Comments on Otto Kernberg’s “Some Implications of New Developments in Neurobiology for Psychoanalytic Object Relations Theory”

Freud famously hoped that once brain-research techniques had advanced significantly, neuroscientific concepts would replace his hypothetical constructs and metaphors for the human psyche. In 1914, for example, he stated that “all our provisional ideas in psychology will presumably some day be based on an organic substructure” consisting of “special substances and chemical processes” (Freud, 1914, p. 78). Research on the brain is now sufficiently advanced that such a day may be quickly approaching. Otto Kernberg has greeted that research warmly here, with this thoughtful consideration of the implications of contemporary neuroscience for psychoanalytic theories and treatments. For at least three reasons, Kernberg is an excellent person to address this question. First, he is temperamentally integrative, as evidenced by the fact that at a time when ego psychology and object relations theories were rigidly polarized, he synthesized them in ways that liberated psychoanalysis from an increasingly stale controversy (e.g., Kernberg, 1976). He has integrated scholarship in personality with literatures on group and organizational psychology (e.g., Kernberg, 1998). And he has persistently urged psychoanalytic institutes to expand their curricula to include material from academic disciplines outside the usual canon (e.g., Kernberg & Michels, 2016). His knowledge of relevant theoretical and empirical literatures is encyclopedic. Second, Kernberg’s thinking is original, independent, and skeptical of conventional orthodoxies. Despite the resistance of some colleagues to diluting the “pure gold” of “classical” analytic technique, he has developed innovative methods for treating borderline conditions and severe personality disorders (e.g., Caligor et al., 2018; Kernberg, 1975, 1984). He has recurrently critiqued conventional models of analytic training (e.g., Kernberg, 1986, 1996, 2000, 2014). In contrast to analysts who insist that psychodynamic artistry does not lend itself to scientific investigation, he has conscientiously subjected his own innovations to empirical scrutiny (e.g., Levy et al., 2006). When scientific study has controverted his beliefs, he has taken the unusual step of publicly recanting them (e.g., Kernberg, 2003). Third, and most relevant here, Kernberg feels strongly about establishing and maintaining the scientific status of psychoanalytic theories, especially theories about technique for serious psychopathology. In this essay, he integrates current neuroscience with his decades of clinical experience, empirical investigation, and theorizing. He reviews evidence for affects as primary motivational systems, investigates the neurobiology of the child’s emerging awareness of self and other, confronts the controversial notion of a death drive, and summarizes the evolution of the dynamic unconscious. In the process, while finding support for some Freudian ideas, he challenges and suggests revisions to others. Finally, he explicates in both neuroscientific and psychoanalytic languages the earliest phases of human mental development, commenting on the personality consequences when epigenetic factors and traumatic experiences arrest a child’s maturation at each stage. From this summary, he derives implications for psychotherapy. To therapists, probably the most salient conclusions Kernberg has drawn from neuroscience involve the primacy of affects and the inference that what analysts have called “drives” are secondary phenomena, built on constellations of affects that have been sorted, as the infant matures, into positive and negative categories. This formulation follows arguments by Solms (2021) and others (e.g., Damasio, 1994) for the origin in