Bankers are like child abusers, says psychoanalyst

February 4, 2010

Today belongs to MedPage Today for its fascinating coverage of the American Psychoanalytic Association’s recent meeting in New York, which included an analysis of the financial crisis.The message? Don’t just blame greed: that may work as explanation in an Oliver Stone movie, but the psychoanalytic perspective is that other, equally powerful emotions kicked in once banking stopped being boring as a profession.

The entire process of consulting with financial (and not psycho) analysts, studying patterns and forecasts, stimulates the imagination and stirs up fantasies much like gambling, but with the illusion of greater scientificity.

At the same time, reports MedPage Today’s Kristina Fiore, the financial crisis revealed parallels with trauma theory. According to David M. Sachs, MD, it is false to assume that market abusers, like spousal or child abusers, will change their behavior; in fact, they are more likely to shift the blame to their victims.

This evasion of responsibility might explain why we didn’t see the classic financial  disaster trope of self-defenestration in the recent crash. In the stock market losses of the 1980s, leaping off the ledge seemed like the only response to losing other people’s fortunes, as it did in the crash of 1929, when syndicated columnist Will Rogers wrote that “you had to stand in line to get a window to jump out of, and speculators were selling space for bodies in the East River.”

In fact, as Bennett Lowenthal has pointed out, just two people used Wall Street as a perch to fall into the great hereafter after taking losses in the stock market crash of 1929. Black Monday in 1987 didn’t drive brokers and bankers over the ledge either, and the high profile financial suicides documented by New York Magazine may, in fact, shrink into statistical insignificance when compared to the overall number of people working in finance.

All of which might spell more rather than less anxiety for the pyschoanalytic profession, as research presented at the conference shows that the thought of a patient committing suicide is more distressing for analysts than a patient actually committing suicide. Clearly, the cliched stage-of-life leaping exits during financial crashes are more thought-about and talked-about than resolved with a thud. The question, I suppose, is how many bankers and brokers are patients who just haven’t made an appointment.

Other topics discussed at the meeting included the need for psychoanalysts to get out more. Harold Kudler, MD said that the idea that analysts were “introspective denizens of their own quiet offices” needed to be countered by leaving the office for mutually enriching engagements with the community outside.

Perhaps this will also lead to less rumination and more hard work. When the annual output of the top three psychoanalytic journals between 2001 and 2008 was combined, researchers  “found 76 original research articles, which yielded a mean of 9.5 total articles per year — only about three in each journal.”

As the lead author put it, “That’s not very many in a scientific field.”

The call for more rigorous research speaks to the wider, and fundamental debate over whether psychoanalysis, in its classic and commonly understood “Freudian” conception can actually be scientific.  As the philosopher Ludwig Wittgenstein, who had a keen interest in the field, observed, the underlying problem with Freudian analysis is that it conflates possible reasons for thinking or doing something with actual causes for thinking or doing something. Popper dismissed psychoanalysis as unfalsifiable, and therefore immune to scientific validation.

Given these longstanding criticisms and the revelations that Freud was less-than-ethical in his treatment of his patients, psychoanalysis has been fighting a rearguard battle against irrelevance. But the backlash may have devalued not just psychoanalytic approaches to psychology, but also the value of psychotherapy. Not all behavioral diagnoses are necessarily neurological in orgin, admitting only treatment by medication, and as Esther Fine, PhD told the meeting:

“Unfortunately, it is now a prevalent notion that it is no longer necessary or relevant to understand the unconscious meaning of psychological symptoms. It’s becoming a popular idea to consider psychoanalysis, and even psychotherapy, ‘dinosaurs’ in the treatment of mental disorders.”

Given the rapid increase in prescription treatments for ADHD, it may be, Fine warned, that  teachers are  turning into interpretative shrinks, and parents, who seek a quick-pharma fix from their pediatricians, are avoiding  the possibility that they, and not neurology, are their child’s underlying problem.

Parenting magazines endanger babies

August 18, 2009

A new study in Pediatrics warns that parenting magazines geared towards women who are pregnant routinely portray sleeping babies in inappropriate positions and environments. The researchers evaluated photographs of sleeping babies  in 28 magazines to see if they conformed to the American Academy of Pediatrics safe sleeping guidelines. The conclusion:

“More than one third of pictures of sleeping infants in magazines geared toward childbearing women demonstrated infants in an inappropriate sleep position, and two thirds of pictures of infant sleep environments were not consistent with AAP recommendations. Messages in the media that are inconsistent with health care messages create confusion and misinformation about infant sleep safety and may lead inadvertently to unsafe practices.”

As MedPage Today notes, the AAP “started recommending that babies sleep on their backs to reduce the risk of sudden infant death syndrome (SIDS) in 1992. It has since advised parents to remove pillows, soft bedding, and other objects from infant sleep areas.”

Research headline of the day: Two-fisted eaters…

October 22, 2008

Medpage Today reports on some less-than-surprising research into obesity published in the British Medical Journal Online: “Two-Fisted Eaters Who Wolf Down Food to Bursting Point May Be Overweight.” The article notes that:

“Past studies have found that eating quickly is associated with being overweight, but this research adds that combining it with eating until full could have a substantial impact on being overweight.”

If the cautious deployment of “may” and “could” seems odd and a little disappointing, it is because the study was cross sectional and thus cannot determine causality. The researchers called for prospective cohort studies to confirm the findings. Still, two-fisted eaters who wolf down food to bursting point may want to reconsider the whole “bursting point” part of their nutritional game plan.


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