Tuesday, September 13, 2011

David Bernstein had a blog-post in part on Freud which led me to comment with some thoughts I had been wanting to put on my blog:

There is a study that looks at hospitalized adolescents diagnosed with Borderline Personality treated with psychoanalytic (Freudian) methods vs. a control group that does better over 2 years in rates of rehospitalization over 2 years or other quality of life measures. Those sorts of things are possible. Also is ‘David Bernstein’ unscientific because he can’t scientifically prove that his name should be ‘DB?’ I mean how can you prove that his mother got the name right? In part, Freud developed a language. Ego and Mechanisms of Defence by his daughter who signed her name ‘Annafreud’ is very useful in that regard. Take a clinical thought example. You see the ads where the drug Seroquel or Abilify added to antidepressants helps with depression. These drugs were first of all indicated for schizophrenia which might be said to be characterized by the person not knowing what was happening inside or outside themselves, a loss of (ego) boundaries. Well David finds some threat to his self esteem by Brian Leiter’s attacks but he is able to set up a wall and say, ‘Well, you know that’s Brian (that’s not me). And, just to further establish that, let’s cite evidence as to what an odd monkey Brian is (case closed).’ OTOH, we may have a young man whose fiance’ broke up with him. There is, at least, some, probably more than implied, criticism of him. He can’t however regulate his self esteem within his own ego; that (image of) other person has become part of him and he has a narcissistic injury as well as an object loss. The antipsychotic drug Invega, ultimately, is given on the hypothesis that it will help him establish an ego boundary and rescue him from being suicidal. And it works.
Now one might say that Kraepelin, who systematized diagnosis in the early twentieth century is usually more relevant and correct than Freud or that Freud’s excluding Alfred Adler and his ‘will to power’ that may be a predecessor to Cognitive Therapy was incorrect. But there is the model of the mind and other things, but if that’s the sort of thing you like you’ll probably want a different explainer, that have contributed to the clinical science of psychiatry. However it might also be pointed out that psychoanalysis may appear to be like case law. It is built on the success in one reported case starting with certain previous findings from case law and going on to some successful outcome; the rules uncovered along the way may be applied to another similar case and so the ‘case law’ is expanded and refined. (Quote)

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