The Corpus Callosum

One of the earliest theories in psychiatry was psychoanalytic theory.  Psychoanalysis is a particular form of psychotherapy.  The practice of psychoanalysis, and the theory that underlies it, are based upon a set of traditions for the interpretation of symbols.  The symbols can be of any sort.  The spoken word is typically the medium of interest in psychoanalysis, but it is by no means the only medium.

Early practitioners of psychoanalysis were fond of applying their tradition to the interpretation of symbols in nontherapeutic settings.  Sometimes this was interesting; other times, frankly annoying.

In casual social settings, analysts would bop around interpreting people's shoes, hair styles, and the way they held their cigars.  As I said, it was annoying.  Sort of like the way some religious persons try to inject religion into everything, these persons would apply psychoanalytic theory as though it were a theory of everything.

Psychoanalytic theory has merits, but it plainly is not a theory of everything.  It only appears to be, for it provides a way to impute meaning to symbols, and symbols are everywhere.  The obsessive interpretation of random symbols is a practice of questionable value.  In contrast, however, there is meaning in the psychologically-informed interpretation of symbols, as presented in works of art.

For some modes of human endeavor, symbolism is entirely the point of the endeavor.  Art is like that.  That is the difference between visual impact and visual art.  Without symbolism, art is no more interesting than a table of random numbers.  

39634 62349 74088 65564 16379 19713 39153 69459 17986 24537
14595 35050 40469 27478 44526 67331 93365 54526 22356 93208
30734 71571 83722 79712 25775 65178 07763 82928 31131 30196
64628 89126 91254 24090 25752 03091 39411 73146 06089 15630
42831 95113 43511 42082 15140 34733 68076 18292 69486 80468
80583 70361 41047 26792 78466 03395 17635 09697 82447 31405
00209 90404 99457 72570 42194 49043 24330 14939 09865 45906
05409 20830 01911 60767 55248 79253 12317 84120 77772 50103

The image of Vincent Van Gogh is nothing more than a string of 881,320 zeros and ones.  If you look at the zeros and ones, they appear to be random.  The meaning arises when the raw information is interpreted.

There is a paper, available online, describing one aspect of the history of the relationship between psychoanalysis and the interpretation of art: Psychoanalytic Aesthetics: The British School, by Nicola Glover.  It is not a paper of general interest for most people, but it does highlight an important finding:

As we noted in the last Chapter, Klein contributed only three papers which touched on artistic material and did not develop an aesthetic theory as such. Like Freud, her interest in art related to the way it could illuminate and clarify certain aspects of her psychoanalytic theory that she was interested in at the time.

What this shows, is that the early analysts were not merely interested in applying their theory to understand art; rather, they were interested in art as a way to advance their theory.  It worked both ways.

For Sigmund Freud and Melanie Klein, the study of art was merely more grist for the mill.  The greater the variety of human endeavor they studied, the more they were able to elaborate and validate their psychoanalytic theory.

Ms. Glover delineates the history of the interactions between the development of psychoanalytic theory, and the development of aesthetic theory.  It started with Sigmund Freud, who really just scratched the surface:

This chapter will look at the general direction of Freud's writings on art, and its relationship to his metapsychology. My intention is to show that Freud's contribution to aesthetics, although criticised for being ambivalent and incomplete, is significant largely because it has made subsequent developments possible within the British School of Psychoanalysis.

Ms. Glover next discusses the contributions of Melanie Klein.  Klein was one of the few early analysts who was a woman.  For various reasons, she ended up doing a lot of work with children.  She also diverged from classical Freudian theory in several respects.  Her work with children led to an interest in play, then to art.  Not that art is play, but the two endeavors share a common element of free expression.  Klein advanced some of Freud's work on aesthetics:  

Klein, however, was herself interested in art and literature (although, like Freud, mainly for the exegesis of her clinical theory) and she contributed three papers which were specifically devoted to the analysis of artistic and creative themes, the most relevant one being (as far as this study is concerned) 'Infantile Anxiety Situations Reflected in a Work of Art and the Creative Impulse' (1929).

The thing is, no matter how smart the analysts were, sooner or later a scholar of art was going to have to be involved, if there were ever to be a successful integration of psychoanalytic theory and aesthetic theory.

As we shall see in Chapter three, it was her pupil, Dr. Hannah Segal who developed a systematic theory of creativity and aesthetics based on Klein's insights. Another important exponent of Kleinian aesthetics was the art critic and historian, Adrian Stokes (an analysand of Klein) who successfully integrated Klein's account of infantile experience into his aesthetic criticism. Thus it was largely through the work of Segal and Stokes that Kleinian aesthetics became fully established as a coherent approach to the visual arts.

An analysand is a person who undergoes psychoanalysis.  So Klein psychoanalyzed Stokes, then Stokes took what he learned from his analyst, combined it with his formal training, and put together a coherent method of understanding art through analytic theory.

Early practitioners in any area of scientific inquiry often are limited by a lack of techniques with with to gather objective, replicable data.  So they end up theorizing in abstract, symbolic ways.  This leads to a richness of thought that can be quite engaging.  However, despite all its armchair intrigue, this abstract symbolic stuff is of limited practical use.  It is hard to practice evidence-based medicine, when most of your evidence consists of case studies with an N of 1.

Still, you have to start somewhere, and you take your inspiration wherever you can find it.  



The image above is the sort of data that modern psychiatric research generates.  It's from an article in NEJM, Cognitive Behavioral Therapy, Sertraline, or a Combination in Childhood Anxiety.  It's based on a study of 488 children, sponsored by NIMH, involving dozens of investigators, in several institutions.

In this randomized, controlled trial, we assigned 488 children between the ages of 7 and 17 years who had a primary diagnosis of separation anxiety disorder, generalized anxiety disorder, or social phobia to receive 14 sessions of cognitive behavioral therapy, sertraline (at a dose of up to 200 mg per day), a combination of sertraline and cognitive behavioral therapy, or a placebo drug for 12 weeks in a 2:2:2:1 ratio. We administered categorical and dimensional ratings of anxiety severity and impairment at baseline and at weeks 4, 8, and 12.

The results showed exactly what was expected: medication helps, psychotherapy helps, and the two together work better than either one alone.  It's always nice to have a study that shows that what you think you know, is in fact correct.  Studies such as this were not possible in Melanie Klein's time.  

Would we have gotten to the point of being able to do such a study, if psychoanalysis had never been invented?  

Another question, a bit more vexing, is this: would we have gotten to this point, if art had never been invented?