Psychoanalysis as Biological Science: A Comprehensive Theory (Book Review)

Author:  Gedo, John E.
Publisher: Baltimore: Johns Hopkins University Press
Reviewed By: Johanna Krout Tabin, Fall 2005, pp. 54

John Gedo is retired from his full professorship in clinical psychiatry at the University of Illinois Medical School and his position as training and supervising analyst at the Chicago Institute for Psychoanalysis. In his acknowledgments, Gedo charmingly tells that the Johns Hopkins University Press's medical director and Richard Perlman, editor of Perspectives in Biology, combined to convince him to write this book even though he had just published an essay "In Praise of Leisure." The Press did its part in creating the book, from its attractive cover to the fine paper and print, and excellent editing. Gedo did his part by presenting a beautifully organized manuscript. The purpose of every chapter is clear and neatly laid out. Every chapter concludes with a concise summary that aptly states the essentials of the chapter. The exposition is delightfully readable.

A forthright man, Gedo announces in his preface that he is not a romantic about psychoanalysis. Falling back on artistic operations on the ground that psychoanalysis is a humanistic enterprise is to him a rationalization for not having plausible hypotheses. He believes that a psychobiological viewpoint is the only sensible basis for the work. He thinks of Freud as a Biologist of the Mind, not appreciating that Freud's last words on the subject were that the science of psychoanalysis lay in "translating unconscious processes into conscious ones and thus filling in the gaps in conscious perception" (Freud, 1964, p.286). Gedo, however, gives Freud credit for only two things: the psychoanalytic method of observation and the significance of the unconscious.

At first it seemed in reading this book that the author intended it as a cautionary and educational exposition for romantic psychoanalysts. Characterizing it is not so simple. For example, and curiously, he offers an instance of what he called the raising of the emotional temperature of the analysis in a transference reaction by a patient. Gedo says he disagrees with Freud's statement in Chapter 7 of The Interpretation of Dreams. He quotes Freud as saying that what gets transferred is untamed psychic energy. One might think that is a biological view and whatever it means, that Gedo would agree with it. Instead, Gedo's idea is that the "emotional intensity of full-fledged transferences is actually an echo of affectively charged transactions in childhood" (p. 43). He does not take into account, either, that Freud's view in 1900 was expressed before Freud conceived of transference in human relationships. Nor that Gedo's idea would probably find agreement among advocates of all schools of psychoanalytic thought.

His manner of fighting Freud is one of the themes of the book. Another is the importance of the hierarchical functioning of the nervous system. True to the title of the book, Gedo presents a developmental scheme in neurological terms. Nonetheless, he runs into the difficulty that besets
current neuroscientists. When dealing with consciousness and the unconscious in human beings, one necessarily switches over to psychological concepts. Nobel Prize winner Eric Kandel (2005) is co-founder of the new journal, Neuro-Psychoanalysis. He and his colleagues are no further than Freud (1960) was when trying to write his Psychology for Neurologists (which Strachey renamed Project for a Scientific Psychology). While he wrote it, Freud turned into being primarily a psychologist.

Gedo's developmental scheme, which he coordinates with characteristic behavioral capacities and with vulnerabilities to pathology stemming from each level, is simplistic. He substitutes skeletal knowledge for the complexities that exist in the remarkable workings of the brain. In applying his scheme to the analytic process, however, he generalizes that fundamentally the task is to help people to establish new neural connections for more mature adaptation. Gedo's examples of how he conducts analyses may have an autocratic tinge, in that he states his interpretations firmly. Otherwise, he does not seem to be applying himself to the task differently from many romantic psychoanalysts. Here is an excerpt he gives of a transference reaction of
a patient:

Following a weekend interruption, the patient reported a dream in which she felt that the present weekend would be her last. "In other words, I was going to commit suicide. Then I thought, why not go to Italy?"
She talked about having been terribly upset since our last session. “I felt alone. I just felt empty. I had no father; I cried. The pain is as bad as if I were having the most terrible physical illness.... I was so frantic; I almost took [suicidal] action.... I dreamt
of another Italian trip. [During the last one,] when I saw the Pope at the Vatican, I cried."
I interjected, "It's like having contact with your father in heaven."
"Yes! I want to go back...I wouldn't want to miss a minute here. It's curious: in the dream, although I was going to Italy, I was still going to have my appointments here."
"So Italy is the analysis, and I am a substitute for your father, like the Pope." (This woman assumed that I am Italian.)
"That's true. On Saturday it seemed so far from the last hour to the next one—I felt so far from a father.” (p. 43)

Technical discussion and scholarly references abound in this book, but Gedo includes an elementary description of the analytic situation, too. It is a bit difficult to be sure for what readership the book is meant. The book is possibly most of interest to people who know and admire this sincere man.

References

Freud, S. (1895). Project for a scientific psychology. In Standard Edition 1, 283-397. London: Hogarth Press, 1953.
Freud, S. (1938). Some elementary lessons in psycho-analysis. In Standard Edition 23, 281-286. London: Hogarth Press, 1953.
Kandel, E.R. (2005). Psychiatry, psychoanalysis, and the new biology of mind. Washington, DC: American Psychiatric Publishing, Inc.

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