Where is psychotherapy going?

An exciting, thought-provoking and fundamental challenge to psychotherapy.

The following text is taken from the final chapter of Robert Langs' forthcoming book, "The Immune System and the Emotion-processing Mind."

In the last decade of the 19th century, there were two outstanding pioneers of science, one in the field of immunology and the other in psychoanalysis or psychotherapy. The immunologist was Paul Ehrlich and the therapist was, of course, Sigmund Freud. Ehrlich made contributions to biochemistry, bacteriology, pharmacology, cancer research, chemotherapy -- a field he founded and to which he brought the first therapeutic agent for the treatment of syphilis -- and immunology. In contrast, Freud contributed to neurology, psychology, and psychotherapy. That is, from the beginning, one researcher explored a vast territory, the other a constricted field.

Among Ehrlich's many original contributions, perhaps his most brilliant proposal ran entirely counter to existing ideas that antibodies are manufactured in the body de novo at the direction of an invading antigen -- the so-called instructionistic theory of immune system operations. As a bold alternative, he proposed that a huge array of different antibodies already exist in the body as cell receptors for nutrient intake. The key idea, then, was that these cell receptors are able to recognize incoming antigens or their toxins, and thereby are stimulated to make copies of themselves in order to combat the provocative antigen invader. This was, then, essentially a selectionistic theory of antibody formation -- the idea that a huge number of antibodies stand ready in the human body to be selected by a pathogenic antigen which,in so doing, arranges its own execution. And even though the nutrient concept did not hold up, this was a bold conjecture with enormous ramifications for the field. What then was its fate?

The challenge raised by Ehrlich's idea stimulated active research searching to find ways of testing which mechanism -- instructionism or selectionism -- is the key to immune system operations. And in time, especially after the monumental discovery of the double helix in 1953, the weight of evidence favored the selectionism theory, which achieved full formulation in the mid-1950's. From there, drawing on enormous advances in technology and research methods, the field of immunology has become one of the most fast moving and progressive fields in all of medicine and biology.

How does this compare with the fate of Freud's landmark thinking about the importance of unconscious processes in emotional life? Long term answers to this question may vary -- which is not the case in the far better defined field of immunology -- and this in itself is a sign of the uncertainty that prevails about progress in the field of psychotherapy.

It seems fair to say first, that Freud's ideas have not met with acceptance throughout the field -- if anything, there are more doubters than supporters. The notion of unconscious processes cannot be reasonably questioned, but Freud's changing definition of the realm has led to turning the concept of "the unconscious," into an ill-defined, waste-basket notion. Experimental research into its essentials has been equivocal and the term "unconscious" is used in so many different ways as to defy definition. Furthermore, the communicative-adaptive approach has offered an empirically-grounded and precise definition of this concept in terms of emotion-related adaptation, processing, and communication, but its propositions have not even been debated or explored -- and either accepted or refuted. Serious challenges in psychotherapy that entail paradigm shifts generally go unmet.

A review of the history of psychoanalytic theory reveals minor changes, such as the shift toward object relations and interactional factors, but there has been no major revision, nor has there been significant advances in clinical or formal research methodology, and we lack a much-needed explosion of knowledge. Compared to immunology, psychotherapy is moving at a crawl, if at all.

What does this comparison tell us? I would suggest that it highlights the narrowness of the purview of psychoanalysts and psychotherapists and the unfortunate isolation and stultification of the field. We are stuck in a mire of competing ideas without strong leadership or a key guiding principle. We are a field in danger of replacement by neuroscience and chemical "cures." We deny our roots in biology in favor of adaptively meaningless hermeneutics, and given our need for denial -- much of it seemingly necessitated by existential death anxieties that overwhelm patients and therapists alike. It is this bent for denial that had made our field so difficult to advance and so wanting of essential truths. Immunology is blessed with having to deal with biochemical entities that, while fighting the scepter of death, have no awareness of its inevitability.

Psychotherapy is in desperate need of scientists and research methods that can advance the field significantly. In an era of rapid scientific progress on all other fronts, we are still mired in methods and thinking that belong to the 19th century and that will not carry us forward to the 21st. All in all, comparing the two men and the fate of their revolutionary ideas should be cause for alarm for every psychotherapist and psychoanalyst in practice today.

We have as yet lifted but a thimbleful of wisdom from the vast ocean we call the body of knowledge of psychoanalysis and psychotherapy.

Where is psychotherapy going?

An exciting, thought-provoking and fundamental challenge to psychotherapy.

The following text is taken from the final chapter of Robert Langs' forthcoming book, "The Immune System and the Emotion-processing Mind."

In the last decade of the 19th century, there were two outstanding pioneers of science, one in the field of immunology and the other in psychoanalysis or psychotherapy. The immunologist was Paul Ehrlich and the therapist was, of course, Sigmund Freud. Ehrlich made contributions to biochemistry, bacteriology, pharmacology, cancer research, chemotherapy -- a field he founded and to which he brought the first therapeutic agent for the treatment of syphilis -- and immunology. In contrast, Freud contributed to neurology, psychology, and psychotherapy. That is, from the beginning, one researcher explored a vast territory, the other a constricted field.

Among Ehrlich's many original contributions, perhaps his most brilliant proposal ran entirely counter to existing ideas that antibodies are manufactured in the body de novo at the direction of an invading antigen -- the so-called instructionistic theory of immune system operations. As a bold alternative, he proposed that a huge array of different antibodies already exist in the body as cell receptors for nutrient intake. The key idea, then, was that these cell receptors are able to recognize incoming antigens or their toxins, and thereby are stimulated to make copies of themselves in order to combat the provocative antigen invader. This was, then, essentially a selectionistic theory of antibody formation -- the idea that a huge number of antibodies stand ready in the human body to be selected by a pathogenic antigen which,in so doing, arranges its own execution. And even though the nutrient concept did not hold up, this was a bold conjecture with enormous ramifications for the field. What then was its fate?

The challenge raised by Ehrlich's idea stimulated active research searching to find ways of testing which mechanism -- instructionism or selectionism -- is the key to immune system operations. And in time, especially after the monumental discovery of the double helix in 1953, the weight of evidence favored the selectionism theory, which achieved full formulation in the mid-1950's. From there, drawing on enormous advances in technology and research methods, the field of immunology has become one of the most fast moving and progressive fields in all of medicine and biology.

How does this compare with the fate of Freud's landmark thinking about the importance of unconscious processes in emotional life? Long term answers to this question may vary -- which is not the case in the far better defined field of immunology -- and this in itself is a sign of the uncertainty that prevails about progress in the field of psychotherapy.

It seems fair to say first, that Freud's ideas have not met with acceptance throughout the field -- if anything, there are more doubters than supporters. The notion of unconscious processes cannot be reasonably questioned, but Freud's changing definition of the realm has led to turning the concept of "the unconscious," into an ill-defined, waste-basket notion. Experimental research into its essentials has been equivocal and the term "unconscious" is used in so many different ways as to defy definition. Furthermore, the communicative-adaptive approach has offered an empirically-grounded and precise definition of this concept in terms of emotion-related adaptation, processing, and communication, but its propositions have not even been debated or explored -- and either accepted or refuted. Serious challenges in psychotherapy that entail paradigm shifts generally go unmet.

A review of the history of psychoanalytic theory reveals minor changes, such as the shift toward object relations and interactional factors, but there has been no major revision, nor has there been significant advances in clinical or formal research methodology, and we lack a much-needed explosion of knowledge. Compared to immunology, psychotherapy is moving at a crawl, if at all.

What does this comparison tell us? I would suggest that it highlights the narrowness of the purview of psychoanalysts and psychotherapists and the unfortunate isolation and stultification of the field. We are stuck in a mire of competing ideas without strong leadership or a key guiding principle. We are a field in danger of replacement by neuroscience and chemical "cures." We deny our roots in biology in favor of adaptively meaningless hermeneutics, and given our need for denial -- much of it seemingly necessitated by existential death anxieties that overwhelm patients and therapists alike. It is this bent for denial that had made our field so difficult to advance and so wanting of essential truths. Immunology is blessed with having to deal with biochemical entities that, while fighting the scepter of death, have no awareness of its inevitability.

Psychotherapy is in desperate need of scientists and research methods that can advance the field significantly. In an era of rapid scientific progress on all other fronts, we are still mired in methods and thinking that belong to the 19th century and that will not carry us forward to the 21st. All in all, comparing the two men and the fate of their revolutionary ideas should be cause for alarm for every psychotherapist and psychoanalyst in practice today.

We have as yet lifted but a thimbleful of wisdom from the vast ocean we call the body of knowledge of psychoanalysis and psychotherapy.

ReturnWhere is psychotherapy going?

An exciting, thought-provoking and fundamental challenge to psychotherapy.

The following text is taken from the final chapter of Robert Langs' forthcoming book, "The Immune System and the Emotion-processing Mind."

In the last decade of the 19th century, there were two outstanding pioneers of science, one in the field of immunology and the other in psychoanalysis or psychotherapy. The immunologist was Paul Ehrlich and the therapist was, of course, Sigmund Freud. Ehrlich made contributions to biochemistry, bacteriology, pharmacology, cancer research, chemotherapy -- a field he founded and to which he brought the first therapeutic agent for the treatment of syphilis -- and immunology. In contrast, Freud contributed to neurology, psychology, and psychotherapy. That is, from the beginning, one researcher explored a vast territory, the other a constricted field.

Among Ehrlich's many original contributions, perhaps his most brilliant proposal ran entirely counter to existing ideas that antibodies are manufactured in the body de novo at the direction of an invading antigen -- the so-called instructionistic theory of immune system operations. As a bold alternative, he proposed that a huge array of different antibodies already exist in the body as cell receptors for nutrient intake. The key idea, then, was that these cell receptors are able to recognize incoming antigens or their toxins, and thereby are stimulated to make copies of themselves in order to combat the provocative antigen invader. This was, then, essentially a selectionistic theory of antibody formation -- the idea that a huge number of antibodies stand ready in the human body to be selected by a pathogenic antigen which,in so doing, arranges its own execution. And even though the nutrient concept did not hold up, this was a bold conjecture with enormous ramifications for the field. What then was its fate?

The challenge raised by Ehrlich's idea stimulated active research searching to find ways of testing which mechanism -- instructionism or selectionism -- is the key to immune system operations. And in time, especially after the monumental discovery of the double helix in 1953, the weight of evidence favored the selectionism theory, which achieved full formulation in the mid-1950's. From there, drawing on enormous advances in technology and research methods, the field of immunology has become one of the most fast moving and progressive fields in all of medicine and biology.

How does this compare with the fate of Freud's landmark thinking about the importance of unconscious processes in emotional life? Long term answers to this question may vary -- which is not the case in the far better defined field of immunology -- and this in itself is a sign of the uncertainty that prevails about progress in the field of psychotherapy.

It seems fair to say first, that Freud's ideas have not met with acceptance throughout the field -- if anything, there are more doubters than supporters. The notion of unconscious processes cannot be reasonably questioned, but Freud's changing definition of the realm has led to turning the concept of "the unconscious," into an ill-defined, waste-basket notion. Experimental research into its essentials has been equivocal and the term "unconscious" is used in so many different ways as to defy definition. Furthermore, the communicative-adaptive approach has offered an empirically-grounded and precise definition of this concept in terms of emotion-related adaptation, processing, and communication, but its propositions have not even been debated or explored -- and either accepted or refuted. Serious challenges in psychotherapy that entail paradigm shifts generally go unmet.

A review of the history of psychoanalytic theory reveals minor changes, such as the shift toward object relations and interactional factors, but there has been no major revision, nor has there been significant advances in clinical or formal research methodology, and we lack a much-needed explosion of knowledge. Compared to immunology, psychotherapy is moving at a crawl, if at all.

What does this comparison tell us? I would suggest that it highlights the narrowness of the purview of psychoanalysts and psychotherapists and the unfortunate isolation and stultification of the field. We are stuck in a mire of competing ideas without strong leadership or a key guiding principle. We are a field in danger of replacement by neuroscience and chemical "cures." We deny our roots in biology in favor of adaptively meaningless hermeneutics, and given our need for denial -- much of it seemingly necessitated by existential death anxieties that overwhelm patients and therapists alike. It is this bent for denial that had made our field so difficult to advance and so wanting of essential truths. Immunology is blessed with having to deal with biochemical entities that, while fighting the scepter of death, have no awareness of its inevitability.

Psychotherapy is in desperate need of scientists and research methods that can advance the field significantly. In an era of rapid scientific progress on all other fronts, we are still mired in methods and thinking that belong to the 19th century and that will not carry us forward to the 21st. All in all, comparing the two men and the fate of their revolutionary ideas should be cause for alarm for every psychotherapist and psychoanalyst in practice today.

We have as yet lifted but a thimbleful of wisdom from the vast ocean we call the body of knowledge of psychoanalysis and psychotherapy.

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