Freudian concepts in the twenty-first century: a neuropsychoanalytic update and discussion

After a rich collection of articles was published in our 25th volume, we are now ready to start volume 26 with an equally interesting set of papers on topics that focus on the core of neuropsychoanalysis, such as Freudian concepts and clinical work. As old as Freud’s theory is, it is still difficult to find the complexity and quality that his model of the mind offers anywhere else. Updating and discussing some of its core notions is a crucial task of neuropsychoanalysis. The exploration of Freudian concepts, such as primary and secondary processes and the perceptual-conscious system, from a neuropsychoanalytic perspective contribute to our further understanding of Freud’s ideas in the twenty-first century. No less important is our commitment to support the development of the clinical implications of neuropsychoanalysis by presenting a clinical paper that shows the outcome of looking at a case from an integrative point of view to deeply understand the challenges of neurodiversity to our usual techniques. For the target article section, we present Doug Watt’s elaborate response to the commentaries on his recent paper “The Separation Distress Hypothesis of Depression – An Update and Systematic Review” (Watt, 2023), which had commentaries by Paul Badcock and Karl Friston (Badcock & Friston, 2023), Barton Blinder (Blinder, 2023), Otto Kernberg (Kernberg, 2023), Ken Davis and Christian Montag (Davis & Montag, 2023), Stephen Siviy (Siviy, 2023), and Howard Steele (Steele, 2023). Watt’s careful response to each author could be considered another target article due to his thorough elaboration on several topics that will inform the reader interested in depression about further clarifications and potential lines of research. Relevant work from our vibrant neuropsychoanalytic community also contributes to this issue. We report on the research presented at the 22nd Congress of the International Neuropsychoanalysis Society, which particularly addressed the topic of PLAY. Our Book Review and Research Digest sections bring us up to date with recent work related to neuropsychoanalysis.

Many will be interested in Doug Watt’s very impressive response to the commentaries, in this issue, about his Target Article on the origins of depression, which was presented in the previous issue of the Journal (Watt, 2023). As these commentaries are from several important leaders in this field, Watt’s response is a detailed and interesting review of the discussions with a deep consideration of the back-and-forth with those authors. Watt writes voluminously, and also clearly and interestingly, about these complex and at times multilevel issues relating the basic ideas about the causes and evolution of depression, deriving from early child abuse and child neglect, and the many results from early life to the phenomena of adulthood, with its many at times profound and surprising aspects. One finds oneself, at the end of many a paragraph thinking, “this is really interesting, previously ignored, with a complexity I have never even thought about before.” It will be a treat of great value!

Ariane Bazan's fascinating paper “Primary and secondary process mentation: Two modes of acting and thinking from Freud to modern neurosciences,” through the lens of contemporary neuroscience, revisits Freud’s early work on the primary and secondary processes of mental functions. In Freud’s early thinking about human mental function, within an axial model, on a horizontal plane, the primary process is associative, whilst on the vertical plane, the secondary process is inhibitory. Integrating Freud’s early work with modern neuroscience, Bazan makes the case that Freud’s primary and secondary processes are, in fact, compatible with the functions of the ventral and dorsal brain pathways in humans. To evidence this, Bazan points out that the dorsal pathway has an inhibitory influence on the ventral pathway and originates from a shared physiology, mirroring that of the secondary on the primary in Freud’s model.

The paper “A Closer Observation of the Pcpt-Cs. System in Freud’s Thinking and its Relation to Time Perception from a Neuroscientific Perspective” by Ali Pajoohandeh, Maryam Hadi, and Raheleh Jafari deals with an interesting and mostly unexplored subject. It begins with a review of the perceptual-consciousness (Pcpt-Cs.) system in Freud’s work and how it may relate to the experience of time perception. This section, in itself, would suffice to make this an appealing metapsychological paper, but the authors go further, and suggest connections with the neuroscientific understanding of time perception. Using neuroanatomical, clinical, and electrophysiological data, the authors try to link concepts such as working memory, beta and gamma oscillations with the Freudian understanding of the Pcpt-Cs. system and with primary and secondary processes. Although this is clearly a theoretical paper, it is filled with insights and hypotheses that may fuel the creative thinking of both psychoanalysts and neuroscientists alike. After all – paraphrasing Glen Gabbard (Gabbard, 2005, pg. 31) – like a sailor without a sextant, a neuropsychoanalyst who sets out to navigate the dark waters of the MindBrain without a theory, will soon be lost at sea.

Michelle van Den Engh's highly sophisticated and touching case report entitled “‘I’m a fish!’ Deepening Receptivity to Neurodiversity: A Neuroscientifically Informed Integration of Psychoanalytic Psychotherapy, Reciprocal Prediction and Mindfulness” details her psychoanalytic work with a neurodivergent patient exhibiting autistic features. It raises pertinent questions about how a neurotypical therapist who uses neurotypical and “typical” psychoanalytic formulations can effectively assist such individuals. How can therapists develop receptivity to the unique worldview of neurodivergent patients? To borrow van den Engh's metaphor, can a fish be attended to as a mammal? Van den Engh's perspective on this matter is optimistic. By analyzing the therapeutic process she and her patient underwent, along with the techniques and tools employed, she effectively bridges classical psychoanalytic concepts (e.g. reverie, evenly suspended attention) with neurological driven theories (e.g. mirror neurons, predictive coding). Particularly noteworthy is her interpretation of predictive coding, wherein she proposes that in treating neurodivergent patients, analysts should loosen their preconceived predictions and rely more on the bottom-up information encountered in the therapeutic setting. We anticipate that insights like these, along with other neurologically driven psychoanalytic formulations, will enrich and broaden our comprehension of clinical situations, leading to more fulfilling therapeutic encounters.

Last year from the 6th to the 8th of July, the International Neuropsychoanalysis Society hosted a successful and thought-provoking 22nd Annual Congress in Tel Aviv-Yafo, Israel. The topic of the Congress was “Play: The Social Mind and Brain.” The Society Proceedings section of this current issue houses a summary, in the form of abstracts, of the rich array of impressive research and symposium talks that were given at the Congress. From discussions on memory and PLAY, to dominance, empathy and PLAY, we are delighted to showcase the rich and diverse array of knowledge that is on display within the neuropsychoanalysis community. Whether or not you attended the 2023 Congress in Tel Aviv, you will benefit greatly from Daniela Flores Mosri’s report. She has provided us with a detailed summary of all the plenary sessions from the Congress. Starting with the Education Day, we can review Dr Siviy’s presentation on his experiments with the PLAY system in rats, Dr. Berger’s talk on the neurodevelopmental aspects of play in humans, and Dr. Shalgi’s ideas regarding the evolution of play in psychoanalysis. We can revisit the two days of the conference itself and review, from the first day, Dr. Siviy’s talk focusing on what he is learning from his work with the Fischer 344 rat, Mark Solms’ reflections on possible revisions of Freudian drive theory based on Panksepp’s discoveries in affective neuroscience and then on to the plenary symposium “Memory Meets PLAY: Three Perspectives from Neuroscience”, with speakers Mouna Maroun, Simone Shamay-Tsoory, and Nikolai Axmacher. Flores Mosri focuses on the second day of the Congress with summaries of talks by Yoram Yovell who explored the function of play in improving well-being in humans and a discussion between Mark Solms and Shlomo Mendlovic, moderated by Boaz Shalgi, regarding approaches to psychotherapy based on their understandings of how the mind works. A plenary symposium, entitled “Disturbance in the Sense of What Belongs to Whom in Narcissistic Patients and the Neural Correlates of Somatization”, included presentations by Susan Mizen, Elizabeth Weightman, Michal Tanzer, and Aikaterini Fotopoulou. In his concluding remarks, Mark Solms highlighted the central importance of play in human life and presented further arguments supporting a revision of Freudian drive theory based on Pankseppian theory. With this in-depth summary of Congress proceedings, Dr. Flores Mosri has provided a great service to all of our readers – those who will encounter this material for the first time or are revisiting the groundbreaking work that was presented at our 2023 Congress.

As we reached the 25th volume of the Journal, the editorial team celebrated with an online gathering of members of our community that featured as our special guests, the past and present editors as well as members of our editorial board. Listening to the founding editors tell the story about how this project began back in 1999 was a moving moment, followed by the inspiring reflections of other editors. This special anniversary brought old friends together and welcomed the newer generations involved with keeping the project going while always attempting to enhance the quality of the papers we publish. We wanted to keep our memory fresh and present the document of the most remarkable comments of that meeting.

Jane Abrams and Ana Delgadillo Hernández are pleased to present a report on the exciting and varied activities of our regional groups around the world. We have reports from Bucharest, Liverpool, Kyoto, Siberia, the Netherlands, Manchester, Madrid, Mexico City, Tel Aviv, Lithuania, New York City, Sweden, and Turkey. Members of two groups – The Edith Laufer Center in New York City and the Turkish group – have produced papers that have been published this year in our journal. The Swedish and Tel Aviv groups are focusing on trauma – both personal and collective. Our bulletin co-editor, Ana Delgadillo Hernández, has been very busy, presenting on the Default Mode Network to the Madrid group and on sleep disorders and insomnia from a neuropsychoanalytic perspective to the Mexico City group. In Bucharest, members have designed interesting approaches to studying the dynamics of the basic emotional systems in kindergarten-age children as well as adults. Other topics that have been the focus of our groups have been aphasia, long Covid, applications to Jungian theory, cross-cultural affective neuroscience, Integrative Psychosomatics, and clinical applications. You will learn much and will be inspired as you read the details of these regional reports.

Our book review section covers two recent publications relevant to neuropsychoanalysis. Written by our Book Review editor Hessel Boerboom, the first book reviewed is The Psychosomatic Therapy Casebook by Jean Benjamin Stora (Stora, 2023). Boerboom provides the reader with a concise description of the first and second generations of the French psychosomatic school and highlights Stora’s proposal of neuropsychosomatics, which explores the role of the mind in different illnesses through case illustrations. Boerboom’s second contribution is his review of Mark Kinet’s The Spirit of the Drive in Neuropsychoanalysis (Kinet, 2023), which is the first title in a book series edited by Mark Solms on neuropsychoanalysis. Boerboom describes Kinet’s interest in neuropsychoanalysis by summarizing his encounter with Solms’ neuropsychoanalysis in terms of Panksepp’s affective neuroscience, Friston’s free energy principle, and his focus on homeostasis. The review also covers Kinet’s understanding of Lacanian neuropsychoanalysis as developed by Ariane Bazan and the related discussion of drives in relation to Berridge’s “wanting” and “liking” systems. The reader will be able to grasp the main contents of these two compelling titles thanks to Boerboom’s excellent reviews.

For our Research Digest, editor Jane Abrams has selected the final paper written by the late Joseph Palombo, entitled “Unsuccessful Accommodations: Reconceptualizing the Psychopathology Attributed to Neuropsychological Deficits” (Palombo, 2023), which sensitizes us to how people with neuropsychological deficits struggle to achieve their goals. While the environment and the person’s subjectivity are important aspects that determine whether the person will have unsuccessful accommodations, the author stressed the importance of narcissistic injuries that may cause feelings of shame. Abrams concludes that this article is valuable for neuropsychoanalysis because of the central role it gives to the subjective experience of people with neuropsychological deficits.

We hope the reader of the Journal finds this collection of papers as engaging as we do.