Emeritus Consultant, Nottinghamshire Healthcare NHS Trust, UK.
When we comment on past events or ideas, our view is informed by our own time and place. Not only is it difficult, if not impossible, for us to stand outside our context and take an unprejudiced view but it is equally hard to have true sympathy with past ideas and understand from the thinkers perspective what they believed and why. Particularly in psychology, which is more than the dispassionate weighing of evidence and the formal formation of conclusions; it is shaped by the life history of the person and the intellectual and professional preoccupations of the era. This relativistic position was certainly true of Sigmund Freud and may have been true for Metschnikoff. My contention is not made in order to detract from the formers genius in discerning important, ubiquitous mental processes that complicate and enrich our human relationships and which operate for the most part outside full consciousness but, rather, to set a context for this commentary.
I am looking back nearly 70 years to a text written by a psychoanalyst which gave an account of the late writings of a biological scientist, Metschnikoff, who himself had died 18 years before in 1916.1 My knowledge of what Metschnikoff wrote is third-hand, filtered by Cochrane and coloured by his commentary; Metschnikoff is not a familiar name in the world of psychotherapy. I bring to the task a late 20th century view and 27 years of experience as a consultant in psychotherapy and psychiatry in the British National Health Service and the daily necessity in that work to find helpful ways of understanding human experience and ameliorating maladaptive patterns of interaction.
Shortly before the time of Metschnikoffs death, the founding figures in psychotherapyFreud, Jung, and Adlerwere beginning to follow their differing visions of what was important in human psychology and how engagement with life could give rise to psychopathology. Jung valued the spiritual; he saw a rich, historical connection between the individual and the collective spiritual past; he promoted the finding of personal spiritual meaning in life and, within the person, the integration of complementary, not fully known selves. Adler contributed two main ideas: the existence of a fundamental, threatening sense of inferiority in the individual which has to be guarded against and the concept of social interest, transcending the individual and bringing out the best in communities.
Freud had been a neurologist and was influenced by Darwins Theory of Evolution. Both influences stressed hierarchy in development and function and informed his then current formulation of human nature in terms of drives or instincts. He posited a competition between Eros and Thanatos, a push towards, on the one hand, life and, on the other, death through the discharge of aggressive and destructive wishes.2 Elaboration of this dual-instinct theory was stimulated in part by the phenomenon of negative therapeutic reactions during psychoanalysis.3 Paradoxically, the patient reacts against well-founded interpretations and the analysts praise of progress; her clinical condition may deteriorate. This was seen as resistance, based on unconscious guilt and a consequent reluctance to give up suffering or aggressive envy.
Freuds final theory was structural and gave greater prominence to the functioning of the Ego, the mental structure at the centre of the Self and which has to live by the Reality Principle. The Ego attempts to reconcile the conflicting pushes (Trieb) of the Id and the Super-Ego and the imperatives of external life; its failure is signalled by the emergence of symptoms. His daughter, Anna, and Melanie Klein continued to use the death instinct in their theories. Klein, especially, saw envy and aggression as being innate and primary. Here developed one of the major lines of cleavage in theory amongst psychoanalysts: hate, envy, and fear as primary inevitable processes or secondary reactions to frustration. Heinz Kohut, the Chicago psychoanalyst,4 and John Bowlby, the British developmental researcher and psychoanalyst, strongly assert the latter.5 Their position makes sense to me. Contemporary analysis stresses the relationship-seeking nature of human beings, their capacity to trust and be sufficiently independent, the recreation of problematic patterns of relationship in the here-and now of the analysis, and the significance of the intersubjective reality created between patient and therapist.6 Interactional theories have replaced those based on instinct and drive discharge.
As reported by Cochrane, Metschnikoffs theory of an instinct de la mort appears insubstantial in evidence (I have no problem with there being a drive for life, instinct de la vie, in biological organisms). Anthropomorphism of a lack of escape behaviour in mayflies is a slight foundation to suppose that there is an instinctual desire for death. Certainly, an individuals life may be so horrible that they want to end it (and may properly chose to die) but why complicate the explanation by supposing an instinct? Surely, Metschnikoffs theory reflects the dominant metaphor of his time i.e. opposing hydraulic forces?
I am much more drawn to Erik Eriksons formulation. In his epigenesis, humans face a progression of phase-specific psycho-social tasks during their lives. The eighth and ultimate task comes in old age: being able to look back on a well-lived, generative life facilitates task resolution through integrity rather than despair.7 Integrity as a concept is not far from Metschnikoffs orthobiosis, the pinnacle of human development, which is signified by a long and vigorous old age, leading to the final period of satiety with life and desire for death. Satiation based on having had the well-lived, generative life can help people cope with physical decline and illness in old age. Resignation (decathecting life in analytical language) is common in the process of coming to terms with dying while relief at not having to continue the struggle with terminal ills is ubiquitous. Integrity, despair, resignation, and relief are descriptive sufficient explanations; they do not amount to an instinct. However, should Metschnikoffs idea of long-delayed, endogenous death be realised in the future through presumably genetic manipulation of the ageing process, humans would face a new psycho-social task. Death, then, would be a more elective step, needing a particular attitude of mind to overcome the final disharmony.
I warmed to Metschnikoffs optimism that the human condition could be improved though I doubt that science is the full answer. I am left with two thoughts. Freud wanted to be a scientist but was a storyteller. Metschnikoff was a distinguished scientist who, perhaps, wanted to tell stories that would comfort him in old age and his own extinction.
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2 Bateman A, Holmes J. Introduction to Psychoanalysis. London: Routledge; 1995.
3 Freud S. From the History of an Infantile Neurosis. In: Standard Edition. London: Hogarth, 1918, pp. 1122.
4 Kohut H. The Analysis of the Self. New York: International Universities Press, 1971.
5 Bowlby J. A Secure Base: Clinical Applicatiions of Attachment Theory. London: Routledge, 1988.
6 Stolorow RD, Atwood GE, Brandchaft B (eds). The Intersubjective Perspective. Northvale, NJ: Jason Aronson Inc., 1994.
7 Erikson EE. Childhood and Society. Harmondsworth: Penguin, 1965.