There’s an essay I wrote quite early, called “Psychotherapy and the Single Synapse,” in which I first pointed out — before imaging — that ultimately we need to understand the action of psychotherapy the way we understand the action of drugs — at the level of altering synaptic communication, and that insofar as psychotherapy works, it produces anatomical changes, just like learning does. For me, that was an obvious statement. For them, it was an a-ha! A number of the things I have said are absolutely obvious once you think about it, but they [the psychoanalytic community] just weren’t thinking along those lines.
BW: Do you endorse some lines of psychotherapy over others? Such as cognitive behavioral therapy?
EK: Yes, I think that all these processes can be studied, and you can say, “This is better than that.” Twenty to 30 years ago, they said it was too complicated to study. But the fact is, they’re going to go down the tubes if they don’t study it. And they need to find biological markers of psychiatric illnesses — even mild mental illnesses — and see how they’re affected by psychotherapy. I think that’s going to come.
I think I have an advantage over some neuroscientists, because I’m not hostile to psychoanalysis. I like psychoanalysis. I just don’t think it’s doing its job scientifically. It’s an art, rather than a science. But I think most people who know me realize that I do this in order to help encourage the survival of what I think is a very valuable therapeutic adjunct, not to destroy it.
BW: If you’re in traditional psychoanalysis, trying to find the root of a problem, and you’re going over the same painful memories again and again, aren’t you reinforcing —
EK: The same behavior patterns? Well, there are two issues. One is implicit, the other explicit. The explicit one is that there is a reason for a repetition compulsion. If you have a behavior — you gamble all the time, or sell yourself short, or work too hard — understanding why — Whom are you trying to please? What are you accomplishing? — sometimes frees you up. The implicit thing is just the psychiatrist being there for the patient. There’s something very healing about the human interaction. When you’re 1 year old, you can easily pick up a foreign language, like Mandarin Chinese, which you couldn’t do at age 12. But you can only do it if you are in the presence of a teacher. You can’t do it if you’re in front of a television set with the projected image of a teacher. You need the human interaction, even at that age. So the human interaction in accepting what the patient says, and treating it as meaningful, is very therapeutic. Just being there for a person is very helpful. So there are many levels on which treatment works.
BW: You have demonstrated how a nerve will eventually stop responding to a mild stimulus through prolonged exposure. If you take someone with a fear of heights, and in therapy they talk about it — What caused it? How do heights make them feel? — they might be reinforcing that fear by obsessing on it. Whereas if they don’t talk about it at all, but each day stand a step higher on a ladder — one foot, three feet, six feet—they may become desensitized to it.
EK: That’s exactly right. There is desensitization therapy, which is extremely effective, and it can be done with a computer in a virtual environment. But I think in good therapy both happens. You’re very frightened of heights? I would say, “That must be terrible to be so frightened. Why don’t we talk about it, and why don’t you start experimenting with going up one flight and looking out the window.”
BW: In the film, it shows how a nerve removed from an organism and placed in a petri dish responds to a stimulus the same way the organism responded. This hasn’t reduced your perspective of human psychology and behavior to a more mechanical level?
EK: Well, that is a common worry. In fact, in the preface of my next book, which is about art and science, I say that a lot of people feel uncomfortable about it. They think that a scientific approach is going to trivialize art by focusing on the nitty-gritty biology. I don’t sense that. You know the heart is a pump that pumps the blood around. But there is a way that the heart is magical. One is able to hold both ideas in one’s head, at least sequentially if not simultaneously.
Number one, there’s danger in the delusional enthusiasm that some have about the mind, which is the idea we’re about 80 percent there, instead of 10 percent there. But I think most people working on the brain realize that it’s a long haul. We’ve made a lot of progress, but boy, how much more needs to be done.
Number two, even if we had a complete solution, it would be very complex and it would enrich our understanding of mental processes. It wouldn’t trivialize them. There are people who understand how a Mercedes works. It doesn’t make the driving any less wonderful.
BW: And if you say, by analogy, that a television show is just a grid of tiny colored lights …
EK: Sure, or that a book is just ink on the page. Of course it’s not just that. There’s poetry, story …
BW: In your book, you write a lot about revealing the secrets of consciousness. Do you think that’s ever going to be possible through a mechanical understanding?
EK: It’s not just mechanical. Science is more than a mechanical understanding. At an early point in the science, you shouldn’t say can’t, because you don’t know what’s going to be possible. Every time you move forward in science, it involves changing your conceptual scheme — making it more sophisticated — and encouraging the development of new tools that allow you to go to the next step. So the methodology itself is moving brilliantly. Imaging was unheard of 30 years ago, and even thought it has its weaknesses, it’s opening up whole new dimensions. So I don’t see why consciousness should be so difficult.
This article was originally published in Brain World Magazine’s Spring 2010 issue.
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