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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
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,
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 expressIt may not
be shame per se that distinguishes men who go on to abuse but
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
accomplishedquickly 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
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.
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