In the previous post in this series I discussed how we can see public health strategies as “technologies” which reveal human health, life and behaviour in particular ways and act as tools for changing these. In this post I will discuss how different forms of what Nikolas Rose calls the “psy-sciences” (the disciplines concerned with the psyche) also use “technologies” for understanding and intervening in human life. In the process they help to shape how our minds, brains, consciousness and unconscious are understood and experienced.
Psychoanalysis
Some of the most important “technologies” of psychology were developed by Sigmund Freud. One of the key problems which Freud tried to tackle was how to gain access to, and intervene in, the unconscious. This was important to Freud because he believed that our unconscious drives and desires play a huge part in directing our behaviour and influence our mental health. However, the unconscious is inherently hidden from direct view.
Initially he thought the best route to his goal would be to analyse dreams, as outlined in his famous book The Interpretation of Dreams, as dreams seem to be the time when the unconscious mind takes over. Other methods he used included analysis of slips of the tongue (“Freudian slips”), which are never simply mistakes but unconscious thoughts escaping past our conscious mind.
He also used hypnotism as a way of observing unconscious thoughts. The principle being that hypnotism can put people into a dreamlike state while still allowing communication with a therapist. He later developed the more sophisticated approach of “introspection” which involved interviewing patients in a relaxed state (while lying on his famous “couch”). Patients would be trained in methods of looking into their own psyche, thoughts and feelings for the sources of their mental anxieties.
Embed from Getty ImagesAlthough Freud firmly believed in the scientific validity of his approach it is now clear that the idea of the unconscious mind as something which can be accessed through therapeutic intervention is at least to some extent constructed through the process of looking for it. For instance, there have been many reported cases of phantom “repressed” memories of child sexual abuse and other traumatic events which seem to be planted through the suggestions of a psychiatrist (deliberately or not).
Behaviourism
While Freudian psychoanalysis was hugely influential in the 20th century another completely different strand of psychological investigation was developed almost concurrently, this is “behaviourism”. Behaviourists have an entirely different view of consciousness to psychoanalysts in the sense that they largely deny the existence of the unconscious mind. Or at least consider it to be beyond the realm of scientific observation and investigation. Instead human consciousness is seen as a “black box” with the behavioural psychologist merely observing inputs (stimulus) and outputs (response).
Behaviourists such as John Watson initially developed behaviourism as a method for investigating animal psychology. It was not possible for a Freudian method of psychoanalysis to be used on animals because dream analysis and hypnosis required the use of language by the patient or subject. The behaviourist approach was effective with animals as the consciousness of the animal was treated as a simple information-processing unit with the psychologist just concerning themselves with the relationship between stimulus and response.
Later behaviourist psychologists such as BF Skinner developed the concept of “operant conditioning” which enabled subjects to be trained to behave in particular ways by rewarding desired behaviour and punishing undesirable behaviour. This approach to consciousness is very different to the “deep” understanding of Freud and the psychoanalysts. The behaviourist understands consciousness as “shallow”. Again we can clearly see how the methods of analysis and intervention to some extent shape the mind they are observing.
Perhaps the most significant and influential technology of psychology in the 20th century is a book. Or more properly a series of books, the Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association (APA). This is a guide to all the officially sanctioned psychiatric disorders. Although it is produced by the APA it is also widely influential outside of America.
This book is so important because if symptoms displayed by an individual are deemed to match those in the DSM this has powerful and significant consequences. For instance, it might mean someone can be legitimately “sectioned” or sedated or that they will be granted much desired treatment. In countries such as the United States, where healthcare is paid through insurance, most health insurers will only pay out for treatment of conditions which are listed in the DSM. Thus the inclusion of the disorder in the book, and the particular ways in which it is characterised and therefore can be legitimately diagnosed is significant and powerful.
The DSM has gone through several different versions in its history. The first two versions were highly psychoanalytical in character. There were very few listed disorders and all were effectively seen as neuroses of one kind or another. These are all presented in a descriptive fashion with a lot of detail and the onus was still very much placed on the clinician to interpret the symptoms of the patient and align them with the qualitative description in the manual.
However, there was a highly significant change with the DSM III in 1980 which completely transformed the manual and threw out the psychoanalytical approach entirely. It was instead replaced with a kind of behaviourist model in which the detailed descriptions were removed in favour of lists of symptoms. In most cases these specified that positive diagnosis could be given if a patient presented three or more (for instance) of the listed symptoms. These symptoms tended to be behavioural or attitudinal traits rather than psychodynamic processes. From the introduction of the DSM III a more behaviourist approach to psychiatry became institutionalised (Mayes and Horwitz, 2005).
Neuroscience
Perhaps the most influential technologies used for understanding and interpreting consciousness in recent years have come from developments in the neurosciences. Devices such as computerised tomography (CT) machines and electroencephalograms (EEG) produce visual representations of neural (brain) activity. These devices translate electrical impulses or heat signatures in the brain into lines on a page or highlighted brain maps.
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They function as what Bruno Latour refers to as “inscription devices” as they draw (or inscribe) things which couldn’t otherwise be seen. The assumption behind the use of these technologies is that the readings they provide can tell us something about the processes of thought. Just as Freud used dreams or “introspection” as a way of accessing the unconscious thoughts of his patients, today’s neuroscientists use CT scans to do the same.
Embed from Getty ImagesBut the technologies which are used to access the conscious or unconscious mind produce different pictures. The version produced by neuroscience presents a “neuromolecular” picture with consciousness understood in terms of material processes and electrical impulses, this is a “fleshy” self (Rose and Abi-Rached, 2013). Of course the brain is biological but can the self be reduced to simply an electrical circuit running through matter?
In the next post I will explore how genetic technologies are affecting how understand what it means to be human.
Mayes, R. and Horwitz, A.V. 2005 ‘DSM-III and the revolution in the classification of mental illness’ Journal of the History of the Behavioral Sciences 41(3): 249-267.
Rose, NS. and Abi-Rached, JM. (2013) Neuro : the new brain sciences and the management of the mind. Princeton University Press.