Makari’s History of Psychoanalysis

Review of George Makari, Revolution in Mind: The Creation of Psychoanalysis. New York, NY: Harper, 2008. ISBN: 978-0-06-134661-3, 613 pages, $32.50.

Psychiatrist George Makari is certainly familiar with the recent Freud Wars. In his Revolution in Mind: The Creation of Psychoanalysis, he says Freud is often portrayed as genius or fraud (p. 2). Some “believe psychoanalysis is a hopeless pseudoscience. Others want to save it by shoring up its scientific claims. Still others believe salvation will come only when psychoanalysts recognize their endeavor is…akin to the work of the humanities.” Despite this “turmoil” Makari proclaims that psychoanalysis contains “the richest systematic description of inner experience that the Western world had produced” (pp. 5, 483). There is a division in Makari’s text between his strong belief in Freud’s creation and his recognition of the problematic nature of psychoanalytic knowledge.

He contends that there has been too much focus on Freud. To illustrate the evolution from Freudianism to a broader psychoanalysis, Makari divides his history of the field up through World War II into “three closely intertwined, sequential phases.” First, Freud forged “a scientifically tenable theory of mind” that was “an overarching synthesis” that “took command of revolutions that were already in progress” (pp. 4-5). Second, Freud created a movement. But schisms wracked his followers. Freudian psychoanalysis was accused of being “authoritarian and unscientific;” and internecine conflicts “exposed the highly tenuous nature of” psychoanalytic “knowledge claims” (pp. 4-5).

Third, after World War I, psychoanalysis became a pluralistic community with the development of different outlooks. Still Makari’s history raises questions. If the knowledge claims of psychoanalysis are tenuous how can it contain Western thought’s richest account of inner experience?

Dr. Makari combats the old myth that Freud was an isolated genius creating psychoanalysis alone. Freud’s theories emerged out of Freud’s deep immersion in nineteenth century science and philosophy. The conceptions Freud developed grew out of “post-Kantian philosophers, biophysicists and psychophysicists.” It is “a scientifically plausible model of the mind” (pp. 83, 108). “Freud’s synthesis…broadened natural science so that it could take up the great questions of human interiority…. Through this integration, it seemed science could be rescued from an embarrassing poverty and the humanities could be understood according to universal laws” (p. 123).

If one motif in Makari’s history is the scientific plausibility of Freud’s initial theory, another is that psychoanalysis is unscientific. Freud’s insistence on sexuality as the cause for psychological problems, led “many of his colleagues” to question, how “any clinician working with a limited number of patients” could “claim to know that one factor always caused an illness” (p. 90). French doctors thought the Viennese, had “an ‘idee fixe’ in regard to sexuality and generalized wildly on the subject” and rather than being science, this was “grand philosophical speculation” (p. 215).

The tension in Revolution in Mind over the scientific status of Freud’s work comes to a head in Makari’s account of Freud’s confrontations with his followers. In 1910, at the Nuremberg Congress of psychoanalysts, according to Makari, Freud called for “standardization” and “uniformity…. There was a problem with such invariance…. it ran counter to the requirements of scientific research, which called for freedom of inquiry, experimentation, and innovation” (pp. 240-241). Even within the earlier Wednesday Society of Freud’s adherents, there were “few tested rules…. no stable method” nor “explanatory principles” that did not require explanation (p. 155). Makari says, “the Viennese Freudians…. could not…question Freud’s clinical authority, his veracity as an empirical observer, or his therapeutic claims” (p. 161).

It is not surprising then that when Adler and Freud’s views conflicted that it was “not possible to demonstrate that one system of thought had

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more truth value than the other.” Loyalty to Freud’s views, lack of standards of evaluating evidentiary and doctrinal claims revealed “Freud’s Achilles heel.” His libido theory “seemed to flout the rules of empiricism and scientific epistemology” (p. 263).

After another doctrinal challenge had led to Jung’s leaving, Freudians made “commitment to the psychosexual unconscious…a litmus test.” This “postulate was not a fact” and “scientific theories…had no power to compel acceptance without proof.” Once, Freud had tried to “build a psychology of inner life that conformed with science,” but now “post-Nuremberg Freudians became more of a polemically driven interest group…. Findings that contradicted the theory…were not acceptable” (p. 296). Renowned Swiss psychiatrist, Eugen Bleuler, called psychoanalysis a “sect” that did not strive to have “many shared views with the rest of science and scientists,” but “closed itself off to the outside world with a prickly skin that is hurting friend and foe” (quoted in Makari, p. 255).

This account paints a bleak picture and a strong indictment of psychoanalysis. Yet George Makari says that after World War I, “Freudian studies” became “a broader, more diverse, more open, and ultimately more popular field. Freethinking men and women would flock to this reformed community…. Many stopped calling themselves Freudians and began to see themselves as psychoanalysts” (p. 299). With Freud’s new post-1918 ideas, he himself “altered from hoary old patriarch to one of many sons and daughters of what might be a nascent science” (p. 319).

Does this mean that psychoanalysis developed a sense of unity and recognized standards by which to evaluate competing claims? Not really. Dissenters continued to split off, be cast out or talk past each other. In 1941, the New York Psychoanalytic Society demoted Karen Horney to lecturer and revoked her training privileges. During World War II, the British were divided among followers of Anna Freud, Melanie Klein, and Independents. Discussions between them lasted for much of the war. They could come to no epistemological consensus, and eventually allowed each to retain their own separate, though, interacting practices. Makari comments, “it seemed psychoanalysis had separated into irreconcilable worldviews…. fragmenting psychoanalysis into many schools. It seemed no one could bring unity to this raucous chorus” (p. 439).

On one hand Dr. Makari presents psychoanalysis as having common ideas that give it prominence; on the other hand it is a raucous chorus of irreconcilable worldviews. When Makari says psychoanalysis is the leading theory of the mind and has the richest account of inner life, which of the many psychoanalyses is he discussing?

Makari recognizes that the Achilles heel of psychoanalysis is that it makes claims which often are scientific, yet it has not established scientific methods. Even such a stalwart as Martin Bergmann recognizes the epistemological hole in psychoanalysis. “Disagreements between psychoanalytic schools were not those encountered in the natural sciences, which further experiments eventually resolve, but more closely resembled religious and philosophical disputes, which cannot be resolved by rational means” (Martin Bergmann, Understanding Dissidence and Controversy in the History of Psychoanalysis, 2004, p. 2).

These epistemological dilemmas that haunt psychoanalysis can be found, with variations, in other more academically established disciplines. “Modern biology,” R.C. Lewonton writes, “is characterized by a number of ideological prejudices that shape the form of its explanations and the way its researches are carried out” (Biology as Ideology, 1991, p. 41).

Biologist Ernst Mayr concurs. He says: a “reason why consensus is hard to achieve is that disagreeing scientists adhere to different underlying ideologies making certain theories acceptable to one group which are impossible for another group” (This Is Biology, 1997, p. 103). It is not only ideology splitting biology, it is varying criteria for evaluating evidence. Science historian Evelyn Fox Keller writes an “analysis of the literature on biological development over the course of the century reveals not only great variability in criteria—over time and between different research schools—for what might count as an explanation of biological development, but also how flexible these criteria can be” (Making Sense of Life, 2002, p. 6).

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The academic discipline of psychology also finds itself divided. Historian of psychology, C. James Goodwin, writes: “psychology at the close of the twentieth century seems to be characterized more by disunity than unity.” He also declares that “it is unclear if psychology has ever been a coherent discipline” and that “psychology today is really a plurality of sub-disciplines, each a specialty in its own right,” for “psychology is not a single discipline but a collection of them” (A History of Modern Psychology. 1999, pp. 438, 439).

That other related subject areas face dilemmas does not diminish the issues psychoanalysis must confront. Psychoanalysis straddles a fine line. It investigates subjects that, in some ways, are beyond the realm of science’s competency, and psychoanalysis also makes claims that are clearly within the domain of the sciences. Psychoanalysis needs to pursue both directions simultaneously, to be outside and inside the sciences. Makari’s admirable history illuminates the need for psychoanalysis to retain its theoretical fluidity, while integrating research findings from other fields, and establishing some rigorous means of adjudicating claims from rival psychoanalytic schools.

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