SHOULD PSYCHOANALYSTS BELIEVE WHAT THEY SAY?

David L. Smith

Science does not rest upon solid bedrock. The bold structure of its theories rises, as it were, abovea swamp. It is like a building erected on piles. The piles are driven down from above into theswamp, but not down to any natural or `given' base; and if we stop driving the piles deeper, it isnot because we have reached firm ground. We simply stop when we are satisfied that the piles arefirm enough to carry the structure, at least for the time being. (Popper 1959, p. 111)

Introduction

During the course of the twentieth century psychoanalysis has attracted a certain amount ofattention from philosophers. This attention has emanated mainly from two sorts ofphilosophers: philosophers of science and philosophers of mind. Although my ownspeciality is philosophy of mind, I want to concentrate today on the view from philosophyof science (perhaps with occasional forays into philosophy of mind).

Many people regard philosophy as a kind of `ivory tower' activity. A lot of philosophyis fully deserving of this criticism, but a lot is not. Many people are put off by thephilosophers' use of esoteric language and their propensity for splitting hairs. They just donot see the point of considering psychoanalysis - practical, clinical psychoanalysis - from aphilosophical perspective. Of course, my perspective will be partial and biased. Philosophyof science has a large literature representing diverse points of view. Many philosophers ofscience disagree with one another about fundamental issues. I will be presenting only a fewof these views: the ones that I personally find most relevant to challenges confrontingpsychoanalysis.

I want to show why philosophy - specifically philosophy of science - is relevant topsychoanalysis. I want to do this in plain, simple English so that non-philosophers canappreciate my points. Maybe this will give some of you the courage to engage with theissues in the more technical literature. This is not too difficult once you have got the hangof the rules of the language-game. By the way, the issues that I will be talking about arerelevant to most forms of psychotherapy, so we need not be psychoanalytically provincial.The only reasons why philosophers of science have picked on psychoanalysis are that (a)Freud clearly and unequivocally described psychoanalysis as a science, and (b) Freud wasvery clever, and it is therefore worthwhile to engage with him critically.

It is only fair to say to you that I am not, and never have been, a working scientist. I ama psychotherapist, philosopher and educator. Of course, this does not disqualify me fromtalking about science but it does place some constraints upon me.

One final preliminary point. Some of you may get annoyed that philosophers are so

DAVID L. SMITH is the Director of Regent's College MA in Psychotherapy and Counselling. Addressfor correspondence: School of Psychotherapy and Counselling, Regent's College, Inner Circle, Regent'sPark, London, NW1 4NS.

British Journal of Psychotherapy, Vol 13(1), 1996© The author

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critical of psychoanalysis. Well, philosophy is largely about criticism. Criticism is whatphilosophers are paid to do. The point of this sort of criticism is to help people get their acttogether: to address the real weaknesses of their position. Last year, at a psychoanalyticconference in Ghent, Belgium, Adolf Grunbaum - a notorious critic of psychoanalysis -prefaced his talk with similar remarks. Grunbaum stated that he thought thatpsychoanalysis asked important questions and was therefore worthy of philosophicalcriticism. He emphasized that he did not believe in beating dead horses, and expressed thehope that psychoanalysts would engage constructively with the very serious issues that hewas raising. You have heard some criticisms from Joe Schwartz, and you will hear morefrom me. I hope that you will receive our criticisms in the (constructive) spirit in whichthey are offered.

Philosophy of Science

Philosophy of science is that branch of philosophy that is mainly about the ways in whichwe can acquire reliable, objective knowledge about the world. Sometimes this gets prettyesoteric as, for instance, when philosophers talk about competing interpretations ofprobability theory or quantum mechanics, or discuss competing theories of truth. I will notget into this sort of stuff today. Indeed, I am far too ignorant of most of these things tospeak intelligently about them. I will confine myself to more basic, non-technical questionsabout how we can acquire reliable, objective knowledge about the world. Some of youmight be getting irritated with me already. You may be thinking something like `Inpsychoanalysis we deal with the psyche. Freud even called it the `soul'. What does thishave to do with knowledge of the world?' Well, that's a good question which, fortunately,is easy to answer. When philosophers of science talk about `the world' or `the universe'they mean something like `everything that really exists'. If psyches or souls really exist - orcorrespond to things that really exist - then they are part of `the world' in the philosophicalsense. I bet that I ruffled some more feathers in my effort to smooth the first ruffled lot. Ibet some of you got upset when I spoke of souls as `things'. This probably links in withworries about my statement that science seeks objective knowledge. Surely, the soul is notan objective thing about which we can acquire knowledge. The soul, the mind, the personis not a thing, he or she (not `it') is a subject. Psychoanalysis should thus be concernedwith subjective rather than objective knowledge. These worries are quite valid but theystem from a misunderstanding of the philosophical language-game. In philosophy, `object'just means `that which is'. In this sense subjects are objects, and their object-status doesnot cancel out their subjectivity. Objectivity, in the sense that I am using the term here, justmeans that there is some fact of the matter. If someone says that you are angry, this is anobjective claim: that is, there is some fact of the matter about whether or not you are angry,even though your anger may be an entirely `subjective' state. It is easy to misunderstandthis and to assume that I mean that scientific endeavour is dispassionate and uncommitted.Of course this isn't true. Like all meaningful human activity, scientific activity is fuelled bydeep passion.

Science is a disciplined way to try and get at the facts of whatever is beinginvestigated. That is, it tries to do this in a reasonable way. But science is also aboutfinding ways to explain why it is that the facts are as they are. These explanations are oftencalled `laws'. The laws that scientists talk about are not like rules. You cannot violate ascientific law, like T.S. Eliot's 'McCavitythe Mystery Cat' who breaks the law of gravity.Laws tell us how nature is put together. Laws describe causal relations.

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The term `law' can be rather misleading if not used carefully. Strict laws probably applyonly at the most fundamental level of the material universe, the level described by thescience of physics. Reality is stratified, and as we get to the higher strata it becomes lesspossible to formulate strict laws. We are forced to introduce other explanatory principlesappropriate to the level under consideration. So, for example, when life enters the pictureand we enter the domain of the science of biology, we have to start to think in terms ofdesign and purpose. When we think about living systems we have to consider what thesystem is for, what it has been designed by Mother Nature to do. Some philosophersbelieve that when dealing with psychology we can do no more than formulate ceterisparibus laws, statements that such and such will happen `all things being equal. ..'. Oncewe get beyond physics it is usually preferable to speak of `regularities' or `empiricalgeneralizations' rather than laws.

People are sometimes worried by the word `cause' when talking about human beings.Some of you might think that people aren't caused to do or feel or think things. People arefree to choose. Again, this perfectly understandable objection turns on a misunderstanding.In science-speak, to say that one event is a cause for another just means that the first eventmakes a difference to the occurrence of the other. So, if I say that an upsurge of sexualdesire is a cause of your furtively looking at the person sitting next to you, all that I mean isthat your sexy feelings had an impact on your decision to peer at your neighbour. Youweren't forced into it. Also, scientists almost always think in terms of complex causal websor causal circumstances. Any given effect in the real world is the upshot of lots of causes.

Finally, it is important to emphasize that science is not some pure, other-worldly,totally objective process. Scientists are real human beings. It follows from this that theywant the world to be this way or that, and may `cheat' in order to make it seem as if theevidence supports a favoured point of view. Even though science tries to build insafeguards against cheating, this does not always work. Scientists are emotional, social andpolitical creatures, and their efforts towards objectivity will inevitably be constrained byemotional, social and political forces.

The Mother of Reductionism

But isn't this approach rather (shudder) reductionistic? In some quarters, reductionism andits malevolent twin, logical positivism, are anathema to a truthful, vital and humaneapproach to human beings. But those who hold out these terms as terms of abuse rarelyunderstand their philosophical meaning. A sort of lurid glow is evidently sufficient.

I will not bother about logical positivism today, a noble but now dated philosophicalapproach, promulgated by a group of brilliant and courageous men, which is now mainly ofhistorical interest (although it may interest you to know that this movement was centred inVienna, and that many members of the positivist `Vienna Circle' had originally come toVienna in order to be psychoanalysed). Logical positivism was an offshoot of positivismproper, a philosophical movement that originated with the work of Saint-Simon and Comtein the nineteenth century. The original positivists regarded philosophy as the handmaidenof science, and claimed that science - and only science - can deliver certain knowledge ofthe world. When people speak of `positivist science' they usually use the term in a ratherloose way to denote a certain attitude to science: the view that science is everything andcan deliver certainty. Needless to say, this is an outmoded view.

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Reductionism is a different matter. There is a large and rather technical philosophicalliterature dealing with reduction, and I have no intention of going into all of the details.Basically, reduction is the explanation of a phenomenon in more fundamental terms. We dothis, for instance, when we explain a magnificent lightning flash as an electrical discharge.This sort of explanation does not take away the lightning flash: it just explains it. But whenpeople try to explain psychological phenomena in this general way, we often feel that weare being robbed of our humanity. I think that this must stem from our puzzling (narcissistic) desire to situate ourselves outside of nature. Dennett (1995) talks about thisissue so nicely that I cannot resist quoting him.

There is no reason to be compromising about what I call good reductionism. It is simply thecommitment to non-question-begging-science without any cheating by embracing mysteries ormiracles at the outset. .. But in their eagerness for a bargain, in their zeal to explain too much toofast, scientists and philosophers often underestimate the complexities, trying to skip whole layersor levels of theory in their rush to fasten everything securely and neatly to the foundation. That isthe sin of greedy reductionism, but notice that it is only when overzealousness leads to thefalsification of the phenomena that we should condemn it (p. 82).

Greedy reductionism is bad because it is incompetent reductionism. We should abhor it formuch the same reason that we abhor incompetent cooking, or incompetent poetry. But Idon't see any cause, apart from arrogance, to abhor competent reductionism.

What are Theories?

There are lots of different views on this one, but basically theories are mental tools formaking sense of the world. My favourite theory about theories is Giere's (1988). Accordingto him a theory is like a picture or `model' of how some aspect of the world works, and abunch of rules saying how to link that picture with the real world. There are two reallyimportant things to remember about theories. Firstly, theories don't try to say everythingabout everything. They take one bit of the world and try to say something about how thatbit works. Secondly, theories idealize the world. By this I mean that they describe theworld in a rather simplistic, cut-and-dried way. They give a nice, tidy picture of the chaoticmess of reality. This is OK. No theory describes perfectly what really happens in the world.They all give approximations based on simplifying the picture. If scientists didn't simplifythe picture in this way, it would be impossible to get anywhere with science. It might beuseful to pause for a minute to distinguish theories from paradigms. The only point indoing this, really, is because the term `paradigm' gets thrown around quite a lot nowadays.As a philosophical term, `paradigm' was introduced by Thomas Kuhn (1962), and it tooksome criticism from fellow philosophers to get Kuhn (1974) to tighten up the meaning ofthe term. Basically, a paradigm is a global and deeply-rooted scientific vision of the worldshared by virtually all scientists in a given field. Paradigms therefore encompass theories.You can see that this conception is pretty far removed from the glib announcementsheralding `new paradigms' that pepper the psychotherapy literature.

Testing Theories

A classical philosopher of science, Hans Reichenbach (1938), said that scientific activityhas two aspects: creating theories and testing theories (he called these the

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`context of discovery' and the `context of justification'). Reichenbach's idea caught on, andnowadays almost everyone agrees with it. You may be surprised to hear me talk aboutcreating theories. Aren't theories discovered rather than invented? No, they are not. Back inthe seventeenth century Francis Bacon - a great philosopher of science - claimed thattheories just pop out of the data. Psychoanalysts still often claim that theories `emerge'from clinical data, like Nessie breaking water. Philosophers don't buy this any more.Theories are imaginative creations - they are works of art. Theories are imposed on data toorganize it. Even better, there are no rules for creating theories. Anything goes. Your theorymight be revealed in a dream, or you may think that God whispered it in your ear. This is alllegitimate. The origin of a theory has no bearing at all on its scientific value. People whocriticize a theory on the basis of its origins - as Jeffrey Masson does with the theory of theoedipal causation of psychoneuroses - therefore make a big mistake. Philosophers call thismistake the `genetic fallacy': the fallacy of judging the value of something on the basis ofits origins.

When it comes to testing theories, things get a little tighter. You have to use some rules,or at least some norms, when testing theories. In other words, when we test theories, weneed to guard against using sloppy methods in order to make a test come out the way wewant it to. There have been all sorts of ways that people have thought theories should betested. One idea, which was popular early this century, was just to check if what the theorypredicts actually comes true. The theory tester should just pile up loads of statistics onconfirmations of the theory. With each new sighting, the truth of the theory gets more andmore likely. This approach is called verificationism and is associated with the philosophicalmovement, mentioned before, called logical positivism.

So, let us say that you have a theory that all doughnuts are chocolate flavoured. If youwere to take this verificationist line, you would travel around London looking for chocolatedoughnuts and note each sighting. This is obviously a pretty dumb, wasteful way to test thetheory. Yet, this is precisely the sort of reasoning that psychoanalysts often use. Analystsoften write papers propounding some theory or other; they then select, say, three clinicalexamples that support the theory and present these; then they make some claim that thetheory is supported by the evidence. But of course the damned theory is supported by theevidence: the evidence was selected because it supports the theory! It's the chocolatedoughnut man all over again!

Now what if this guy had looked for one non-cholate doughnut instead of piling upstatistics on sightings of chocolate ones? That would be a lot easier and quicker. Onesighting of a non-chocolate doughnut would show that his theory is false. This approach iscalled falsificationism and was the brainchild of Karl Popper. Popper (1959) said that if youwant to test theories you should try to disprove them rather than try to prove them.Obviously, you need to establish just what counts as a disproof in order to play this game.You need to be able to say in advance just what kind of observations would disprove yourtheory, and then go and hunt for just these sorts of observations. If you can't do this, thenyour theory is scientifically empty because there is no way of testing it. Popper famouslyclaimed that this is just what is wrong with psychoanalysis. He said that psychoanalystsdon't and can't stipulate what observations would disprove their theories. Although this isnot 100% right, there is a lot of truth in it. Ask a psychoanalyst what observation one couldconceivably make to show that the theory of the Oedipus complex is wrong. I bet you won'tget a useful reply. How could he or she answer? Let us say, you put it that if a child neverreported

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wanting to marry mummy or daddy this would falsify the Oedipus theory. The analystmight then justifiably respond `But this might be because the child is inhibited'. Fine, but isthere any way to test such an idea? The problem with psychoanalysis, according to thisview, is that there are just too many ways of monkeying around with the evidence to thetheory. Inferences are unconstrained. The theory of the Oedipus complex might be totallyfalse and there would be no way to tell that this was the case! I think that this is veryserious, and that we have an intellectual and moral responsibility to address it by statingquite clearly what observations would disprove our theories.

Nice as it sounds, falsificationism is no panacea. It has got its own problems. One ofthese involved the notion that we never falsify theories in a vacuum. In the real world weare always trying to choose between competing theories. So, in practice, when we test atheory we are really testing it against another theory. Science is like a boxing match withone theory trying to knock out the other. Also, the fact that a theory is falsifiable is notgood enough. A theory that is falsifiable but does not get falsified still might be wrong. Letus say that there is a theory that predicts something, say, `x'. If `x' does not happen, thetheory gets falsified. Let us say that `x' happens. The theory is therefore corroborated,right? Wrong! The theory might be corroborated but it might not. The theory might havesuccessfully predicted `x' but for reasons that are totally loopy. So, for example, let us saythat you have a theory stating that small grey granular objects are really the eggs ofsneezing demons. Black pepper is composed of small, grey granules. So, deductively, blackpepper is really sneezing demon eggs. Putting this thesis to the test, you inhale some blackpepper. Lo and behold, you sneeze! But does this establish that small grey granules aresneeze demon eggs? Of course not. One needs to look for a rival explanation.

In the philosophical jargon, this approach is called eliminative inductivism. It is `eliminative' because it aims at eliminating one of two (or more) competing theories fromthe running. It is called 'inductivism' because it attempts to use particular observations todraw general conclusions.

Adolf Grunbaum (1984; 1993) brings this sort of critique to bear on psychoanalysis asa theory and as a therapy. Grunbaum's argument addresses the question `How can we knowwhether psychoanalytic theories are true?' His argument goes something like this. At firstFreud thought that his theories were true on the grounds that they created meaning out ofthe otherwise meaningless. He gave a sort of `jigsaw puzzle' argument: psychoanalytictheories provide the uniquely fitting missing piece that allows us to make sense of patient'sdifficulties. This argument would be pretty good if it was really true that for any patientthere was a uniquely fitting theoretically deduced conjecture - deducible from one theoryonly - that made sense of the clinical picture. But this is not so. It is a commonplace inphilosophy of science that `theories are underdetermined by data'. This means that anychunk of data is compatible with an infinite number of theories. You can explain anythingin infinitely many ways. Some such theories might be pretty weird but they wouldnevertheless give an explanation of the data. You can get a hold of this idea by consideringhow analysts of different persuasions - Freudian, Kleinian, Lacanian, Jungian, etc. - mightmake sense of the same clinical episode. They would all provide different explanations.Personally, I think that some of the explanations offered by analysts are weird andimplausible, but I don't doubt that they establish a sort of coherence. A paranoiac can alsoestablish (delusional) coherence probably more elegantly than any psychoanalyst. (Aparanoiac psychoanalyst would probably be even better!)

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According to Grunbaum, Freud eventually changed his tack. He came to reason that, ifwe get our interpretations from our theories and if only true interpretations get peoplebetter, it follows that if our interpretations are therapeutic they must therefore be true.Freud's first premise is certainly correct. Interpretations are always deduced from theories.If you think that you don't get your interpretations from theories, you have simply notarticulated to yourself the theory that you are operating from, which may be a veryidiosyncratic one. Freud's second premise is more doubtful. Freud was well aware that non-analytic interventions could produce therapeutic effects. He called these 'transference cures'or `cures through suggestion' (he treated these as synonymous). He also had the courage toadmit that psychoanalysis, insofar as it mobilizes the positive transference, has an essentialand powerful component of suggestion (remember, Freud thought that psychoanalysiscould not work without positive transference). So, Freud was confronted with an obstacleto his argument: the competing hypothesis of cure through suggestion. He was confrontedwith a classical eliminative inductivist situation. What did he do? First of all (unlike manylater psychoanalysts and, by the way, most therapists of other persuasions) he took theproblem seriously. He tried to neutralize the competing hypothesis of suggestion by meansof the claim that, in psychoanalytic treatment, positive transference, and therefore thepsychological basis for suggestion, is ultimately analysed and thereby resolved. AdolfGrunbaum (1984) has rightly called this a 'viciously circular bootstrap operation'. Ofcourse, if interpretations of positive transference are accepted, there are no clear groundsfor saying that this very acceptance is not a manifestation of positive transference, ofsuggestion. Grunbaum argues that there is no way around this problem in the clinicalsituation, and that psychoanalytic theories must therefore be tested extra-clinically: bymeans of experimental and/or epidemiological studies.

I hope that I have not given you the impression that theory testing is a clear, simple anddefinitive process. This is not the case. Testing a theory involves finding creative ways ofengaging with it. In fact, even if a test procedure seems to show that a theory is wrong, ascientist may - out of commitment to the theory - look for faults in the test design and seekout alternative strategies.

Some of you may say 'But what about outcome research? Surely, outcome research is amethod of directly testing clinical claims!' Well, you would be quite right. It is a method oftesting clinical claims. But it is not a method for testing the theories underwriting thoseclaims. Even if psychoanalytic treatments were 100% effective, this still would not meanthat it was effective for the reasons stated by its proponents. Think of the history ofmedicine. For most of its history, effective medical treatments have worked for reasonsother than those advanced by physicians. This point is screamingly obvious. Physicianshave used opiates as analgesics for centuries if not millennia. Prior to the emergence ofmodern chemistry and neurophysiology, however, it was simply impossible to explain thecausal sequence by virtue of which opiates produced their analgesic effects. One isreminded of Moliere's physician in Le Malade Imaginaire, who attributed the sleep-inducing power of opium to its virtus dormitiva, which is simply Latin for 'sleep-inducingpower'. More recently, during the 1950s in the United States, the ligation of the mammaryartery was a common treatment for angina pectoris. Physicians reasoned that this wouldtake pressure off of the ischemia of the heart muscle, which causes angina. The proceduredid work. But a later study showed that a skin incision over the heart, that is, phoneysurgery, worked just as well.

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In other words, the arterial ligation worked because of the psychological effect of surgicalintervention, not because it increased blood flow in collateral vessels (cf. Grunbaum 1993)!

The Way Forward

I do think there is a way forward. I think that there is a way of clinically testingpsychoanalytic theories `on the couch'. This general strategy was first put forward by PaulKline (1972) but did not seem to generate much interest. It goes as follows. When youthink about it, the main problems about testing psychoanalytic theories `on the couch' arethat:(a) Psychoanalytic theories can make clinical predictions and retrodictions only withrespect to events occurring within the psychoanalytic situation itself (retrodictions arereverse predictions, reconstructions of earlier events).(b) As Freud himself openly avowed, the psychoanalytic process evokes states ofsuggestibility in analysands.(c) The psychoanalytic process is itself suggestive in that success entails patients'conscious acceptance of hypotheses which the analyst regards as true, or are at leastcompatible with his or her theoretical framework.Taking these three factors together, it is pretty clear why we cannot take phenomenaoccurring in a Freudian analysis as corroborating Freudian theory, events occurring in aKleinian analysis as corroborating Kleinian theory, events occurring in a Jungian analysiscorroborating Jungian theory, and so on. But why not use events occurring in a Kleiniananalysis to confirm - or disconfirm - Freudian theory, or vice versa? If we could test apsychoanalytic theory using clinical data extracted from a form of psychoanalysis that doesnot share its theoretical premises we would manage to test psychoanalytic theory `on thecouch' without falling prey to the pollution of the analysand's material by the analyst'sexpectations and subtle cues. This would work because the analyst conducting thetreatment would not be encouraging the analysand to produce material conforming to thebeliefs of the person using the clinical data to test a theory. The beauty of this approach isthat we do not have to care about the suggestive influence of the analyst. This suggestiveinfluence has no bearing on the use of the data to test a rival theory.

It might be argued, of course, that this very suggestive element loads the dice againstthe possibility of any rival theory being corroborated in this way. But this is not necessarilytrue. It is only true if we take a psychoanalytic clinical theory to be validated only by meansof communications, the content of which directly confirms the theory. What I mean is this.Imagine that an analyst offers an interpretation to his patient explaining some action ofhers in terms of oedipal issues. Imagine that the patient accepts the interpretation and goeson to present additional evidence strongly supportive of the interpretation. Obviously, thissort of support is not worth much. It might be that the supporting evidence - for example, achildhood memory - may have been selected just because it coheres with the interpretation.In that case, even if the patient experienced an immediate and profound transformation,and a complete loss of neurotic symptoms, it would not be warranted to assume that thecurative effect stemmed from the truth of the interpretation. I hope you understand why. Itis simple. The patient might have got better just because he or she thinks that theinterpretation will make them better. Obviously, if we employ this strategy we must regardany apparent corroborations of the theory deployed by the analyst conducting the sessions

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being used as data against which theories are to be tested as strictly irrelevant to the testprocedure. I have argued in my book Hidden Conversations (Smith 1991) as well aselsewhere that Langs's communicative approach to psychoanalysis readily lends itself tothis sort of testing. Briefly, communicative psychoanalytic theory claims to have identifieda number of regularities in unconscious mental functioning. These mainly revolve aroundthe therapeutic setting or `frame'. According to this view, if we have an understanding of `initial conditions', i.e. the structure of a therapeutic setting, we can use the theory to predictthe thematic content of sessions occurring within that setting. If we possess anunderstanding of initial conditions plus the trajectory of a psychoanalytic session up topoint x when an intervention occurs, we can use communicative psychoanalytic theory topredict deductively the thematic content of the first displaced narratives following theintervention. Such predictions can be made for non-communicative psychoanalyticsessions, and they have clear falsification criteria. Furthermore, aspects of the frame can,according to this view (which, by the way, I endorse), be retrodicted on the basis of thethematic content of patients' discourse.

In order to test a theory we must find a way of using it to make predictions (use it toanticipate what will happen) or make retrodictions (use it to make testable claims aboutpast events). Some argue that psychoanalytic theories cannot do that sort of thing, eitherinside or outside of the circumstances of their own therapeutic application. Those whoagree with this claim tend to fall into three general camps: the anti-psychoanalytic camp,the hermeneutic camp and the clinical pragmatist camp.

The anti-psychoanalytic camp argues as follows.

Well, if you can't use the theory to predict or retrodict anything, what's the use of it? If you can'tpredict or retrodict anything using the theory then it's pretty worthless as a theory, and anyway,there's no way to tell if it's right or wrong, so you could claim the most absurd things in an analytictheory! Why not admit that the whole business is a farce and let scientific psychology take over?

I'll show my hand here: I have considerable sympathy with this view. However, I think thatit is misguided on two counts. Firstly, I do not think that it is true that psychoanalysiscannot, in principle, make clinical predictions and retrodictions. Such predictions andretrodictions are made in assessment interviews and supervision sessions all the time. Theproblem with these is that they are rather undisciplined: inspired by rather than deducedfrom their mother theory. It is because of this rather loose relationship between thepredictions and their theory of reference that the fact of a prediction's not coming off doesnot impact on the analyst's commitment to the theory. Let me put it more simply. Let us saythat, confronted with a clinical phenomenon in an assessment interview, a psychoanalystdecides to make a Freudian prediction (silently, to herself). She says to herself somethinglike `This guy has obsessional characteristics. He is stingy, he's into control, and so on. Ibet he's got anal problems.' Let us say this man never gets into anal material in his analysisand poo-poos it when his analyst brings it up. I bet that the analyst will not respond bythinking `There's something really wrong with the Freudian theory of obsessional neurosis'.I think that she will be inclined to say something like 'I must have missed the anal aspectsof such and such', or `his powerful resistance prevented him from coming to grips with hisanality' or `the clinical picture was of a pseudo-obsessional type', and so on. In other words,the observations do not discipline the theory. Coming at this sympathetically, given thesheer complexity and ambiguity of the data, and the frailty

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of the analytic instrument, such caveats seem warranted. But if all psychoanalyticobservations, from Freud onwards, have been subject to these vulnerabilities, where doesthis leave the theory? Why on earth should one have faith in it? To invest one's faith in sucha theory betrays a certain amount of idealization. I am reminded of an experience that Ioften have when interviewing candidates for the psychotherapy training course of which Iam director. In the interview, I often ask the candidate if he or she has any criticisms oftheir psychotherapist, taking care to emphasize that I do not expect them to itemize anysuch criticisms. Nine times out of ten, candidates are astonished by the question. Theanswer, given with surprising if not monotonous regularity, is 'I don't always make the bestuse of her'. To me, this is hard-core idealization of a dangerous kind. This is just whatanalysts often say about their theories. Given the ambiguous relationship between theoryand observation in psychoanalysis, what else could one say? What a bind! Under thecircumstances, I don't see how you can avoid idealizing your theory. It is only fair to saythat one philosopher of science, Imre Lakatos, has claimed that science always operateswith such idealizations. According to Lakatos (1970) every 'research programme' (he wouldcall psychoanalysis a research programme) has a 'hard core' of theoretical propositions thatare taken on faith and are sacrosanct. This hard core is surrounded by a 'protective belt' ofless important 'auxiliary hypotheses' that can be fiddled with impunity. So, with Lakatos,the failure of a prediction to come off can be attributed to a failure to use the hardtheoretical core properly. However in psychoanalysis this fiddling with the protective beltis more or less chronic and ad hoc. This starts to look like an effort to protect the coretheory from incursions of reality: sort of a scientific psychosis.

Secondly, it is my opinion that psychoanalysis could, in principle, do better than thiswith more motivation and effort. We have research traditions that can be refined andextended. The hermeneutic camp says:

You needn't really worry about this state of affairs because the truth of psychoanalytic claims is ared herring. Psychoanalysis is really about finding meaning, and this has nothing to do with causalrelations and scientific testing. The inability of psychoanalytic theories to make predictions andretrodictions isn't a failing, it's a virtue. It shows psychoanalysis to be a true human science -perhaps the paradigmatic one!

I have little sympathy with this view although there is certainly a sense in which it is true.There are certainly areas of psychoanalytic practice that use an extended version of ourordinary way of making sense of one another (Dennett's (1995) term for this, which hascaught on, is 'folk psychology'). In ordinary life, when we attribute a mental state tosomeone, we consider their whole pattern of behaviour in light of a few normativeassumptions (e.g. 'People do what they think is best, all things considered'). Arguably, thisinterpretative practice is more fundamental than scientific reasoning and cannot reasonablysubserve it. But attributing meaning is not enough. Psychoanalysis is distinct from folkpsychology in that it claims that there is much more to human mental life than can beencompassed by folk-psychological strategies. Psychoanalytic theories make universalcausal claims about mental events. They were not created merely as useful and evocativenarratives. Freud, by the way, and with characteristic philosophical sophistication,repudiated the view that psychoanalytic claims are 'fictions' which should be evaluatedpragmatically.

In my view, a global assimilation of psychoanalysis to hermeneutics amounts to givingup. It means abandoning finding real answers to the very important questions

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that Freud and his successors have raised. Given the profound problems confrontingpsychoanalysis as science, though, I can understand the attraction of this position.

The clinical pragmatists say:

Well, this is all airy-fairy philosophical stuff. Psychoanalysis gets people better and helps usunderstand the origins of emotional distress. Isn't that good enough?

Of course, this line is just question-begging. Sure, psychoanalysis (sometimes) gets peoplebetter, but how? This matters. Unless we are seriously interested in how psychoanalysisworks when it does work, we will never be able to understand why it often doesn't work.That is, we will give up on working out how we can help people most effectively. Surely,you cannot get more clinically pragmatic than that! With regard to the second claim, as Ihave already said, explanations of the origins of emotional distress are not good enough.We need true explanations. For this, I think, we need true scientific discipline.

I began this talk with the question `Should psychoanalysts believe what they say?' Inlight of the issues raised, I wonder what you think the answer to this question should be.

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