Prof Raymond Tallis’s excellent review of Mark Solms’s book The Only Cure (12 January) underplays the lack of curiosity that is so striking in psychotherapy. The field’s insistence that “it works” and “research can’t be done” is counterintuitive, given its positioning as interested in people.
Creativity and imagination, as found in active scientific fields, would suggest designing trials of psychodynamic psychotherapy versus talking to an untrained person; or therapy versus a weekly gym membership; or long versus short therapy; or therapy versus an evening education class; or therapy versus waiting list (a classic test of interventions); or therapy versus cash transfer in this age of universal basic income and financial strain. Generating these ideas is not hard. Implementing them requires discipline.
Curiosity, creativity and discipline on a base of knowledge are the underpinnings of science, and eminently applicable to psychology. Sadly, psychodynamic psychologists do not seem interested in exploring uncertainties and generating knowledge. A meta-question is whether this uninterest is due to selection or training.
Listening to psychodynamic psychotherapists does remind me of Ambrose Bierce’s definition of faith: “Belief without evidence in what is told by one who speaks without knowledge, of things without parallel.”
Dr James Taylor
Galashiels, Scottish Borders
• Prof Tallis’s book review raises important questions about whether modern neuroscience has vindicated Sigmund Freud. But the debate itself reveals something troubling: we’re still asking the wrong questions about mental health treatment.
As someone who has spent more than 50 years applying Adlerian psychology in therapeutic settings, I find the entire discussion oddly beside the point. Whether brain imaging confirms Freudian hypotheses or psychoanalysis meets clinical trial criteria doesn’t address the fundamental question: does this approach help people live more fulfilling, socially connected lives?
Solms argues for “the longstanding and profound effects of early-life experiences” that keep people “under the intoxicating influence of contextually inappropriate emotions”. This deterministic framework positions individuals as passive victims of their buried past. Yet Alfred Adler recognised a century ago that we are not prisoners of early experiences but active interpreters of them, capable of reconstructing meaning through insight and choice.
What’s most striking about Solms’s defence is what’s absent: any consideration of community, social contribution, or cooperative relationships. The focus remains relentlessly introspective – internal drives, buried conflicts, aggressive impulses. This is possessive individualism, to use Canadian historian CB Macpherson’s term: the atomised self wrestling with internal demons rather than a social being finding meaning through connection and contribution to others.
The question isn’t whether neuroscience has proved Freud right, but why we keep trying to salvage a system that pathologises human nature when we have approaches that encourage human potential. Almost 90 years since Freud’s death and a century since Adler’s split from him, perhaps it’s time to move on.
Grendon Haines
Montreal, Quebec, Canada
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