Melancholic biology: Prozac, freud, and neurological determinism

Configurations

Volumn 7, Issue 3, 1999, Pages 403-419

  Wilson, Elizabeth A ^a  

^a UNIVERSITY OF SYDNEY   (Australia)

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[No Author keywords available]

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EID: 0742334518     PISSN: 10631801     EISSN: 10806520     Source Type: Journal    
DOI: 10.1353/con.1999.0027     Document Type: Article

References (58)

1. Peter Kramer, Listening to Prozac (New York: Penguin, 1993), p. 67.
2. Ibid., Listening to Prozac p. 107.
3. Judith Kegan Gardiner, for example, in her 1995 review of Listening to Prozac ("Can Ms. Prozac Talk Back? Feminism, Drugs, and Social Constructionism," Feminist Studies 21 [1995]: 501-517)
4. suggests that Kramer is advocating a fairly straightforward version of biological determinism: "He claims it [Prozac] does more than restore sick people to their former selves; it makes them 'better than well' (p. x)
5. and so proves the dominance of biological over psychological forces in determining personality" (p. 503).
6. Similarly: "Kramer believes that Prozac proves psychoanalysis to be wrong in attributing adult misery to childhood psychological trauma. Instead, he prefers biological, even evolutionary arguments about the functions of mood and chemicals in the brain" (pp. 505-506).
7. What strikes me as interesting in this assessment (which I take to be typical of many critical responses to Listening to Prozac) is the way in which Kramer's biologism can be so readily determined. If, as Kegan Gardiner herself claims, "biological and social aspects of human personality are mutually constitutive" (p. 512),
8. why is Kramer's text not taken to be a particularly arresting account of such "mutual constitution"? Is it that, in truth, Kegan Gardiner (like so many feminists) is only able to allow this constitutive effect to flow one way: from the social to the biological? Why is it that an account of "mutual constitution" cannot be sustained with "biological, even evolutionary arguments"-after all, isn't evolutionary theory an account of the mutual constitution of the organism and the environment? In such critical moments, feminism's commitment to a position of mutual constitution becomes specious; and this mode of feminist analysis falls back into a cultural determinism that is as narrow as the biological determinism it claims to contest. What I hope to demonstrate in my reading of Listening to Prozac is that Kramer presents a thesis of "mutual constitution" that is profoundly enabling for feminist politics.
9. Kramer, Prozac (above, n. 1), p. 105.
10. George Beard, Sexual Neurasthenia: Its Hygiene, Causes, Symptoms and Treatment, 4th ed. (New York: E. B. Trent, 1895), p. 15.
11. George Beard, cited in Jane Goodall, "General Adaptation Syndrome: Hypochondrias of the Fin de Siècle," in Aestliesia and the Economy of the Senses, ed. Helen Grace (Kingswood, Australia: PAD, 1996), p. 65.
12. "It is difficult to make any statement of general validity about neurasthenia, so long as we use that name to cover all the things which Beard has included under it. In my opinion, it can be nothing but a gain to neuropathology if we make an attempt to separate from neurasthenia proper all those neurotic disturbances in which, on the one hand,'the symptoms are more firmly linked to one another than to the typical symptoms of neurasthenia (such as intracranial pressure, spinal irritation, and dyspepsia with flatulence and constipation); and which, on the other hand, exhibit essential differences in their aetiology and mechanism from the typical neurasthenic neurosis" (Sigmund Freud, "On the Grounds for Detaching a Particular Syndrome from Neurasthenia under the Description 'Anxiety Neurosis,'" in Standard Edition of the Complete Psychological Works ofSiginund Freud, 24 vols., éd. and trans. James Strachey [London: Hogarth, 1953-1974], vol. 3, p. 90 [hereafter cited as Standard Edition}).
13. This hypothesis covers only the cases of acquired neurasthenia, where heredity or family disposition can be ruled out as the cause of nervous weakness: "It may be taken as a recognized fact that neurasthenia is a frequent consequence of an abnormal sexual life. The assertion, however, which I wish to make and to test by my observations is that neurasthenia is always only a sexual neurosis"
14. (Sigmund Freud, "Draft B: The Aetiology of the Neuroses," in Standard Edition, vol. 1, p. 179).
15. Ibid., Standard Edition p. 180.
16. Jean Laplanche and Jean-Bertrand Pontalis, Tlie Language of Psychoanalysis (London: Karnac Books, 1988), p. 10.
17. Or at least this is the case for men. In women, neurasthenia is rarely caused directly by masturbation, but more usually through inadequate sexual relations with a neurasthenic husband: "Neurasthenia in females. Normally, girls are sound and not neurasthenic; and this is true as well of young married women, in spite of all the sexual traumas of this period of life. In comparatively rare cases neurasthenia appears in married women and in older unmarried ones in its pure form; it is then to be regarded as having risen spontaneously and in the same manner [? as in men]. Far more often neurasthenia in a married woman is derived from neurasthenia in a man or is produced simultaneously" (Freud, "Draft B" [above, n. 8], p. 181).
18. "The essence of the theories about the 'actual neuroses' which I have put forward in the past and am defending to-day lies in my assertion, based on experiment, that their symptoms, unlike psychoneurotic ones, cannot be analysed. That is to say, the constipation, headaches and fatigue of the so-called neurasthenic do not admit of being traced back historically or symbolically to operative experiences and cannot be understood as substitutes for sexual satisfactions or as compromises between opposing instinctual impulses, as is the case with psychoneurotic symptoms (even though the latter may perhaps have the same appearance)"
19. (Sigmund Freud, "A Discussion on Masturbation," in Standard Edition, vol. 12, p. 249).
20. Sigmund Freud, "Introductory Lectures on Psycho-Analysis (Lecture XXIV: The Common Neurotic State)," in Standard Edition, vol. 16, p. 388.
21. "The problems of the 'actual' neuroses, whose symptoms are probably generated by direct toxic damage, offer psycho-analysis no points of attack. It can do little towards throwing light on them and must leave the task to biologico-medical research" (ibid., p. 389).
22. Freud, "On the Grounds for Detaching" (above, n. 7), pp. 90-139.
23. Ibid., On the Grounds for Detaching p. 108.
24. Ibid., On the Grounds for Detaching
25. Ibid., On the Grounds for Detaching p. 109.
26. Anxiety neurosis, on the other hand, results when the somatic excitation cannot be worked over psychically: "The manifestations of the anxiety neurosis appear when the somatic excitation which has been deflected from the psyche is expended subcortically in totally inadequate reactions" (ibid.).
27. See Eve Kosofsky Sedgwick and Adam Frank, "Shame in the Cybernetic Fold: Reading Silvan Tomkins," in idem, Shame and Its Sisters: A Silvan Tomkins Reader (Durham: Duke University Press, 1995), pp. 1-28, for a cogent and timely account of the normative tendencies to be found in many contemporary critical assessments of biological theories.
28. No doubt a theoretical caveat concerning "distributed networks" is necessary here. The structure I am elucidating in Freud could be called a "distributed network" only when certain ontological conditions have been meet. Specifically, the logic of "distri-button" is critically effective only as it approximates a Derridean notion of dissemination or diflerance-that is, a distribution or relationality that is constitutive of its component elements. The distribution of already intact entities (penis; cortex; psyche) into part- or subentities is not what is entailed in nay reading of Freud. In this second sense of distribution, the problematic of a singular, localized presence (penis; cortex; psyche) is not addressed by "distributing" that presence secondarily into fragments or mobile assemblages. Distribution has to be "originary" and constitutive. See
29. Elizabeth A. Wilson, Neural Geograpliies (New York: Routledge, 1998), for an extended discussion of networks, location, and presence in relation to contemporary connectionist models in psychology.
30. Sigmund Freud, "Draft G: Melancholia," in Standard Edition, vol. 1, pp. 200-206.
31. Ibid., Standard Edition fig. 1., p. 202.
32. Ibid., Standard Edition p. 205.
33. Ibid., Standard Edition pp. 205-206 (italics in original).
34. In the Studies on Hysteria (written at much the same time as this work on neurasthenia) Freud documents the other side of this ontological integration-that is, how a generalized somatic weakening (conversion hysteria) can be instigated by a psychic trauma. Analyzed in this way, neurasthenia is the psychosomatic corollary of hysteria.
35. See Joseph Breuer and Sigmund Freud, "Studies on Hysteria," in Standard Edition, vol. 2.
36. While the term "obligation" is usually enlisted to designate a contractual relation between people (or, more broadly, between two agents), Freud's use of the term here implies no such human or conscious action. This is not a metaphorical use of obligation, if "metaphorical" is taken in the narrow sense of bringing the meaning of obligation to bear on psychosomatic action when it is "properly" applicable to another domain (social relations). Obligation at the level of neuro-psychic interchange is meant to denature the human- and conscious-centric lucidity with which obligation is used "properly" elsewhere. The point is not to render neurological action knowable via obligation, but to make obligation curious via its association with the microbiological. Derrida has already commented on Freud's particularly cogent use of metaphor (here in relation to the metaphorics of writing): "Freud, no doubt, is not manipulating metaphors, if to manipulate a metaphor means to make of the known an allusion to the unknown. On the contrary, through the insistence of his metaphoric investment he makes what we believe we know under the name writing enigmatic"
37. (Jacques Derrida, "Freud and the Scene of Writing," in idem. Writing and Difference [Chicago: University of Chicago Press, 1978], p. 199).
38. See ibid., Writing and Difference pp. 196-231, for a brilliant account of the operations of breaching in Freud.
39. Both anxiety and pain-two dominant concerns in Freud's writing at this timeexpose (often all too acutely) the kinship between the psychic, nervous, digestive, circulatory, and excretory systems.
40. See, for example, Goodall, "General Adaptation Syndrome" (above, n. 6), pp. 55-83;
41. Paul Martin, The Sickening Mind: Brain, Behavior, Immunity and Disease (London: Harper Collins, 1997);
42. Elaine Showalter, Hystories: Hysterical Epidemics and Modem Media (New York: Columbia University Press, 1997).
43. Kramer, Prozac (above, n. 1), p. 108.
44. Ibid., Prozac p. 114.
45. My use of the term "shocking" in relation to the death of Lucy's mother is not narrowly metaphorical (see n. 27, above): while the stress of electrical current and the stress of psychological trauma are different in nature, they may be similar in their neuropsychological effects. Kramer discusses experimental evidence that suggests that a psychological trauma can cause changes in the endocrine system, such that the brain itself is rewired. These Stressors "can cause chemical and anatomical changes whose behavioral effects may not be apparent for some time" (ibid., p. 118). Sexual abuse is one form of such stress in humans. Kramer cites a study in progress by the US. National Institute of Mental Health that points to the effect of childhood sexual abuse on stresshormone systems: in a four-to-five-year period following sexual abuse, girls who had been subjected to this abuse had higher-than-normal cortisol levels compared to a matched sample; moreover, these disruptions to the stress-hormone system were highly correlated with depression. Kramer hypothesizes that the original trauma may itself not be causing depression, but may be rendering these girls more susceptible to depression from that point on. A similar ontological-temporal model has been elucidated by Freud under the name Nachträglichkeit-deferred action.
46. Elizabeth Wurtzel, Prozac Nation: Young and Depressed in America (New York: Riverhead, 1995), p. 346.
47. Kramer, Proiac (above, n. 1), pp. 123-124.
48. Ibid., Proiac p. xv.
49. Moreover, any attribution of an antipsychological or antipsychoanalytic agenda to Kramer should be demolished by his subsequent book, Should You Leave? (New York: Scribner, 1997), which is grounded in a traditional (i.e., nonbiological) psychotherapeutic literature.
50. One définition of "determination" offered by the Oxford English Dictionary (2d ed.) is: "The determining of bounds or fixing of limits; delimitation; definition; a fixing of the extent, position, or identity (of anything)."
51. In the "Afterword" to Peter Kramer, Listening to Prozac (New York: Penguin, 1997), p. 318.
52. Camilla Griggers, Becoming-Woman (Minneapolis: University of Minnesota Press, 1997), p. 107.
53. Ibid., Becoming-Woman p. 115.
54. See also Margot L. Lyon, "C. Wright Mills Meets Prozac: The Relevance of 'Social Emotion' to the Sociology of Health and Illness," in Health and the Sociology of Emotions, ed. Veronica James and Jonathon Gabe (Oxford: Blackwell, 1996), pp. 55-78, for a comprehensive analysis of Listening to Prozac. Lyon fully understands the difficulties of articulating the relation between neurological and socio-psychological domains: "
55. The so-called Prozac debates have frequently been cast in terms of a search for the foundations of the 'modem self/ and whether these are to be located in chemical or in sociopsychological phenomena.... [Sjuch debates can be seen to be part of the larger concern with the boundaries between, and limitations of, biological and social or humanistic explanations of human behavior" (p. 55). Nonetheless, Lyon retreats from the critical efficacy of biological detail-in the end, Listening to Prozac is too biologically oriented. Lyon invokes "social emotion" as a bridge between biological and social explanations. Notably, however, the specificity of the physiology of emotion is relinquished by her discussion of the biology of emotion under the rubric of that ubiquitous critical euphemism "the body."
56. See the introduction of Wilson, Neural Geographies (above, n. 21), for a discussion of the awkward relation between "the body" and biology in contemporary criticism.
57. Penelope Deutscher has alerted me to the critical deployment of kettle logic (as delineated by Freud in The Interpretation of Dreams): in defending himself from an accusation that a returned kettle is damaged, the accused responds with a series of contradictory claims-the kettle you lent me is brand new; the holes were already in it when you lent it to me; you never lent me a kettle in the first place.
58. See Penelope Deutscher, Yielding Gender (London: Routledge, 1997), for a discussion, via Kofman and Derrida, of the sustaining effects of kettle logic in Rousseau.