Freud, Fraud and the Delusion of Experience. Part 1
If all else fails, immortality can always be assured by spectacular error.
John Kenneth Galbraith
Freud’s immortal ideas are an object lesson in bad science and also in lack of probity: he must be one of the most intellectually dishonest people ever to have achieved such notoriety. It is wry that the words Freud and fraud should be so similar. I am not going to expend much time or effort here, nor anywhere else for that matter, on discussing Freud’s fancifully groundless notions. Ideas can be even more dangerous than drugs and sadly his ideas have done, and are still doing, a deal of harm to a great many people, e.g. see, among various possible examples: “Freud’s False Memories: Psychoanalysis and the Recovered Memory Movement”.
& the French analytical school’s scandalous current regressive views and treatment of autism
One of the few reasons it is worth commenting about Freud at all is because the story of Freud’s ideas, imaginative notions, fabrications (they were all of these) constitutes an object lesson in understanding how such pseudo-scientific pontificating has been, and still is, so influential among supposedly educated people. The reasons for that have important lessons for science and education, especially since medicine is still beset with third-rate thinking and poor methodology (1, 2).
I got into trouble during my training for staunchly maintaining my view that Freud was unscientific and for my description of the man’s writings as “the biggest intellectual confidence trick of the century”.
Readers may imagine that quite a few of my colleagues ridiculed me for that view (thereby exhibiting the thinking error of “that many clever people cannot be wrong”: the answer to which is, “look at history, they are wrong most of the time”). I was therefore heartened and amused when later I found similar scathing sentiments dismissing Freud in an essay by the famous Nobel prize-winning scientist Sir Peter Medawar (3):
“Opinion is gaining ground that doctrinaire psychoanalytic theory is the most stupendous intellectual confidence trick of the twentieth century: and a terminal product as well – something akin to a dinasaur or a Zepplin in the history of ideas, a vast structure of radically unsound design with no posterity”.
This stupendous Freudian blunder is a dramatic illustration of why the key concepts of science as a system are an indispensable prerequisite for the progress of knowledge.
The key concepts of science as a system (e.g. see science reference books or Wikipedia on scientific method) include the way it organises and records knowledge, observation, investigation and experiments in order to avoid errors. Among the many possible errors are selective observations, confirmatory bias, and the “delusion of experience”. The scientific method avoids or minimises these by a variety of established and proven logical and systematic steps which are well described in reference texts. The first discipline which most spectacularly transgressed the basic scientific rules was phrenology, then “Mesmerism” aka hypnosis, which Freud uncritically embraced when he visited Charcot in Paris. The profound and widespread influence that the ridiculous pseudo-science of phrenology exerted in the Western world and beyond has been forgotten, yet it dominated the thinking of supposedly educated people for around one hundred years. In the duration and extent of its influence phrenology eclipses psychoanalysis.
A recent experience of interacting with colleagues served for me as an illustration of the continuing power of the misleading nature of personal experience, which is typically informal and incompletely documented: that is the “delusion of experience”. It is a delusion because human nature makes it inevitable that successes, unusual occurrences, preconceptions etc. assume an unwarranted predominance in one’s recollections; memory is malleable and fallible. What we recall is always imperfect (see commentary “How your mind works”). Frequently when talking about the effects of new drugs doctors will recite their experience of the first batch of cases that they have treated and say that, to take a simple example, the drug causes more weight gain than some previous treatment (a common problem with various antipsychotics and antidepressants).
However, when asked to list the last 10 consecutive cases that they have treated and give the exact figures for the weight before and after treatment the vast majority of them cannot do so. This is because they have not weighed all, or any, of their patients before, during and after treatment. Nevertheless, they convince themselves that the drug has caused a specific change one way or the other, despite the absence of recorded measurements, of contemporaneous records or of formal analysis of the outcome.
The scientific method on the other hand obliges us to record contemporaneously and accurately, using appropriate methodology (like for instance, an accurate pair of scales), data about patients and then analyse it using formal mathematical and statistical techniques in order to determine whether there is a significant effect one way or the other.
Just like Freud these doctors do not treat data scientifically, even with the simplest and most categorical of measurable changes, as represented by weight. What hope is there then for meaningful scientific advances when things like feelings of depression are so much trickier to quantify reliably? This is the delusion of experience, brought on by selective attention and memory, poor record keeping, and a host of other well documented distorting factors (including pharmaceutical company “drug dinners”). Indeed, this is why so-called expert opinion (usually derived from “In my experience …”) is of minimal value in most scenarios. In the scientific approach to assessing evidence, expert opinion is relegated to a low level of reliability.
Freud: a Paradigm of Unscientific Method
In the mainstream scientific world there are few who give credence to Freud’s ideas. Indeed, few real scientists ever took them seriously, and for good reason. They cannot be discredited because they were never accredited. However, in the medical community, or branches of it, they gained, and retain, a toe-hold. Freud has more influence in the woolly intellectual areas of sociology and the arts. Nonetheless, some comment about him is appropriate because there remain places where his ideas retain significant influence in medicine, and cause sub-standard clinical outcomes and suffering; e.g. France, where some 80% of psychiatrists still have analytical “training”: note the above link to the current fiasco about analysis and autism described by Stuart Schneiderman.
There are those who concede that Freud was unscientific and dishonest but still claim that much of what he said was valuable and insightful. I suppose one could say similar things about most religions. But just because these belief-systems contain a few wise words and observations about the condition of man is not sufficient reason to include them in a scientific conception or study of either human psychology or medicine.
Freud was certainly a poor scientist and his poor science was noted by his contemporaries, many of whom held him in low regard. Indeed Freud’s poor science and egregious thinking played a part in the formation of important ideas defining the scientific method propounded by the famous philosopher of science, Karl Popper. These were expounded in “Conjectures and Refutations” (4) and I can do no better than quote from Popper an illustration of the self-fulfilling character of Freud’s style of thinking as it pertains to the “delusion of experience”. Although this quotation refers to Adler, Popper applied it equally to Freud:
“As for Adler, I was much impressed by a personal experience. Once, in 1919, I reported to him a case which to me did not seem particularly Adlerian, but which he found no difficulty in analyzing in terms of his theory of inferiority feelings, although he had not even seen the child. Slightly shocked, I asked him how he could be so sure. “Because of my thousandfold experience,” he replied; whereupon I could not help saying: “And with this new case, I suppose, your experience has become thousand-and-one-fold.”
For those unaware of this, it should be noted that Freud’s case histories, as he published them (mostly in book form and thus un-peer-reviewed), bear an indirect, even distant, relationship to the actual facts of the cases that he saw. It appears beyond doubt that he misrepresented those facts, probably combining elements of different cases to produce the picture he finally promulgated in his writings (remember, however unbelievable it may now seem- he never published a single peer-reviewed scientific paper about his cases or methods). Nowadays he would perhaps have been found guilty of academic fraud. E.g. for his misrepresentation of Breuer’s first infamous case of Anna O (Pappenheim) see: Remembering Anna O.: “A Century of Mystification” by Mikkel Borch-Jacobsen, or, “Adventures of a Bystander”, Peter Drucker, and, to give but one example, his own case of the “wolf-man”. The historian Frank Sulloway has recorded in minute detail the distortions and outright inventions that Freud engaged in: these reveal he was a fantasist and a flagrant serial liar (5). Anyone who has been deceived into thinking analysts and analysis constitutes a decent and honest enterprise should read Sullivan’s account of the story of the “Wolf-man” (p 258 et seq.), and learn how, for years, the psychoanalytic establishment paid him to keep quite and tried to stop him talking to the Austrian journalist, Karin Obholzermay, who eventually revealed the long-running deceit. That story might modify any notions readers may entertain that analysis constitutes a decent and honest enterprise.
Not only did Freud misrepresent/invent the facts of his cases, but also he was an incompetent medical diagnostician (even for that time): such actions now would probably see doctors being disciplined by the medical board for malpractice. Before he even started “analysis”, when he was still relying on hypnosis and “Faradization” (electrical stimulation; although I rather doubt Michael Faraday, FRS would have been very impressed), he was already fooling himself that he was curing patients with such methods when in fact they had incurable illnesses: e.g. his incompetent Faradization treatment of the cancer suffered by the father of an eminent senior colleague, Professor Erwin Stransky; no wonder he was poorly regarded professionally and that his practice was “run of the mill” (6); in fact, a more frank appraisal is that his practice was heading rapidly down the gurgler.
Link to Part 2, below
1.Ioannidis, JP, Why most published research findings are false. PLoS Med, 2005. 2(8): p. e124.
2.Ioannidis, JP, An epidemic of false claims. Competition and conflicts of interest distort too many medical findings. Sci. Am., 2011. 304(6): p. 16.
3.Medawar, PS, Victims of Psychiatry. Vol. New York Review of Books Jan 23 17. 1975.
4.Popper, K, The Demarcation between Science and Metaphysics. Conjectures and Refutations: The Growth of Scientific Knowledge (1963), 1963. Ch 11.
5.Sulloway, FJ, Reassessing Freud’s case histories. Isis, 1991. 82: p. 245-275
6.Shorter, E, A history of psychiatry: from the era of the asylum to the age of Prozac. 1997: Wiley.