In Search of Memory: The Emergence of a New Science of Mind

by Eric R. Kandel

The idea of using brain imaging to evaluate the outcome of different forms of psychotherapy is not an impossible dream, as studies of obsessive-compulsive disorder have shown. This disorder has long been thought to reflect a disturbance of the basal ganglia, a group of structures that lies deep in the brain and plays a key role in modulating behavior. One of the structures of the basal ganglia, the caudate nucleus, is the primary recipient of information coming from the cerebral cortex and other regions of the brain. Brain imaging has found that obsessive-compulsive disorder is associated with increased metabolism in the caudate nucleus. Lewis R. Baxter, Jr., and his colleagues at the University of California, Los Angeles have found that obsessive-compulsive disorder can be reversed by cognitive behavioral psychotherapy. It can also be reversed pharmacologically by inhibiting the reuptake of serotonin. Both the drugs and psychotherapy reverse the increased metabolism of the caudate nucleus. Brain-imaging studies of patients with depression commonly reveal a decrease in activity in the dorsal side of the prefrontal cortex but an increase in activity in the ventral side. Again, both psychotherapy and drugs reverse these abnormalities. Had imaging been available in 1895, when Freud wrote “On a Scientific Psychology,” he might well have directed psychoanalysis along very different lines, keeping it in close relationship with biology, as he outlined in this essay. In this sense...