Abstract

What if Wittgenstein and Popper were right after all? What is psychoanalysis is not “scientific,” not scientific by any contemporary definition—including Adolf Grünbaum’s—but what if it works all the same?1 What if psychoanalysis is all right in practice, but the theory isn’t scientific? Indeed, what if “science” is defined ideologically rather than philosophically? If we so redefine “science,” it is not to dismiss psychoanalysis but to understand its origin and impact, to follow the ideological dialectic between the history of psychiatry, its developing as a medical “science,” and the evolving self-definition of psychoanalysis which parallels this history. We know that Freud divided psychoanalysis into three quite discrete areas—first, a theory, a “scientific structure”; second, a method of inquiry, a means of exploring and ordering information; and last, but certainly not least, a mode of treatment. Let us, for the moment, follow the actual course of history, at least the course of a history which can be described by sorting out the interrelationship between psychoanalysis and psychiatry, and assume that we can heuristically view the mode of treatment as relatively independent of the other two aspects of psychoanalysis. What if the very claims for a “scientific” basis for psychoanalytic treatment and by extension the role of the psychoanalyst as promulgated by Freud and his early followers were rooted in an ideologically charged historical interpretation of the positivistic nature of science and the definition of the social role of the scientist? This may seem an odd premise to begin an essay on the mutual influence of psychoanalysis and psychiatry, but it is not stranger than the actual historical practice. Psychoanalysis originated not in the psychiatric clinic but in the laboratories of neurology in Vienna and Paris.2 Its point of origin was not nineteenth-century psychiatry but rather nineteenth-century neurology. That origin points to a major difference between the traditional practice of nineteenth-century psychiatry and modern clinical psychiatry in our post-positivistic age. Psychiatry in nineteenth-century Europe, in Vienna as well as in Paris, was an adjunct to the world of the asylum. Indeed, the second great battle which nineteenth-century psychiatry waged was the creation of the “alienist” as a new medical specialty. The alienist was the medical doctor in administrative charge of the asylum, rather than a medical adjunct to the lay asylum director as had earlier, in the age of “moral treatment,” been the practice. Sander L. Gilman is professor of human studies in the departments of German literature and Near Eastern studies, Cornell University, and professor of psychiatry at the Cornell Medical College. He is the author of numerous books on intellectual and literary history. His most recent study is Jewish Self-Hatred . Forthcoming is his study Oscar Wilde’s London and the English edition of his Conversations with Nietzsche. His previous contribution to Critical Inquiry is “Black Bodies, White Bodies: Toward an Iconography of Female Sexuality in Late Nineteenth-Century Art, Medicine, and Literature”