Psyche and Brain: The Biology of Talking Cures

On the cover of this pithy paperback is a computer-generated image of a seascape with a vertically circulating toroid of water emerging from the surface of the sea and plunging down again into it, the movement indicated by a playful dolphin following the same arc. The cover suggests that, once in the book, the reader will be invited to imagine and play with more than can possibly be seen in nature, namely, the “commodious vicus of recirculation,” to borrow a phrase from Joyce’s Finnegan’s Wake, of the contents of mind within the corridors of brain structures and the contents of a therapeutic session within a “tunnel” model of mathematical possibility. Levin’s new book follows his effort more than a decade earlier to bridge psychoanalytic and neuroscientific knowledge (1). The current attempt, still somewhat breathless from the effort to keep up with scientific progress and often reaching hypothetically beyond the state of the art, is both an engrossing synthesis and a critical review of the meshing and clashing of contemporary models.

Against a learned background of psychoanalytic neuromodeling from Freud onward, Levin talks structural turkey about cerebral hemispheric functions and the model of Posner and Raichle (2) of the brain’s executive control network of anterior structures serving the selection and zooming in on mental foci as well as the posterior brain structures serving detachment and moving on, with consciousness an emergent property. Levin’s application of this dimension of neuropsychiatry to psychotherapeutic interventions offers useful measures and warnings to consider the patient’s brain-functional givens. Much of the book deals with conscious and unconscious functions while granting that their philosophical definitions will take time.

Levin relies on Ito’s concept of the nonconscious (3), inclusive of the dynamic unconscious, which postulates a large role for the cerebellum in copying other systems and using error signals to self-organize its neural networks (Ito is the co-author of two chapters). Cerebellar maps provide for adaptive behavior without explicit awareness and have a role in attention and anticipation. Thus the mental image of movement can have practice effects similar to the effects of actual movements.

If his language smacks of neurocomputation, it is because Levin has culled widely the psychiatric synthesizers of those models. For example, the locus of the will may be unclear, but the utility of such neurocomputational considerations as Ito’s is the postulation of necessary functional agencies of mind such as will, starting with the need for instructional signals to initiate action, similar to the readiness potential in the supplementary motor area. Levin discusses transference in terms of learning readiness windows, coinciding with chaos models of freedom to reach a bifurcation in thinking.

One of Levin’s most useful distinctions is between the concepts of representation in neuroscience (feature maps) and those in psychoanalysis (introjection, identification) and cognitive psychology (semantic nets, frames, and scripts), based on “a rapidly aging analogy between mind-brain and computer” (p. 216). Levin points out that data coding in computers is concrete and mechanical, but no one yet knows how information is coded in the mind-brain. Levin goes on to discuss expert knowledge, psychoanalytic learning hierarchies, and nonrepresentational learning windows in psychotherapy. At book’s end, I was left wondering what neuromental structures psychotherapists will be playing with in another decade if Levin returns with another roundup.

Psychotherapy is possible without neuroscience, much as figure painting is possible without knowledge of anatomy, but, as Kafatos and Eisner (4) remarked,

How well positioned is psychiatry to link these domains, beginning with brain and psyche, as in the present volume.