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    Empirical Studies Validate Prominence of Unconscious Processes

    by Deborah A. Lott

    Psychiatric Times July 2000 Vol. XVII Issue 7


    In a 1999 article in the Journal of the American Psychoanalytic
    Association (JAPA), Boston University psychologist and research associate
    professor Drew Westen, Ph.D., drew on a rich body of experimental studies
    attesting to the prominence of unconscious processes in mental life.
    Culled largely from cognitive psychology, these studies describe this
    mental activity as subliminal priming, implicit memory or automatic
    activation, rather than as unconscious per se. Nevertheless, Westen
    regards the implication of this research to be clear: "Consciousness is
    the tip of the psychic iceberg that Freud imagined it to be" (1999).

    During a presentation at the 1999 annual meeting of the American
    Psychoanalytic Association, Westen concluded, "The evidence of
    unconscious processes-cognitive, motivational and affective-is now
    incontrovertible and should inform our clinical thinking." In an
    interview with Psychiatric Times, Westen discussed the studies and their
    relevance to clinicians.

    In general, the data call for another look at the Freudian notion of the
    unconscious-they don't vindicate it in its entirety. "It's time to get
    past the idea that there is an unconscious," explained Westen. "What
    research in cognitive science is now clearly demonstrating is that we
    have multiple unconscious processes mediated by different neural systems."

    Conscious and Unconscious

    Some of the earliest demonstrations of the dissociation of conscious
    processes and unconscious processes came from observing patients with
    neurological deficits. Korsakoff's disorder, a consequence of long-term
    alcoholism, results in an inability to form or retrieve any new conscious
    memories, so that patients report amnesia for the recent past. The
    research suggests, however, that their experience is implicitly or
    unconsciously stored psychically in a way that influences their affects
    and motivations.

    Westen (1999) recounted a famous demonstration from nearly a century ago.
    Psychologist Edouard Claparède (described in Cowey, 1991) hid a pin
    between his fingers so that, as he shook the hand of a patient with
    Korsakoff's disorder, he pricked the patient's palm. When re-introduced
    to Claparède a few days later, the patient had no conscious recollection
    of having met him but refused, nevertheless, to shake his hand, feeling
    as if something bad might happen. "The Korsakoff's patient had stored the
    affective associations that made him unwilling to shake Claparède's hand
    again," said Westen. These associations remained outside of
    consciousness. Implicit, associative memories influenced the patient's
    emotions, motives and behavior, although he lacked any conscious
    awareness of them.

    In another, more recent experiment, Korsakoff's patients read fictional
    biographies of two different men's photographs, one depicted in positive
    terms and the other in negative language (Johnson et al., 1985). About 20
    days later, the subjects could not recall any prior exposure to the
    characters. Yet they preferred the "good" character when asked to choose
    between them. "Such neurological cases," wrote Westen (1999) in JAPA,
    "suggest that the neural circuitry for affective associative
    learning-learning to connect stimuli with feelings-is distinct from the
    neural circuitry for conscious, explicit learning, just as implicit and
    explicit memory have been shown to be neuroanatomically distinct."

    The 'Priming' Literature

    This disconnection of conscious from unconscious processing has been
    demonstrated just as dramatically in neurologically intact subjects.
    According to Westen, we all form networks of association that remain
    outside of conscious awareness and yet influence our feelings,
    motivations and behaviors. A large cognitive literature on priming (which
    Westen describes in detail in the JAPA article) documents the existence
    and activation of these networks. Westen convincingly demonstrated how
    priming works in presentations last year at the national meetings of both
    the American Psychoanalytical and American Psychological Associations.
    When members of the audience first heard him say the words ocean, beach,
    moon and waves and were then asked to name a laundry detergent, the
    majority responded with Tide. The preceding words "acted as a prime to
    activate a network of associations," he explained.

    Priming studies have not only shown that exposure to a prime will
    influence a subject's responses, but that this exposure can be subliminal
    or supraliminal and still have the same effect (Bowers and Schacter,
    1990; Schacter, 1992).

    For example, in dichotic listening tests, subjects hear two distinct
    streams of information simultaneously through two separate channels of a
    pair of earphones. When taught to attend to only one channel and ignore
    the other, their "conscious recognition memory for information presented
    in the unattended channel is at chance levels" (Westen, 1999). In other
    words, he explained, if you ask them whether they have heard a particular
    word-such as taxi-in the unattended channel, their likelihood of getting
    the answer right is no better than chance. Nevertheless, after being
    exposed to the word pair taxi:cab in the unattended channel, subjects
    will be more likely to spell the auditorially presented homophone pair
    fare:fair as fare because of the unconscious association with taxi
    (Murphy and Zajonc, 1993; Westen, 1999).

    Can Racism Be Implicit?

    A priming study of implicit racism demonstrated how a network of
    affective associations can operate outside of awareness and reflect
    feelings at direct odds with those that are conscious. In 1995, Fazio and
    colleagues presented subjects with a series of photographs of
    African-American and Caucasian faces. Each face was followed by an
    adjective, which the subjects had to identify as positive or negative by
    pressing a key.

    "If people have negative feelings toward blacks, seeing a black face will
    activate a network of unconscious negative associations so that when they
    see a negative word, they'll be primed to recognize it more quickly than
    they will a positive one," explained Westen.

    This hypothesis was borne out: a subgroup of subjects did recognize the
    negative adjectives significantly faster after seeing an African-American
    face than after seeing a Caucasian face, and these subjects were rated as
    having a high degree of what the researchers called implicit racism.

    When they attempted to correlate this implicit racism with the subjects'
    overt attitudes about race as assessed by self-report, "they found no
    correlation whatsoever," Westen said. There was a powerful disconnection
    between what people were aware of feeling and what they felt implicitly.

    The researchers then added a final wrinkle by asking a young
    African-American woman to debrief the subjects and rate each on a scale
    of one to five according to her level of comfort with them. Whereas
    subjects' conscious, explicit attitudes about African-Americans were
    uncorrelated with these ratings, the implicit racism scores correlated
    highly (about 0.5) with the debriefer's degree of comfort with the
    subjects. Westen told PT, "What people express in their behavior over
    time and don't seem to be able to control very well is their implicit,
    affective associations."

    Trauma, Shame and Violence

    As part of his doctoral dissertation in 1999, Adam C. Conklin, Ph.D., a
    psychology fellow at Austen Riggs Center, explored the relationship
    between childhood abuse, feelings of shame and perpetration of violence,
    a link that several other authors had observed in working with
    perpetrators of violence (Gilligan, 1996; Scheff and Retzinger, 1991). In
    a series of studies, Conklin analyzed men who had been sexually or
    physically abused during childhood. This is a group that faces a
    significantly increased risk of committing acts of violence themselves.

    In one study, subjects completed a self-report questionnaire that asked
    them about their own feelings of shame. Those subjects who had
    perpetrated violence reported feeling significantly less shame than did
    subjects with a history of child abuse who had not perpetrated acts of

    In a second study, a similar group of subjects took the Thematic
    Apperception Test (TAT), in which they were asked to make up narratives
    about relatively neutral human encounters. Subjects who had perpetrated
    violence revealed significantly more shame themes than did those with
    similar childhood histories who had not perpetrated violent acts. The
    findings of the explicit self-report measure and the implicit TAT measure
    were contradictory. This suggested to Westen that "the perpetrators felt
    shame unconsciously which they could not consciously expressŠIt may not
    be shame per se that distinguishes men who go on to abuse but
    unacknowledged shame."

    The Implicit, Psychic Defenses

    In Westen's mind, studies like those of Fazio et al. and Conklin have
    broad implications for how psychological research is conducted. He said,
    "The findings of researchers who rely on self-report as a measure of
    people's feelings and motivations [are apt to be] misleading at times,
    particularly when implicit and explicit feelings and attitudes conflict.
    The literature suggests that self-report correlates poorly with other,
    more implicit measures of people's feelings and motives." Westen further
    explained, "When you are asking people about anything they might have
    feelings about, you've got to measure a second, more implicit way,
    because people can be motivated by feelings that they don't know about

    From a clinical standpoint, Westen wrote (1999), "[This evidence] poses a
    challenge to competing therapeutic schools that assume that change can be
    accomplishedŠquickly and without careful attention to uncovering and
    altering unconscious associative networks." Dealing only with conscious
    feelings or cognitions may be an inadequate approach to changing feelings
    or behaviors in the long term.

    On the other hand, thinking about unconscious processes in traditional
    psychoanalytic terms may be misleading as well, according to Westen.
    Freud depicted the unconscious as the realm of the forbidden wish, sexual
    and aggressive drives, the primitive, and the libidinal, while current
    research suggests that content need not be primitive, sexual or
    aggressive to be unconscious. "Unconscious networks of association form
    as a result of life experience," said Westen, "and there's no necessary
    connection between drives, wishes, primitive mental processes and
    associationist thinking. From an evolutionary perspective, forming
    associations unconsciously and acting on them outside of awareness is
    adaptive," he explained. "No one could consciously process all the
    information necessary to perform all mental functions."

    The psychoanalyst's tendency to assume that feelings are always kept
    unconscious for defensive reasons needs to be revised, according to
    Westen's point of view. "People can be unaware of their emotions, or of
    the triggers for emotions, for any number of reasons, including the fact
    that activation of emotions is an implicit process," he explained. But he
    also acknowledged that some research suggests psychic defenses can
    operate in just this fashion, with measurable consequences.

    A group of researchers (Shedler et al., 1993) asked subjects to report
    their own symptoms of psychological distress, such as anxiety, depression
    or unhappiness. They were also asked to describe their earliest memories,
    "essentially an implicit measure of feelings about significant
    relationships," said Westen. Without knowledge of the subjects'
    self-assessments, raters evaluated the subjects on the basis of their
    childhood memories.

    If anecdotes of early life were filled with psychological pain and seemed
    chaotic, the raters tended to evaluate the subjects as being
    psychologically distressed. The subjects were then categorized into three
    groups: those who said they were distressed and the raters agreed; those
    who said they were not distressed and the raters agreed; and a third
    group who denied distress and the raters disagreed.

    All three groups were then subjected to mildly stressful tasks, such as
    reading aloud or performing a phrase association test. Those subjects who
    denied feeling the distress implicit in their childhood histories showed
    disproportionate physiological stress responses, such as rises in heart
    rate and blood pressure, when compared to the other two groups.

    While reporting "the lowest conscious test anxiety," they also expressed
    "numerous signs of unacknowledged psychic discomfort such as stammering,
    stuttering, sighing and blocking," explained Westen. "This is as clear a
    demonstration of defensive blocking off of affective experience as anyone
    has ever produced." The findings also suggest that psychic defenses have
    their costs. "Keeping yourself chronically unaware of your own affects
    takes its toll physiologically," he added.

    Implications for Clinicians

    How can understanding and delineating the different types of unconscious
    processes improve the practice of psychotherapy? "Thinking more carefully
    about the different kinds of unconscious processes will allow us to think
    more carefully about what it is that we want to change [in therapy] and
    how we are going to change it," Westen told PT. "Part of helping people
    change is helping them recognize unconscious networks of association
    which are guiding their behavior," he said, a task that may be well
    served by psychoanalytic methods. "But if you want someone to change a
    conscious process," he added, "you may need, as the
    cognitive-behaviorists do, to key in on the conscious process."

    If this research suggests that the psychotherapy patient may need to
    integrate some disconnected aspects of conscious and unconscious
    processing to improve affect and behavior, it also suggests that the
    field of psychotherapy needs to undergo a similar process of integration.
    From Westen's perspective, it is high time for clinicians to integrate
    the empirical findings of cognitive science with psychodynamic theory.


    Bowers JS, Schacter DL (1990), Implicit memory and test awareness. J Exp
    Psychol Learn Mem Cogn 16(3):404-416.

    Cowey A (1991), Visual perception. Grasping the essentials. Nature

    Fazio RH, Jackson JR, Dunton BC, Williams CJ (1995), Variability in
    automatic activation as an unobtrusive measure of racial attitudes: a
    bona fide pipeline? J Pers Soc Psychol 69(6):1013-1027.

    Gilligan J (1996), Violence: Our Deadly Epidemic and Its Causes. New
    York: G.P. Putnam.

    Johnson MK, Kim JK, Risse G (1985), Do alcoholic Korsakoff's syndrome
    patients acquire affective reactions? J Exp Psychol Learn Mem Cogn

    Murphy ST, Zajonc RB (1993), Affect, cognition, and awareness: affective
    priming with optimal and suboptimal stimulus exposures. J Pers Soc
    Psychol 64(5):723-739.

    Schacter DL (1992), Understanding implicit memory. A cognitive
    neuroscience approach. Am Psychol 47(4):559-569.

    Scheff TJ, Retzinger SM (1991), Emotions and Violence: Shame and Rage in
    Destructive Conflicts. Lexington, Mass.: Lexington Books.

    Shedler J, Mayman M, Manis M (1993), The illusion of mental health. Am
    Psychol 48(11):1117-1131.

    Westen D (1999), The scientific status of unconscious processes: is Freud
    really dead? J Am Psychoanal Assoc 47(4):1061-1106.

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