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Neuropsychoanalysis: An Interdisciplinary Journal

for Psychoanalysis and the Neurosciences
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The Neuropsychology That Would Have Interested

Freud Most: Commentary by Oliver Turnbull (Bangor,
UK)
Oliver Turnbull

Centre for Cognitive Neuroscience, School of Psychology, University of Wales, Bangor,

383670, Gwynedd, Wales, LL57 2DG, U.K. e-mail:
Published online: 09 Jan 2014.

To cite this article: Oliver Turnbull (2001) The Neuropsychology That Would Have Interested Freud Most: Commentary by
Oliver Turnbull (Bangor, UK), Neuropsychoanalysis: An Interdisciplinary Journal for Psychoanalysis and the Neurosciences,
3:1, 33-38, DOI: 10.1080/15294145.2001.10773334
To link to this article: http://dx.doi.org/10.1080/15294145.2001.10773334

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Psychoanalysis and Cognitive Neuroscience

(Kosslyn, 1999). Language activation studies show
discrete regional responses in classical language areas
when the brain is "sliced" axially or coronally. My
colleagues at the Brain Imaging Research Institute in
Melbourne, Graeme Jackson and David Abbott, have,
for analytic purposes, viewed the brain as a series of
decreasing concentric volumes. Voxel counts are projected onto the surface of each volume. This approach
yields a rather different view. What appear to be discrete regions in conventional cuts through the brain,
can now be appreciated as continuous transcortical
ribbons of activation. This finding has something in
common with Freud's aphasiological model, and is
interesting from that point of view. The difficulty that
remains, however, is that cognitive activation paradigms do not contain within them the broad mental
reach of psychoanalytic concepts. The most we can
hope for at this stage is a cerebral map of fragments
of the Freudian view of mind. Working memory is
a favorite topic amongst the neuroimaging fraternity;
perhaps the mystic sketchpad would allow one to
claim working memory as a fundamentally Freudian
concept!
Along similar lines, the notion of verbal memory
is crucial in censor-ego function (Gilmore and Nersessian, 1999). There is a growing body of literature on
the functional neuroanatomy of verbal memory. It is
becoming clear that this function is underpinned by
a widely distributed cortical system that includes the
highest levels of neocortical association cortex (Dolan
and Fletcher, 1997), and pathways to the hippocampus
via perirhinal and entorhinal cortices (Saling and
Weintrob, 1999). This system clearly has one foot in

33
the external world, and the other in the inner world.
But does this finding lead us to the seat of ego?
While I find it difficult to accept the idea of a
special and natural nexus between cognitive neuropsychology and psychoanalysis, I applaud Semenza's
contribution to the search for a link between the two
cultures of psychology, for its desire to bring to an end
the "century of misunderstanding" (Whittle, 1999).

References
Dolan, R. J., & Fletcher, P. C. (1997), Dissociating prefrontal and hippocampal function in episodic memory encoding. Nature, 388:582-585.
Freud, S. (1891), On Aphasia. New York: International
Universities Press, 1953.
Gilmore, M., & Nersessian, E. (1999), Freud's model of the
mind in sleep and dreaming. This Journal, 1(2):225-232.
Kosslyn, S. M. (1999), If neuroimaging is the answer, what
is the question? Philosoph. Trans. Roy. Soc. Lond., B.,
354: 1283-1294.
Saling, M. M., & Weintrob, D. (1999), The functional neuroanatomy of verbal memory in focal epilepsy. J. Internat. Neuropsycholog. Soc., 5:274.
Whittle, P. (1999), Experimental psychology and psychoanalysis: What we can learn from a century of misunderstanding. This Journal, 1(2):233-245.
School of Behavioural Science
Department of Psychology
The University of Melbourne
Victoria 3010
Australia
e-mail: m.saling@psych.unimelb.edu.au

The Neuropsychology That Would Have Interested Freud Most:

Commentary by Oliver Turnbull (Bangor, UK)

Carlo Semenza has offered a thought-provoking discussion on the relationship between the theoretical
foundations of psychoanalysis, and those of modern
cognitive neuropsychology. In doing so, he reviews
the core features of the cognitive approach, and suggests that psychoanalysis shares much in common

Oliver Turnbull, Ph.D., is Senior Lecturer in Cognitive Neuroscience

at the University of Wales, Bangor, and Consultant Neuropsychologist at
The Anna Freud Centre, London.

with modern cognitivism. It is a radical, and rather

interesting, argument. The idea is interesting because
there are unquestionably some similarities between the
two fields, which is (to some extent, see below) captured by Semenza's use of Howard Gardner's list
(1985). For example, there is much merit in the argument that both fields are investigating the mental apparatus, and that they do so using the language of
"representation." Semenza's idea that Freud can be
regarded as a diagram maker has some appeal. In addi-

34

tion, Freud was clearly of the opinion that the mental

apparatus consists of a number of component parts,
each of which is relatively independent, and that such
systems can be (at least to some extent) independently
modified (though the process is one of over- or underactivation, rather than by lesion). These arguments
make Semenza's suggestion rather interesting.

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The Modern Opinion of Semenza's Position

However, Semenza's argument is "radical' because
one can already hear the howls of objection from both
sides. I can think of very few cognitive neuropsychologists who would blithely accept that their discipline
shares its core assumptions with psychoanalysis. Certainly, such scientists would be wondering why the
core assumptions and methods of the two disciplines
appear to be so different (for a review of these concepts see the introductory chapters of Ellis and Young
[1988]~ McCarthy and Warrington [1990]~ Parkin
[1996]). For example, where are the concepts of modularity and dissociation in psychoanalysis? Where are
the painstaking experimental attempts to "localize" a
deficit to a single component of a model of mental
apparatus? There are no doubt ways in which such
questions can be countered by Semenza, but only with
difficulty. However, I feel that the most important objection relating to a link between psychoanalysis and
cognitive neuropsychology relates to the type of patient that is studied. Where in psychoanalysis would
you find the investigation of neurological patients with
focal brain lesions? It is true that there has been some
work of this sort, especially recently (e.g., KaplanSolms and Solms, 2000). However, it has been almost
entirely absent from the earlier history of psychoanalysis. I will return to this point later in this discussion.
The objections against an analogy between psychoanalysis and cognitive neuropsychology would
also be strongly heard from the psychoanalytic side.
Where, analysts would doubtless ask, are the great
questions of motivation, emotion, and personality to
be found in cognitivism? This is, I feel, the weakest
aspect of Semenza's argument. He claims, from Gardner's list, that the two fields share a common foundation in the (momentary) "deemphasis of affect and so
on." Such an argument is difficult to defend. It seems
that psychoanalysis is, in many respects, directly concerned with context, culture, and history. Indeed, it is
beyond dispute that affect is of central concern to
psychoanalysis, and it almost certainly is not a viable
enterprise if the role of emotion is deemphasized. The

Oliver Turnbull
obverse side of the coin is also true: The absence of a
consideration of affect lies at the core of the cognitive
approach. For this reason, in particular, I doubt that
many analysts would agree with Semenza.

Freud's Opinion of Semenza's Position

Semenza's argument is all the more interesting because of the matter of historical precedent. As he
points out, modern cognitive neuropsychology has explicitly looked to the behavioral neurologists of the
late 19th century as intellectual forebears (Shallice,
1988). Of course, we also know that psychoanalysis
was predated by Freud's substantial academic career
as a neurologist during the same period. Thus, we are
in the interesting position of having a clear set of historical documents in which Freud gives his opinion
of the acknowledged forebears of modern cognitive
neuropsychology. In one sense, then this allows us to
ascertain Freud's position on Semenza's claim.
Freud had a variety of opinions about the state
of behavioral neurology in the late 19th century. On
the one hand, he was sufficiently interested in the topic
to have followed the literature, investigated a number
of patients, and published on the topic-the best example being Freud (1891). This sort of behavioral neurology was the forerunner of neuropsychology in
general (rather than cognitive neuropsychology in particular), and it clearly held great interest for Freud in
the period before psychoanalysis.
However, it is also well known that Freud's admiration for the neuropsychology of his time was far
from total. From one perspective, Freud was unhappy
with some specific aspects of the data collected in the
field (see the early chapters of Freud [1891]). More
importantly, in the present context, he disagreed with
his "cognitive" colleagues on some core theoretical
points. For example, he seems particularly uncomfortable with the "narrow localizationist" view, which
is (arguably) the forerunner of modularity, and hence
cognitive neuropsychology. Thus, in the famous chapter 6 of On Aphasia, he describes the thought-provoking model that offers a reinterpretation of the
classic aphasiological data. In its place he suggests a
"nonmodular" account of the dissociation evidence,
which stands up well to modern scrutiny (cf. Pribram,
1962~ Shallice, 1988, pp. 245-257). However, it is a
position that is more-or-Iess incompatible with modularity. Given that modularity is central to modern cognitive neuropsychology (Ellis and Young, 1988~
McCarthy and Warrington, 1990~ Parkin, 1996) this

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Psychoanalysis and Cognitive Neuroscience

makes it difficult to regard Freud as a founder of the
discipline.
However, while Freud was clearly interested in
the neuropsychology of his time, the interest was not
sustained through his career-he described problems
of this sort as "a silly game of permutations" (Solms,
2000, p. 83). Of course, the clearest evidence of his
waning interest in neuropsychology is his growing interest in what was to become psychoanalysis. This
intellectual shift was (arguably) a result of the fact
that many patients (notably those with hysteria) had
no demonstrable brain lesion at autopsy, and could not
adequately be explained in terms of the box-and-arrow
diagrams offered by the neuropsychology of Freud's
time. One of the reasons for this may have been that
such models focused on cognition, at the expense of
emotion and motivation. Indeed, by dealing with this
omission, affective neuroscience and modern neuropsychiatry are making great strides in establishing the
biological basis of disorders which were previously
classed as "functional" rather than "organic." The
absence of knowledge of this sort in the neuroscience
of Freud's time is likely to have been one of the reasons for his shift of emphasis to psychoanalysis, where
Freud developed a theory that was capable of explaining the deficits of his patients. We can observe
the period of transition in the fact that the 1895 "Project for a Scientific Psychology" is an attempt to develop a neurological model which incorporates affect
and motivation. It was, of course, famously abandoned-and marks the turning point in Freud's interest in the neurobiology of the mental apparatus.

What Sort of Neuropsychology Would Have

Interested Freud?
This presents us with an interesting question. Freud
would have had no real desire to investigate the neurobiology of, say, language and vision, when his interests had moved on to those of emotion and motivation,
which lie at the core of psychoanalysis. However, as
the years passed, Freud had access to an increasingly
well-developed model of the mental apparatus, which
could potentially be tested using the method which
was familiar to him from his earlier career. If he had
pursued this line of enquiry, then he would have been
able to establish the biological basis of psychoanalysis-the problem which he had failed to deal with in
the "Project." This begs the question of why Freud
did not investigate the biological basis of the psychological topics that were of interest to him. Had he done

so, then the discipline that we have recently named

neuropsychoanalysis would have emerged decades
earlier than it now has. Why did he not begin to investigate the neuropsychology that would have been of
greatest interest to him? One way to view this issue
is in the context of the standard detective novel, where
one evaluates evidence using three criteria: means,
motive, and opportunity. We should briefly examine
each.

Means, Motive, and Opportunity

First, it would seem that Freud had the means to study
the psychoanalytic aspects of the changes seen after
brain injury. This is the question of whether he had
the knowledge and skills necessary to carry out the
task. The evidence here seems, at first sight, fairly
clear. For example, Freud had all the clinical tools
required to make an assessment of an appropriate patient. He was, after all, not only a neurologist and
neuropathologist, but also an experienced psychoanalyst. His years of experience in various domains of
neurological science leave us in no doubt that he had
sufficient knowledge of neuroanatomy and neuropathology to carry out such a study. In fact, clinicoanatomicallocalization of function was' 'a subject of very
special interest to him" (Solms, 2000, p. 80). Finally,
he was extraordinarily familiar with the detail of psychoanalytic theory, having developed the theory himself. Thus, it seems self-evident that Freud had the
necessary knowledge and skills.
Second, Freud clearly had a motive. We have established above that Freud had little taste for the neuropsychological investigation of cognitive abilities in
his later career-they no longer held any great interest
for him. However, he would have had very good reason to investigate the biological basis of psychological
functions of psychoanalytic interest. Some evidence
of this comes from the fact that he lived to see the early
emergence of the science of psychopharmacology, and
appears to have followed the progress of the discipline
with some interest. More importantly, he frequently
made statements to the effect that our understanding
of various depth psychological functions would be all
the easier if we knew their biological basis.! Finally, he
made frequent reference to the fact that the separation
between psychoanalytic theory and neuroscience was
l' 'The deficiencies in our description would probably vanish if we
were already in a position to replace the psychological terms by physiological or chemical ones" (Freud, 1920, p. 60).

Oliver Turnbull

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36

only temporary, and that the disciplines would one

day be reunited. 2 Thus, Freud would have been delighted to see the present-day moves toward interdisciplinarity. One surely cannot claim that he would have
been anything but highly motivated to investigate the
neurobiological basis of psychoanalysis.
This leaves the final question-of whether Freud
had the opportunity. Would he have been able to carry
out such investigations, even if he had both the skills
and the motivation to complete the task? One should
recall that Freud was seeing patients more or less all
day, every day of the working week, for the duration
of his analytic career (Jones, 1956). Thus, we may
assume that he would not have had the time to visit
hospitals and to investigate the appropriate patients.
Indeed, he would certainly not have considered a brief
interchange with a patient at the bedside to be sufficient to draw any sort of reliable psychoanalytic inference about them. It would be necessary to meet
regularly with the patient, in a setting like that of his
analytic consultation room. Without this, he would not
be investigating the depth psychological issues that
were of real interest to him.
However, the lack of time to visit hospitals need
not be such a major objection to the claim of lack of
opportunity. Freud was spending a great deal of time
seeing patients, and he could have perhaps taken on
someone as an analytic patient who had suffered a
neurological injury. In such a case, Freud would not
have to travel to the hospital to see the patient, and he
need not be hurried in making a premature diagnosis
at the bedside. Instead, he would be able to take his
time in assessing the mental apparatus in all its complexity. If the proposal that Freud could have seen
neurological patients in his consulting room is valid,
then Freud would have had the opportunity (as well
as the motive and means) to investigate the biological
basis of psychoanalysis. To the best of my knowledge,
he did not do so. Why did he not choose this strategy?
There are a range of possible reasons for Freud's
reluctance to take on neurological patients. Perhaps
(1) no one would refer neurological patients to him.
This seems unlikely, given that psychiatry and neurology were closely allied disciplines, that Freud was
well connected in the medical community in Vienna,
and that he received a huge number of international
referrals (Jones, 1956). Another option is (2) that
Freud may have been of the opinion that such patients
would not benefit from analytic treatment, and hence
2' 'We must recollect that all of our provisional ideas will presumably
one day be based on an organic substructure" (Freud, 1914, p. 78).

seeing such cases would have been unethical. This argument has a slightly stronger basis, given that the
"talking cure" was designed for the treatment of neurosis, and that Freud was always skeptical of those
who attempted its use for other disorders (such as
schizophrenia). Finally, for those who favor conspiracy theories, there is the unlikely possibility (3) that
Freud did see such patients, but chose not to report
them.

The Claim of "Lack of Means"

To the best of my knowledge, there has only been one
attempt to explain why Freud did not embark on an
analytic investigation of neurological patients. Solms
(2000) claims that Freud did not attempt to investigate
the problem because "the clinico-anatomical method ... was incapable of providing the correlations he
sought" (p. 81). Thus, he suggests that Freud did not
have the means (the theoretical and methodological
tools) necessary to undertake this line of enquiry, because of the limitations of the currently available
method. Now, we should recall that the clinicoanatomical method has been a central feature of neuropsychology for some 150 years, and was the technique
by which so many of the great discoveries of the discipline were made (aphasia and the language areas of the
left hemisphere; recent memory and the hippocampus,
etc.). It is not a method that lacks reliability; it is also
the tool that is currently being recommended as an
excellent candidate method for pursuing modern neuropsychoanalysis (Solms, 1998a,b, 1999,2000; KaplanSolms and Solms, 2000). Thus, it is of some importance that we clarify why Freud may have rejected this
approach, and also how it is that Solms et al. now
come to recommend it.
Solms's claim is that Freud rejected the clinicoanatomical method, as it existed during his lifetime,
because it was incapable of accommodating "(1) the
functional nature of neurotic pathology and (2) the
dynamic nature of normal mental processes" (p. 81).
This situation, Solms argues, has now changed; he
dates this change to the work of Aleksandr Romanovich Luria (1902-1977). The claim is that Luria's introduction of the concept of a functional system
"adapted the clinico-anatomical method to accommodate the essentially dynamic nature of the mental process" (Solms, 2000, p. 98). This method was not
available during Freud's lifetime, because it was developed by Luria after the Second World War (see
Luria's [1979] autobiography for an account of the

Psychoanalysis and Cognitive Neuroscience

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chronology). This argument suggests, then, that Freud

did not feel able to undertake the task of developing
a depth neuropsychology because of the inadequacy
(real or merely perceived) of the available methods in
neuropsychology. He lacked the "means" to do so. It
may well be that there are problems with Solms's
claim; for example, why did Freud not have another
attempt at developing a dynamic neuropsychology, as
he did in the 1895 "Project"? He might well have
had greater success in the 1930s, in the context of
developments in psychopharmacology. However, the
one merit of Solms's argument is the best one: that it
explains the evidence-that Freud does not seem to
have tried to develop neuropsychoanalysis.

Semenza's Argument Reconsidered

What does this mean for the argument suggested by
Semenza: that Freud came close to "developing by
himself the central tenets of cognitive neuroscience"?
I think there are two points that can be made. First,
Freud clearly did involve himself in the neuropsychology of his time. Had he continued to work in neuropsychology proper (instead of moving to
psychoanalysis) he would have continued to make a
contribution-perhaps even a more substantial one
than he is currently credited with (cf. Pribram, 1962).
However, I doubt that he would have made the substantial contribution to cognitive neuropsychology that
is suggested by Semenza; for example, because of the
great importance of "cognition" to Freud's interests,
and because of his attitude to modularity. Thus, Semenza's claim is interesting, but probably overstated
on this point.
Second, one might rephrase Semenza's position
to consider Freud as the founder of another sort of
neuropsychology, which investigated the neurobiology of the psychological functions that were of interest
to him. This discipline, now called neuropsychoanalysis, is the neuropsychology that would have interested Freud most, and the field that he would have
liked to have founded. It seems that he did not make
the attempt. The one argument in his favor on this
point is that his repeated suggestions that such a discipline would be inevitable, given that neuroscience
would grow across the decades, has laid the groundwork for the new field. It will be of some interest to
see what happens to psychoanalysis in the process, for
"Biology is truly a land of unlimited possibilities. We
may expect it to give us the most surprising information, and we cannot guess what answers it will return

37

in a few dozen years to the questions we have put to

it" (Freud, 1920, p. 60).
In summary, Semenza contends that Freud
founded a discipline that I believe he would not have
wanted to found (cognitive neuropsychology). In addition, it is clear that Freud did not found a discipline
that I believe he would have wanted to found (neuropsychoanalysis). To make a set of claims other than
this would, I think, not do justice to Freud's attitude
to the neuropsychology of his day and its relationship
to psychoanalysis. Freud made substantial contributions to both psychoanalysis and neuropsychology, but
it seems that we have identified some areas in which
he did not make a radical contribution. We should
remind ourselves of the enormous contribution that
Freud made (in several domains), but also recall that
excellence in one domain does not imply omniscience.

References
Ellis, A. W., & Young, A. W. (1988), Human Cognitive
Neuropsychology. Hillsdale, NJ: Lawrence Erlbaum.
Freud, S. (1891), On Aphasia. New York: International
Universities Press, 1953.
- - - (1895), Project for a scientific psychology. Standard Edition, 1:281-391. London: Hogarth Press, 1966.
- - - (1914), On narcissism: An introduction. Standard
Edition, 14:67-102. London: Hogarth Press, 1957.
- - - (1920), Beyond the Pleasure Principle. Standard
Edition, 18:1-64. London: Hogarth Press, 1955.
Gardner, H. (1985), The Mind's New Science. New York:
Basic Books.
Jones, E. (1956), Sigmund Freud: Life and Work, Vol. 2.
London: Hogarth Press.
Kaplan-Solms, K., & Solms, M. (2000), Clinical Studies in
Neuro-Psychoanalysis. London: Karnac Books.
Luria, A. R. (1979), The Making of Mind: A Personal Account of Soviet Psychology. Cambridge, MA: Harvard
University Press.
McCarthy, R. A., & Warrington, E. K. (1990), Cognitive
Neuropsychology: A Clinical Introduction. Orlando, FL:
Academic Press.
Parkin, A. J. (1996), Exploration in Cognitive Neuropsychology. Cambridge, MA: Blackwell.
Pribram, K. H. (1962), The neuropsychology of Sigmund
Freud. In: Experimental Foundations of Clinical Psychology, ed. A. J. Bachrach. New York: Basic Books.
Shallice, T. (1988), From Neuropsychology to Mental Structure. Cambridge, U.K.: Cambridge University Press.
Solms, M. (1998a), Towards an integration of psychoanalysis and the neurosciences. Part I: Neuroscientific roots of
psychoanalysis. Forums der Psychoanalyse, 14: 193-202.
(In German)

38
- - - (1998b), Preliminaries for an integration of psychoanalysis and neuroscience. Brit. Psycho-Anal. Soc.
Bull., 34(9):23-38.
- - - (1999), Towards an integration of psychoanalysis
and the neurosciences. Part 2: Syndrome analysis of psychic functions. Forum der Psychoanalyse, 15:58-70.
(In German)
- - - (2000), Freud, Luria and the clinical method. Psychoanal. & Hist., 2:76-109.

Carlo Semenza
Centre for Cognitive Neuroscience
School of Psychology
University of Wales, Bangor, 383670
Gwynedd, Wales
LL57 2DG, U.K.
e-mail: o.turnbull@bangor.ac.uk

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Response to Commentaries by Carlo Semenza (Trieste)

General
While waiting for relevant case studies, neuropsychoanalysis, as I think this journal is trying to promote,
can only be an intellectual exercise. This exercise of
exploring the fields of psychoanalysis and neuroscience primarily consists of the search for concepts that,
while developed in one of the two disciplines, may
turn out to be useful if somehow incorporated into
the other.
The shared belief is obviously that psychoanalysis and neuroscience, while differing in aims and
methods, are ultimately about the same thing-the human mind. We know that the two disciplines have
been separated almost from the very beginning, and
that adepts of one field have generally gone their own
way without knowing too much about the other field.
In many respects this separation was desirable,
and dictated by theoretical necessity and lack of empirical findings bridging the two fields. In the past
decade, however, the opinion emerged that there was
no longer a reason for this state of affairs. It was intuited that the advanced knowledge in neuroscience
could now allow useful interaction with psychoanalysis. I am also convinced that the reverse is true: Psychoanalysis
can
indeed
inspire
interesting
interpretations of findings in neuroscience.
Within this framework I felt I could offer a few
suggestions. These were by no means prescriptions, as
some of my commentators, notably Green, understood
them to be. My aim was only to provide some food
for thought. In short, my main suggestions were the
following:
Carlo Semenza, M.D., is Professor of Neuropsychology at the University of Trieste, Italy.

1. If psychoanalysis is to benefit from neuroscience,

this could better and more naturally happen with
the mediation of cognitive psychology.
2. Cognitivism is not a psychology entirely extraneous to Freud's thought. If Freud's scientific background and his work on aphasia in particular are
closely considered, his familiarity with ideas and
methods that would later be the basis of cognitive
psychology is revealed.
3. Cognitive neuropsychology and psychoanalysis
have methodological affinities. The supremacy of
single case methodology, valid in both disciplines,
stems from what cognitive neuropsychologists
have called the principle of transparency: Pathology, provoking an imbalance among working structures and processes, may highlight, in specific
cases, functions that are obscured by the harmonious flow of a relatively undisturbed mind.
4. Connectionist models should be adopted with the
utmost caution. Shallow analogies will not work
and would make any theorization more prone to
criticisms of Popper's type (while I believe that,
properly defended by the same sort of arguments
that cognitive neuropsychologists use, psychoanalysis could instead be virtually immune to such devastating objections).
5. Somehow, against immediate intuition, the modularity theory may be useful, especially in a less rigid
form than Fodor's. There are indeed theoretical
distinctions within memory functions that are neurologically implemented. These distinctions may be
useful when considered within psychoanalysis. A
key concept in Fodor's theory, that of "informational encapsulation," may perhaps be specula-