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Neuropsychoanalysis: An Interdisciplinary Journal
for Psychoanalysis and the Neurosciences
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Jaak Panksepp’s Response: Commentary by Clifford
Yorke
a

Clifford Yorke
a

Fieldings, South Moreton, Nr. Didcot, Oxon, 0X11 9AH, United Kingdom, e-mail:
Published online: 09 Jan 2014.

To cite this article: Clifford Yorke (1999) Jaak Panksepp’s Response: Commentary by Clifford Yorke,
Neuropsychoanalysis: An Interdisciplinary Journal for Psychoanalysis and the Neurosciences, 1:2, 251-254, DOI:
10.1080/15294145.1999.10773266
To link to this article: http://dx.doi.org/10.1080/15294145.1999.10773266

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For that reason. As far .M. lowed. regardless of whether or not it seems appropriate. fantasy. Honorary Consultant Psychiatrist. a pull toward childhood-and give the primitive thought processes characteristic of the unconscious a greater influence on current experience.P. however willingly the patient accepts the conditions. This may afford a helpful degree of physical relaxation. find the degree of regression so deep that it is hard for them to get up at the end of the session and at once resume normal adult functioning. It also has a bearing on some further points to be made after a brief consideration of the analyst's role. One can be familiar. it may be hard to appreciate the nature of the clinical setting in which psychoanalysts are obliged to operate. even very familiar.. but mainly through recollection. without personal experience of the treatment process itself. It may help to reduce misunderstanding. I am entirely in agreement with Panksepp that' 'we do need to probe more deeply" into the problem of "how the widely used psychotherapeutic drugs modify the emotional dynamics of human personality and other dimensions of the human mind" (p. effects. The restriction of motility imposed by the patient's physical position means that mental excitation cannot normally be discharged (or gratified) in action. British Psychoanalytic Society. the entire exchange shows every sign that the positions taken by the various participants will lead to the clarification vital for constructive debate. Complete privacy means that the telephone is inoperative and no interruptions alClifford Yorke. He must say nothing that can interfere with the patient's focus on his own mental processes.R. D. The technical methods of dealing with these difficulties need not concern us here. if they do. The "basic rule" requires the patient to try to say everything that comes to mind. to try to see whether it invited misunderstanding. listening: his occasional comments are designed only to foster the patient's self-understanding or to further the analytic process. if psychoanalysis can "help to craft the needed tools" (p. Normally. or personally or socially acceptable.. If that were so. I was in no way supporting the "fencing-in" of the discipline and' 'arbitrarily precluding" contacts with other forms of knowledge. to my mind. far-reaching. Questions are distracting. and is generally more important for the analysis than any formal answer. London. I would not be taking part in this discussion. but it has other. he cannot talk about himself or his real life. too. Before addressing them. that. and affect. largely restricts the patient's attention to his own mental processes. Anna Freud Centre. For the analyst. with the main tenets of psychoanalysis but. The analyst is out of sight. This "free association. in context. the patient lies supine on a couch. is restricted in what he can say or do. F. It may be helpful for those participants who lack that experience if I try to say something about both the setting and its rationale. it has a compelling duty to do so. In questioning the feasibility of the experimental use of pharmaceutical agents in the course of clinical psychoanalysis.251 Ongoing Discussion Downloaded by [Gazi University] at 06:35 18 August 2014 Jaak Panksepp's Response: Commentary by Clifford Yorke I appreciate the courteous and considered reply by Jaak Panksepp to the points I made in discussing his response to the paper by Solms and Nersessian. so that the capacity to test reality is reduced or partially suspended. External stimuli are further reduced by the lack of social interchange: the analyst is. and are rarely asked (analytic patience will generally supply the answer in due course)." in the context of the analytic setting. All these circumstances facilitate regression-a partial return to earlier stages of psychological development. but concluded that the difficulty was perhaps of another kind. If what follows seems a digression. Neither (within the limits of common sense) will the patient's questions be answered: the reason why the question is asked is by no means always conscious. I simply want to emphasize the potential power of the regressive pull. to do so would inhibit or interfere with the patient's fantasies about him. I firmly believe that. who has nothing more stimulating to look at than the ceiling (usually blank). I should like to say.C. I have looked once more at the relevant part of my commentary. for the most part. 178). It is that influence that usually gives every analytic hour an underlying theme. It may be worth adding that a few patients are too frightened to lie down or. Psych. The analyst makes only interventions that further the analytic work-in particular. It fosters a measure of helplessness in the face of professional authority. 178). comments that tend to bring unconscious material into consciousness. I believe it to be a necessary one. sitting behind the patient. is a Training and Supervising Analyst.

The compulsion to repeat earlier modes of attachment and behavior reflects a conservative trend in the organism: older methods of adaptation are preferred at the expense of the new. conversely. Dealing with the inhibition of the processes by which affects reach awareness often calls for slow and patient work. of course. but spoke with no evidence of anger. The patient is nothing if not conflicted. There are people who are terrified of anything new. the conservative trend in the repetition compulsion is rarely absolute: if it were there would be no such thing as progressive development and certainly no capacity for adventure. directly. But. Perhaps the first thing to say is that spontaneous transference occurs in everyday life. he tries to avoid suggestion. for that matter. The analyst said that the patient would perhaps feel very frightened if he were able to feel that he really wanted to do him so much damage. 1914. instantly like her for opposite reasons. dislike a woman who is too reminiscent of unacceptable maternal traits or. The pull back to childhood plays a major part in the development of that vital agent in analytic work. when repeated. derive from a childhood attitude to a father. Mental content unaccompanied by affective experience has its counterpart in affect seemingly divorced from mental content. But the repetition compulsion is real enough: I . must be told in the same way. listening in a very special way. The illness and the wish to get better contribute strongly to its nature and quality. a defense will generally need to be addressed before the drive representative behind it can be brought into awareness. The analyst is. One can feel furious. As for affects. It is usually a minute step toward recovery. the technique of interpretation is aimed at the uncovering of the unconscious mental representations. but the affective component is usually substantial. the analyst or. expectations. He would not have told the patient that he did feel something when the patient knew very well that he didn't. and acts as a pointer to the less conscious implications of what the patient is saying. There are other defenses against affective awareness: these are different in kind from defenses against the mental content of drive representatives. They do not. thoughts. without recognizing the object of that fury. of feelings. if a patient's need for love is unmet in reality or not fully satisfied. A distressing form of the repetition compulsion is seen in traumatic neurosis. A bank manager may be approached as a benign paternal figure who can be relied upon to look after his client's best interests. But. and attitudes toward the analyst more appropriate to parental and other important figures from the past. In that case. transference-the reexperience. as the analysis gets under way. let alone rage. It is most readily observed in children's play and in their insistence that the same story. It should not be thought that free association (which is not in fact' 'free" but motivated) will itself convey. in general.Downloaded by [Gazi University] at 06:35 18 August 2014 252 as possible. or as a somewhat daunting character only too likely to turn down a request for a loan. To take a rather vivid example from an actual analysis: a patient told his analyst that he would like to break every bone in his (the analyst's) body. and conscious and unconscious fantasies about the analyst to whom he is entrusting so much. time and time again. A full explanation of this phenomenon is beyond brief summary: but the two most important factors are regression (discussed above) and the repetition compulsion (Freud. and normally these defenses are themselves unconscious. in the present. It is affected by the patient's hopes. however remotely. In analysis. The analyst listens withfree-floating attention. This method of listening means that. But spontaneous transference can be of any degree of intensity. the overwhelming excitation aroused by that event is fractionally discharged. these can only be conscious. Mental content that the patient was unable to tolerate in everyday life will face opposition from psychological defenses. For that reason. spontaneous transference is there from the beginning. 1920. unconscious material." There is a readiness for transference. Some people approach any figure of authority with attitudes that may. trying not to attach greater importance to anyone of the patient's utterances than he does to another. for example. listening with an analyzed mind that facilitates an understanding of the underlying meaning of what the patient has said. Or someone may. and makes no conscious effort to remember. almost instantly. but they may find psychoanalysis rather too novel for their tastes. however. 1925). It may be useful to say a few words Clifford Yorke about this remarkable phenomenon. The person concerned may not know why certain people bring out strong likes or dislikes even when there has been no time to get to know them. relevant information from earlier sessions-sometimes weeks or months before--comes to mind unbidden. will be met by what Freud (1912) called "libidinal anticipatory ideas. always present themselves when they might be expected to do so. Furthermore. the transference becomes more complex and increasingly centered around the person of the analyst. any new person in the patient's life. above all. The traumatizing incident is lived (or dreamed) over and over again: each time.

The experimental use of pharmaceutical agents is a very different matter. or fails to work. with unpredictable consequences. Classically this referred to the analyst's unconscious responses to the patient stemming from his own past. We need to know. I once tried to treat a heroin addict who attempted a "cold turkey" recovery.Downloaded by [Gazi University] at 06:35 18 August 2014 Ongoing Discussion was particularly impressed when I met a patient who had twice married tuberculous husbands and nursed each through to his death. generally. To do so would require him to step outside his analytical role. for example. make suggestions which I would endorse. he may see the drug as an elixir of life. the analyst. The unconscious being what it is. On the other hand. but that is not the view he will take of his analyst's responsibilities.g. be seen as an external source of proscription (or support). If. at least unconsciously. for example. The analysis will effectively be sabotaged. This difference of opinion with Panksepp only applies. too. I tried to examine these processes from the standpoint of metapsychology (Yorke. The analyst may. occasionally. is. It is a safe general rule that the analyst should never himself prescribe. That has important consequences for the nature of what can properly be called the transference neurosis. or indeed anything else. (The remarks made above do not. that the analyst has stepped out of his proper role." I believe that statement to be generally true. directly acting on the patient's body. if she wanted self-understanding. since there can be no sound theory of technique without a clarification of these important issues. apply to children and to those on the border of psychosis. and what adaptations of technique are called for in widely differing types of disorder. Patients do. there was a particularly strong drive attachment to an infantile object. I believe. as I hope my brief resume of the method has suggested. for reasons that have nothing to do with experiment. and I omit it from this brief account. Similarly. to be dealt with by self-scrutiny and. I will not repeat here the objections I voiced in previously published material. however. I have not discussed here what has been called countertransference. His emotional response will vary accordingly. The level of regression varies in different disorders. calls for the reduction of external stimuli and interference to the lowest possible level. even if he has given formal consent. at best. one way or another. for example. some self-analysis. The metapsychology of the treatment process. even at different phases of the same analysis. to the use of drugs during formal psychoanalysis itself. however well intentioned. All this will be variously reflected in the transference. Some years ago. and the reasons for the behavior (e. when called for. The patient may resent that interference.. 1965): that attempt needs updating. Panksepp is in accord with .) On this occasion I have tried to do no more than give a bare outline of how an analysis is conducted. Today. drive organization (the mental organization structured around the drive representatives and derivatives at any given phase of development) reverts to a point at which. 224). the nature and quality of ego regression and superego regression varies. a legitimate claim to mutual interest. Solms and Nersessian. in their concluding remarks (p. psychoanalysis has made most of its discoveries. a patient referred by a psychiatrist who was seriously anergic and unable to talk until treated by antidepressants would. but it is not meant to set aside considerations of common sense. The transference relationship would be seriously interfered with. That may be fine if the patient is consulting a doctor for a physical disability. correctly. I return to Jaak Panksepp's comments. But. a negative transference reaction and/or self-destructiveness) cannot be analyzed either. its meaning is more controversial. is a delicate undertaking and. become treatable if her background mood had returned to something like its norm. after all. in the hope that it will further discussions between our disciplines. from the standpoint of personal history. and we can observe the effects. Pharmaceutical agents cannot be administered in the course of psychoanalytic treatment without interfering with the necessary conditions without which the treatment cannot operate. It has. but as soon as she ran into painful experiences she returned to the needle and analysis was impossible. Analysis. as I believe. like the parental figure of a 3-year-old-well before the superego has been fully internalized. and I hope to return to the subject elsewhere. In my original commentary I said that if "drugs were used which divorced thought from af- 253 fect. turn up under the influence (say) of alcohol. is something we all need to understand better from our two perspectives. of the method by which. he will feel. as a poison. Whatever else. These examples are meant to do no more than point to the fact that drugs can make treatment possible or quite impossible. associations would lose their power to convey information without which the analyst would not be able to operate. why and how interpretation works. It is a crucial matter for psychoanalysts. and it is likely that psychoanalytically informed methods of investigation could be devised.

Standard Edition. Although Freud included hunger and thirst among the "self-preservative instincts" in his earlier formulations. including serious physical defects that affect psychological functioning. I was interested in Panksepp's responses to my comments on this distinction. but I cannot think we are aiming at impossible goals.(1920). II).. New York: International Universities Press. The somatic oral erotogenic zone is not in itself the source of a biological need. I am less enthusiastic than Panksepp about the value of rating scales. Standard Edition. Remembering. 1973). and to drug-induced conditions. Assessment of childhood disturbances. psychotic patients (Freeman. The metapsychological profile schema. The concept of developmental lines (A. (1973). A. T. But it is worth remembering that we can reach a very useful if provisional psychoanalytic diagnostic assessment of patients with all kinds of disabilities. In all this I would. appetitive strivings ought not to be equated with drives in the psychoanalytic sense. Yorke.. I find the comments of Solms and Nersessian very much to the point. Yorke. New Haven. repeating and workingthrough (Further recommendations on the technique of psycho-analysis. Didcot.. London: Hogarth Press. Wiseberg. 1958. Mongr. The clinico-anatomical method has.Clifford Yorke Downloaded by [Gazi University] at 06:35 18 August 2014 254 these suggestions. The status of the profile in relation to the concept of developmental lines has been discussed elsewhere (Yorke. . 5. by our editors. 1980). however. Freud. Med. 1959. I believe. that a "psychological model only becomes accessible to physical investigation once the neural correlates of the components of the model have been identified" (p.net . Freud. Studies of this kind still fall within the ideographic rather than the nomothetic approaches to science. In: The Psychoanalytic Study of the Psychoses. 18:1-64. On this and the question of affects there are a number of psychoanalytic tools that can be used to examine the effects of drugs prescribed for valid medical reasons. London: Hogarth Press. Yorke.yorke@virgin. S. As for aca- demic psychology. (1962). OX]] 9AH United Kingdom e-mail: clifford. already given us invaluable work without recourse to mensuration. Some metapsychological aspects of interpretation.(1925). by the use of Anna Freud's profile schema (A. . however. Beyond the Pleasure Principle. Brit. In: Studies in Child Psychoanalysis Pure and Applied. Oxon.. On the question of drives. S. The differences between Panksepp and myself have been diminished. 213). there is no good reason why there should be any significant disagreement on this score. .. PsychoI. and Radford. and their link with affects. There is much to debate in matters of this kind. (1973). New York: International Universities Press. 17:149-158. It can be applied to children. 38:127-142. C. New York: International Universities Press. (1965). 1963) is one of them. Freud. Aspects of self-cathexis in "mainline" heroin addiction. 18:245-265. References Freeman. London: Hogarth Press. but there is room for further discussion. C. The Psychoanalytic Study of the Child. echo the reminder. 1962). . In respect of the drives. P. CT: Yale University Press. A pilot study of ten severe heroin addicts was made many years ago (Wiseberg. I find little to add to what has already been said. 1973).(1963). (1914). and from the nomothetic standpoint neuropsychology can be expected to offer us valuable information. & Radford. 12: 145-156. Freud. adults. 20:1-74. Success may only be partial in the foreseeable future. 1955. Standard Edition. An Autobiographical Study. Clifford Yorke Fieldings South Moreton Nr. The concept of developmental lines. J. The Psychoanalytic Study ofthe Child.