Psychoanalysis, with its insistence on the centrality of the unconscious, has long stood apart from the dominant paradigms of American psychology. Freud’s famous remark, “They don’t realize I’m bringing them the plague,” during his 1909 visit to Clark University captures the tension psychoanalysis faced—and continues to face—in American culture and with regard to American academic psychology. In the field of modern psychology, which is increasingly dominated by utility, quantification, and symptom management, psychoanalysis stands apart by confronting the widespread denial of the unconscious in psychology, and the social and natural sciences in general.
However, psychoanalysis has found alternative homes in the university, thriving in a variety of disciplines within the humanities and in specialized programs like NYU’s Postdoctoral Program in Psychotherapy and Psychoanalysis. These spaces resist the pressures of standardization, privileging meaning over data and embracing the complexities of human subjectivity. By focusing on interpretation, depth, and the unconscious dynamics that shape experience, psychoanalysis transcends the reductive emphasis on quantifiable outcomes, offering a richer framework for understanding the human mind. Understanding why psychoanalysis has been marginalized in American psychology while flourishing in other areas requires a closer look at how knowledge is structured in the university, as Lacan’s “discourse of the university” and “discourse of the analyst” reveal.
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The Discourse of the University and Behaviorism
Lacan’s concept of the “discourse of the university” provides a compelling framework for understanding why psychoanalysis has been largely excluded from American psychology. This discourse prioritizes knowledge as a tool for mastery and control, favoring frameworks that produce measurable outcomes and align with institutional and societal demands. Behaviorism, which dominated American psychology throughout much of the 20th century, epitomizes this orientation. Figures like John B. Watson and B.F. Skinner rejected introspection and unconscious processes in favor of observable behaviors that could be quantified and manipulated. This methodological emphasis marginalized psychoanalysis in American science, dismissing it as speculative and unscientific due to its reliance on interpretation and its focus on the unmeasurable or "undecidable" unconscious.
Yet, as Mark Solms argues in his paper "The Scientific Standing of Psychoanalysis," this marginalization is not justified by a lack of evidence. Solms demonstrates that psychoanalysis is both scientifically valid and highly effective, particularly in achieving long-term psychological change. He notes that psychoanalysis often surpasses other therapeutic modalities in sustaining outcomes, particularly because it addresses unconscious, automatized patterns of behavior and thought—areas that cognitive and behavioral approaches frequently fail to understand, let alone reach and transform. His findings emphasize that the exclusion of psychoanalysis from American psychology reflects institutional and cultural biases rather than any deficiency in its scientific foundation.
Even as behaviorism gave way to cognitive psychology, the emphasis on utility, control, and efficiency persisted. Cognitive-behavioral therapy (CBT) emerged as the preferred treatment model, aligning closely with the evidence-based movement and the profit-driven priorities of managed care systems, often described as the "bottom line." CBT thrives within this framework because it produces measurable, standardized outcomes that align with institutional demands. Its short-term focus and ability to deliver quick, observable results make it compatible with managed care’s cost-efficiency priorities.
Psychoanalysis, by contrast, emphasizes depth, complexity, and the long-term exploration of unconscious conflicts—qualities that defy easy quantification. Moreover, such extended clinical work is fundamentally at odds with the profit-driven logic of managed care, which prioritizes minimizing expenses rather than investing in the time and depth required for lasting transformative care. This fundamental incompatibility underscores why the pursuit of genuine psychological health often clashes with the financial imperatives of the American healthcare system.
In this context, the truth of the unconscious becomes a reality that the system simply cannot afford to acknowledge. Programs like CBT flourish in the discourse of the university because they provide measurable results that fit institutional goals. Psychoanalysis, with its focus on uncovering and addressing unconscious conflicts over the long term, directly challenges this framework, rendering it incompatible with a system that prioritizes affordability over comprehensive mental health. Psychoanalysis’ commitment to deeper, transformative care makes it invaluable to the pursuit of psychological health but fundamentally at odds with the economic structures that dominate American mental healthcare.
The Humanities, Psychoanalysis, and the Discourse of the Analyst
While psychoanalysis has been marginalized in psychology, it has found a natural home in the humanities. Literature, philosophy, cultural studies, and other fields in the humanities have embraced psychoanalysis as a powerful tool for understanding subjectivity, culture, and the complexities of human experience. These disciplines align more closely with what Lacan called the “discourse of the analyst,” which prioritizes truth over mastery and engages with the unconscious as a disruptive and transformative force.
The humanities provide a fertile ground for psychoanalysis because they value interpretation, complexity, and the exploration of meaning—qualities that resonate deeply with psychoanalytic practice. Psychoanalysis has enriched the study of literature, history, and culture by offering frameworks for exploring unconscious dimensions of texts and human behavior. In this context, psychoanalysis is not merely a clinical practice but a method of inquiry that illuminates the hidden dynamics of human life.
Psychoanalysis and the humanities share an intrinsic alignment, rooted in what Lacan described as the discourse of the analyst. This discourse prioritizes truth over mastery, interpretation over control, and transformation over mere utility—values that stand in stark contrast to the dominant paradigms of American psychology and the discourse of the university. Psychoanalysis, like the humanities, refuses reductionism and instead engages with the unmeasurable complexities of human existence, including desire, conflict, and the unconscious. Indeed, psychoanalysis is the humanities, and the humanities are psychoanalysis; the two are inextricably intertwined in their shared commitment to meaning, depth, and ethical engagement with the human condition.
However, this alignment with the humanities underscores a critical gap in psychoanalytic training programs, including NYU’s Postdoctoral Program in Psychotherapy and Psychoanalysis. These programs, when tied to universities, are often too closely affiliated with the social sciences, particularly psychology, which operates predominantly within the discourse of the university. This association frequently imposes priorities of mastery, quantification, and standardization that dilute psychoanalysis’ transformative potential. As a result, psychoanalytic training risks becoming entangled in the reductionist frameworks of mainstream psychology, which prioritize symptom management and empirical validation over depth and interpretation.
To fully realize its transformative potential, NYU PostDoc must make a deliberate effort to integrate more deeply with the humanities and disentangle itself from the frameworks of American psychology. This means embracing the interpretive, ethical, and transformative values found in disciplines like literature, philosophy, and cultural studies. These fields, which share psychoanalysis’ focus on complexity, ambiguity, and the subjective dimensions of human experience, offer essential tools for enriching psychoanalytic training. By aligning itself more closely with the humanities, NYU PostDoc could reclaim its place within the discourse of the analyst, centering the unconscious and subjective transformation rather than succumbing to the pressures of standardization and reductionism.
While NYU PostDoc exemplifies a step in the right direction by grounding its training in psychoanalytic theory and clinical practice, it must do more to resist the reductionist tendencies of American psychology. The program’s unique position within the university provides an opportunity to redefine psychoanalytic training as an interdisciplinary endeavor, firmly rooted in the humanities. By fostering stronger connections with the intellectual traditions of the humanities, NYU PostDoc could expand its influence, not only as a clinical training program but as a cultural and intellectual force within the university.
Such integration would ensure that psychoanalysis is not just a clinical discipline but a vital part of the humanities, reclaiming its role as a framework for understanding and addressing the complexities of human experience. By separating itself more fully from the paradigms of American psychology and aligning with the discourse of the analyst, NYU PostDoc could lead the way in reimagining psychoanalytic training for the 21st century, affirming its place as both a clinical practice and a transformative intellectual pursuit.
Evidence-Based Practices, Psychoanalysis, and the Centrality of Meaning
The evidence-based movement in psychology has often marginalized psychoanalysis, but this exclusion is unwarranted. As Mark Solms demonstrates in The Scientific Standing of Psychoanalysis, psychoanalysis is supported by robust empirical evidence, particularly for its long-term outcomes. Studies and meta-analyses reveal that psychoanalytic therapy often achieves sustained improvements in symptoms and deeper personality structures, outperforming short-term treatments like CBT. This “sleeper effect” underscores psychoanalysis’ capacity for transformative, enduring change.
Beyond its empirical validation, psychoanalysis highlights a foundational truth about psychology: it is a discipline rooted in meaning. Unlike the natural sciences, which prioritize quantifiable data, psychology—whether in its psychoanalytic or American form—must engage with the interpretive processes that shape human experience. Symptoms are not mere problems to be managed but expressions of unconscious conflicts, desires, and histories demanding understanding and integration. Psychoanalysis addresses these deeper dimensions, distinguishing itself from approaches like CBT that often focus narrowly on symptom management.
As Solms points out, psychoanalysis also aligns with contemporary neuroscience, which increasingly validates the role of unconscious processes in shaping behavior and emotion. This convergence challenges outdated perceptions of psychoanalysis as unscientific and positions it as an integrative framework that bridges empirical science with the symbolic and subjective realities of human life.
Ultimately, the exclusion of psychoanalysis from mainstream psychology reflects a misunderstanding of the discipline’s core purpose. Psychology is not just a social or natural science—it is a study of meaning, transformation, and the unconscious. By reclaiming this foundation, psychoanalysis offers a richer, more comprehensive approach to psychological health, emphasizing depth and integration over superficial symptom relief.
Conclusion: Reimagining NYU PostDoc and Health Humanities
Psychoanalysis’ exclusion from American psychology reflects the dominance of the discourse of the university, which prioritizes utility, control, and measurable outcomes. Programs like NYU’s Postdoctoral Program in Psychotherapy and Psychoanalysis, however, show that psychoanalysis can thrive within the university when it aligns with the humanities and the discourse of the analyst. By emphasizing the unconscious, long-term transformation, and the ethical dimensions of clinical work, NYU PostDoc challenges the reductionist tendencies of mainstream psychology and reclaims psychoanalysis as a vital, living discipline.
Undoing the Missteps of American Psychology PhD Training
To fulfill its mission, NYU PostDoc must address the intellectual baggage that many of its trainees bring from American psychology PhD programs. These programs are often steeped in the discourse of the university, teaching frameworks that prioritize symptom management, efficiency, and empirical validation over engagement with the unconscious. Trainees entering NYU PostDoc are often immersed in cognitive-behavioral models that emphasize control and quantification, leaving little room for the depth and complexity central to psychoanalytic work.
Undoing this "learning" requires reorienting trainees to the interpretive, transformative approach that psychoanalysis demands. This involves not only introducing them to psychoanalytic theory but also helping them unlearn the reductionist assumptions ingrained in their previous training. A more robust connection to the humanities could play a crucial role in this reorientation. By engaging with disciplines like literature, philosophy, and cultural studies, trainees can develop a richer appreciation of subjectivity, ambiguity, and the unconscious dimensions of human experience. These fields offer frameworks that resist the commodification of knowledge and instead value interpretation and complexity—qualities essential to psychoanalysis.
Integrating Psychoanalysis into the Health Humanities
As I have argued in my vision for an aspirational health humanities center, psychoanalysis should be a cornerstone of the health humanities. By addressing the unconscious dimensions of illness, caregiving, and healing, psychoanalysis provides a deeper, more comprehensive framework for understanding health and human experience. Integrating these insights into academic and clinical training programs bridges the gap between theoretical inquiry and practical application, fostering a richer, more transformative engagement with the complexities of mental health.
Psychoanalysis and the health humanities share a commitment to exploring the human condition in all its depth and complexity. Just as the humanities provide critical tools for understanding the symbolic and subjective dimensions of experience, psychoanalysis offers a method for engaging with the unconscious processes that shape behavior, relationships, and health. A deeper collaboration between these fields could transform the health humanities into a space where the unconscious is not only acknowledged but placed at the center of inquiry and care.
The Path Forward: A Model for Integration
NYU PostDoc, with its dual emphasis on clinical practice and psychoanalytic theory, is uniquely positioned to lead this integration. By forging stronger connections with the humanities, the program could model a new approach to psychoanalytic training—one that emphasizes interdisciplinary collaboration and values depth over standardization. Such a shift would enhance the program’s intellectual and clinical rigor while expanding the relevance of psychoanalysis across academic and healthcare contexts.
By embracing the transformative values of psychoanalysis and resisting the pressures of commodification, NYU PostDoc ensures that Freud’s “plague” continues to challenge and enrich our understanding of the human mind. Deepening its engagement with the humanities and expanding psychoanalysis’ influence in fields like the health humanities would not only strengthen the program but also pave the way for a broader, more integrated vision of psychological health. In this vision, the unconscious is no longer denied or marginalized but recognized as a central, inescapable truth—one that has the power to transform both individuals and the institutions that serve them.
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