Mary Shepherd (2007): Testing a Psychoanalytic Hypothesis using Biological and Psychosocial Data

Abstract:

This interdisciplinary study attempted to investigate a psychoanalytic theory about the nature of the relationship between destructive impulses, the structures that inhibit those impulses, the consequences of such interactions in the mind or behavior of the individual, and the possible biological correlates of such mental structures.  Spotnitz’ (1969, 1985) hypothesis asserts that schizophrenia is a defense against destructive behavior, which results in the fragmentation of the psychic apparatus.  MRI data from individuals who had exhibited violent behavior to a greater or lesser degree were studied in order to look for biological correlates of mental and behavioral phenomena.  The literature review explored three areas, 1) the controversies regarding the relationship between psychoanalysis and biology, 2) the psychological and biological etiologies of schizophrenia and their possible interrelationship at the level of earliest mental functioning, and, 3) the latest biological theories abut the various cortices, the amygdala and other sub-cortical structures, as well as the nature of the relationship between these two major brain areas.

Seventeen subjects were divided into two groups, psychic and non-psychotic according to DSM IV diagnostic criteria.  They were also ranked for severity of violent behavior according to two psychosocial measures.  Thirdly, brain volumes of both the cortical and subcortical areas were available for each subject.  Given the Spotnitz hypothesis, it was predicted that schizophrenics/psychotics would exhibit less violent action and reveal higher volume scores of orbito-frontal cortical measures indicating greater inhibition of the impulse activity.  Secondary hypotheses predicted 1) a larger volume amygdala in the more psychotic population [given that there is a “build-up” (innate or environmental) of frustration/aggression in the schizophrenic, Spotnitz, 1985, p.85], 2) a direct correlation between volume of amygdala and OFC in this population, 3) an inverse relationship between the volume of the amygdala and OFC in the violent population, higher impulse arousal, less inhibition, and 4) a similar inverse relationship between violent action and OFC volume in the population in general.  T tests and correlation statistics were used to analyze the data. 

The results were inconclusive, to a great extent explicable by the small N and other confounds.  However, it did appear that volume correlates better with violence than with psychosis.  How can this be explained?  See below.  Further correlations corroborated this tendency.  Other researchers using this data (Fulwiler, Gansler, 2006) had also found both amygdala volume and OFC volume to correlate with violent behavior, especially when correcting for asymmetry.  This led to further exploration.  The right hemisphere is the seat of emotional activity.  Brain systems that mediate pain repeatedly will be strengthened.  Overstimulation, overuse, overactivity are implicated in the increased volume in both cortical and sub-cortical structures.  This will appear on a structural MRI whereas the more fleeting defense may only appear on a functional MRI. Clinical psychoanalysis helps explain this distinction between inhibition/repression and discharge/action.  For example, in 1896, Freud distinguished between two kinds of defenses, compulsions, uninhibitable pleasure, and repressions, which mitigate against the release of unpleasure; in 1969 Spotnitz delineated two aspects of inadequacy behaviors in schizophrenia, the action/discharge pattern and the inhibited pattern.  Further research may attempt to trace and refine the distinction between overuse, compulsion defenses, and inhibiting, or ‘repression’ defenses.