Tuesday, December 12, 2006

Q&A Peter Kramer

Originally appeared in the Boston Globe,

By Harvey Blume

When I phoned Peter Kramer recently to talk about his new book, "Freud: Inventor of the Modern Mind," he said the volume represented his "most negative" encounter yet in a "lifelong series of encounters" with the work of Sigmund Freud. Given Kramer's knack for summing up and helping to shape the zeitgeist -- as demonstrated by his 1993 bestseller "Listening To Prozac" -- a negative report from him is not good news for 21st-century Freudianism.

To be sure, "Listening To Prozac" had already nudged Freud toward the sidelines. Kramer argued in that book that antidepressants like Prozac promoted notions of the mind, the brain, mental health, and personal identity that conflicted with the psychoanalytic model. Kramer maintained that "modern psychopharmacology" was poised to become, "like Freud in his day, a whole climate of opinion under which we conduct our different lives."

But the Kramer of "Freud" is no longer content just to wait for psychiatric climate change; he demands it. That's not because he's more enthusiastic about psychopharmacology. On the contrary, in "Against Depression" (2005), he's forthright about the fact that Prozac and related drugs have turned out to have only limited use in the treatment of clinical depression.

No, Kramer's impatience with Freud stems from his having steeped himself in tales of psychoanalysis told by people who were actually analyzed by the master. These make up a sort of samizdat literature of psychoanalysis, widely at variance with the self-congratulatory accounts penned by Freud himself. Kramer, who is a practicing psychiatrist and a professor of psychiatry at Brown University, has written that he had once "loved and admired Freud." But, he told me, when the new literature let him peek over "Freud's shoulders into how he really conducted his cases and drew his conclusions, it was disappointing."

Kramer attributes some of Freud's success to his having been "an inspired storyteller," adept, for example, at blaming patients when therapeutic disaster struck. Kramer is a skilled storyteller, too. His slim, absorbing book makes a strong case that Freud was crafty, despotic, and "focused single-mindedly on his own interests."

IDEAS: You think Freud will ultimately be remembered more as a great writer than as a scientist, don't you?

KRAMER: I was just at a conference with my humanities colleagues -- philosophers, literary critics, and so on. Freud had been so rich for them because of the sense that science had placed its imprimatur on him. I was the party pooper, saying science has withdrawn its approval.

IDEAS: One of your complaints is that Freud wasn't really very original.

KRAMER: True, but a lot of the things Freud championed that were not original have remained valuable, like psychotherapy. You can't say Freud's particular psychotherapy stems from the most legitimate view of the human mind and is most effective. But there is something about spending time with a concerned person and engaging in some thoughtful project about the self that seems valuable to people. Beyond that, we have difficulty specifying what goes on.

IDEAS: Freud's been attacked from many sides before. What's novel about your book, it seems, is the focus on the difference between what Freud said about therapy and what many of his patients said.

KRAMER: I think that is new. I don't think anyone before has taken a linear biographical approach and pulled in all this critical history. And what does Freud look like over the course of an intellectual life? He does look bad.

Let me admit that there may be a personal aspect to this. I am an atheist, of European Jewish origins. And it seems to me that if you are going to be an avatar of secular European Jewish thought, as Freud was, you should have your hands on the table every now and then.

IDEAS: "Hands on the table" is a curious turn of phrase. Let me take up one implication and ask why Freud is so interested in masturbation.

KRAMER: Early on he needed some dynamic that connected mind and body. His answer had to do with the notion that if you didn't release sexual energy the right way, you had these mental illnesses. He never got very far from that. Masturbation and coitus interruptus keep coming up as harmful to brain and mind. And we know from his letters he seems to have had remarkably little actual sex with another person.

IDEAS: Again, what are you implying?

KRAMER: Look, one of the things I struggle with in this book is: How important was he? If he's not like Darwin or Copernicus, if he was often wrong and wrong in ways that were apparent at the time, not just in retrospect, how is it he captured the imagination of an era? I think his focus on personal sexual history -- masturbation, fantasy, maybe early escapades or traumas -- was very interesting to lots of men and to lots of doctors. People in the Viennese Psychoanalytic Society, early on, were discussing their own sexual history. It was liberating to do that, though not especially rebellious. Here, again, psychoanalysis was about giving a scientific stamp to a central interest of journalism, fiction, and theater.

IDEAS: So Freud crystallizes the zeitgeist?

KRAMER: To have your finger on the pulse of the zeitgeist is a form of genius. But being wrong is a problem. It's clear to me that if Freud had never lived, medical science would be pretty close to where it is now.

IDEAS: Still, much as you discredit Freud, you seem wistful about him. You seem to miss him.

KRAMER: We no longer have a comprehensive theory of mind. The neurological take, mostly, is that mind is effectively an illusion. But in our everyday life, we believe we have mind and self and continuous personality. Freud thought he had a system for saying how those are arrayed and develop. We've lost that.

Intuitively, we are Cartesians. We think there's something that needs to be explained about the connection between mind and body. Freud was more optimistic than we are about getting it right. It isn't that we now have some theory that's better than Freud's. And we're not on the verge of one. There's a sense of loss.

But what are we to do? That is the problem with psychotherapy. I can sit across from another person -- I'm going to do it this afternoon a few times -- but what is the basis for my responses when someone behaves or talks in a certain way? There are many kinds of psychotherapy. Why is one better than another? We're agnostic now. It's not that Freud has been superseded by a better theory of mind. We do without.

IDEAS: You write fiction, too. Your novel, "Spectacular Happiness," a portrayal of a Cape Cod ecoterrorist who likes to swim and to read, had the bad luck to come out around 9/11.

KRAMER: [laughing] A month before 9/11. I comfort myself by thinking if it had come out a month later it wouldn't have been better.

There's a strain in my work that allows for lots of things to be psychotherapy. In "Spectacular Happiness," a therapist thinks a good explosion or two might help bring his patients back into accord with themselves. But does liberating the self justify everything?

Harvey Blume is a writer based in Cambridge. 

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