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Blechner, M.J. (2015). Dreams: How Neuropsychoanalysis and Clinical Psychoanalysis Can Learn from Each Other. Ann. Psychoanal., 38:142-155.

(2015). Annual of Psychoanalysis, 38:142-155

Dreams: How Neuropsychoanalysis and Clinical Psychoanalysis Can Learn from Each Other

Mark J. Blechner, Ph.D.

Many clinical psychoanalysts, when they think of neuropsychoanalysis, become anxious. They anticipate having to absorb difficult data from PET scans and the like, and they wonder, “Is that effort going to make any difference in my clinical work? Will it, for example, change what I do when I hear a patient's dream?” While neuropsychoanalytic findings are consequential for a reassessment of psychoanalytic theory (Solms, 1995, 1999; Blechner, 2006), it is not always obvious whether such data are relevant to how we do clinical work. Some analysts are also intimidated or made anxious by the prospect of learning about data collected by methods with which they are not familiar. as a consequence, they may reject the whole enterprise of integrating modern neuroscience and psychoanalysis. Some do this privately; some do it publicly and in print (e.g., Pulver, 2003; Blass and Carmeli, 2007). This wish not to know is unfortunate. Surely, if a psychoanalytic patient said categorically, “What you have to offer is of no interest to me,” we might suspect resistance and defensiveness.

Even if one were to accept the spurious arguments that findings in neuroscience have no bearing on clinical work, there is the reciprocal possibility that findings from clinical psychoanalysis could be of use to further neuroscience research (Pugh, 2007; Mancia, 2007). the clinician can do research in the consulting room, finding unique data that would be useful to neuroscientists in guiding their research. In doing so, the clinician would be following a plan anticipated by Freud.

The rejection of neuroscientific data was not Freud's attitude. on the contrary, Freud began his work studying neuroanatomy and his first publications were in that field (Gray, 1948; Triarhou and del Cerro, 1985). He continued to value neuroscientific findings and suggested that the whole edifice of psychoanalysis might one day require complete revision, based on neuroscience research:

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…. Biology is truly a land of unlimited possibilities.

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