Douglas Berger Psychiatrist Tokyo’s Letter to the Editor of The New York Times, RE: “Tell it about You Mother ” by Casey Schwartz, June 24, 2015


FW: New York Times: Letter to the Editor RE: “Tell it about You Mother ” by Casey Schwartz, June 24, 2015

The article “Tell it about You Mother ” by Casey Schwartz, June 24, 2015, (http://www.nytimes.com/2015/06/28/magazine/tell-it-about-your-mother.html?_r=1) is a review of a study that suggests there is a link of psychoanalysis with specific brain changes. The article reports the fMRI images of one-patient which is neither a report of results nor analysis, and the one-patient data is a personal contact from the study authors to the NY Times article author, not a publication of the results (“Images from Andrew J. Gerber and Katherine R. Surrence/Columbia University”).

I could not find any results from this fMRI study on a literature search. I asked the authors of the original paper Gerber and Peterson for some data or analysis, and received no reply. One article I did find was a description of the of the study plan but no results are reported: Measuring Transference Phenomena with fMRI, Andrew J. Gerber and Bradley S. Peterson, Am Psychoanal Assoc. 2006; 54(4): 1319–1325 (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2367227/. This article noted that the study planned only 10 subjects and was not blinded to the therapist nor the subject as to the content of the procedures (so there was no blinded control group). The NY Times article had the term “Preliminary research” under the image, however, In spite of only presenting the data of one unblinded subject, and the data having no publication or analysis, the NYT article says “ goes on to state, “… indicates that brain regions involved in transference include the left and right insula”. The research article itself stated, “It is crucial that the paradigm be designed for optimal reliability and clinical relevance at this stage, before it is applied broadly to questions of development, psychopathology, and psychotherapeutic change.”

Changes in the brain are also seen in other activities. For example, this study, http://www.nature.com/neuro/journal/v12/n11/full/nn.2412.html, Nature Neuroscience 12, 1370 – 1371 (2009); 11 October 2009 | doi:10.1038/nn.2412, found an increase in white matter underlying the intraparietal sulcus following training of a complex visuo-motor skill. This study was not blinded and there was no placebo control group. Mindfulness meditation has also been found to alter regions of the brain associated with memory, awareness of self, and compassion, according to a brain imaging study: Psychiatry Research: Neuroimaging (Jan. 30, 2011). http://www.health.harvard.edu/mind-and-mood/mindfulness-meditation-practice-changes-the-brain. The subjects in this study were not blinded and there was no placebo control group.

The brain is clearly an organ that can modify itself to various stimuli, changes are not necessarily indicative of effects of a specific psychotherapy. There is data on only one subject presented, the study is not blinded, there is no comparison group, no blind placebo group, and no analysis of any cohort of data that can be found in the literature at this time. The NYT should look into whether there is any published data

and analysis of this data, and make an addendum to the Schwartz article of what is or isn’t published, the robustness of any study presented (i.e., number of subjects, blinding, placebo, comparison group, etc.), and revise any suggestions of effects of psychoanalysis on the brain in a new article written by a panel of clinical trial experts or as least by the Editors.

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