Philosophy, Psychiatry, & Psychology

In their very thoughtful and stimulating replies, the three commentators foreground several topics crucial for both psychoanalysis and philosophical psychiatry. In my short response, I focus primarily on what the commentators believe to be the paper's main shortcomings. The first critique reads as follows: Freud never claimed that the Homo sapiens is a fundamentally sick animal, but in fact thought that normalcy is possible and that normal behavior need not be interpreted as neurotic, perverse or psychotic. The second is that current Darwinian psychiatry does not substantiate the view that Homo sapiens is essentially an ill animal, whatever Freud's position might be. Third and last, the proposal that all human beings are ill to the core seems to be more of a religious slogan than a scientifically useful description.

What Freud Really Said

A transhistorical approach to Freud's work is far from simple, considering that it spans a period of over forty years and that it underwent considerable changes during that time. Not only did Freud introduce some radically new concepts during that time, such as narcissism and the death drive. Also, he regularly changed his position on the aim of psychoanalytic therapy, the ontogenesis of anxiety, and the nature of human sexuality. That Freud sometimes saw homosexuality as an inborn drive did not keep him on other occasions from thinking that homosexual desire was a result of the repression or projection of an oedipal (heterosexual) drive. Examples like these show that any exegesis of Freud's writings inevitably has to deal with some tensions. Freud's work contains numerous apparent, as well as real, contradictions, so that it is no surprise at all that Katherine Morris can produce textual evidence "proving" that Freud never held the view I attribute to him. According to her, Freud thought that we are not all neurotics and that normalcy is possible.

I do not deny that several passages in Freud's work underscore the possibility of non-neurotic normalcy. Indeed, Freudian theory even describes processes—sublimation, the transformation from Id to Ego, the resolution of the oedipal complex, among others—that explain how human beings can escape neurosis and other mental disorders. But Freud's illustrations of these mechanisms or processes make clear that he could not conceive [End Page 343] of a nonpathogenic psychodynamics. Consider, for instance, how Freud emphasizes throughout his study of Leonardo da Vinci that Leonardo's sublimations make him extremely vulnerable to psychic exhaustion or "neurasthenia" (1910). Freud never tires of repeating that there is only a gradual difference between a neurotic patient and Leonardo da Vinci, the sublimating ("healthy") artist and scientist.

Morris (2005) is right, of course, in arguing that a gradual difference between normality and mental illness does not imply that there is no difference at all. Quantity should not be thought the opposite of quality, because small quantitative differences can transform an "articulation" into a "breach." To use Hegel's famous example, there is a continuum between 110° C and -10° C, but everybody knows that that water evaporates above 100° C and freezes below 0° C. Applied to mental disorders, quantitative differences in levels of testosterone and serotonin may lead to qualitative differences in behavior; in other words, categorical and dimensional approaches to mental illnesses are not mutually exclusive. Having established that, we now need to take a closer look at how Freud articulated the differences between seemingly normal individuals and the mentally ill.

Freud held that neurosis, psychosis, and perversion are caused by the interplay between instincts and defense mechanisms. Further, he thought that the pathogenic instincts were almost exclusively sexual. Now, although it is true that he sometimes recognized that the fear of death and the death drive are important factors for psychic life (Deeley 2005) and for the etiology of psychosis, more often than not he interpreted the fear of death as a symbolization of...