections get more
complicated, but early structures persist
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Gold chloride stain-reported in brain
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Types of neurons-Phi for perception, Psi
for memory, Omega for Cs
Ambition thwarted-how to be great
when funding is lost and want to marry?
 Viennese dim view of clinical practice
 Virchow- “the academic physician can
do nothing; the practitioner knows
nothing”
 Solution-apply scientific, observational,
theoretical, literary skills to achieve
greatness for clinical not lab work
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Agnosia- deficits with intact perception
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Cerebral palsy
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Aphasia
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Cocaine as psychotropic drug
Translates Charcot and Bernheim;
practices and writes on hypnosis
 Collaborates with Breuer and has
specialty practice focused on hysteria
 Attempt to transcend cathartic and
suggestion models for psychotherapy
 Free association to provide a study tool
based on faith in psychic determinism
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Early-misled by simple Koch causality
 Into a series of blind alleys
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› Inborn degeneration
› Current sexual frustration
› Early sexual seductions
 Stimulation by caretakers
 Stimulation but only by father
Repression of inborn sexual instinct
 Later-complementary epigenetic
interaction of instinct with experience
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Excitement regarding Darwin sexual
selection
 Sexology brings scientific legitimacy
 Staging explains choice of neurosis
 Libido is missing link mediating brain
biology and mental functioning
 Interaction nature/nurture
 Conflict over instinctual wish fulfillment
seems to explain everything
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Brain as hydraulic power plant
 Sexual libido is power source
 Symptoms due to discharge, build-up, or
transfer of libidinal energies
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› Neurasthenia-too much masturbation
› Anxiety-toxic undischarged stimulation
› Neuroses-psychic conflict/repression
Autoerotic stage-schizophrenia
 Narcissistic stage-delusional disorder
 Oral stage-depression
 Anal stage-obsessive/compulsive
 Phallic stage-hysteria
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Regressions
 Fixations
 Repressions in neurosis
 Expression in perversions
 Also determine character
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Premature closure/incomplete facts
 Deductive theory of everything
 Way too rigid-everything is sex instinct
 Ignores other instincts-aggression,
attachment, status, mastery, altruism
 Ignores neural network dysfunctions
 Ignores context/interpersonal issues
 Freud’s humoral theory
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Brain as computer
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Information processing, not energies
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Symptoms the result of hardware and
software malfunction
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Kant and Schopenhauer-dreams as brief
madness/madness a long dream
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Freud-mind a creative dream machine
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Insights from dreams explain not only
symptoms but myth, art, literature, and
psychopathology of everyday life
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Allow scientific study UCS process
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Reflect lawful connections of all mental
functioning-nothing is random
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Instincts less repressed revealing primary
process and contents of UCS
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Free association to interpret content and
determine latent content
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Associations may be secondary elaborations,
not key to latent content
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Dream may be no more that Rorshach
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No gold standard for interpretation
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Wish fulfillment-random pontine firings?
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Dreams tell us a lot, but not everything about
human nature
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Still a mystery
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We now know when dream, but not why
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Role in memory/homeostasis
Borrowed from Fechner, Jackson, Darwin
 CS tip of iceberg; most behavior UCS
 Different rules govern different levels of
psychic functioning
 Freud adds method of study, instinct,
regulation by censor, primary and
secondary process
 Stands up well to modern cognitive
science and brain imaging
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Self-preservative and self-evaluating
instincts in part inborn and largely UCS
 General psychology that anticipates
cognitive psychology
 But ego psychologists are theorists, not
experimenters, so doesn’t advance field
 Useful description, not explanation
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An ingenious but wrong 1890
neuroscience model that restricted its
openness to including emerging brain
and cognitive science
 Freud somewhat corrects imbalance
with aggression and the “I” and the “It”
 Followers extend further with attachment
theory, ego psychology, role of
interpersonal factors, conflict free
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Brain too complex for simple models
 Newton: “I can calculate the movement
of stars but not the madness of men”
 No Newton, Darwin, or Einstein of mind
 Ambition spurs insights-but premature
models can’t possibly answer all
questions and don’t wear well
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ID- limbic system/brain stem
 I-dorsal prefrontal/somatosensory
 Over I-ventromedial frontal
 Anxiety-amygdala
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Psychotherapy change brain fx-reduced
amygdalar firing in panic pts
 Cortical control-can’t decondition
amygdalar responses unless cortical
connections intact
 Mirror neurons explain empathy for
other’s emotions-inferior front gyrus
connected to amygdala via insula
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Rat maternal behavior influenced by
childhood nurturing experiences-methylation
changes gene expression
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Low MAOA 80% rate ASPD if abused as child;
20% not abused
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As Freud predicted, it is interacting/modulated
networks not isolated regions
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Search for how connections work: NIMH RDOC
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Very rapid decline from cultural icon of
hope/modernism/sexual revolution to
quaint psychological charlatan
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Tipping point in 1970’s
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Psychoanalysis disappoints-Berthe P:
“Psa like confession depends on person
applying it-useful or double-edged
sword”
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Institutes freeze rather than adapt-other
more practical therapies prevail
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Too tied to specific medical rx, not to
broader cultural and intellectual trends
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Neuroscience tools lead to reductionism
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Pharma adverts-chemical imbalance
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Novelty wears off-once brilliant insights
seem like tired cocktail clichés
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No interest in cognitive or brain science
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Standardize theory and method
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Closed and rigid religious cults
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Indoctrination stifles incorporation of new
science/new ideas/new therapies
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Secret committee/loyal tests/”treason”
Was the Project central or blind alley?
 Jones-Freud was a psychologist, cutting
psychoanalysis off from neuroscience
 Revisionist version emphasizes biology,
and some biologists now embrace Freud
 Freud was reformed lab-rat would have
loved and incorporated neuroscience
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Not a research tool
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Not a practical therapy
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Not a modern model of the mind
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Embalmed Freud to save him
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When it is incorporated into cultural
studies in other disciplines
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Stays open to new ideas, finding, and
techniques
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Was previously less dominant
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Freud was overvalued in his own time as
a lone pioneer with final answers-but not
lone and no final answers
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Freud is undervalued now because his
followers were too dogmatic to keep
psychoanalysis lively and relevant
Opens up science of UCS vs. Compte
 cognitive and neuroscience behavioral
economics, sociology
 Treatment insights:
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Optimism
Value of life narrative
Role of psychic conflict
Transference/repetition compulsion
Corrective emotional experience
Art and literary criticism
Einstein
 Darwin
 Marx
 Freud
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Made inspired guesses
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Brain complexity still defeats powerful
modern tools
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Evolution, atomic theory, history are less
complicated than human behavior
Valued psychoanalysis more for research
than therapy-would back brief dynamic
and cognitive therapies
 No problem with medication treatmentfor better and worse a pioneer
 Not surprised psychoanalytic and
medical professions don’t mix well
 Would Freud’s biggest weaknesses
(dogmatism, epistemology, experiment)
be cured by long sleep? Would need a
good analysis
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Partly the subjectivity of subject matter
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Partly Freud’s autocratic personality
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Partly relation of theory to professional
guilds
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Mostly issue of experimental validation
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Mytheopoesis of everyday life
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Interior monologue
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Gave people permission to be
complicated and conflicted
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Glory of individual
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His ideas deserve better follow-up
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His dominance prevented the inclusion
and adaptation to new data